tbuckley/cabot-search huggingface dataset:
Proteinuria in Mexican Americans and Non-Hispanic Whites With NIDDM
Authors: Steven M Haffner, Braxton D Mitchell, Jacqueline A Pugh, Michael P Stern, M Katherine Kozlowski, Helen P Hazuda, Judith K Patterson, Ronald Klein
Journal: Diabetes Care (1989)

Mexican Americans have a threefold greater prevalence of non-insulin-dependent diabetes mellitus (NIDDM) than non-Hispanic Whites as found in the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease. In addition, Mexican-American d a etic subjects have higher levels of glycemia than non-Hispanic White diabetic subjects. We therefore hypothesized that the prevalence of clinical proteinuria would be greater among Mexican-American diabetic subjects (n = 317) than among non-Hispanic White diabetic subjects (n = 67). Clinical proteinuria, defined as ≥1 + on the Ames Albustix test, was 2.82 times more prevalent in Mexican-American diabetic subjects compared with non-Hispanic White diabetic subjects adjusting for age and duration (95% confidence interval [Cl] = 1.05, 7.55; P = .039). After controlling for other possible confounding variables (i.e., glycemia, systolic b ood pressure, smoking, and insulin use), the excess of proteinuria in Mexican-American diabetic subjects was only slightly attenuated, although the statistical significance became borderline (odds ratio [OR] = 2.59, 95% Cl = 0.91, 7.32; P = .072). The prevalence of microalbuminuria (&amp;gt;30 mg/L) was also significantly higher in Mexican-American diabetic subjects than in non-Hispanic White diabetic subjects (OR = 3.54, 95% Cl = 1.28, 9.81; P = .015). We also compared previously diagnosed Mexican-American diabetic subjects (n = 243) from San Antonio with previously diagnosed non-Hispanic White diabetic subjects in Wisconsin (n = 476). After controlling for age and duration of diabetes, Mexican-American diabetic subjects had a significantly higher prevalence of clinical proteinuria than the Wisconsin diabetic subjects (Mantel-Haenszel OR = 1.58, 95% Cl = 1.05, 2.40; P = .017). Our data indicate that Mexican-American diabetic ubjects have a higher prevalence of clinical proteinuria and microalbuminuria than non-Hispanic White diabetic subjects.
Mesangial cell immune injury. Synthesis, origin, and role of eicosanoids.
Authors: E A Lianos, B A Bresnahan, C Pan
Journal: Journal of Clinical Investigation (1991)

The synthesis, cell origin, and physiologic role of eicosanoids were investigated in a model of mesangial cell immune injury induced by a monoclonal antibody against the rat thymocyte antigen Thy 1.1 also expressed in rat mesangial cells. A single intravenous injection of the antibody resulted in enhanced glomerular synthesis of thromboxane (Tx)B2, leukotriene (LT)B4, and 12-hydroxyeicosatetraenoic acid (HETE), whereas that of PGE2 and PGF2 alpha was either unaltered or impaired. The enhanced eicosanoid synthesis was associated with decrements in glomerular filtration rate (GFR) and renal blood flow (RBF). Complement activation mediated both the increments in TxB2, LTB4, and 12-HETE and the decrements in GFR and RBF. The decrements in GFR were abolished by the TxA2 receptor antagonist SQ-29,548. Although both neutrophiles and Ia (+) leukocytes infiltrated glomeruli, glomerular LTB4 originated mainly from the latter. Platelets entirely accounted for the enhanced 12-HETE synthesis in isolated glomeruli and to a lesser extent for that of LTB4 and TxB2. Glomerular PGE2 and PGF2 alpha originated from mesangial cells as their impaired synthesis coincided with extensive mesangial cell lysis. The observations indicate that in mesangial cell immune injury vasoactive and proinflammatory eicosanoids originate from recruited or activated Ia (+) leukocytes and platelets and may exert paracrine effects on mesangial cells.
Twelve strategies for effective communication and collaboration in medical teams
Authors: E. Rider
Journal: BMJ (2002)

Creating the right climate Many doctors who behave objectionably are reacting to the climate in which they are working. Psychological factors in the work climate contribute to performance. People who feel supported, clear about what is expected, able to contribute in a meaningful way, recognised for their work, free to express their views, and challenged to develop, are more likely to feel involved in their job and devote more effort to it. These factors in turn boost performance.
Amniotic membrane transplantation for acute chemical or thermal burns
Authors: Daniel Meller, Renato T.F Pires, Robert J.S Mack, Francisco Figueiredo, Arnd Heiligenhaus, Woo Chan Park, Pinnita Prabhasawat, Thomas John, Stephen D McLeod, Klaus P Steuhl, Scheffer C.G Tseng
Journal: Ophthalmology (2000)
Laser angioplasty: progressing, but opinions, forecasts vary
Authors: M. F. Goldsmith
Journal: JAMA (1985)

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
Acute Type B Hepatitis among HBsAg Negative Patients Detected by Anti-HBc IgM
Authors: Peter Kryger, Jan Aldershvile, Lars R. Mathiesen, Jens O. Nielsen
Journal: Hepatology (1982)

A consecutive group of 169 patients with acute hepatitis found negative for hepatitis B surface antigen (HBsAg) and negative for IgM antibody against hepatitis A (anti-HAV IgM) was studied for presence of IgM antibody against hepatitis B core antigen (anti-HBc IgM) by ELISA. Anti-HBc IgM was found in a total of 34 of 60 patients with detectable total anti-HBc. One hundred and nine patients had no detectable anti-HBc IgM and no total anti-HBc and were thus considered as having acute non-A, non-B hepatitis. Among the 34 patients with anti-HBc IgM in their first serum sample, 23 were anti-HBs negative and all had high and steadily decreasing ratio unit (RU) values for anti-HBc IgM (mean RU value 17.1). Twelve of the 23 patients showed seroconversion to anti-HBs during the follow-up, indicating an actual hepatitis B virus infection. Eleven of the 34 anti-HBc IgM positive patients had anti-HBs in their first serum sample. In this group, the RU values for anti-HBc IgM were high and steadily declining and the initial values were significantly lower (mean RU value 9.9) (p &lt; 0.05) than in the anti-HBs negative group. Evidence is provided that anti-HBc IgM in serum from patients with HBsAg negative hepatitis with or without anti-HBs indicates an actual hepatitis B virus infection. According to generally accepted criteria, the demonstration of anti-HBc IgM identified 20% of the 169 patients with acute non-A, non-B hepatitis as having an actual hepatitis B infection.
TAT-mediated Delivery of LAD Restores Pyruvate Dehydrogenase Complex Activity in the Mitochondria of Patients with LAD Deficiency
Authors: Matan Rapoport, Ann Saada, Orly Elpeleg, Haya Lorberboum-Galski
Journal: Molecular Therapy (2008)

Modern medicine offers no cure for mitochondrial disorders such as lipoamide dehydrogenase (LAD) deficiency. LAD is the E3 subunit shared by alpha-ketoacid dehydrogenase complexes in the mitochondrial matrix, and these complexes are crucial for the metabolism of carbohydrates and amino acids. We propose a novel concept for restoring the activity of an immense multicomponent enzymatic complex by replacing one mutated component, the LAD subunit. Our approach entails the fusing of LAD with the transactivator of transcription (TAT) peptide, which is capable of rapidly crossing biological membranes, thereby allowing TAT-LAD to be delivered into cells and their mitochondria where it can replace the mutated endogenous enzyme. Our results show that TAT-LAD is indeed delivered into the cells and their mitochondria, where it is processed, restoring LAD activity to normal values and, most importantly, increasing the activity of pyruvate dehydrogenase complex. We report here, for the first time, that TAT-mediated replacement of one mutated component restores the activity of an essential mitochondrial multicomponent enzymatic complex in cells of patients with enzyme deficiencies. We believe that this approach involving TAT-mediated enzyme replacement therapy (ERT) can be applied to the treatment of LAD deficiency as well as to other mitochondrial and metabolic disorders.
Correlation of persistently high serum amyloid A protein and C-reactive protein concentrations with rapid progression of secondary amyloidosis.
Authors: H M Falck, C P Maury, A M Teppo, O Wegelius
Journal: BMJ (1983)

The importance of serum amyloid A protein in the progression of renal failure was studied over three years in 28 patients with secondary (amyloid A type) amyloidosis predominantly due to rheumatoid arthritis. Creatinine clearance, the amount of protein in the urine, and serum amyloid A and C-reactive protein concentrations were determined regularly. Linear regression analysis showed a close correlation between the change in creatinine clearance each year and both serum amyloid A concentrations (20 patients: r= -0.83, p less than 0.001) and C-reactive protein concentrations (28 patients: r= -0.80, p less than 0.001). The correlation between serum amyloid A and C-reactive protein concentrations was also significant (317 parallel measurements: r=0.81, p less than 0.001). These findings suggest that monitoring serum amyloid A or C-reactive protein concentrations is valuable in assessing the prognosis in secondary amyloidosis and that therapeutic measures that lower serum amyloid A concentrations may reduce the formation of amyloid.
Randomised controlled trial of alfa interferon in chronic active hepatitis non A non B
Authors: P. Marcellin, N. Boyer, E. Giostra, F. Degos, H. Coppere, P. Cales, P. Couzlgou, M. Martinot, M.A. Loriot, J.P. Benhamou
Journal: Journal of Hepatology (1989)
Valiyezhuth Krishnankutty Jayaram
Authors: J E D Charles-Jones
Journal: BMJ (2004)

Consultant geriatrician Countess of Chester Hospital, Chester (b Cochin, India, 1929;q Stanley Medical College, Madras, 1953; DTM&H, FRCP), died on 23 June 2004 following a stroke.​stroke.




Figure 1




“J” (as he was universally called) came to Britain in 1956, taking up senior house officer posts at Northampton and at the Whittington Hospital, London. From 1959 to 1961 he was involved in malaria control with the World Health Organization. Before his consultant appointment he was a medical assistant in geriatrics at St James's Hospital, Leeds. He founded the Chester Stroke Association and was a member of the British Geriatric Society and the British Heart Foundation (Chester committee). He leaves a wife, Sujatha; two sons; and two grandchildren.
Abstract PD2-7: Vigorous exercise across the lifespan and reduced risk of estrogen receptor negative breast cancer in African American women
Authors: LL Adams-Campbell, JR Palmer, T Bethea, K Kipping-Ruane, L Rosenberg
Journal: Cancer Research (2013)

Abstract Background. Recreational exercise has been associated with a reduced risk of breast cancer, but evidence regarding breast cancer among African American women and about breast cancer subtypes is sparse. Methods. We assessed lifetime vigorous exercise (average of high school, age 21, age 30, and baseline) in the Black Women's Health Study in relation to the incidence of invasive breast cancer overall (n = 1,377), estrogen receptor-positive (ER+) breast cancer (n = 556), estrogen receptor-negative (ER-) breast cancer (n = 327), and triple negative breast cancer (TN) (n = 103); analyses were based on 275,188 person years of follow-up of 44,704 African American women who were aged 30 or more at entry to the study. Cox proportional hazards models estimated incidence rate ratios (IRR) and 95% confidence intervals (CI), controlling for breast cancer risk factors. Results. For ER- breast cancer, the IRRs for 1-2.2 hours/week, 2.3-2.9 hours/week, and 3+ hours/week relative to &amp;lt;1 hour/week were 0.76 (95% CI 0.52-1.11), 0.78 (95% CI 0.52-1.17) and 0.53 (95% CI 0.31-0.90), respectively; the p value for trend was 0.058. The inverse association was apparent only among postmenopausal women. There was also an inverse association, although nonsignificant, of exercise with the incidence of TN breast cancer. Vigorous exercise was not associated with a reduction in ER+ breast cancer risk. Conclusion. These results indicate that physical activity may protect against the development of ER- breast cancer in African American women. The association, if confirmed, is of great public health importance given the high mortality associated with this subtype and its higher incidence in African American women. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr PD2-7.
Words as Scalpels: Transmitting Evidence in the Clinical Dialogue
Authors: STANLEY JOEL REISER
Journal: Annals of Internal Medicine (1980)

This paper examines rationales and policies developed by physicians through history about what to tell patients found to have serious illness. The widespread belief among doctors that the revelation of threatening news causes patients considerable anguish and seriously erodes the prospect of maintaining their hope encouraged a policy of concealment for many centuries. Arguments that encourage candor have been increasingly pressed during the last two centuries. Advocates point out that candor can be beneficial and is favored by many patients, and that a policy of concealment usually fails to work, tends to place stress on patients by constraining discussion of anxieties generated by vague or explicit knowledge of the true situation, and exerts a damaging effect on trust in the medical relationship. Not only the moral aspects of this problem but also its clinical dimensions, such as mastering the skill to discuss threatening news with patients, bear considerable scrutiny by physicians and medical educators.
Mental health services' framework must tackle age discrimination, commission says
Authors: J. Wise
Journal: BMJ (2009)

The care and treatment offered to users of mental health service of all ages in England have substantial failings, according to two reports by the Healthcare Commission.

The first report, Equality in Later Life , found that older people are discriminated against in access to out of hours and crisis services, psychological treatment, and alcohol services.

The independent health regulator for England studied services for older people at six specialist mental health trusts, about 10% of the total number. It found some evidence of high quality care where there was good integration of health and social services. But older people were often denied access to care because of stretched services or a lack of age appropriate care.

Provision of psychological treatments for older people was poor in …
The Patient Package Insert
Authors: E. Douglas Rooke
Journal: JAMA (1976)

<h3>To the Editor.—</h3> I have followed with interest the letters concerning the use (or lack of it) of patient package inserts in the March 8 (235:1003,1976) and previous issues of<i>JAMA</i>. In the March 8 issue, I was struck by the timely ring of Dr Aring's quotation of Justice Cardozo in his commentary (p 1013)—coming as it did, just a few pages after the "insert" discussion: "Justice Cardozo said that there is an accuracy that defeats itself by overemphasis of details, and that one must permit oneself, quite advisedly and deliberately, a certain margin of misstatement." With the possible substitution of "understatement" for "misstatement," do you suppose it might have some relevance to this "insert" controversy?
Abstract P6-09-04: The Association of Low Level Arm Volume Increases with Lymphedema Symptoms Following Treatment for Breast Cancer
Authors: MN Skolny, CL Miller, M Shenouda, LS Jammallo, J O'Toole, A Niemierko, AG Taghian
Journal: Cancer Research (2012)

Abstract Purpose/Objective: The symptoms associated with breast cancer-related lymphedema are well-documented, and include sensations of heaviness, swelling, and tightness in the upper extremity and trunk. However, the clinical significance of low-level arm volume changes frequently experienced by breast cancer patients is not well understood. We sought to determine the association of low level arm volume changes with patient-reported lymphedema symptoms in women treated for breast cancer. Methods: 267 patients who underwent surgical treatment for breast cancer from 2010–2012 were identified from a cohort of patients prospectively screened for lymphedema at our institution. Patients were assessed with perometer arm volume measurements and a survey of lymphedema symptoms pre and post operatively, and at 3–7 month intervals thereafter. Inclusion in this analysis was limited to unilaterally affected women with ≥ 3 assessments and ≥ 6 months of post-surgical follow-up. Arm volume changes were quantified as Relative Volume Change (RVC): RVC = (A2*U1)/(U2*A1) − 1, where A1 is pre-operative arm volume and A2 is post-operative arm volume on the affected side, and U1 and U2 are arm volumes on the unaffected side at these time points. Low level arm volume change was defined as a measurement with RVC ≥ 5% &amp;lt;10% at an assessment ≥ 3 months post-operatively. Actuarial univariate and multivariate regression analysis was performed to determine the association of low level arm volume change with patient-reported lymphedema symptoms and clinicopathological characteristics. Results: Low level arm volume changes occurred in 21.7% (58/267) of patients during the follow-up period at a median of 10.4 months post-operatively. Median post-operative follow-up was 12.4 months and 5 assessments per patient. By actuarial univariate analysis, symptoms of larger arm, shoulder, or neck (p &amp;lt; 0.001), tighter sleeve, sleeve cuff, or ring (p &amp;lt; 0.001), and having undergone axillary lymph node dissection (p = 0.02) or regional lymph node radiation (p = 0.01) were significantly associated with low-level arm volume change. By actuarial multivariate analysis, only symptoms of larger arm, shoulder, or neck (p &amp;lt; 0.0001) were associated with low level arm volume change. Conclusions: This data suggests that patients may be symptomatic for lymphedema even when experiencing low level arm volume changes. These patients should be followed closely for progression of measured arm volume or heightened lymphedema symptoms suggesting progression of the condition. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P6-09-04.
Intravenous nitroglycerin in acute myocardial infarction.
Authors: J T Flaherty, P R Reid, D T Kelly, D R Taylor, M L Weisfeldt, B Pitt
Journal: Circulation (1975)

Vasodilator therapy has been shown to improve ventricular function in patients with left ventricular failure complicating acute myocardial infarction. Sublingual nitroglycerin also improves ventricular function in these patients but its effects are transient and variable. Infusion of intravenous nitroglycerin in 12 patients with acute infarction resulted in a decrease in left ventricular filling pressure from a mean of 22 plus or minus 2 mm Hg to 12 plus or minus 1 mm Hg (P less than 0.001) associated with a 7 mm Hg decrease in mean arterial pressure (P less than 0.05). Since stroke work index did not change significantly, this represents and improvement in ventricular performance and/or an alteration in ventricular compliance. All six patients in whom serial precordial mapping studies were performed showed a decrease in sigma ST (P less than 0.001). These findings suggest that intravenous nitroglycerin improved left ventricular function and decreased the extent of myocardial ischemia. Longer infusion may act to preserve borderline ischemic myocardium and thus limit infarct size.
Observations on the Epidemiology of Simple Hypospadias
Authors: C. J. Roberts, S. Lloyd
Journal: BMJ (1973)

A descriptive epidemiological study of simple hypospadias-that is, hypospadias without coexisting malformation outside the genital system-in a birth population of 46,927 singleton males and 1,013 twin males showed that the condition was significantly more common (P < 0.001) in uniovular twin males than in either singleton or binovular twin males. Also the temporal distribution of dates of conception had a significant cyclic pattern for each year of the study. Both observations are thought to support the view that gonadotrophin levels at stage 3 sexual organogenesis play an important part in normal masculinization of male external genitalia.
Patients With Poor Responsiveness to Thienopyridine Treatment or With Diabetes Have Lower Levels of Circulating Active Metabolite, but Their Platelets Respond Normally to Active Metabolite Added Ex Vivo
Authors: David Erlinge, Christoph Varenhorst, Oscar Ö. Braun, Stefan James, Kenneth J. Winters, Joseph A. Jakubowski, John T. Brandt, Atsuhiro Sugidachi, Agneta Siegbahn, Lars Wallentin
Journal: Journal of the American College of Cardiology (2008)
DEVICE FOR PROTECTION OF THE TEETH DURING BRONCHOSCOPY AND ESOPHAGOSCOPY
Authors: Sidney Israel
Journal: JAMA (1935)

Protection of the upper teeth is one of the important factors in the technic to be observed during a bronchoscopic or esophagoscopic examination. There have been numerous occurrences of injury to the upper teeth, regardless of what instrument or method has been employed. Unless the teeth have been properly protected, patients frequently complain of sensitiveness or tenderness of the teeth, particularly on the edges, lasting for several days after a bronchoscopic or esophagoscopic examination, as a result of the pressure of the metal tube, which rests on the edges of the teeth. Heretofore to protect the upper teeth from injury by the bronchoscopic or esophagoscopic tube it has been the accepted custom to use the examiner's thumb or a pad of gauze or cotton. Neither of these measures is completely satisfactory. When the thumb of one hand is used, that hand is eliminated