tbuckley/cabot-search huggingface dataset:
Budesonide for Inflammatory Bowel Disease -- Is It a Magic Bullet?
Authors: David B. Sachar
Journal: New England Journal of Medicine (1994)

Crohn's disease and ulcerative colitis are chronic, medically incurable inflammatory bowel diseases. Most patients with these disorders are treated at some point with systemic corticosteroids. The short-term response to corticosteroids may be gratifying, but the long-term effects can be so severe that the treatment is often worse than the disease.The ideal treatment for inflammatory bowel disease would therefore be a “magic bullet” that could induce clinical remissions as effectively as traditional corticosteroids without having as many side effects. For nearly 40 years, this principle has been used effectively in the topical therapy of distal colitis with hydrocortisone enemas. Many . . .
CHEMICAL, CLINICAL, AND IMMUNOLOGICAL STUDIES ON THE PRODUCTS OF HUMAN PLASMA FRACTIONATION. IX. THE TREATMENT OF SHOCK WITH CONCENTRATED HUMAN SERUM ALBUMIN: A PRELIMINARY REPORT 12
Authors: J. V. Warren, E. A. Stead, A. J. Merrill, E. S. Brannon
Journal: Journal of Clinical Investigation (1944)

We have had the opportunity to treat 6 pa- tients in shock with concentrated human serum albumin, prepared from pooled normal human plasma by the method of Cohn and co-workers (1).3Five of these patients had circulatory fail- ure from hemorrhage and the sixth from exten- sive burns.These observations were made at the beginning of our experience with the technics utilized in the study of shock by Cournand and co-workers (3).At this time, routine determinations of the cardiac output before and after therapy were not being made.
A Side Light on Ethics.
Authors: H. B. Young
Journal: JAMA (1903)

Burlington, Iowa, Jan. 5, 1903. <h3>To the Editor:</h3> —During the past year or two I have read inThe Journaland other medical publications a good deal about "organization," "ethics" and "reciprocity," and I have even written a few lines on these subjects, which have found their way into print; but I have seen nothing which so completely sums up the whole matter as Dr. Gillmore's letter in your current issue. Until we can get ethical unification—a oneness of purpose individually and collectively—it seems to me useless to talk about organization and reciprocity; and through one thing and another, mostly perhaps as Dr. Gillmore suggests, the absence of emphasis on the golden rule in the teaching course, we seem to be drifting farther and farther from this unification. I do not wholly agree with Dr. Gillmore that commercialism is a basic fault. It may be difficult to harmonize commercialism with
Hyperlipemia During Estrogen Therapy
Authors: W. V. Applegate
Journal: JAMA (1974)

<h3>To the Editor.—</h3> The conclusion that estrogen administration (Molitch et al, 227:522, 1974) caused an increase in blood lipids, and that withdrawal of estrogen therapy resulted in a lowering of blood lipids, seems to me to be too restrictive in its interpretation. It is apparent on reviewing the case presentations that the patients, when on an unrestricted diet, had high levels of triglycerides and cholesterol, but, when on low-carbohydrate and low-saturated-fat diets, had more normal blood levels. On searching the bibliography, I see no reference to articles on the effect of fructose and estrogen on liver production of triglycerides, and I cannot help but conclude that the authors have overlooked this important synergy. The articles by Ian Macdonald (<i>Clin Sci</i>27:23, 1964;<i>Am J Clin Nutr</i>16:458, 1965;<i>Am J Clin Nutr</i>18:86, 1966) implicated sucrose as a cause of increased fasting triglycerides. Later, Macdonald (<i>Am J Clin Nutr</i>20:185, 1967)
Soluble guanylate cyclase (sGC) down-regulation by abnormal extracellular matrix proteins as a novel mechanism in vascular dysfunction: Implications in metabolic syndrome☆
Authors: C PACKER
Journal: Cardiovascular Research (2006)

Vascular dysfunction plays a role in most if not all cardiovascular disorders. Vascular dysfunction is defined as impaired vasodilation in response to agonists such as acetylcholine (ACh) that mediate vascular smooth muscle relaxation through release of the endothelial derived relaxing factor (EDRF) nitric oxide (NO). There is a wealth of literature to support the understanding that endothelial dysfunction is due to a decreased NO synthesis or an increased NO inactivation. Endothelial dysfunction is generally thought to be responsible for vascular dysfunction, and the terms are often used interchangeably. But the mechanism(s) responsible for vascular dysfunction is (are) far from being completely understood, and labeling all vascular dysfunction as endothelial dysfunction may be application of a misnomer in some cases. Alterations in the cell signaling cascade downstream of NO production and release could explain vascular dysfunction in certain conditions. Nowadays, it is textbook information that NO induces cell relaxation by interacting with sGC and causing an increase in cyclic guanosine monophosphate (cGMP). The end result is thought to be a decrease in intracellular cytoplasmic calcium due to decreased intracellular calcium release [1] and/or increased cGMP-dependent calcium pump activity [1] and/or due to decreased calcium influx because of the opening of K+ channels, resulting in hyperpolarization and the consequent closing of L-type Ca … 

*Tel.: +1 317 274 9765; fax: +1 317 274 3318. Email address: spacker1{at}iupui.edu
Teams: lessons from the world of sport
Authors: M. Brearley
Journal: BMJ (2000)

Based on a presentation from the Millennium Festival of Medicine 

“There's no I in team.” But there is and needs to be, and cricket reveals this more sharply than other team games. For cricket, like baseball, could be described, crudely, as a series of individual contests within a team context. When on the many occasions Michael Atherton faced Curtley Ambrose for the first ball of a test match between England and the West Indies, surrounded as the opening batsman is by a ring of rebarbative faces, he will always have been fully aware of the loneliness of his situation. He knew that he had the moral support of his partner 20 yards away, and the implicit, even fervent backing of the other nine members of the team in the dressing room—especially of the next batsman in. It is a team game. But he also had no illusions about the fact that what would happen next was up to him, alone, plus of course the beanpole figure of Curtley Ambrose silhouetted against and above the sight screen 50 yards away.

So cricket is an individual game par excellence, in which the nation gets an instant view of a player's personal failure, backed up by a written account of it over breakfast the next morning. Yet—again—the character and outcome of these little individual dramas will be influenced by the balance of confidence and morale between the two teams as a whole.

#### Summary points

Good teams consist of groups of strongly characterised individuals

The art of leading such a team is not to suppress individuality but to harness it to achieve the team's goals

Without vivid and unique “I's” a team is flat, uniform, stereotyped. It is a repressed, grey team, a team without desires, passions, jealousies. A small example: when Middlesex played Northants in …
SKIN CHANGES IN PATIENTS TREATED WITH 5-FLUOROURACIL.
Authors: G. FALKSON, E. J. SCHULZ
Journal: British Journal of Dermatology (1962)

Journal Article SKIN CHANGES IN PATIENTS TREATED WITH 5‐FLUOROURACIL. Get access G. FALKSON, G. FALKSON Department of Medicine Search for other works by this author on: Oxford Academic Google Scholar E. J. SCHULZ E. J. SCHULZ Section of Dermatology, University of Pretoria, Transvaal Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 74, Issue 6, 1 June 1962, Pages 229–236, https://doi.org/10.1111/j.1365-2133.1962.tb13497.x Published: 01 June 1962
Beta-Adrenergic Mechanisms in Action Tremor
Authors: Robert R. Young, John H. Growdon, Bhagwan T. Shahani
Journal: New England Journal of Medicine (1975)

To study the mechanisms by which propranolol suppresses essential tremor, accelerometric recordings were made from four normal subjects and eight patients with that tremor, and small amounts of isoproterenol and propranolol were infused intravenously or into one brachial artery. Intra-arterial isoproterenol increased tremor amplitude selectively in that arm in normal subjects and in patients with essential tremor (range, 1.85 to 3.50 with mean 2.74 times the base-line level). Intra-arterial or intravenous propranolol quickly blocked the enhanced action tremor in both groups. It did not simultaneously affect the underlying essential tremor, whereas long-term oral propranolol therapy did diminish the amplitude of the essential tremor in each patient. Peripheral beta-adrenergic tremorogenic receptors function normally even in patients with essential tremor; their function is not necessary for the production of essential tremor, and the efficacy of chronic propranolol therapy in the suppression of essential tremor is not mediated via its peripheral beta-adrenergic blocking action.
World Health Organisation: change and progress
Authors: I. Kickbusch
Journal: BMJ (1995)

A lot of the GMC is in little boxes-education, standards, fitness to practise-and we need to function more as a whole.In particular, I'm keen for us to look outwards and forwards.We must see what is going on in health care and constantly refresh ourselves.We must listen, be more modern, make full use of new technology.We can learn a lot from others.There is a world outside medicine that can enrich medicine.Rs: Radical change can be difficult to achieve in an organisation that has been going along a particular track for a century.We must be less bureaucratic and more welcoming DI: Yes, but it's not just me that wants to change.The council and the staff do as well.We start with the golden asset that people want to move on.Rs: What about the size of the council?DI: It's very large, and that is a problem.But it's come to this through the need to satisfy a lot of different constituencies.We can do a lot to make it more enjoyable and productive.We have a lot oftalent on the council, and going to two meetings a year is not the only way to contribute.Rs: What about getting more people to vote in the election?DI: We have this debate after each election for the council, and one view is that a relatively low turnout is common in most professional organisations.People don't vote if they think that things are going reasonably well or if the election doesn't touch their lives.When Good Medical Practice comes in and the performance procedures begin to work I think that more doctors may see the GMC as touching their lives and more may vote in future.
Making decisions about mammography
Authors: Paul Taylor
Journal: BMJ (2005)

AIMS--To test the hypothesis that alterations in acid base or calcium concentration may affect proinsulin processing or the insulin secretion mechanism. METHODS--Changes in proinsulin secretion or cleavage were assessed by measuring serum intact proinsulin and immunoreactive insulin concentrations in three models of acid base and calcium disturbance: (1) subacute changes in acid base status in six volunteers who received oral placebo, ammonium chloride, or sodium bicarbonate for three five day periods; (2) acute changes in calcium concentration in eight subjects who received 25 mmol oral calcium; (3) chronic changes in calcium concentration in seven patients with primary hyperparathyroidism and five with pseudohypoparathyroidism. RESULTS--Acid base changes were confirmed by rises in serum bicarbonate concentrations (p &lt; 0.01). No changes in serum insulin, intact proinsulin, or the proinsulin:insulin molar ratio were found. Serum calcium concentrations increased (2.49 v 2.38 mmol/l; p &lt; 0.05) and parathyroid hormone concentrations decreased (1.1 v 1.9 pmol/l; p &lt; 0.01) two hours after acute calcium loading. There were no significant differences in serum glucose, insulin, or intact proinsulin concentrations. Fasting proinsulin concentrations were significantly lower in the hyperparathyroid group (1.1 v 2.1 pmol/l; p &lt; 0.05) and increased significantly after parathyroidectomy (2.1 v 1.1 pmol/l; p &lt; 0.05). CONCLUSIONS--The results indicate that subacute acid base changes do not affect proinsulin cleavage. Although acute calcium loading has no demonstrable effect, chronic hypercalcaemia may influence the mechanism of insulin secretion.
Inhibition of T lymphocyte mitogenesis by 1,25-dihydroxyvitamin D3 (calcitriol).
Authors: W F Rigby, T Stacy, M W Fanger
Journal: Journal of Clinical Investigation (1984)

Recent studies have suggested that vitamin D may have other important biologic activities in addition to its well-characterized role in the maintenance of calcium homeostasis. Discovery of cytosolic receptors for vitamin D in human peripheral blood monocytes and lectin-stimulated lymphocytes prompted us to study the effects of 1,25-dihydroxyvitamin D3 (calcitriol), the most biologically active metabolite of vitamin D, upon phytohemagglutinin (PHA)-induced lymphocyte blast transformation. We have found that calcitriol is a potent inhibitor of PHA-induced lymphocyte proliferation, achieving 70% inhibition of tritiated thymidine incorporation after 72 h in culture. Furthermore, calcitriol suppressed interleukin-2 (IL-2) production by PHA-stimulated peripheral blood mononuclear cells in a concentration-dependent fashion. Lastly, the suppressive effect of calcitriol on cellular proliferation was partially reversed by the addition of saturating amounts of purified IL-2. We conclude that calcitriol is a potent inhibitor of PHA-induced lymphocyte blast transformation and that this effect is mediated, in part, through suppression of IL-2 production. Thus, calcitriol appears to possess immunoregulatory properties that have been unappreciated heretofore.
Complex political emergencies
Authors: E. Sondorp
Journal: BMJ (2002)

Education and debate p 342 

Acute disasters attract international media and political attention — and often funds to support a response. However, if hundreds of thousands of people, or even millions, die over several years because of prolonged conflict this may go almost unnoticed. A recent survey in eastern Congo revealed an excess mortality of 2.5 million people in only 32 months. Of these deaths 350 000 were because of direct violence; most died from malnutrition and disease.1 The death toll in longstanding and continuing conflicts in Sudan, Angola, Burma, and Sierra Leone has been similarly massive. These too often forgotten crises are complex political emergencies, a term that underlines the political nature of these internal wars, with their complex origins and multiplicity of players.

Complex political emergencies are not isolated events but linked with globalisation, foreign policies,2 and, as Stewart emphasises in this issue, economic interests (p 342).3 Conflict in the Congo, for example, has been associated with struggles over access and control of coltan, a metallic ore which is an essential component of mobile phones.4 But although prolonged …
A Reappraisal of Fluid Therapy in the Burned Patient
Authors: Irving Feller
Journal: JAMA (1962)

Formulas for estimating the requirements of the severely burned patient for water, electrolytes, and colloid solution are used extensively. Although these are useful clinically, indiscriminate application of burn formulas may prove detrimental to the individual patient. The authors carried out a detailed study of the fluid therapy which 75 burned patients received during the emergent phase of treatment. The volume and types of fluids actually administered varied importantly from the theoretical requirements as determined by the established formulas. These data indicate that careful individualization of fluid therapy is of paramount importance in the successful management of the burned patient.
Management of Septic Chemical Abortion with Renal Failure
Authors: Denis F. Hawkins, Lewis H. Sevitt, Paul F. Fairbrother, Anne U. Tothill
Journal: New England Journal of Medicine (1975)

The concept that hysterectomy is of value in the management of septic abortion induced by instillation of soap or phenolic antiseptics into the uterus is challenged. Nineteen out of 20 such cases with renal failure were managed with intensive antibiotic therapy, peritoneal dialysis and an absolute minimun of surgical intervention. Seventeen patients recovered, with normal renal function. Of the 11 known to be subsequently exposed to conception seven have achieved normal pregnancies.20 cases of septic abortion were reviewed, all of which had suffered septic shock and renal failure attributed to intrauterine instillation of soap or phenolic antiseptic solutions, which were treated at Hammersmith Hospital from 1965-1972 to determine proper management of such patients. 19 were managed conservatively, from a surgical point of view, with 13 not even having the products of conception removed from the uterus. Intensive antibiotic treatment and peritoneal dialysis were the principles of management. 17 of the 19 recovered; all 17 retain normal renal function. Of these 17 survivors, 7 have had normal pregnancies, but only 11 of the 17 have been exposed to conception.
Case 35-1988
Authors: Mark Donowitz, Michael L. Talbert
Journal: New England Journal of Medicine (1988)

Presentation of CaseA 63-year-old man was admitted to the hospital because of fever and diarrhea.He was well until nine years earlier, when leukocytosis and splenomegaly were found. Biopsy specimens of the bone marrow and liver were obtained, and a diagnosis of idiopathic myelofibrosis was made.Two years later, because of abdominal fullness and early satiety, a splenectomy was performed; the patient was provided with penicillin and was advised to take it in the event of infection. Six years before admission the white-cell count rose as high as 155,000, and busulfan was begun. One year later an x-ray film . . .
Hypokinetic Disease; Diseases Produced by Lack of Exercise
Authors: F. T. Jung
Journal: JAMA (1961)

The authors' purpose is "to acquaint larger circles of the medical profession with the role played by lack of exercise in the origin of a variety of diseases," both physical and mental. After an opening chapter defining "hypokinetic" as "caused by insufficient motion," there follow 2 chapters on back pain and orthopedic disabilities, a chapter on lack of exercise among present-day American young people, 6 chapters on cardiovascular aspects of the problem, 2 on metabolic or internal disease, 1 on emotional disturbances, and 2 on constructive suggestions. Most people are prepared to admit that we need more physical exercise, but much of this book is devoted to efforts to drive the point home by all sorts of evidence. Some of this comes from recent work with a fitness-test that has been widely criticized, as in the recent article by Rodahl et al. (<i>Arch Environ Health</i><b>2</b>:499-510 [May] 1961). Some
D2-03: Erlotinib (E) as a single agent or intercalated with carboplatin and paclitaxel (ECP) in an EGFR biomarker-selected, previously untreated NSCLC population
Authors: Fairooz Kabbinavar, Helen Ross, Renato Martins, Karen Kelly, D.R. Camidge, Everett Vokes, Bret Wacker, Maureen Conlan, Fred Hirsch, Paul Bunn
Journal: Journal of Thoracic Oncology (2007)
Is an intravenous glucocorticoid pulse better than oral taper for asymptomatic cardiac rejection? A randomized trial
Authors: Jon A. Kobashigawa, Lynne W. Stevenson, Jaime D. Moriguchi, Nobuyuki Kawata, Amar S. Kapoor, Payam Kamjoo, Lisa Leonard, Roxella Fondrich, Katherine Medkiff, Gaia Magnani, Davis D. Drinkwater, Hillel Laks
Journal: Journal of the American College of Cardiology (1990)
Outcomes of Extremely-Low-Birth-Weight Infants between 1982 and 1988
Authors: Maureen Hack, Avroy A. Fanaroff
Journal: New England Journal of Medicine (1989)

Infants with birth weights under 750 g are disproportionately represented in perinatal mortality and morbidity rates. We reviewed the outcomes of 98 infants delivered at our perinatal center between July 1982 and June 1985 (period 1) whose lengths of gestation were 20 or more weeks and whose birth weights were under 750 g, and compared them with the outcomes of 129 such infants born between July 1985 and June 1988 (period 2). The frequency of cesarean section increased from 12 to 19 percent between the two periods. During the entire six-year period, 12 percent of the infants with birth weights under 500 g were intubated, as compared with 28 percent of those between 500 and 599 g, 60 percent of those between 600 and 699 g, and 90 percent of those between 700 and 749 g. The frequency of endotracheal intubation increased between the two periods only for infants with birth weights above 500 g (P less than 0.02). Despite more aggressive treatment, survival did not change, although the mean time to death among infants transferred to the neonatal intensive care unit increased from 73 to 880 hours. Among all live-born infants with birth weights under 750 g, the rate of survival was 20 percent during period 1 and 18 percent during period 2, but 48 and 43 percent of those transferred to the neonatal intensive care unit survived in the two periods reviewed. Neonatal morbidity also did not change. Among survivors at a corrected age of 20 months, 4 of 18 born during period 1 and 7 of 14 born during period 2 had moderate-to-severe neurodevelopmental impairment. When all live-born infants of less than 28 weeks' gestation were considered, only 8 percent of those born at 23 weeks survived, as compared with 16 percent of those born at 24 weeks, and 53, 63, and 72 percent of those born at 25, 26, 27 weeks, respectively. Thus, despite a tendency to perform more cesarean sections and active resuscitations, no improvement in the survival of babies with lengths of gestation below 25 weeks or birth weights under 750 g was observed. The probability of survival is very poor if the length of gestation is less than 24 weeks or the birth weight less than 600 g.
Late restenosis after emergent coronary angioplasty for acute myocardial infarction: Comparison with elective coronary angioplasty
Authors: Charles A. Simonton, Daniel B. Mark, Tomoaki Hinohara, David S. Rendall, Harry R. Phillips, Robert H. Peter, Victor S. Behar, Yihong Kong, William G. O'Callaghan, Christopher O'Connor, Robert M. Califf, Richard S. Stack
Journal: Journal of the American College of Cardiology (1988)
The Current State of the Evidence for Bariatric Surgery
Authors: David E. Arterburn, David P. Fisher
Journal: JAMA (2014)

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