tbuckley/cabot-search huggingface dataset:
Insulin Resistance and Risk of Congestive Heart Failure
Authors: Erik Ingelsson, Johan Sundström, Johan Ärnlöv, Björn Zethelius, Lars Lind
Journal: JAMA (2005)

Diabetes and obesity are established risk factors for congestive heart failure (CHF) and are both associated with insulin resistance.To explore if insulin resistance may predict CHF and may provide the link between obesity and CHF.The Uppsala Longitudinal Study of Adult Men, a prospective, community-based, observational cohort in Uppsala, Sweden. We investigated 1187 elderly (>or=70 years) men free from CHF and valvular disease at baseline between 1990 and 1995, with follow-up until the end of 2002. Variables reflecting insulin sensitivity (including euglycemic insulin clamp glucose disposal rate) and obesity were analyzed together with established risk factors (prior myocardial infarction, hypertension, diabetes, electrocardiographic left ventricular hypertrophy, smoking, and serum cholesterol level) as predictors of subsequent incidence of CHF, using Cox proportional hazards analyses.First hospitalization for heart failure.One hundred four men developed CHF during a median follow-up of 8.9 (range, 0.01-11.4) years. In multivariable Cox proportional hazards models adjusted for established risk factors for CHF, increased risk of CHF was associated with a 1-SD increase in the 2-hour glucose value of an oral glucose tolerance test (hazard ratio [HR], 1.44; 95% confidence interval [CI], 1.08-1.93), fasting serum proinsulin level (HR, 1.29; 95% CI, 1.02-1.64), body mass index (HR, 1.35; 95% CI, 1.11-1.65), and waist circumference (HR, 1.36; 95% CI, 1.10-1.69), whereas a 1-SD increase in clamp glucose disposal rate decreased the risk (HR, 0.66; 95% CI, 0.51-0.86). When adding clamp glucose disposal rate to these models as a covariate, the obesity variables were no longer significant predictors of subsequent CHF.Insulin resistance predicted CHF incidence independently of established risk factors including diabetes in our large community-based sample of elderly men. The previously described association between obesity and subsequent CHF may be mediated largely by insulin resistance.
The Treatment of Simple Rib Fractures
Authors: H. D. W. Powell
Journal: BMJ (1955)

MEDICAL JOURA 90% of patients, with a relapse rate of 57% in the first year; a reduction in the average number of relapses was recorded in 15 cases kept on a maintenance dose for one year.The mode of action of the tablets and the possibility of toxic symptoms arising are discussed.I wish to acknowledge the help of Mr.
Effect of Ductus Ligation on Cardiopulmonary Function in Premature Baboons
Authors: Donald C. McCurnin, Bradley A. Yoder, Jacqueline Coalson, Peter Grubb, Jay Kerecman, John Kupferschmid, Chris Breuer, Theresa Siler-Khodr, Philip W. Shaul, Ronald Clyman
Journal: American Journal of Respiratory and Critical Care Medicine (2005)

The role of the patent ductus arteriosus in the development of chronic lung disease in surfactant-treated premature newborns remains unclear.To examine the effects of ductus ligation on cardiopulmonary function and lung histopathology in premature primates.Baboons were delivered at 125 d, (term = 185 d) treated with surfactant, and ventilated for 14 d. Serial echocardiograms and pulmonary function tests were performed. Animals were randomized to ligation (n = 12) or no ligation (controls, n = 13) on Day 6 of life. Necropsy was performed on Day 14.Compared with nonligated control animals, ligated animals had lower pulmonary-to-systemic flow ratios, higher systemic blood pressures, and improved indices of right and left ventricular performance. The ligated animals tended to have better compliance and ventilation indices for the last 3 d of the study. There were no differences between the groups in proinflammatory tracheal cytokines (interleukin [IL] 6 and IL-8), static lung compliance, or lung histology.Although a persistent patent ductus arteriosus results in diminished cardiac function and increased ventilatory requirements at the end of the second week of life, ligation on Day 6 had no measurable effect on the histologic evolution of chronic lung injury in this 14-d baboon model.
HIV-Infected Health Care Workers: Risk to Patients-Reply
Authors: Ban Mishu
Journal: JAMA (1993)

In Reply.  —Human immunodeficiency virus transmission from a Florida dentist to six of his patients occurred despite the use of standard infection control procedures in the dental practice and the absence of documented injury to the dentist. 1 Similarly, transmission of HBV from infected dentists and surgeons to their patients has occurred despite the use of universal precautions and the absence of recognized injury to health care workers (HCWs). 2 Dr Shields suggests that a sheathed CAS with a single-ended needle may be effective in minimizing transmission of blood-borne pathogens from dentists to patients. Recently, numerous needle devices have been designed with the goal of reducing the risk of needle-stick injury. 3,4 We applaud the efforts to introduce new and potentially safer sharps into the health care setting; however, very few data have documented the effectiveness of these devices. 5 Indeed, it is important to note that recent reports of
Coronary Embolization in a Woman with Advanced Breast Cancer
Authors: Norbert Watzinger, Herbert Stöger, Manfred Ratschek
Journal: New England Journal of Medicine (1997)

To the Editor: Coronary embolism is an uncommon clinical problem that can occur in association with valvular heart disease, prosthetic valves, endocarditis, intracardiac thrombosis, or cardiac catheterization.1 Coronary embolization of malignant tissue is an even rarer condition, and only a few cases have been reported.2–5 Typically, the clinical picture is one of acute myocardial infarction or sudden cardiac death due to occlusion of epicardial vessels. We describe a patient with coronary embolization and an atypical clinical presentation. This 28-year-old woman had undergone surgery for breast cancer (lobular–ductal carcinoma, pT3pN1pG2–3) nine months earlier. There were no risk factors for coronary . . .
Handling Pacemaker Electrode Displacement
Authors: Fouad G. Azzam
Journal: JAMA (1974)

<h3>To the Editor.—</h3> The interesting article of Kim et al (228:74, 1974) concerns the late displacement of cardiac pacemaker electrodes due to heavyweight pulse generator. In one of our recent cases, the same situation occurred, and the electrode pacemaker had to be repositioned as in Dr. Kim's cases. However, instead of going to an extensive procedure, a simple loop was made inside the subcutaneous pocket, suturing the lead to the fascia of the pectoral muscle or the upper part of the posterior wall of the old subcutaneous pocket (Figure). The patient has done well, and we have used this as a routine procedure in all our elderly patients, or when the electrode displacement has occurred late in the course of the life of the pacemaker. I hope that this suggestion would avoid other lengthy procedures and that it will be as successful in other hands as it is in ours.
ABCB1 GENETIC VARIANTS, PHARMACODYNAMIC RESPONSE, AND CARDIOVASCULAR OUTCOMES FOLLOWING TREATMENT WITH CLOPIDOGREL AND PRASUGREL
Authors: Jessica L. Mega, Sandra L. Close, Stephen D. Wiviott, Lei Shen, Joseph R. Walker, Elliott M. Antman, Eugene Braunwald, Marc S. Sabatine, None TIMI Study Group
Journal: Journal of the American College of Cardiology (2010)
Melatonin Level and Risk for Type 2 Diabetes
Authors: Sabra M. Abbott, Phyllis C. Zee
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
Cost effectiveness of sildenafil calls for political discussion
Authors: E. Stolk
Journal: BMJ (2000)

EDITOR—Freemantle comments on our analysis of the cost effectiveness of sildenafil. 1 2 He argues that the validity of quality adjusted life year (QALY) measures is based on strong assumptions and the measures are therefore insufficient for political decision making. Given that our analysis takes a conservative approach towards the cost effectiveness of sildenafil, however, these arguments cannot affect the conclusion that sildenafil is a highly cost effective drug.

Freemantle recognises the assumptions of classical welfare theory on which QALY analyses can be based. This is not the only interpretation of QALYs. There is the extra-welfarist …
Hydrodynamics of Gallbladder Filling
Authors: Robert E. Lempke
Journal: JAMA (1963)

GALLBLADDER FILLING assumed to occur passively as a result of the back pressure produced by the resistance of the choledochoduodenal sphincteric mechanism to the flow of bile. The association of the sphincter of Oddi with the gallbladder among various species suggests that this component of that mechanism is of prime importance in this regard. Sphincterotomy supposedly abolishes gallbladder function by reducing the resistance to bile flow sufficiently to prevent filling. Previously reported studies in patients with alcoholic and idiopathic pancreatitis treated by transduodenal section of the sphincter of Oddi, without prior or concomitant cholecystectomy, have demonstrated that gallbladder function can be exhibited by oral cholecystography<sup>1</sup>and that sphincteric resistance returns to normal levels as early as the second postoperative week.<sup>2</sup>The present report deals with the direct and simultaneous measurement of gallbladder filling and choledochal pressure in such patients. <h3>Materials and Methods</h3> Sixteen patients with alcoholic or idiopathic,
74 THE ANTIVIRAL RESPONSE TO TENOFOVIR DISOPROXIL FUMARATE (TDF) IS COMPARABLE IN LAMIVUDINE (LAM)-NAIVE AND LAM-EXPERIENCED SUBJECTS TREATED FOR CHRONIC HEPATITIS B (CHB)
Authors: M. Manns, L. Jeffers, G. Dalekos, T. Berg, C. Trepo, S. Roberts, M. Prieto, M. Rizzetto, J. Sorbel, J. Anderson, E. Mondou, F. Rousseau
Journal: Journal of Hepatology (2008)
Caring for patients with asthma Teaching self management takes time
Authors: I Charlton, G A Charlton, A Jones, N Drummond, M Abdalla, J Beattie, I Russell, J Friend, J Legge, G Douglas
Journal: BMJ (1994)

EDITOR, - The Grampian asthma study concluded that peak flow meters and self management plans offered “little clinical benefit.”1 Closer examination of the methods shows that the self management plans used by Beasley et al.2 and by us3 were not used and that the crucial ingredient of doubling the dose of inhaled steroid as the peak flow falls was not adhered to. Our recently published work confirms the importance of this step. If patients manage themselves by increasing bronchodilators only, as occurred in one arm of our study, the outcome is not as impressive.4

The self management plans of the Grampian asthma study focused on when to start oral steroids and when to seek immediate medical help. Such a plan is more suited to preventing admission and increasing doctor contact rather than reducing morbidity. It is therefore no surprise that the number of consultations with general practitioners rose in the intervention group.

In our experience, consultants who tailor treatment to individual patients produce less effective self management plans than asthma nurses who follow the protocol and implement tested self management plans.

Teaching patients self management skills requires an initial consultation of 45 minutes and a follow up examination one week later. Specifically designed diary cards can enhance this process.4 It usually takes patients three months before they are familiar with such plans. Patients often need to be guided through their first attack. Once the concepts have been grasped then patients require little input and quite often use their peak flow meters only during an asthma attack. Although initially time consuming, such an approach reduces morbidity and is cost effective for both patient and doctor.5 The Grampian asthma study made no mention of what efforts were made …
Smooth muscle cell–extrinsic vascular spasm arises from cardiomyocyte degeneration in sarcoglycan-deficient cardiomyopathy
Authors: Matthew T. Wheeler, Michael J. Allikian, Ahlke Heydemann, Michele Hadhazy, Sara Zarnegar, Elizabeth M. McNally
Journal: Journal of Clinical Investigation (2004)

Vascular spasm is a poorly understood but critical biomedical process because it can acutely reduce blood supply and tissue oxygenation. Cardiomyopathy in mice lacking γ-sarcoglycan or δ-sarcoglycan is characterized by focal damage. In the heart, sarcoglycan gene mutations produce regional defects in membrane permeability and focal degeneration, and it was hypothesized that vascular spasm was responsible for this focal necrosis. Supporting this notion, vascular spasm was noted in coronary arteries, and disruption of the sarcoglycan complex was observed in vascular smooth muscle providing a molecular mechanism for spasm. Using a transgene rescue strategy in the background of sarcoglycan-null mice, we replaced cardiomyocyte sarcoglycan expression. Cardiomyocyte-specific sarcoglycan expression was sufficient to correct cardiac focal degeneration. Intriguingly, successful restoration of the cardiomyocyte sarcoglycan complex also eliminated coronary artery vascular spasm, while restoration of smooth muscle sarcoglycan in the background of sarcoglycan-null alleles did not. This mechanism, whereby tissue damage leads to vascular spasm, can be partially corrected by NO synthase inhibitors. Therefore, we propose that cytokine release from damaged cardiomyocytes can feed back to produce vascular spasm. Moreover, vascular spasm feeds forward to produce additional cardiac damage.
Ocular Surgery in Patients with Diabetic Nephropathy
Authors: N Abourizk, M Ishaq Arastu, T Arora, J C Briones, A Kaldany, L M Aiello, J A D'elia
Journal: Diabetes Care (1980)

Patients with severe diabetic nephropathy often have diabetic retinopathy requiring eye surgery. During the course of their nephropathy, which was treated medically (group A, N = 34), with dialysis (group B, N = 18), or with renal transplantation (group C, N = 2), 54 diabetic patients have had eye surgery. The ophthalmologic procedures included cataract extraction, vitrectomy, scierai buckling, and cyclo-cryosurgery. The complications included postoperative hemorrhagic glaucoma and persistent retinal detachment. These were encountered in two patients of group A and in two of group B. All other cases showed uneventful intra- and postoperative courses. Major eye surgery can be performed safely during therapy for diabetic nephropathy, including hemodialysis with anticoagulation and transplantation with immunosuppression.
Urate Spherulites in Gouty Synovia
Authors: Justus J. Fiechtner
Journal: JAMA (1981)

We have identified urate crystals in gouty synovial fluid in a spherulite form. Studies in vitro established these "beachball" structures as chemically identical to classic "needles" of monosodium urate monohydrate, the prime factor in gouty arthritis. Previously described in the 1890s by a German scientist, these structures have not been recognized by clinicians examining fluid from arthritic joints. We suggest an identification scheme for "beachball-like" structures in synovial fluid. (<i>JAMA</i>1981;245:1533-1536)
NOTCH-induced aldehyde dehydrogenase 1A1 deacetylation promotes breast cancer stem cells
Authors: Di Zhao, Yan Mo, Meng-Tian Li, Shao-Wu Zou, Zhou-Li Cheng, Yi-Ping Sun, Yue Xiong, Kun-Liang Guan, Qun-Ying Lei
Journal: Journal of Clinical Investigation (2014)

High aldehyde dehydrogenase (ALDH) activity is a marker commonly used to isolate stem cells, particularly breast cancer stem cells (CSCs). Here, we determined that ALDH1A1 activity is inhibited by acetylation of lysine 353 (K353) and that acetyltransferase P300/CBP-associated factor (PCAF) and deacetylase sirtuin 2 (SIRT2) are responsible for regulating the acetylation state of ALDH1A1 K353. Evaluation of breast carcinoma tissues from patients revealed that cells with high ALDH1 activity have low ALDH1A1 acetylation and are capable of self-renewal. Acetylation of ALDH1A1 inhibited both the stem cell population and self-renewal properties in breast cancer. Moreover, NOTCH signaling activated ALDH1A1 through the induction of SIRT2, leading to ALDH1A1 deacetylation and enzymatic activation to promote breast CSCs. In breast cancer xenograft models, replacement of endogenous ALDH1A1 with an acetylation mimetic mutant inhibited tumorigenesis and tumor growth. Together, the results from our study reveal a function and mechanism of ALDH1A1 acetylation in regulating breast CSCs.
"SPINAL ANESTHESIA EXCLUDING THE MOTOR NERVES"
Authors: C. D. Leake
Journal: JAMA (1931)

<h3>To the Editor:</h3> —The fact that local anesthetics more readily influence sensory nerves than motor nerves, as noted in spinal anesthesia by Dr. Edward J. Martin (The Journal, April 4, p. 1168), has been long recognized pharmacologically. For example, Sollmann (Manual of Pharmacology, ed. 3, Philadelphia, 1926, p. 325) states, in discussing local anesthetics, "Sensory fibers are especially easily attacked; and by using appropriate dilutions, the paralysis can be confined strictly to them." In most pharmacologic laboratories, medical students have the opportunity to demonstrate for themselves this differential effect of local anesthetics on various nerve fibers. It is encouraging that clinical application of this fact can be made in spinal anesthesia, especially since it may tend to reduce the amount of local anesthetic agent used for spinal anesthesia and perhaps in this way help to lower the incidence of local anesthetic toxicity. I cannot let this opportunity pass without a
Baseline concussion symptom report in college athletes: comparison of scores on SCAT2 versus impact
Authors: Constance M Lebrun, Martin Mrazik, Joan Matthews-White, Nicole Lemke, Dhiren Naidu.
Journal: British Journal of Sports Medicine (2013)

Objective To investigate differences between baseline self-report of concussion symptoms with two commonly used concussion assessment tools. Design Retrospective, cross-sectional. Setting University of Alberta. Subjects One hundred and ninety-four varsity athletes (117 males; 77 females). Intervention Prior to the competitive season, subjects completed baseline testing, including self-report of concussion symptoms, with the Subjective Concussion Assessment Tool (SCAT2) and the on-line computerised Immediate Post-Concussion Assessment of Cognition (ImPACT) test, under supervision of an athletic therapist. Testing was counterbalanced to control for serial position effect. Outcome Measures The 18 shared self-report concussion symptoms were compared, and a general linear model used to identify possible interactions between gender and group type (SCAT2 vs ImPACT). Finally correlations were calculated. Results There was an interaction between gender and group type for 1 symptom (trouble falling asleep). Surprisingly, pairwise comparisons identified differences (p≤ 0.05) on 10/18 paired symptoms, with correlations ranging from 0.08 to 0.58. Conclusions Subjects respond differently when self-reporting concussion symptoms, depending on type of instrument used, and mode of administration. Despite test items being similar in content, there are significant differences in symptom reports in the same subject between SCAT2 and ImPACT tests. Use of similar data collection methods for baseline testing, assessment post-injury and prior to return-to-play is indicated, to increase both the diagnostic and prognostic utility of such tests. This further emphasises current recommendations that these tests not be used in isolation to make therapeutic decisions regarding athletes with concussion; and underscores the importance of serial clinical evaluations by a suitably qualified physician. Competing interests None. All authors have signed the disclosure form.
Abstract B48: Targeting chemo-resistance in CCNE1-amplified ovarian cancer
Authors: Barbie Taylor-Harding, Hasmik Agadjanian, Paul Joseph Aspuria, Takako Mizuno, Dong-Joo Cheon, Sandra Orsulic, Beth Karlan, Christine Walsh, Wolf Ruprecht Wiedemeyer
Journal: Clinical Cancer Research (2013)

Abstract The putative oncogene CCNE1 (cyclin E1) is frequently amplified in human high-grade serous ovarian cancer. CCNE1-amplified cancers tend to be wildtype for BRCA1 and BRCA2 and are associated with shorter survival and resistance to platinum-based chemotherapy. Cyclin E1 is an activating cofactor for cyclin-dependent kinases (CDK), which stimulate cell cycle progression through phosphorylation of the retinoblastoma (RB) protein and subsequent induction of E2F transcriptional activity (cyclin E1-RB-E2F signaling). Since BRCA1 and BRCA2 are known target genes of E2F transcription factors, we hypothesize that cyclin E1 signaling actively contributes to high DNA repair capacity and chemo-resistance in a BRCA1/2-dependent manner. We predict CCNE1-amplified ovarian cancers to exhibit an “anti-BRCAness” phenotype. In two independent gene expression datasets, generated by TCGA and The Women's Cancer Program at Cedars-Sinai, we found that CCNE1-amplified ovarian cancers maintain higher levels of BRCA1 than CCNE1-wildtype tumors. Moreover, we have employed genetic and pharmacological targeting approaches in order to assess if inhibition of cyclin E1-dependent signaling can induce BRCAness and restore chemo-sensitivity. Here, we show that pharmacological CDK inhibitors (CDKi) effectively shut down E2F-mediated transcription, resulting in downregulation of BRCA1 and BRCA2 in CDKi-treated cells. Long-term exposure of ovarian cancer cell lines to CDKi selected for cells with reduced dependency on cyclin E1, and genomic profiling revealed de novo DNA copy number changes which compensate for loss of cyclin E1 function. Importantly, CDKi-resistant subclones retained lower levels of BRCA1 and were significantly more sensitive to cisplatin than parental cell lines. Collectively, our results suggest that cyclin E1 signaling is required for BRCA1 expression and chemo-resistance. Currently available CDKi such as Dinaciclib, which is in a phase 3 clinical trial, may be useful to specifically sensitize CCNE1-amplified ovarian cancers to cisplatin. Citation Format: Barbie Taylor-Harding, Hasmik Agadjanian, Paul Joseph Aspuria, Takako Mizuno, Dong-Joo Cheon, Sandra Orsulic, Beth Karlan, Christine Walsh, Wolf Ruprecht Wiedemeyer. Targeting chemo-resistance in CCNE1-amplified ovarian cancer. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research: From Concept to Clinic; Sep 18-21, 2013; Miami, FL. Philadelphia (PA): AACR; Clin Cancer Res 2013;19(19 Suppl):Abstract nr B48.