tbuckley/cabot-search huggingface dataset:
Virologic Response Rates of Weight-Based Taribavirin Versus Ribavirin in Treatment-Naive Patients with Genotype 1 Chronic Hepatitis C
Authors: Fred Poordad, Eric Lawitz, Mitchell L. Shiffman, Tarek Hassanein, Andrew J. Muir, Bruce R. Bacon, Jamie Heise, Deanine Halliman, Eric Chun, Janet Hammond
Journal: Hepatology (2010)

Ribavirin-induced hemolytic anemia can prompt dose reductions and lower sustained virologic response (SVR) rates in the treatment of patients with chronic hepatitis C. The study aimed to determine if weight-based dosing of taribavirin (TBV), an oral prodrug of ribavirin (RBV), demonstrated efficacy comparable to RBV while maintaining its previously demonstrated anemia advantage with fixed dose administration. A U.S. phase 2b randomized, open-label, active-controlled, parallel-group study was conducted in 278 treatment-naive patients infected with genotype 1 who were stratified by body weight and baseline viral load. Patients were randomized 1:1:1:1 to receive TBV (20, 25, or 30 mg/kg/day) or RBV (800-1400 mg/day) with pegylated interferon alfa-2b for 48 weeks. The SVR rates in this difficult-to-cure patient demographics (mean age, 49 years; 61% male; 30% African American or Latino; high viral load; advanced fibrosis; and mean weight, 82 kg) were 28.4%, 24.3%, 20.6%, and 21.4% in the 20, 25, and 30 mg/kg TBV groups and the RBV group, respectively. There were no statistical differences in the efficacy analyses. Anemia rates were significantly lower ( P &lt; 0.05) in the 20 and 25 mg/kg/day TBV treatment groups (13.4% and 15.7%, respectively) compared to RBV (32.9%). The most common adverse events in all groups were fatigue, diarrhea, and insomnia. Diarrhea, reported in 38% of TBV patients versus 21% of RBV patients, was generally mild and not dose-limiting. Conclusion: All TBV doses demonstrated efficacy and tolerability comparable to that of RBV; however, the 25 mg/kg dose demonstrated the optimal balance of safety and efficacy. Anemia rates were significantly lower for TBV given at 20-25 mg/kg than RBV. These data suggest weight-based dosing with TBV provides a safe and effective treatment alternative to RBV for chronic hepatitis C. American Association for the Study of Liver Diseases. (Hepatology 2010)
Occupational Exposure to Silica and End-stage Renal Disease-Reply
Authors: Geoffrey M. Calvert
Journal: JAMA (1997)

We agree with Dr Wilke that the pathogenesis for the increased risk of ESRD caused by glomerulonephritis among silica-exposed gold miners is unclear. In our article, we described the competing theories of pathogenesis, ie, immunologic injury vs direct toxic effect of silica. Our intent was to give equal attention to these 2 theories. As is the case with silicosis, evidence of immunologic injury has been observed in some, but not all, silica-exposed patients with renal injury.<sup>1</sup> Therefore, different mechanisms of toxicity may be operating in different patients. In patients with evidence of immunologic abnormality, it is not clear if these abnormalities are directly responsible for renal injury or if they are a response to the direct toxic effect of silica. It is worth noting that there is evidence linking silica exposure to a broad range of autoimmune diseases.<sup>2</sup> One factor responsible for the variability in the mechanism of
Indexes of Insulin Resistance and Secretion in Obese Children and Adolescents
Authors: Louise S. Conwell, Stewart G. Trost, Wendy J. Brown, Jennifer A. Batch
Journal: Diabetes Care (2004)

OBJECTIVE—To assess the concurrent validity of fasting indexes of insulin sensitivity and secretion in obese prepubertal (Tanner stage 1) children and pubertal (Tanner stages 2–5) adolescents using estimates from the modified minimal model frequently sampled intravenous glucose tolerance test (FSIVGTT) as a criterion measure. RESEARCH DESIGN AND METHODS—Eighteen obese children and adolescents (11 girls and 7 boys, mean age 12.2 ± 2.4 years, mean BMI 35.4 ± 6.2 kg/m2, mean BMI-SDS 3.5 ± 0.5, 7 prepubertal and 11 pubertal) participated in the study. All participants underwent an insulin-modified FSIVGTT on two occasions, and 15 repeated this test a third time (mean 12.9 and 12.0 weeks apart). Si measured by the FSIVGTT was compared with homeostasis model assessment (HOMA) of insulin resistance (HOMA-IR), quantitative insulin-sensitivity check index (QUICKI), fasting glucose-to-insulin ratio (FGIR), and fasting insulin (estimates of insulin sensitivity derived from fasting samples). The acute insulin response (AIR) measured by the FSIVGTT was compared with HOMA of percent β-cell function (HOMA-β%), FGIR, and fasting insulin (estimates of insulin secretion derived from fasting samples). RESULTS—There was a significant negative correlation between HOMA-IR and Si (r = −0.89, r = −0.90, and r = −0.81, P &amp;lt; 0.01) and a significant positive correlation between QUICKI and Si (r = 0.89, r = 0.90, and r = 0.81, P &amp;lt; 0.01) at each time point. There was a significant positive correlation between FGIR and Si (r = 0.91, r = 0.91, and r = 0.82, P &amp;lt; 0.01) and a significant negative correlation between fasting insulin and Si (r = −90, r = −0.90, and r = −0.88, P &amp;lt; 0.01). HOMA-β% was not as strongly correlated with AIR (r = 0.60, r = 0.54, and r = 0.61, P &amp;lt; 0.05). CONCLUSIONS—HOMA-IR, QUICKI, FGIR, and fasting insulin correlate strongly with Si assessed by the FSIVGTT in obese children and adolescents. Correlations between HOMA-β%, FGIR and fasting insulin, and AIR were not as strong. Indexes derived from fasting samples are a valid tool for assessing insulin sensitivity in prepubertal and pubertal obese children.
GW25-e1666 The knockdown of the HDAC1 gene promotes the directed differentiation of bone mesenchymal stem cells into cardiomyocytes
Authors: Lu Dongfeng, Ying Wang, Zi-Zhuo Su, Zhao-Hua Zeng, Xiao-Wen Xing, Zhi-Yu He, Dong-Feng Lu
Journal: Journal of the American College of Cardiology (2014)
Preservation of ventricular function by treatment of ventricular fibrillation with phenylephrine
Authors: Mark G. Midei, Seiryo Sugiura, W.Lowell Maughan, Kiichi Sagawa, Myron L. Weisfeldt, Alan D. Guerci
Journal: Journal of the American College of Cardiology (1990)

Epinephrine promotes resuscitation from ventricular fibrillation because of its peripheral vasoconstrictive effects. However, the beta-adrenergic effects of epinephrine may be detrimental because of the stimulation of myocardial oxygen demand. To test whether functional recovery from fibrillation in hearts treated with a selective alphaadrenergic agent is greater than in hearts treated with epinephrine, ventricular fibrillation was induced in eight isolated dog hearts white coronary perfusion pressure was maintained at 30 mm Hg. In random order, epinephrine (5 μg/min), phenylephrine (50 μg/min) or no drug was infused for 5 min. The heart was then defibrillated, the drug infusion stopped and coronary perfusion pressure increased to 100 mm Hg. Coronary blood flow (ml/min per 100 g), arteriovenous oxygen difference (ml O2/dl) and myocardial oxygen consumption (ml O2/min per 100 g) measured after 4 min of ventricular fibrillation were greater with epinephrine (mean ± SD 30.9 ± 11.7, 17.5 ± 1.6 and 5.4 ± 1.9, respectively) than with phenylephrine (24.4 ± 6.0, 15.7 ± 2.6 and 3.8± 1.1, respectively) or no drug (19.8± 5.2, 12.8 ± 1.8 and 2.6 ± 9.7, respectively) (p < 9.05, p < 0.05 and p < 0.05, respectively). The slope of the end-systolic pressure-volume relation 19 min after defibrillation and restoration of normal coronary perfusion pressure was depressed (percent of prefibrillation value) most by epinephrine infusion (72 ± 17%, n = 6), less by no drug infusion (82 ± 12%, n = 4) and was increased after phenykphrine infusion (143 ± 17%, n = 6) (p < 0.002). Volume axis intercepts (Vo) were not different (p = NS). It is concluded that at a coronary perfusion pressure of 30 mm Hg, left ventricular function declines as a consequence of epinephrine administration during ventricular fibrillation and is preserved by the use of pheaylephrne. This epinephrwe-associated impairment likely results from increased oxygen demand and intensification of ischemia, whereas the benefit of phenylephrine seem to be the result of a weak and prolonged positive motropic effect.
Quantitative evaluation of postectopic beats in the normal and failing human heart using indices derived from catheter-tip manometer readings
Authors: J. KVASNICKA, B. LIANDER, H. BROMAN, E. VARNAUSKAS
Journal: Cardiovascular Research (1975)

Postextrasystolic potentiation was studied by means of a catheter-tip manometer in patients with and without cardiomyopathy. The results imply that the enhancement of the left ventricular contraction is increased in patients with cardiomyopathy.
Key Witness Against Morning Sickness Drug Faces Scientific Fraud Charges
Authors: Andrew Skolnick
Journal: JAMA (1990)

WILLIAM McBRIDE, MD, the Australian obstetrician many credit as being among the first to notice the association between thalidomide and birth defects (see accompanying article), is now facing charges of scientific fraud and professional misconduct before an Australian medical tribunal.  Some of the 15 charges against him concern his efforts to show that the anti-morning sickness drug Bendectin is also teratogenic. According to the New South Wales State Department of Health's Complaints Unit in Sydney, McBride is accused of fabricating data in a published study and falsely testifying in US federal courts about his research. His testimony played a key role in many of the lawsuits against Merrell Dow Pharmaceuticals, Inc, Cincinnati, Ohio, which manufactured Bendectin, the only drug approved by the US Food and Drug Administration for the treatment of nausea during pregnancy.  Responding to the onslaught of hundreds of lawsuits, Merrell Dow halted production of its anti-morning sickness
Some Cases Testing the Antiseptic Method
Authors: A. Wilson
Journal: BMJ (1881)

have not seen any record of this more heroic practice having been hitherto employed.The first of these cases occurred as long ago as October I878, and I then hesitated to report it; because I thought it better, for various reasons, to wait for the confirmation, or the contrary, of the advantage of the local use of these strong solutions of carbolic acid to the uterus in "puerperal fever".Now, however, the satisfactory result of this second case makes me hesitate no longer to report the two.It may not be a waste of time here briefly to recall the present views as to the group of diseases classed under the generic name of puerperal fever.Dr. Matthews Duncan, in his admirable paper, recently read before the Birmingham Medical Society, points out that, as now under- stood, puerperal fever is not a simple entity, but that a case to which we give this name may be one, either, a, of traumatic inflammation, with general fever; b, of poisoning of the blood by absorption of putrid matters or discharges (saproemia); or, c, of infection of the blood by living germs or micrococci (septicaemia, pyoemia); the distinction, however, between these varieties of postparturient fever appears not always to be very well marked.And Dr. Playfair says, it is probable that two distinct groups may be formed-namely, those in which the patient is poisoned by her own septic matters ; and those in which the septic poison is conveyed from without.
Infectious Disease Experts Offer Laboratory Testing Guide
Authors: Mike Mitka
Journal: JAMA (2013)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2022 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Dignity and Agential Realism: Human, Posthuman, and Nonhuman
Authors: Linda MacDonald Glenn, George Dvorsky
Journal: The American Journal of Bioethics (2010)

Both Jotterand's (2010) and Bostrom's (2005; 2007) use of the term “dignity” with regard to human versus posthuman miss the mark; they create a dichotomized, “us versus them” scenario, rather than ...
Quantitative analysis of erythrocytes containing fetal hemoglobin (F cells) in children with sickle cell disease
Authors: Stacy J. Marcus, Thomas R. Kinney, William H. Schultz, Erin E. O'Branski, Russell E. Ware
Journal: American Journal of Hematology (1997)

Variation in the level of fetal hemoglobin (HbF) accounts for much of the clinical heterogeneity observed in patients with sickle cell disease (SCD). The HbF level has emerged as an important prognostic factor in both sickle cell pain and mortality, and a % HbF of 10–20% has been suggested as a threshold level for diminished clinical severity. The number of erythrocytes that contain HbF (termed F cells) may also be critically important, as F cells resist intravascular sickling and have preferential in vivo survival. Since F cells can be enumerated with high accuracy using flow cytometry methods, we prospectively studied a cohort of 242 children with SCD. Children with HbS and hereditary persistence of fetal hemoglobin (S/HPFH) had essentially 100% F cells. In contrast, children with homozygous sickle cell anemia (HbSS), HbS/β0 thalassemia, or HbS/β+ thalassemia had significantly lower mean % F cell values (55.9, 61.6, and 51.3%, respectively; P < 0.001), and children with HbSC had even fewer F cells (27.0%; P < 0.001). There was a highly significant correlation between the % F cells and the log (% HbF), which was observed for the total population of children (r = 0.95, P < 0.001), as well as for each of the individual subgroups of children with HbSS (r = 0.94, P < 0.001), HbSC (r = 0.89, P < 0.001), or HbS/β0 thalassemia and HbS/β+ thalassemia (r = 0.95, P <0.001). This logarithmic correlation between % F cells and % HbF has not been previously described and has important implications for the pharmacologic manipulation of HbF in patients with SCD. Am. J. Hematol. 54:40–46, 1997 © 1997 Wiley-Liss, Inc.
Incidence of malignant melanoma of the skin in England and Wales and its relationship to sunshine.
Authors: A J Swerdlow
Journal: BMJ (1979)

In most of England and Wales the incidence of malignant melanoma of the skin has risen rapidly in recent years, especially in women. Mean incidences in the 14 English health regions and Wales correlated negatively with latitude and positively with hours of sunshine, suggesting that exposure to sunshine was an important causal factor. Male and female incidences within a region tended to show similar yearly fluctuations, implying a common factor affecting the incidence in both men and women with a short latent period of action. This factor may be exposure to sunshine, which may cause melanoma after an induction period of about two years; for women the incidence of melanoma in the regions of England and Wales correlated positively with hours of sunshine two years earlier.
The Effects of Infusion of Water on Renal Hemodynamics and the Tubular Reabsorption of Sodium*
Authors: Joseph A. Martino, Laurence E. Earley
Journal: Journal of Clinical Investigation (1967)

Anesthetized dogs receiving an infusion of chlorothiazide and ethacrynic acid were given 600-ml infusions of distilled water or dilute dextrose solutions. The absolute rate of tubular sodium reabsorption was depressed, and the glomerular filtration rate was increased during the water loading, despite the associated decreases in plasma sodium concentration and decreases in the filtered load of sodium. The extent to which fractional sodium reabsorption decreased and the excretion of sodium increased was inversely related to the degree to which the filtered load of sodium was depressed as a result of the decreased plasma sodium concentration. We conclude that, in the presence of the diuretic blockade of distal tubular sodium reabsorption, infusion of water depresses proximal tubular reabsorption of sodium and that these changes are qualitatively similar to those previously observed during infusions of saline. Similar depression of tubular reabsorption of sodium and increased excretion of sodium occurred during water loading in the absence of diuretics in dogs undergoing saline diuresis, which presumably provided a high rate of distal sodium reabsorption before water loading. We suggest that volume expansion with water depresses proximal tubular reabsorption of sodium in a manner qualitatively similar to infusions of saline and that the extent to which sodium excretion is increased during water loading is dependent upon 1) the absolute extent to which proximal reabsorption is depressed, 2) the extent to which the filtered load of sodium is maintained in the presence of a falling concentration of sodium in plasma, and 3) the extent to which increased distal reabsorption compensates for the depressed proximal reabsorption of sodium. Mechanisms are suggested whereby the previously reported inverse relationship between plasma concentration of sodium and over-all tubular reabsorption of sodium may be only apparent, and could be the result of physiologic "glomerulotubular balance" during the specific experimental maneuvers.
Metaphor in Medicine
Authors: John H. Caster
Journal: JAMA (1983)

To the Editor.—  We were delighted to read Dr John Burnside's essay on the importance of metaphor in medicine (1983;249:2091), since a small unit on medical metaphors forms a crucial part of the humanities integrated with science in our curriculum for first-year medical students.  The war metaphor, discussed by Dr Burnside, is among those that have been explored by social critic Susan Sontag. 1 In Illness as Metaphor , inspired by Sontag's own experience as a cancer patient, she demonstrates that inappropriate use of metaphors can introduce biases into the perception of illness by laymen and professionals alike, with unfortunate consequences for quality of care. In our own curriculum, we illustrate the hazards of metaphor by having students consider the impact of loaded language when communicating with patients. They are asked to explore the ramifications for a woman's sense of culpability and self-worth when she is told that she is a
Cultures of Healing: Correcting the Image of American Mental Health Care
Authors: H. Richard Lamb
Journal: JAMA (1996)

It was necessary for this book to be written, because those who practice psychotherapy and those who are treated by it need to know what psychotherapy is and is not. Toward that end, the author examines in great detail and puts into perspective the ideologies of the four most influential schools of psycho-social thought: psychoanalysis, behaviorism, Beck's cognitive therapy, and biological psychiatry. These analyses are both thorough and penetrating.  This depth is crucial, for most professionals who practice psychotherapy soon learn that rigid adherence to any of these schools of thought may well give poor results. Most psychotherapists soon learn that flexibility is essential and that there is something to be learned from all these schools of thought. But this sentiment is not what is usually found in the literature. Most of these flexible practitioners do not write (the author is a fortunate exception), and if they did write in
Exacerbation of Monoclonal Gammopathy in a Patient Treated with G-CSF
Authors: Morio Sawamura
Journal: Annals of Internal Medicine (1993)

Letters15 February 1993Exacerbation of Monoclonal Gammopathy in a Patient Treated with G-CSFMorio Sawamura, MD, Tohru Sakura, MD, and Shiuchi Miyawaki, MDMorio Sawamura, MDSearch for more papers by this author, Tohru Sakura, MDSearch for more papers by this author, and Shiuchi Miyawaki, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-4-199302150-00029 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Caution in using the granulocyte colony-stimulating factor (G-CSF) has been urged because it may stimulate proliferation of leukemic cells [1]. In contrast, few reports suggest that G-CSF causes the growth of nonmyeloid tumor cells. We describe a patient with acute myelogenous leukemia (AML) and monoclonal gammopathy of undetermined significance treated with G-CSF for neutropenia after induction therapy against AML.A 69-year-old Japanese man referred to our hospital in December 1988 was diagnosed as having AML (M2 according to the French-American-British criteria) associated with IgG λ-type monoclonal gammopathy. Laboratory investigation showed a hemoglobin of 10.3 g/dL, a leukocyte ...References1. Lieschke GJ, Burgess AW. Granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor (second of two parts). N Engl J Med. 1992; 327:99-106. Google Scholar2. Klein B, Zhang XG, Jourdan M, Boiron JM, Portier M, Lu XY, et al. Interleukin-6 is the central tumor growth factor in vitro and in vivo in multiple myeloma. Eur Cytokine Netw. 1990; 1:193-201. Google Scholar3. Klein B, Bataille R. Cytokine network in human multiple myeloma. In: Barlogie B; ed. Hematology/Oncology Clinics of North America. Multiple Myeloma. Philadelphia: Saunders; 1992:273-84. Google Scholar4. Kawano M, Hirano T, Matsuda T, Taga T, Horii Y, Iwato K, et al. Autocrine generation and requirement of BSF-2/IL-6 for human multiple myeloma. Nature. 1988; 332:83-5. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByMultiple myeloma with infiltration into skeletal muscle after injections of granulocyte-colony stimulating factorsPrognosis in MyelomaFilgrastim 15 February 1993Volume 118, Issue 4Page: 318KeywordsBone marrowCellsGranulocyte colony stimulating factorMyelomaNeutropeniaPlasma cellsPlateletsProteinsResearch laboratoriesSepsis Issue Published: 15 February 1993 CopyrightCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Efficacy of enprofylline in acute airway obstruction
Authors: T. Sandström, J. R. Andersen, G. Boethius, G. Eriksson, A. Hagman, M. Helsted, B. Lund, H. Matsols, T. Månsson, L. Rosenhall
Journal: Allergy (1991)

The efficacy and safety of different regiments of intravenously administered enprofylline, an anti‐asthma xanthine, were evaluated in a randomized open study, including 155 patients with acute exacerbation of obstructive long disease. The regimen 2.5 mg/kg i.v over 10 min was canceled after seven patients had been included, due to tow cases of hypotensive/vasovagal reactions. The regimens 2.0 mg/kg/20 min and 2.5 mg/kg/20 min were significantly more effective with regard to bronchodilation than 2.0 mg/kg/10 min (PEF Increase +35%+ 30% and +17% respectively). Nausea and headache were the most common side effects (16–33% and 23–33% of the patients respectively on different regimens) with the lowest frequency on 2.0 mg/kg/20 min Four additional hypotensive reactions occurred: one on each 2.0 mg/kg regimen and two on 2.5 mg/kg/20 min. The regimen 2.0 mg/kg/20 min was found to be the most favourable with regard to efficacy and side effects. Enprofylline i.v. was found to be an effective bronchodilating treatment of acute airway obstruction but the frequency of side effects has to be considered.