tbuckley/cabot-search huggingface dataset:
Association Between Intensification of Metformin Treatment With Insulin vs Sulfonylureas and Cardiovascular Events and All-Cause Mortality Among Patients With Diabetes
Authors: Christianne L. Roumie, Robert A. Greevy, Carlos G. Grijalva, Adriana M. Hung, Xulei Liu, Harvey J. Murff, Tom A. Elasy, Marie R. Griffin
Journal: JAMA (2014)

Preferred second-line medication for diabetes treatment after metformin failure remains uncertain.To compare time to acute myocardial infarction (AMI), stroke, or death in a cohort of metformin initiators who added insulin or a sulfonylurea.Retrospective cohort constructed with national Veterans Health Administration, Medicare, and National Death Index databases. The study population comprised veterans initially treated with metformin from 2001 through 2008 who subsequently added either insulin or sulfonylurea. Propensity score matching on characteristics was performed, matching each participant who added insulin to 5 who added a sulfonylurea. Patients were followed through September 2011 for primary analyses or September 2009 for cause-of-death analyses.Risk of a composite outcome of AMI, stroke hospitalization, or all-cause death was compared between therapies with marginal structural Cox proportional hazard models adjusting for baseline and time-varying demographics, medications, cholesterol level, hemoglobin A1c level, creatinine level, blood pressure, body mass index, and comorbidities.Among 178,341 metformin monotherapy patients, 2948 added insulin and 39,990 added a sulfonylurea. Propensity score matching yielded 2436 metformin + insulin and 12,180 metformin + sulfonylurea patients. At intensification, patients had received metformin for a median of 14 months (IQR, 5-30), and hemoglobin A1c level was 8.1% (IQR, 7.2%-9.9%). Median follow-up after intensification was 14 months (IQR, 6-29 months). There were 172 vs 634 events for the primary outcome among patients who added insulin vs sulfonylureas, respectively (42.7 vs 32.8 events per 1000 person-years; adjusted hazard ratio [aHR], 1.30; 95% CI, 1.07-1.58; P = .009). Acute myocardial infarction and stroke rates were statistically similar, 41 vs 229 events (10.2 and 11.9 events per 1000 person-years; aHR, 0.88; 95% CI, 0.59-1.30; P = .52), whereas all-cause death rates were 137 vs 444 events, respectively (33.7 and 22.7 events per 1000 person-years; aHR, 1.44; 95% CI, 1.15-1.79; P = .001). There were 54 vs 258 secondary outcomes: AMI, stroke hospitalizations, or cardiovascular deaths (22.8 vs 22.5 events per 1000 person-years; aHR, 0.98; 95% CI, 0.71-1.34; P = .87).Among patients with diabetes who were receiving metformin, the addition of insulin vs a sulfonylurea was associated with an increased risk of a composite of nonfatal cardiovascular outcomes and all-cause mortality. These findings require further investigation to understand risks associated with insulin use in these patients.
Site of Heart Block in Acute Myocardial Infarction
Authors: KENNETH M. ROSEN, HENRY S. LOEB, RUBEN CHUQUIMIA, M. ZIAD SINNO, SHAHBUDIN H. RAHIMTOOLA, ROLF M. GUNNAR
Journal: Circulation (1970)

Bundle of His electrograms were recorded in eight patients with acute myocardial infarction and heart block. Three patients with diaphragmatic myocardial infarction (DMI) and one with subendocardial infarction were characterized by slowing or block above the bundle of His and A-V junctional escape rhythms during periods of advanced or complete block. An additional patient with DMI had block in the His bundle itself. Intraventricular conduction in the above patients was characterized by normal H-Q intervals (35 to 60 msec) and absence of widened QRS. In contrast, three patients with anterior infarction (AMI) manifested complete block below the bundle of His and idioventricular escape. P-H intervals were normal (80 to 140 msec) and A-V conduction was considered unaffected. Our electrophysiologic observations coupled with previous clinical, anatomic, and pathologic findings suggest that the heart block in DMI is usually due to an ischemic lesion of the A-V node, while heart block in AMI is due to necrosis involving both bundle branches.
The Histone H3 Methyltransferase G9A Epigenetically Activates the Serine-Glycine Synthesis Pathway to Sustain Cancer Cell Survival and Proliferation
Authors: Jane Ding, Tai Li, Xiangwei Wang, Erhu Zhao, Jeong-Hyeon Choi, Liqun Yang, Yunhong Zha, Zheng Dong, Shuang Huang, John M. Asara, Hongjuan Cui, Han-Fei Ding
Journal: Cell Metabolism (2013)

Increased activation of the serine-glycine biosynthetic pathway is an integral part of cancer metabolism that drives macromolecule synthesis needed for cell proliferation. Whether this pathway is under epigenetic control is unknown. Here we show that the histone H3 lysine 9 (H3K9) methyltransferase G9A is required for maintaining the pathway enzyme genes in an active state marked by H3K9 monomethylation and for the transcriptional activation of this pathway in response to serine deprivation. G9A inactivation depletes serine and its downstream metabolites, triggering cell death with autophagy in cancer cell lines of different tissue origins. Higher G9A expression, which is observed in various cancers and is associated with greater mortality in cancer patients, increases serine production and enhances the proliferation and tumorigenicity of cancer cells. These findings identify a G9A-dependent epigenetic program in the control of cancer metabolism, providing a rationale for G9A inhibition as a therapeutic strategy for cancer.
An opportunity missed at Brighton
Authors: W. Russell
Journal: BMJ (1980)

Strange are the ways of Cabinet ministers. Mr Jenkin was faced with the chance to reply to the Conservative Party conference debate on health and social security, albeit to a motion lauding the valuable contribution made by the voluntary organisations towards the care of the sick, the disadvantaged, and the elderly. Against all advice the Social Services Secretary chose to speak about the voluntary services and nothing else. It seemed a rather odd decision considering that he has just put on the Statute Book an Act which allows a major reorganisation of the National Health Service. He could have spoken about what he liked, since Conservative conference motions are merely an expression of opinion?not, as at the Labour Conference, an instruction as to what must be Party policy. It was an opportunity missed. At last year's conference Mr Jenkin was upstaged by his deputy, Dr Gerard Vaughan, the Health Minister, who scored a quite notable success with his speech. This year Dr Vaughan was not among the ministers chosen to reply to a debate?well, there was no debate on the NHS to reply to. A platform was, however, readily available. Dr Vaughan is one of the founders of the Conservative Medical Society and it invited him along one lunchtime to talk about the NHS. He attacked Labour's record as one of drift and indecision and claimed that he had inherited an appallingly chaotic situation.  nettle, however, had been grasped. It was his proud boast, and one we will hear repeatedly, that far from cutting NHS resources, this year the Government will be spending ?200m more in real terms than Labour in their last year. He also announced that the latest figures from the DHSS showed that there had been a marked fall in hospital waiting lists. By March 1980, he said, the numbers had been reduced by 92 000. That must be good news for the NHS. I believe we are now well on the road to putting the NHS back on its feet, he added. The policy of small hospitals is going very well indeed. Now we must turn to directing resources towards prevention and the community  One area in which he is planning action is on the general practitioner services. We do not make the best use of our GP skills, he said. I am asking the Royal College of General Practitioners to come to me now with advice about the kind of GP service they would like to see, about ways of extending the range of initiatives so that GPs can have the freedom to exercise their skills. He criticised the way some doctors interpret clinical freedom and said it was one of the great dilemmas in the NHS. Is it right to give total clinical freedom to override other circum stances so that a doctor on a particular whim can spend huge sums of money when his colleagues do not agree with him ? he asked. Then he answered the question. He was all for clinical
Noninvasive determination of coronary artery bypass graft patency by cine magnetic resonance imaging.
Authors: G P Aurigemma, N Reichek, L Axel, M Schiebler, C Harris, H Y Kressel
Journal: Circulation (1989)

Cine magnetic resonance imaging (MRI) is a gradient-recalled, retrospectively gated, fast-scan technique that depicts laminar flowing blood as bright signal and has been proposed as a useful method for determination of coronary artery bypass graft (CABG) patency. Therefore, we performed a blinded prospective study to assess the value of cine MRI determination of CABG patency in 20 patients with 45 CABG proximal anastomoses who were undergoing repeat angiography. Ten normal subjects served as controls to define normal intrathoracic vascular patterns. There were 21 left anterior descending (LAD) grafts, of which four were left internal mammary (LIMA), 12 left circumflex (Cx), and 12 right coronary (RCA) grafts. After localizing spin-echo coronal images were obtained, multiple axial multislice interleaved cine MRI acquisitions, each consisting of two to four 5-10-mm-thick slices at eight to 24 frames per cardiac cycle, were obtained from the superior main pulmonary artery to the inferior left ventricle. Each acquisition took 5-8 minutes with a subsequent 5-10 minutes of computer image reconstruction. Total study time per patient was 50-75 minutes. Known to cine MRI interpreters were the original surgical CABG insertions but not the angiographic findings. A graft was called patent if a bright graft flow signal, not corresponding to a normal vessel, was identified on multiple frames at multiple levels abutting the great vessels or epicardial surface of the heart. Angiographically, there were 33 patent grafts, of which 29 were identified as patent by cine MRI (sensitivity, 88%).(ABSTRACT TRUNCATED AT 250 WORDS)
"Failure" of the random zero sphygmomanometer in general practice
Authors: C R Hayler
Journal: BMJ (1985)

We also doubt whether, after missing a pill at the start of a packet, the normal practice of taking wo pills would increase the risk of ovulation.This is because a good dose of progestogen as well as oestrogen is thereby given, and Yuzpe et al have shown that a similar regimen is a good postcoital contraceptive even during spontaneous cycles.)
Long-Term Comparison of Three Dietary Prescriptions in the Treatment of NIDDM
Authors: Robyn M Milne, Jim I Mann, Alex W Chisholm, Sheila M Williams
Journal: Diabetes Care (1994)

OBJECTIVE To compare three sets of dietary guidelines for the treatment of non-insulin-dependent diabetes (NIDDM) in free-living individuals and to observe the effects on metabolic control over an 18-month period. RESEARCH DESIGN AND METHODS Seventy volunteer subjects with NIDDM were randomly assigned to one of three diets, a weight-management diet, a high-carbohydrate/fiber diet, or a modified-lipid diet and followed for 18 months. Nutrient intakes, weight, blood lipids, and glycemic control were measured. RESULTS In all diet groups, glycated hemoglobin (HbA1) fell significantly before diet intervention began, remaining lower throughout the study and at follow-up 9 months later. Low-density lipoprotein (LDL) cholesterol showed a sustained fall in all groups after diet intervention. Apart from transient changes in high-density lipoprotein (HDL) cholesterol and triglyceride (TG) in the diet groups with the higher carbohydrate intake, no lasting differences were found between the three diet groups. CONCLUSIONS In the long term, there were few differences in the outcome of the three dietary prescriptions. Even with intensive instruction, participants found it difficult to meet recommended nutrient intakes; however, specific dietary advice did result in an improvement in LDL cholesterol. Adverse changes in HDL cholesteroland TG because of diet intervention were transient. The significant improvement in glycemic control during the recruitment phase may have been the result of particpants' previous dietary knowledge and the increased attention that they received during the intervention.
Abstract 4160: DEPTOR, an mTOR inhibitor, is a novel substrate of SCFαTrCP E3 ubiquitin ligase upon S6K1/RSK1 phosphorylation and regulates survival and autophagy
Authors: Yongchao Zhao, Xiufang Xiong, Yi Sun
Journal: Cancer Research (2012)

Abstract DEPTOR, an inhibitor of mTORC1 and mTORC2, is degraded via ubiquitin-proteasome pathway by an unknown E3 ubiquitin ligase. Here we report that DEPTOR is a physiological substrate of SCFαTrCP E3 ligase for targeted degradation. Upon growth factor stimulation, RSK1 and S6K1 kinases are activated to phosphorylate DEPTOR, which is then recognized by the F-box protein, αTrCP via its degron sequence for subsequent ubiquitination and degradation by SCF E3. Endogenous DEPTOR levels are negatively regulated by αTrCP; being decreased or increased upon αTrCP overexpression or knockdown, respectively. DEPTOR half-life is shortened by αTrCP but extended by its dominant negative mutant, by RSK1/S6K1 inhibition, or upon αTrCP degron site mutations. Biologically, DEPTOR, accumulated upon αTrCP knockdown, inactivates mTORC1 and activates AKT in cancer cells to confer resistance to rapamycin and paclitaxel. Furthermore, DEPTOR, accumulated upon glucose deprivation and mTOR inhibition, induces autophagy. Thus, αTrCP-DEPTOR-mTOR intertwines to regulate cell survival and autophagy. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4160. doi:1538-7445.AM2012-4160
Manganese Superoxide Dismutase, but not CuZn Superoxide Dismutase, Is Highly Expressed in the Granulomas of Pulmonary Sarcoidosis and Extrinsic Allergic Alveolitis
Authors: ESSI LAKARI, PAAVO PÄÄKKÖ, VUOKKO L. KINNULA
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

The role of antioxidant defense mechanisms in the pathogenesis of granulomatous human lung diseases remains open to investigation. In this study we investigated the immunoreactivity of two important superoxide radical scavenging intracellular antioxidant enzymes, manganese superoxide dismutase (MnSOD) and copperzinc superoxide dismutase (CuZnSOD), in pulmonary sarcoidosis and extrinsic allergic alveolitis. In histologically normal lung MnSOD was variable but mostly positive in the cells of bronchial epithelium, alveolar epithelium especially in type II pneumocytes, and alveolar macrophages. Copperzinc SOD showed positive immunoreactivity most markedly in the bronchial epithelium. The biopsies of 22 patients with pulmonary sarcoidosis and 10 with extrinsic allergic alveolitis indicated that MnSOD was highly stained in the granulomas of both diseases, with 60 to 100% of the granulomas showing intensive immunoreactivity. Western blots conducted on the cell samples of bronchoalveolar lavage (BAL) fluid revealed significantly higher amounts of MnSOD in sarcoidosis and extrinsic allergic alveolitis than in the controls. Immunohistochemistry on the cells obtained from BAL fluid showed positive immunoreactivity of MnSOD in the macrophages but not in the lymphocytes. In contrast, copperzinc SOD was not induced in either of these diseases. We conclude that MnSOD is highly expressed in the granulomas of pulmonary sarcoidosis and extrinsic allergic alveolitis, and variable but mostly positive in alveolar macrophages, possibly owing to cytokine mediated induction during the granuloma formation.
Emergency Medicine: A Comprehensive Study Guide
Authors: Robert D. Powers
Journal: JAMA (1996)

The first edition of this text was published in 1978 in paperback as a clinical and review manual for students and practitioners of the fledgling specialty of emergency medicine. Along with the specialty, subsequent editions have grown in size and scope so that the current version has the length (1555 pages) and heft (7% lb) of a reference work. This is the first edition to be published in hardcover, and there has been a slight increase in price. The preface does not contain a specific mission statement but sets forth the laudable goal of assisting "students, house officers, and physicians who practice in any emergency care setting to provide the best patient care possible." Although not stated officially, it is widely recognized among emergency medicine residents and faculty that the book is the traditional source of board preparation information. The imprimatur of the American College of Emergency Physicians is prominent
Serum Sodium and Potassium in Essential Hypertension
Authors: BERNARD E. LEVINE, JOHN M. WELLER, RICHARD D. REMINGTON
Journal: Circulation (1961)

This study was undertaken to determine if an association exists between blood pressure level and serum sodium or potassium concentration. All methods and measurements were standardized, and variables possibly influencing these factors were analyzed. Since increased salt intake has been postulated as an etiologic factor in essential hypertension, each patient was questioned in this regard. Fifty normotensive and 43 hypertensive patients were studied. No significant associations were found between the height of the blood pressure, the serum sodium or potassium level, and the stated salt intake.
Diagnostic Trinity: Graves’ Disease on F-18 FDG PET
Authors: Yen-Kung Chen, Yuh-Feng Wang, Jainn-Shiun Chiu
Journal: Clinical Nuclear Medicine (2007)

A 31-year-old man underwent a whole-body F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) scan for cancer screening. There was no history of diabetes, thyroid disease, or noticeable exercise before imaging. The results demonstrated diffusely increased uptake of F-18 FDG in the thyroid and thymus. In addition, there was symmetrically increased uptake of F-18 FDG in skeletal muscles, especially in the psoas and limb muscles. The concurrent appearance of these characteristics led to a diagnosis of Graves' disease.
Long QT Syndrome Susceptibility Mutations and Pregnancy Loss
Authors: Alan E. Guttmacher, Catherine Y. Spong, Marian Willinger
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 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
Complement activation by anticardiolipin antibodies.
Authors: M B Santiago, N Gaburo, R M de Oliveira, W Cossermelli
Journal: Annals of the Rheumatic Diseases (1991)

A haemolytic assay was used to test the complement fixation ability of 16 serum samples with high concentrations of anti-cardiolipin antibodies. Fourteen patients had clinical complications usually associated with these antibodies--namely, recurrent abortions, thrombosis, or thrombocytopenia. Complement fixation by anticardiolipin antibodies was shown in only four of these patients and was not directly related to the antibody concentration. Because anticardiolipin antibodies in most of these patients did not activate the complement pathway it is unlikely that the complement cascade has an important role in the clinical complications associated with these antibodies.
Treatment of Heat-Related Illness
Authors: John T. Larkin
Journal: JAMA (1981)

<h3>To the Editor.—</h3> The current heat wave in the sun-belt area has prompted the following comments on therapy for heat stroke. My interest in this subject stems from my service in the Iranian Dessert from 1942 to 1944. One of my tasks was supervision of our heat stroke centers. The British Army publication<i>Memoranda on Medical Disease in Tropical and Subtropical Areas</i>, published in 1942 and distributed by the US Army in 1943, states: "the most effective means of reducing pyrexia is by securing evaporation of water from the skin. Evaporation carries away 0.59 calories of heat per gram while the melting of ice takes away only 0.08 calories per gram." These observations on the superiority of evaporation over conduction were earlier noted in an article by Earl C. Elkins<sup>1</sup>in the section on "Heat Stroke." In our centers the nude patient was placed on a table with a
Defining Appropriate Medical Care: Providing Nutrients and Hydration for the Dying
Authors: William J. Curran
Journal: New England Journal of Medicine (1985)

The New Jersey Supreme Court first attained national prominence in medicolegal issues of obligations to critically ill patients in the Karen Ann Quinlan case. The high court in New Jersey issued an eminently sensible opinion in that case, allowing the patient's guardian, her father, to use his discretion in removal of life support from his daughter, who was then irreversibly comatose.1 The court directed that in future cases, the attending physician and the family be advised in such matters by a hospital-based ethics or prognosis committee, which could avoid a case-by-case judicial review. It was expected that the patient would . . .