tbuckley/cabot-search huggingface dataset:
Effect of Intensive Treatment of Diabetes on the Risk of Death or Renal Failure in NIDDM and IDDM
Authors: Richard Hellman, Julie Regan, Howard Rosen
Journal: Diabetes Care (1997)

OBJECTIVE To examine the effectiveness and safety of long-term intensive therapy in NIDDM and IDDM. RESEARCH DESIGN AND METHODS In a private practice setting with a multi-disciplinary team, we compared the rates of total mortality, cardiac-specific mortality, and severe renal failure over 14 years in a cohort of 780 eligible patients, 209 patients with a longer duration of intensive therapy (median duration &amp;gt; 11 years, group I) and 571 patients with shorter duration of intensive therapy (median duration &amp;lt; 1 year, group II). A comorbidity index was used to assess the degree of prognostic risk at baseline. A comprehensive diabetes program was the therapeutic intervention. The endocrinologists and diabetes care team provided primary care, aggressive cardiovascular screening, and risk reduction. Intensive insulin therapy was used in 95.7% of group I IDDM and 66.0% of group I NIDDM patients. RESULTS The overall median HbA1c for group I was 7.3%. Compared with group II, the overall reduction in cumulative total mortality in group I was 22%. In the cohort with less severe initial comorbidity, the reduction in total mortality was 45%. We found similar reductions in renal failure rates in IDDM and in cardiac mortality in NIDDM patients on intensive insulin therapy. CONCLUSIONS This comprehensive diabetes program is associated with lowered mortality and morbidity in both IDDM and NIDDM. Intensive insulin therapy in long-term patients with NIDDM does not increase cardiac mortality. Intensive therapy is safe and effective in NIDDM within the context of a comprehensive program.
Ten Years of Medicine and the Arts: 100 Selections From Academic Medicine 1991-2001
Authors: Stephen J. Lurie
Journal: JAMA (2003)

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
HIV Infection in the Workplace: Protecting the Vulnerable
Authors: Timothy P. Flanigan, Charles CJ. Carpenter, Michael Close
Journal: Annals of Internal Medicine (1992)

Letters1 August 1992HIV Infection in the Workplace: Protecting the VulnerableTimothy P. Flanigan, MD, Charles CJ. Carpenter, MD, Michael Close, MDTimothy P. Flanigan, MDSearch for more papers by this author, Charles CJ. Carpenter, MDSearch for more papers by this author, Michael Close, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-117-3-267_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors: The recent debate about human immunodeficiency virus (HlV)-infected health care workers has overlooked the particular problems facing those medical students, residents, and fellows who are at great risk of acquiring nosocomial HIV infection. These persons are on "the front lines," doing many invasive procedures (blood draws, intravenous insertion, paracentesis, lumbar puncture, and so forth), often in hurried and stressful circumstances. Whereas staff and attending physicians for the most part have disability and longterm health insurance, medical students, residents, and fellows have no or limited disability insurance and marginal long-term health insurance benefits.Medical students, residents, and fellows... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 August 1992Volume 117, Issue 3Page: 267-267KeywordsBloodDisabilitiesHIVHIV infectionsHealth care providersHealth insuranceLumbar puncture Issue Published: 1 August 1992 PDF DownloadLoading ...
Peter Kenneth Philip Harvey
Authors: S. Pollock
Journal: BMJ (2012)

<b>Objectives:</b> To assess the suitability of the Queen’s College step test (QCT) to predict maximum oxygen uptake in Indian men. <b>Methods:</b> Thirty sedentary male university students from West Bengal, India, with the same socioeconomic background and mean (SD) age, height, and weight of 22.6 (0.2) years, 166.4 (0.5) cm, and 53.8 (0.2) kg, respectively, were randomly sampled from University of Calcutta. VO<sub>2</sub>max of each participant was determined by direct procedure involving incremental bicycle exercise and also by applying indirect QCT method with a gap of 4 days between the tests. <b>Results:</b> The difference between the mean (SD) VO<sub>2</sub>max values directly measured (VO<sub>2</sub>max = 39.8 (1.03) ml/min/kg body mass) and indirectly predicted (PVO<sub>2</sub>max = 39.3 (1.07) ml/min/kg body mass) was statistically insignificant (p&gt;0.10). PVO<sub>2</sub>max and VO<sub>2</sub>max values expressed as ml/min/kg body mass corroborated with previous studies in the same laboratory involving the same population, and also exhibited significant statistical correlation (<i>r</i> = 0.95, p&lt;0.001) between them. <b>Conclusion:</b> The results suggest that QCT can be applied in the studied population to produce a good estimation of maximum oxygen uptake, especially in the field where large numbers of participants are to be evaluated without a well equipped laboratory.
Why do poor outcomes persist in diabetic pregnancy?
Authors: Tim Cundy
Journal: BMJ (2006)

Editor-The report from the chief medical officer for England has implications for all UK doctors and needs to be considered very carefully. 1Its aim is a system of medical regulation that puts patients' safety first through the early detection, and where possible, remediation, of poor performance.If the report contributes to that aim, and commands public and professional support, it should be welcomed by everyone involved in health care.The Merrison report was the collective effort of Sir William Merrison and the other 14 members of his committee of inquiry, who took both oral and written evidence. 2A different process has been followed in this case.The government, sensibly, has therefore decided on a period of consultation during which the recommendations can be properly debated, tested, and costed.We have already said that we believe that the recommendations to divorce oversight of medical education from the other regulatory functions of standards, registration, and fitness to practise are not in patients' best interests.We will now be consulting widely with our partners before we submit our considered response.It may be another 30 years before there is another opportunity such as this.We must seize it so that future generations of patients can say that we did not fail them.
THE RESPONSE OF T CELLS TO HISTOCOMPATIBILITY-2 ANTIGENS
Authors: Richard K. Gershon, Stephen A. Liebhaber
Journal: The Journal of Experimental Medicine (1972)

The DNA synthetic response of a wide variety of parental thymocyte doses was studied in the lymphoid tissues of lethally irradiated F(1) mice. The response curves of the thymocytes were strikingly similar in shape to those of T cells responding to antigens, such as sheep red cells, which are more labile than the histocompatibility antigens of the F(1) host. The response was characterized by a dose-dependent latent period of 1-3 days, followed by a sharp increase in activity and a significant subsequent shutoff. Larger thymocyte doses tended to shorten the latent period. A comparison of the responses of different cell doses to one another indicated that the response usually simulated a suppressed first-order reaction. However, occasional multiple order reactions were observed. We have interpreted these data to indicate that both positive and negative interactions occur between thymocytes, without the mediation of B cell products such as conventional antibodies.
Lipemia Retinalis Associated with Secondary Hyperlipidemia
Authors: Young-Hoon Park, Young-Chun Lee
Journal: New England Journal of Medicine (2007)

This 26-year-old man with diabetes mellitus presented with poor glycemic control. He had no problems with his vision. Total serum cholesterol level was 1086 mg per deciliter with a triglyceride level of 11,929 mg per deciliter.
Transplanted beta cell response to increased metabolic demand. Changes in beta cell replication and mass.
Authors: E Montaña, S Bonner-Weir, G C Weir
Journal: Journal of Clinical Investigation (1994)

We determined the capacity of transplanted beta cells to modify their replication and mass when stimulated by changes in metabolic demand. Five groups of Lewis rats were studied: group 1 (Tx-Px) had a 95% pancreatectomy 14 d after transplantation of 500 islets; group 2 (Px-Tx) had a 95% pancreatectomy 14 d before transplantation of 500 islets; group 3 (Tx) was transplanted with 500 islets; group 4 (Px) had a 95% pancreatectomy; and group 5 (normal) was neither transplanted nor pancreatectomized. Blood glucose was normal in Tx-Px and Tx groups at all times. Px-Tx and Px groups developed severe hyperglycemia after pancreatectomy that was corrected in Px-Tx group in 83% of rats 28 d after transplantation. Replication of transplanted beta cells increased in Tx-Px (1.15 +/- 0.12%) and Px-Tx (0.85 +/- 0.12%) groups, but not in Tx group (0.64 +/- 0.07%) compared with normal pancreatic beta cells (0.38 +/- 0.05%) (P < 0.001). Mean beta cell size increased in Tx-Px (311 +/- 14 microns2) and Px-Tx (328 +/- 13 microns2) groups compared with Tx (252 +/- 12 microns2) and normal (239 +/- 9 microns2) groups (P < 0.001). Transplanted beta cell mass increased in Tx-Px (1.87 +/- 0.51 mg) and Px-Tx (1.55 +/- 0.21 mg) groups compared with Tx group (0.78 +/- 0.17 mg) (P < 0.05). In summary, changes in transplanted beta cells prevented the development of hyperglycemia in Tx-Px rats. Transplanted beta cells responded to increased metabolic demand increasing their beta cell mass.
Hereditary Hypochromic Anemia with Transfusion Hemosiderosis Treated with Pyridoxine
Authors: Ronald C. Bishop, Frank H. Bethell
Journal: New England Journal of Medicine (1959)

ALTHOUGH pyridoxal-5-phosphate is known to serve as a coenzyme in the synthesis of heme,1 anemia associated with pyridoxine deficiency has been reported only rarely in human beings. Snyderman and her co-workers2 described an increase in reticulocytes and hemoglobin concentration in an infant treated with vitamin B6 who had become anemic while receiving a pyridoxine-deficient diet. More recently Harris and his co-workers3 reported a therapeutic response to pyridoxine in an anemic adult male. This patient was vitamin B6 deficient as evidenced by abnormalities of tryptophane metabolism. Since the report of Harris et al. several other patients have been described . . .
Trends in Outpatient Prescription Drug Costs in Diabetic Patients in Germany, 1994–2004
Authors: Wolfgang Rathmann, Burkhard Haastert, Andrea Icks, Guido Giani
Journal: Diabetes Care (2007)

New antidiabetic medications have been introduced during the last decade, but their impact on health care cost is largely unknown. Prescription costs in diabetic patients in primary care in Germany were evaluated (1994-2004).A total of 46,017 diabetic patients and 46,017 age- and sex-matched control subjects in 400 nationwide practices (2004) were compared with 29,956 diabetic patients and 13,226 control subjects (361 practices) in 1994 (data from IMS HEALTH). Inflation-adjusted age- and sex-standardized costs (ex-manufacturer prices) were calculated.Mean annual total prescription costs per diabetic patient were 559 euros in 2004 (372 euros in 1994), equaling a 60% (standardized) increase (P < 0.01). Average costs for antidiabetic medication were 172 euros in 2004, a 100% increase (P < 0.01). The major antidiabetic cost factor was insulin and analogs, which accounted for 22% of total drug costs in diabetic patients in 2004 (17% in 1994). All oral antidiabetic drugs together accounted for 8% of total costs (6% in 1994). New drugs (glitazones, glinides, and insulins) accounted for 15% of total costs (40% of antidiabetic drugs) in 2004. A 40% increase (387 euros vs. 286) in all non-diabetes-related drugs was due mainly to cardiovascular and lipid-lowering drugs. In nondiabetic patients, only a 30% cost increase was found (210 euros vs. 147; P < 0.01).Prescription drug costs among diabetic patients increased 60% during the last decade, which was twofold higher than the increase in nondiabetic patients. New types of antidiabetic drugs accounted for a substantial cost share of the overproportional increase for diabetes treatment. Progress in pharmacological therapy is a key driver of drug expenditure growth in diabetes treatment.
Cold Urticaria: Release into the Circulation of Histamine and Eosinophil Chemotactic Factor of Anaphylaxis during Cold Challenge
Authors: Nicholas A. Soter, Stephen I. Wasserman, K. Frank Austen
Journal: New England Journal of Medicine (1976)

Patients with idiopathic acquired cold-induced urticaria were evaluated for the release of the preformed mast-cell mediators of immediate-type hypersensitivity during a study in which one arm was immersed in ice water while the other arm remained as a control. Blood specimens were obtained from each arm serially over a one-hour interval, and serum speciments were assessed for histamine, eosinophil chemotactic factor of anaphylaxis, and complement components. Levels of histamine and eosinophil chemotactic factor rose in the arm subjected to cold immersion for three minutes, with peak values occurring between two and five minutes and returning to base line by 30 minutes. No changes occurred in the control arm or in the immersed arm of normal subjects. Assessment of the classical and alternative complement pathways showed no abnormalities. This initial observation of release of eosinophil chemotactic factor of anaphylaxis in vivo along with histamine assigns the mast cell a central role in cold urticaria.
Darzi’s five pledges for polyclinics are being ignored
Authors: Anne Holmes
Journal: BMJ (2008)

I see no evidence that Lord Darzi’s pledges are being honoured in my practice community.1 I work in a small practice set up four years ago in a deprived area with few doctors. A personal medical services (PMS) contract was awarded to the private, but GP led, company that runs it. The practice has 1250 patients, looks after a prison, teaches medical students, and trains foundation programme doctors.

But the primary care trust …
Common Single-Nucleotide Polymorphisms in the Estrogen Receptor β Promoter Are Associated with Colorectal Cancer Survival in Postmenopausal Women
Authors: Michael N. Passarelli, Amanda I. Phipps, John D. Potter, Karen W. Makar, Anna E. Coghill, Karen J. Wernli, Emily White, Andrew T. Chan, Carolyn M. Hutter, Ulrike Peters, Polly A. Newcomb
Journal: Cancer Research (2012)

Loss of estrogen receptor β (ERβ) expression in the gut is associated with colorectal cancer (CRC) initiation and progression. Germline single-nucleotide polymorphisms (SNP) in genes for the sex-steroid hormone receptors are not strongly associated with CRC risk; however, these SNPs have not previously been evaluated in relation to survival after diagnosis. We enrolled 729 women, ages 50 to 74, diagnosed with invasive CRC between 1997 and 2002 in 13 counties covered by the Seattle-Puget Sound Surveillance Epidemiology and End Results cancer registry. Participants provided germline DNA. We selected 99 tag-SNPs for the androgen receptor (AR), ERα (ESR1), ERβ (ESR2), and progesterone receptor (PGR) genes. Mortality outcomes were ascertained from the National Death Index. During a median of 6.6 years of follow-up, 244 deaths occurred (161 from CRC). We identified 20 SNPs (12 of ESR2 and 8 of PGR) for replication in 1,729 women diagnosed with incident invasive CRC (555 deaths; 405 from CRC) from three prospective cohort studies that participate in the Genetics and Epidemiology of Colorectal Cancer Consortium. Three correlated SNPs in the promoter of ESR2 (rs2987983, rs3020443, and rs2978381) were statistically significant predictors of CRC-specific and overall survival. Minor alleles of each were associated with improved survival [for rs2987983, CRC-specific HR, 0.77; 95% confidence interval (CI), 0.60-0.99 in the initial study, and HR, 0.79; CI, 0.64-0.98 in replication]. No associations were noted for SNPs of AR, ESR1, or PGR. SNPs in the promoter of ESR2 may be important to pathways related to the association between ERβ and tumor progression and metastasis.
The colour of UVB and UVC erythema—how red is pink?
Authors: B.L. Diffey, P.M. Farr
Journal: British Journal of Dermatology (1987)

Journal Article The colour of UVB and UVC erythema—how red is pink? Get access B.L. Diffey, B.L. Diffey Regional Medical Physics Department, Dryburn Hospital, Durham, U.K. Search for other works by this author on: Oxford Academic Google Scholar P.M. Farr P.M. Farr Departmem of Dermatology, Royal Victoria Infirmary, Newcastle upon Tyne, U.K. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 116, Issue 3, 1 March 1987, Pages 459–461, https://doi.org/10.1111/j.1365-2133.1987.tb05858.x Published: 01 March 1987
Heparin and Thrombocytopenia
Authors: HANNO RIESS
Journal: Annals of Internal Medicine (1984)

Letters and Corrections1 December 1984Heparin and ThrombocytopeniaHANNO RIESS, M.D., ERHARD HILLER, M.D.HANNO RIESS, M.D.Search for more papers by this author, ERHARD HILLER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-101-6-875_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: We read with interest the article by King and Kelton (1) on the clinical importance of heparin-associated thrombocytopenia. We wish to make two comments with regard to diagnosis of a platelet-aggregating factor using platelet aggregometry.To avoid misinterpretation due to "spontaneous" aggregation induced by the heparin added to the test system as recommended by King and Kelton, we do a further control experiment. In addition to the control using saline instead of heparin, we use heat-inactivated (56 °C for 30 minutes) serum from a healthy group O donor instead of the patient's serum. Thereafter, heparin is added...References1. KING D and KELTON J. Heparin-associated thrombocytopenia. Ann Intern Med. 1984;100:535-40. LinkGoogle Scholar2. CARDINAL D and FLOWER R. The electronic aggregometer: a novel device for assessing platelet behaviour in blood. J Pharmacol Methods. 1980;3:135-58. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: HANNO RIESS, M.D.; ERHARD HILLER, M.D.Affiliations: III. Medical Department University of Munich D 8000 Munich 70, Federal Republic of Germany PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byHeparininduzierte Thrombozytopenie und Thrombose 1 December 1984Volume 101, Issue 6Page: 875-876KeywordsHeparinPlatelets ePublished: 1 December 2008 Issue Published: 1 December 1984 PDF downloadLoading ...
Case of Extensive Fracture of Skull: Trephining: Recovery
Authors: T. L. Webb
Journal: BMJ (1886)

99.59.nMay 15th.The wound was suppurating freely.Pulse 88 ; tem- perature 99'.Mlay 16th.Puilse 80 ; temiiperature 98'.He wvas imiore rational.Mlay 17th.His condition was the same.The edges of the wound were plde anid sodden.May 19th.He was very hungry, eating all day.MLay 20th.His state wvas the same.Pulse 100 * temperature 99'.His imiind was clearer.May 21st.He was not so well; was much quieter.lIe hadl head- ache.Pulse 120 ; temperature 102°.May 22nd.He was better.The wound gaped, exposingo bone.Pulse 86 ; temperature 98'.May 24th.The left arm trembled and twitched.There was coInsiderable loss of co-ordination in the entire limb.May 26th.He was better in every way; and clear mentally.May 30th.The trembling continued.He vomited twice.After this date, all the symptoms steadily improved.Vision gra- dually became normal.The wound healed soundly, all weakness of the left arm disappeared, and the boy made a complete recovery.
Practical Management of Meningomyelocele
Authors: Oscar Sugar
Journal: JAMA (1974)

Modern medicine permits treatment and survival of many children born with a frightening sac of fluid protruding from the spine. A number of volumes on treatment of these conditions has recently appeared; this is one of the best. The editor, director of the Birth Defects Center at the Johns Hopkins Hospital, wrote the chapters on terminology, epidemiology, embryology and pathogenesis, neurological examination, ethical decisions, psychosocial aspects, and perspectives in the care of these patients. His remarks and opinions are directed at the nonspecialist who must be the intermediary between the bewildered and upset family and the group of specialists whose teamwork is responsible for the future of the child. The neurosurgical aspects of meningocele and the almost invariably concomitant hydrocephalus are well presented by Laws, while Udvarhelyi deals with the variety of milder forms of dysraphism, from skin dimple to intraspinal lipoma. There are unusually clear chapters on orthopedics (Kopitz),
Campaign against Boxing — Doctors Doyle and Watson — Those Pretty Goffered Hats
Authors: John Lister
Journal: New England Journal of Medicine (1959)

RADIO, television and newspaper commentators were quick to seize upon a recent leading article in the Lancet calling for a total ban on boxing as a sport.The article claims that throughout the world in the last four years there have been 64 deaths from boxing, including 22 among amateurs. Most of the hazards are cerebral, death usually being due to gross injury to the brain or its vessels. Furthermore, it is suggested that if boxing causes fatal cerebral damage in a few contestants, the natural conclusion is that it causes material damage in many more, death being a rough . . .
Gastroesophageal Reflux in Infants
Authors: William F. Balistreri, Michael K. Farrell
Journal: New England Journal of Medicine (1983)

Gastroesophageal reflux, the spontaneous passage of acidic gastric contents from the stomach into the esophagus, occurs frequently throughout life. In a survey of presumably normal adults, 36 per cent had the symptom compatible with gastroesophageal reflux — namely, heartburn — at least monthly, and 7 per cent reported daily distress.1 To attribute this phenomenon solely to a decrease in lower-esophageal-sphincter pressure would be simplistic. A complex interaction of alterations in modulating factors (hormonal and neuronal), inherent factors (the length-tension relation of the sphincteric musculature), anatomic features, and environmental factors (such as food substances and abdominal pressure) is most likely to . . .