tbuckley/cabot-search huggingface dataset:
Vitamin D Therapy and Cardiac Function in Chronic Kidney Disease—Reply
Authors: Ravi Thadhani, Hector Tamez, Scott D. Solomon
Journal: JAMA (2012)

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 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 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
Calcium signaling and cytotoxicity.
Authors: G E Kass, S Orrenius
Journal: Environmental Health Perspectives (1999)

The divalent calcium cation Ca(2+) is used as a major signaling molecule during cell signal transduction to regulate energy output, cellular metabolism, and phenotype. The basis to the signaling role of Ca(2+) is an intricate network of cellular channels and transporters that allow a low resting concentration of Ca(2+) in the cytosol of the cell ([Ca(2+)]i) but that are also coupled to major dynamic and rapidly exchanging stores. This enables extracellular signals from hormones and growth factors to be transduced as [Ca(2+)]i spikes that are amplitude and frequency encoded. There is considerable evidence that a number of toxic environmental chemicals target these Ca(2+) signaling processes, alter them, and induce cell death by apoptosis. Two major pathways for apoptosis will be considered. The first one involves Ca(2+)-mediated expression of ligands that bind to and activate death receptors such as CD95 (Fas, APO-1). In the second pathway, Ca(2+) has a direct toxic effect and its primary targets include the mitochondria and the endoplasmic reticulum (ER). Mitochondria may respond to an apoptotic Ca(2+) signal by the selective release of cytochrome c or through enhanced production of reactive oxygen species and opening of an inner mitochondrial membrane pore. Toxic agents such as the environmental pollutant tributyltin or the natural plant product thapsigargin, which deplete the ER Ca(2+) stores, will induce as a direct result of this effect the opening of plasma membrane Ca(2+) channels and an ER stress response. In contrast, under some conditions, Ca(2+) signals may be cytoprotective and antagonize the apoptotic machinery.
Who Should Decide About Your Death?
Authors: Carl M. Kjellstrand
Journal: JAMA (1992)

In our technological hubris, we have mismanaged dying: the only certain ultimate outcome of all our busy efforts. Most of us would like to die a quiet, dignified death.<sup>1</sup>Anyone who works in a hospital knows that this reasonable wish is almost never fulfilled and most of us now die in hospitals. The last rites of respirators, dialysis machines, nasogastric tubes, and gastrostomy tubes along with cardiopulmonary resuscitation and the<i>n</i>th round of chemotherapy are wonderful when prolonging useful life but have changed death to a mechanized spectacle in which no sane person would like to be the main actor. See also p 59. To the patients, it often appears as if there is nobody in charge of the myriads of nurses and technicians, of attending physicians, consultants, residents, fellows, interns, administrators, and lawyers. They are right: no one is in charge. Scared physicians and cowardly hospital administrators
Activation of fetal promoters of insulinlike growth factors II gene in hepatitis C virus-related chronic hepatitis, cirrhosis, and hepatocellular carcinoma
Authors: G Nardone, M Romano, A Calabrò, P V Pedone, I de Sio, M Persico, G Budillon, C B Bruni, A Riccio, R Zarrilli
Journal: Hepatology (1996)

Increased prevalence of hepatitis C virus (HCV) infection has been found in patients with hepatocellular carcinoma (HCC). The expression of insulinlike growth factor II (IGF-II) has been linked to hepatocarcinogenesis in the experimental animal and in humans. Since reactivation of fetal IGF-II transcripts has been observed in human HCC, we have analyzed the levels of adult P1 and fetal P3 and P4 IGF-II promoter-derived transcripts in the liver of patients with HCV-related chronic active hepatitis (CAH), cirrhosis, and HCC by means of a semiquantitative reverse-transcription polymerase chain reaction (RT-PCR) assay. Transcripts derived from adult P1 promoter were increasingly expressed from normals to patients with CAH and cirrhosis, but were undetectable in the tumorous area of 5 of 7 HCC patients and present at low levels in the nontumorous area of all HCC patients. Transcripts derived from fetal P3 promoter were not detectable in normal subjects, while they were expressed abundantly in most CAH and all cirrhotic patients. Transcripts from fetal P4 promoter were detected at high levels in 3 of 9 CAH patients and in the majority of cirrhotic patients. Increased expression of fetal promoter-derived transcripts was also found in the liver of HCC patients, although levels were lower than in cirrhosis. Also, the activity of fetal P3 and P4 promoters was higher in the nontumorous than in the tumorous area of the liver of HCC patients. The expression of IGF-II transcripts was correlated with the rate of cell mitotic activity by measuring the expression of the proliferating cell nuclear antigen (PCNA) gene. PCNA messenger RNA (mRNA) levels progressively increased from normals to CAH and to cirrhotic patients, and persisted at a high level in the tumorous and in the nontumorous area of HCC subjects, thus showing that the increase of IGF-II transcripts in CAH and cirrhosis is accompanied by an activation of cell mitosis in these samples. These data suggest that the activation of IGF-II gene expression from adult and fetal promoters may play a role in premalignant proliferation observed in HCV-related chronic liver disease.
Shall We Count the Living or the Dead?
Authors: Mindel C. Sheps
Journal: New England Journal of Medicine (1958)

WHEN we wish to estimate the beneficial effect of a therapeutic agent, or the harmful effect of a factor such as exposure to radiation, we have the choice of a number of methods. If a new treatment is associated with lower mortality rates, we can estimate its beneficial effect from the absolute increase in the number of survivors, from the percentage increase in the living or from the percentage decrease in the dead. Often, these different methods provide estimates of quite different magnitude. Similarly, we may get quite different estimates of the harmful effect of radiation from the number of . . .
Infectious Hepatitis in Bristol, 1959-1962
Authors: P. W. Bothwell, D. Martin, A. W. Macara, J. F. Skone, R. C. Wofinden
Journal: BMJ (1963)

cases of infectious hepatitis were recorded, by voluntary notification until December 1, 1960, and thereafter by statutory notification.In July, 1959, information was received that 35 cases of infectious hepatitis had occurred in a hospital for the severely subnormal just outside Bristol, with three further cases in an associated hospital within the city boundary.This outbreak was apparently controlled with gamma- globulin, although one or two suspicious cases occurred subsequently.At the end of 1959 school welfare officers in Bristol were reporting unusually high absences from primary schools because of " jaundice."In January, 1960, general practitioners were asked, voluntarily, to inform the medical officer of health of cases of infectious hepatitis, and on December 1, 1960, the disease was made notifiable under Section 147 of the Public Health Act, 1936.Details of notified cases were entered on marginal punched cards.Further data, regarding symptoms, con- tacts, family infection, and home conditions, were added by health visitors at special home visits.Public health inspectors reported on the adequacy and condition of water-closets and hand-washing facilities in the affected schools.Assistant school medical officers also visited some of these schools and the homes of some patients, to investigate school and family aspects of the outbreak.Results Statistics.-There were 1,147 cases in 1960, 960 in 1961, and 288 in 1962.The accompanying graph shows the monthly incidence of cases by date of onset.The peak incidence was between October, 1960 (148 cases), and Janu- ary, 1961 (136 cases).There was a fall in incidence in July, 1960.In February, 1961, a substantial fall coincided with an influenza epidemic; whether this was a coincidence or an " interference " effect it is impossible to say.From July, 1961, the incidence rapidly declined, until in Decem- ber, 1962, there were only eight cases.This paper describes investigation of the 2,107 cases up to the end of 1961.Age and Sex.-TableI shows the age and sex distribution.The incidence was much greater in children between 140 120 F 7~~~~~~~~~~~~~1 00 60-40 v 20 0 Monthly incidence of infectious hepatitis in Bristol, 1960-2.5 and 15 than in any other age-group, and particularly between 5 and 10 years.The sexes were equally affected.TABLE I.-Cases of Infectious Hepatitis, Bristol, 1960-1, by Sex and Age Agegroup -~~~~~~Ñ o of No. of Cases Male
Intubation in Laryngeal Diphtheria
Authors: J. Biernacki, J. C. Muir
Journal: BMJ (1904)

Extensive pharyngeal membrane.Broncho-pneumonia (left).Total dose of antitoxin 40,000 units.Intubated after twenty-four hours.Relief complete.Tube pulled out by child.Replaced after an hour and a-half.Removed on sixth day.Reintuibated after some hours.From now until thirteenth day, especially after eleventh day, tube frequently coughed up (on one occasion swallowed and passed by rectum), reintubatlon being always shortly necessary.Tracheotomy.Could not do without tracheal tube until thirty days later.Recovery.CASE IV.-C.J., female, 3 years.Second day.Membrane on both tonsils.Glands enlarged on both sides.Total do3e antitoxin 28,ooo units.Intubation after five hours.Relief complete.Removed on third day.Recovery.CASE V.-W.B., male, 17 months.Tllird day.Membrane on both tonsils.Total dose antitoxin 26.ooo units.Intubated after six hours.Relief complete.Extubated on fifth day.No further laryngeal trouble .tthat time.Numerous complications (otitis, mastoid abscess, persistent albuminuria, etc.).Second attack of diphtlheriia in eiglhth week, with laryngeal obstruction.Intubated with complete relief, but died on following day from exhaustion.CASE vi.-R.M., female, 4 years.Sexenth day.Membrane on one tonsil.Enlarged glands.Antitoxin z6,ooo units.Intubation after lour hours.Relief complete.Extubated on fourth day.Recovery.CASE v1i.-R.WV., female, I yea'.Third day.Membrane on both tonsili.Antitoxini 14,000 units.Intubation after three hours.Relief -complete.Removed after eight hours for blocking; replaced.Extubated fifth day.In an houir and a half extreme obstruction reintubated.Same occurrence on nintlh day.After-that frequently couglhed up until fourteentl day.Tracheotomy.Death twenty-four hours latelr.CASE vniI.-D
Changing childhood disease pattern linked with day-care boom
Authors: Charles Marwick
Journal: JAMA (1984)

A new pattern of childhood infectious disease is emerging in the United States, the full consequences of which are as yet unknown. Infants and preschool age children are now acquiring infections at an earlier age than previously; in other instances the age pattern of particular diseases is changing. For example,<i>Hemophilus influenzae</i>type b is more likely to affect older children than formerly, while for other diseases, such as hepatitis A, cytomegalovirus (CMV) infections, and diarrheal disease, the parents and other adults who come in contact with children may be at greater risk of infection than in the recent past. The common factor in this changing pattern is the increasing popularity of day-care centers. These centers provide facilities for preschool children whose parents are unable to care for them at home, usually because both parents are working, or they live with only a working mother. "Today, younger and younger children
ADOLESCENCE--FRENCH AND BRITISH
Authors: D. Pirrie
Journal: BMJ (1961)

<h3>Background and objectives</h3> In trials of people with type 2 diabetes, albuminuria reduction with renin-angiotensin system inhibitors is associated with lower risks of cardiovascular events and CKD progression. We tested whether progression or remission of microalbuminuria is associated with cardiovascular and renal risk in a well characterized cohort of type 1 diabetes. <h3>Design, setting, participants, &amp; measurements</h3> We studied 1441 participants in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications study. Albumin excretion rate (AER) was quantified annually or biennially for up to 30 years. For each participant, albuminuria status was defined over time as normoalbuminuria (AER continuously &lt;30 mg/d), sustained microalbuminuria (AER, 30–299 mg/d on two consecutive visits), macroalbuminuria (AER≥300 mg/d), or remitted microalbuminuria (transition from sustained microalbuminuria to AER&lt;30 mg/d on two consecutive visits). We tested associations of time-updated albuminuria status with adjudicated clinical cardiovascular events, the development of reduced GFR (&lt;60 ml/min per 1.73 m<sup>2</sup> on two consecutive visits), and subclinical cardiovascular disease. <h3>Results</h3> At least one cardiovascular event occurred in 184 participants, and 98 participants developed reduced eGFR. Compared with normoalbuminuria, sustained microalbuminuria, remitted microalbuminuria, and macroalbuminuria were each associated with higher risk of cardiovascular events (adjusted hazard ratios [HRs] and 95% confidence intervals [95% CIs]: 1.79 [1.13 to 2.85], 2.62 [1.68 to 4.07], and 2.65 [1.68 to 4.19], respectively) and reduced eGFR (adjusted HRs [95% CIs], 5.26 [2.43 to 11.41], 4.36 [1.80 to 10.57], and 54.35 [30.79 to 95.94], respectively). Compared with sustained microalbuminuria, remission to normoalbuminuria was not associated with reduced risk of cardiovascular events (adjusted HR, 1.33; 95% CI, 0.68 to 2.59) or reduced eGFR (adjusted HR, 1.75; 95% CI, 0.56 to 5.49). Compared with normoalbuminuria, sustained microalbuminuria, remitted microalbuminuria, and macroalbuminuria were associated with greater carotid intima-media thickness, and macroalbuminuria was associated with a greater degree of coronary artery calcification. <h3>Conclusions</h3> In type 1 diabetes, microalbuminuria and macroalbuminuria are associated with higher risks of cardiovascular disease and reduced eGFR, but achieving a remission of established microalbuminuria to normoalbuminuria does not appear to improve outcomes.
Scintigraphic Demonstration of Pectineus Muscle Avulsion Injury
Authors: JHON F. ROCKETT, BARNEY L. FREEMAN
Journal: Clinical Nuclear Medicine (1990)

An exercise-related avulsion injury of the insertion of the pectineus muscle is described. The abnormality was detected on a 4-hour delayed bone scan. Symptomatic injuries of the adductor muscles are uncommon and are not to be confused scintigraphically with a stress fracture of the proximal femoral shaft.
Testing for HIV without permission
Authors: A. Smith
Journal: BMJ (1987)

<b>1352</b> <h3><b>Objectives</b></h3> Lymph node staging is essential in patients with Squamous Cell Carcinoma (SCC) of the head and neck for therapy decision and prognosis. The aim of this study was to compare Computed Tomography (CT), Magnetic Resonance Imaging (MRI), [18F]fluordesoxyglucose PET/CT and ultrasound (US) in lymph node staging of SCC. <h3><b>Methods</b></h3> In this prospective study 25 patients with proven primary SCC of the head and neck were examined by US, PET/CT and MRI prior to radical head and neck dissection. All lymph node stations were analyzed by blinded observers for potential metastases using each of the above-mentioned imaging modalities. CT was analyzed both separately and in combination with PET/CT. The findings were then compared with histopathological results after surgical resection. <h3><b>Results</b></h3> 200 lymph nodes were analyzed. 44 exhibited malignant infiltration in histology. Sensitivities of MRI, PET/CT, CT and US were 96%, 89%, 85% and 86%. The specificity of these modalities were 66%, 98%, 94% and 98%. Positive Predictive Values (PPV) were 34%, 98%, 72% and 98%. There was no significant difference between the modalities regarding Negative Predictive Value (NPV) (97-99%). <h3><b>Conclusions</b></h3> MRI demonstrated the highest sensitivity but low specificity and PPV. US and PET/CT displayed better PPV and specificity than MRI and a NPV equal to that displayed by MRI. While the recorded specificity for CT is only marginally lower than the specificity displayed by US and PET/CT, the PPV of CT remains significantly lower than the PPV exhibited for US and PET/CT. Based on our findings we conclude that PET/CT or US - or a combination of both modalities - should be used first for lymph node staging in the head and neck
Cell kinetics and gene expression changes in colorectal cancer patients given resistant starch: a randomised controlled trial
Authors: S S Dronamraju, J M Coxhead, S B Kelly, J Burn, J C Mathers
Journal: Gut (2008)

<h3>Objective:</h3> This study investigated the effects of oral supplementation of resistant starch (RS) on tumour cell and colonic mucosal cell kinetics and on gene expression in patients with colorectal cancer (CRC), and its potential role in colon cancer prevention. <h3>Methods:</h3> 65 patients with CRC were randomised to treatment with RS or ordinary starch (OS) and were given starch treatment for up to 4 weeks. Pretreatment and post-treatment biopsies were obtained from the tumour and colonic mucosa, and the effects of the starch treatment on cell proliferation and expression of the cell cycle regulatory genes <i>CDK4</i> (cyclin-dependent kinase 4) and <i>GADD45A</i> (growth arrest and DNA damage-inducible, alpha) were investigated. <h3>Results:</h3> The proportion of mitotic cells in the top half of the colonic crypt was significantly lower following RS treatment (3.1 (1.5), mean (SEM)) as compared with OS treatment (13.7 (3.2)) (p = 0.028). However, there was no effect of RS treatment on crypt dimensions and tumour cell proliferation index. There was significant upregulation in expression of <i>CDK4</i> (p&lt;0.01) and downregulation in expression of <i>GADD45A</i> (p&lt;0.001) in the tumour tissue when compared with macroscopically normal mucosa. Following RS treatment, <i>CDK4</i> expression in tumours (0.88 (0.15)) was twofold higher than that in the OS group (0.37 (0.16)) (p = 0.02). The expression of <i>GADD45A</i>, which was downregulated in the presence of cancer, was significantly upregulated (p = 0.048) following RS treatment (1.41 (0.26)) as compared with OS treatment (0.56 (0.3)). However, there were no significant differences in the expression of these genes in the normal mucosa following starch treatment. <h3>Conclusions:</h3> Cell proliferation in the upper part of colonic crypts is a premalignant marker and its reduction by RS supplementation is consistent with an antineoplastic action of this food component. Differential expression of the key cell cycle regulatory genes may contribute to the molecular mechanisms underlying these antineoplastic effects of RS. <h3>Trial registration number:</h3> ISRCTN93586244.
Plasticized polyvinylchloride as a temporary dressing for burns.
Authors: G Wilson, G French
Journal: BMJ (1987)

Plasticized polyvinylchloride film has been used in this burns unit for a long time for dressings before the ward round, before surgery, and when the burned patient is transferred from the casualty department to the burns unit. Plasticized polyvinylchloride film is easy to use, safe, and causes no pain. Most importantly, in the present financial climate, it is cheap.
Paying for Performance in the United States and Abroad
Authors: Arnold M. Epstein
Journal: New England Journal of Medicine (2006)

The British sometimes have been characterized as steadfast, measured, tolerant of bus queues and surgical waiting lists, and perhaps even a bit stodgy. Parts of this portrait may be accurate, but the British adoption of pay for performance should dispel the last of these stereotypes forever.In this issue of the Journal, Doran et al.1 describe the initial operation and effect of a British policy (adopted in April 2004) that bases a substantial portion of salary payments to general practitioners on their success in meeting 146 criteria for high-quality performance, each of which is tied to a variable number of . . .
Frozen shoulder: an arthrographic and radionuclear scan assessment.
Authors: A I Binder, D Y Bulgen, B L Hazleman, J Tudor, P Wraight
Journal: Annals of the Rheumatic Diseases (1984)

The diagnostic criteria and nomenclature used to describe the painful stiff shoulder remain confused. Arthrographic features of capsulitis have come to be accepted as characteristic of the frozen shoulder. Increased technetium uptake has also been noted. Both features have been considered to have possible prognostic and therapeutic importance. During a therapeutic study of strictly defined clinical frozen shoulder 35 of 38 patients showed increased technetium diphosphonate uptake in the affected shoulder in comparison with the opposite side. Of 36 patients who had arthrography 15 showed evidence of capsulitis, 11 rupture of the rotator cuff, and five no abnormality. Five tests failed owing to technical difficulty. There was no association between the technetium uptake and the arthrographic features, and neither was useful in predicting the rate or extent of recovery. Frozen shoulder of traumatic onset behaved no differently from that which arose spontaneously. We do not therefore consider that arthrography or technetium diphosphonate scanning performed at presentation contributes to the assessment of the painful stiff shoulder.
THE AIM OF MEDICAL EDUCATION, AND ITS RELATION TO RESEARCH WORK, BY MEDICAL STUDENTS.
Authors: W. S. CHRISTOPHER
Journal: JAMA (1901)

The work of the medical colleges twenty years ago was such that almost any change in it was a change in the direction of improvement. The result was that as changes were suggested, they were hailed with delight, and adopted as rapidly and as thoroughly as the different schools could accommodate themselves to them, until it has now almost become a habit to accept as good and desirable any innovation in medical college work which may be suggested. The last two decades have seen a general extension of the time of medical study from two courses of five months each to four courses of eight or nine months each; this period has seen introduced into the curriculum many branches of study, previously never attempted; it has seen the standard of admission raised, and the requirements for the degree, and for the right to practice made more stringent. During the same