tbuckley/cabot-search huggingface dataset:
Management of Patients With Deep Venous Thrombosis-Reply
Authors: Charles W. Francis
Journal: JAMA (1994)

<h3>In Reply.</h3> —The comments of Dr Partsch generally agree with my suggestion regarding the practical management of DVT. The observational study cited<sup>1</sup>found a 7.9% incidence of new pulmonary embolism by ventilation-perfusion scanning or autopsy after 11 days of treatment with anticoagulation and ambulatory hospital management. Since there was no control group of patients managed with bed rest in this study, no firm conclusions can be made regarding the benefit or risk of ambulation. However, the (relatively) low incidence of recurrence in comparison with other published studies suggests that ambulation is not harmful. As the letter suggests, compression stockings can be helpful in the symptomatic management of patients following an acute episode of DVT. I look forward to the publication of the randomized prospective study cited by Partsch regarding the effect of compression stockings on the frequency of postthrombotic syndrome.
Thiazolidinone CFTR inhibitor identified by high-throughput screening blocks cholera toxin–induced intestinal fluid secretion
Authors: Tonghui Ma, Jay R. Thiagarajah, Hong Yang, Nitin D. Sonawane, Chiara Folli, Luis J.V. Galietta, A.S. Verkman
Journal: Journal of Clinical Investigation (2002)

Secretory diarrhea is the leading cause of infant death in developing countries and a major cause of morbidity in adults. The cystic fibrosis transmembrane conductance regulator (CFTR) protein is required for fluid secretion in the intestine and airways and, when defective, causes the lethal genetic disease cystic fibrosis. We screened 50,000 chemically diverse compounds for inhibition of cAMP/flavone-stimulated Cl(-) transport in epithelial cells expressing CFTR. Six CFTR inhibitors of the 2-thioxo-4-thiazolidinone chemical class were identified. The most potent compound discovered by screening of structural analogs, CFTR(inh)-172, reversibly inhibited CFTR short-circuit current in less than 2 minutes in a voltage-independent manner with K(I) approximately 300 nM. CFTR(inh)-172 was nontoxic at high concentrations in cell culture and mouse models. At concentrations fully inhibiting CFTR, CFTR(inh)-172 did not prevent elevation of cellular cAMP or inhibit non-CFTR Cl(-) channels, multidrug resistance protein-1 (MDR-1), ATP-sensitive K(+) channels, or a series of other transporters. A single intraperitoneal injection of CFTR(inh)-172 (250 micro g/kg) in mice reduced by more than 90% cholera toxin-induced fluid secretion in the small intestine over 6 hours. Thiazolidinone CFTR inhibitors may be useful in developing large-animal models of cystic fibrosis and in reducing intestinal fluid loss in cholera and other secretory diarrheas.
Thou shalt not strive officiously.
Authors: R I Bayliss
Journal: BMJ (1982)

Thou shalt not strive officiouslyMost medical students encounter the dictum "Thou shalt not strive officiously to keep alive" early in their clinical years.Like other memorable directives it seems unambiguous and simple.Yet in the years ahead the student-and, later, the doctor- will not always find its meaning or application easy."Strive" is not defined, and with advances in medical technology the potential scope for striving is almost infinite.Nor is "officiously" defined-a word with a wide range of meaning in different societies and different cultures.When a patient is gravely ill the objectives are the same on both sides of the Atlantic (to relieve suffering, to heal where possible, and to conform to the patient's expressed wishes), but there are substantial differences in teaching hospitals in Britain and the United States in the application and imple- mentation of the "do not resuscitate" order (also known as "no cardiopulmonary resuscitation"-"no CPR").Few here, and no one in the United States, would disagree with the need for a carefully considered elective decision whether or not to resuscitate a patient in the event of cardiorespiratory arrest.No longer should the choice be left unspoken, undiscussed, and, less.important, unrecorded.To leave the decision to the discretion of the staff on duty at the time is an unmerited delegation of responsibility to those who in the moment of crisis may be least conversant with the patient's illness, his wishes or those of his next of kin, or the consultant's considered opinion.In Britain it is usually, or should be, the consultant who decides whether to resuscitate or not.This decision, often made in discussion with the house staff and ward sister, is predominantly based on clinical judgments and consideration, fallible though these may be.Better than anyone else the consultant and his team know the nature of the patient's disease or diseases and the likelihood of their responding to treatment.Quality of life is relative and should be assessed in relation to the age, state of health, and personal aptitudes and interests of each individual patient.'The age of the patient should not be a prime factor in making the decision, and the younger the consultant the more he should consciously guard against this bias, realising that the physically restricted life of a patient aged 80 may be just as enjoyable as his own.
NHS needs some "creative destruction" to bring in new ways to deliver care, says think tank
Authors: N. Hawkes
Journal: BMJ (2012)

A fundamental change is needed in the way that healthcare and social care are delivered, the King’s Fund concludes in a new report.1

The focus should switch from structures to services, and “outdated ways of working” that provide poor value for money and a lack of responsiveness to patients should be abandoned, it says.

If the financial challenges that lie ahead are to be met, “salami slicing” of budgets and incremental adjustments to existing services will not be enough. The NHS has fallen behind other sectors such as banking and retailing, where the use of new technology has transformed relations between service providers and their customers, say the authors of the report, Chris Ham, Anna Dixon, and Beatrice Brook.

Ham, the King’s Fund’s chief executive, acknowledged that the message was not new. “So, what’s different this time round?” he asked at a meeting at the fund to launch the report. “How are we going to make it different? What are the routes to improvement?” He suggested that two possibilities were the entry of new providers and the decommissioning of existing services. …
THE INFLUENCE OF ADRENOCORTICOTROPIC AND GROWTH HORMONES ON ANTIBODY FORMATION
Authors: Tetsuo Hayashida, Choh Hao Li
Journal: The Journal of Experimental Medicine (1957)

The influence of pituitary adrenocorticotropic hormone (ACTH) and growth hormone (somatotropin, STH), singly and in combination, has been studied in normal, young adult rats, with respect to antibody formation against Fraction IA of Pasteurella pestis. When ACTH was administered during the period of immunization, in a daily dose just sufficient to prevent body weight increase relative to the non-treated, immunized controls, serum antibody levels against the specific antigen employed were significantly depressed. The administration of STH alone resulted in a marked increase in body weight. The increase in antibody level was not significant at the 5 per cent level when compared with the control values. The same dosage of STH given simultaneously with ACTH maintained body weight at a level slightly above that of the controls, and resulted in an effective counteraction of the antibody depression produced by the latter hormone.
The Ledger of Tobacco Control
Authors: Larry H. Pastor
Journal: JAMA (1996)

<h3>To the Editor.</h3> —Several aspects of the Editorial by Dr Davis<sup>1</sup>left me somewhat uncomfortable. First, Davis welcomes "class-action and personal-injury lawsuits... against the [tobacco] industry." He notes the Liggett Group recently paid a monetary settlement in several such cases. Yet Davis failed to explain how a redistribution of wealth away from tobacco companies and toward plaintiffs and their attorneys translates into fewer people smoking. It cannot simply be assumed that successful lawsuits against tobacco manufacturers will discourage people from smoking or encourage current smokers to quit. The reader is left to infer that a tobacco industry sufficiently battered by costly litigation will simply give up, go away, or start manufacturing mechanical pencils instead of cigarettes. Second, Davis makes no argument that individuals who believe they can recover large sums of money from their addiction will therefore be less likely to pick up the smoking habit or, having already started, will be
Innovations in Correspondence
Authors: Gregory D. Curfman, Andrea Graham, Lauren Lindenfelser, Kent R. Anderson, Jeffrey M. Drazen
Journal: New England Journal of Medicine (2003)

Whatever their nature, letters to the editor were much appreciated by the addressee. They kept him and his Journal on their toes. They identified errors that would otherwise go unnoticed. They brought controversy out into the open. Moreover, their variety, brevity and frequent sparkle contributed in a fresh and informal way to the Journal's appeal.1 Written a quarter-century ago by former editor Franz J. Ingelfinger, this description of the Journal's Correspondence section is still accurate today. Letters to the editor have two important functions. They provide a forum for readers to comment about articles recently published in the . . .
Users' guide to detecting misleading claims in research: Meta-analyses have led to misleading claims in the past
Authors: Peter J Horsey
Journal: BMJ (2005)

Users' guide to detecting misleading claims in researchMisleading claims may be symptom of even more serious flaws Editor-Montori et al justifiably draw attention to misleading claims in published clinical trials. 1 This is a serious and common problem. 2 3 However, I object to their radical proposal that only the methods and results sections should be read, while the remainder of the paper should be ignored.The proposal is inconsistent with the title of their paper, "Users' guide to detecting misleading claims in clinical research reports." 1 How are these misleading claims to be identified if the sections containing them are omitted?Furthermore, anyone capable of critically appraising a trial solely on the basis of the methods and results is unlikely to be fooled by misleading claims in the discussion.But, more importantly, the proposal would deprive the discerning reader of witnessing the conflict between the results and the unwarranted conclusions.If researchers are willing to disseminate misleading claims then their integrity is brought into question.But if so, then all aspects of the trial-including the methods and results sections-are also brought into question.Misleading claims should be identified and broadcast loudly for they signal doubts about the entire study.Large scale randomised trials create the ideal conditions for data manipulation.Yet this is merely one of a multitude of problems stemming from a flawed method. 3 The remedy?When reading a study, ignore everything except the number of patients recruited.If this is large proceed no further as there is little prospect of encountering any data of genuine benefit to patients.
Safety and Efficacy of an Inhaled Epidermal Growth Factor Receptor Inhibitor (BIBW 2948 BS) in Chronic Obstructive Pulmonary Disease
Authors: Prescott G. Woodruff, Michael Wolff, Jens M. Hohlfeld, Norbert Krug, Mark T. Dransfield, E. Rand Sutherland, Gerard J. Criner, Victor Kim, Antje Prasse, Michael C. Nivens, Kay Tetzlaff, Ralf Heilker, John V. Fahy
Journal: American Journal of Respiratory and Critical Care Medicine (2009)

Rationale: Epidermal growth factor receptor (EGFR) activation is implicated in mucin hypersecretion in chronic obstructive pulmonary disease (COPD).Objectives: To investigate the safety and efficacy of an inhaled EGFR antagonist (BIBW 2948) in COPD.Methods: Multicenter, double-blind, placebo-controlled trial of 4 weeks of treatment with two doses of BIBW 2948 (15 and 30 mg twice a day) on safety and mucin-related outcomes in 48 patients with COPD. The effect of BIBW 2948 on EGFR activation in airway epithelial cells was assessed using an ex vivo assay. Efficacy measures included the volume of mucin in the airway epithelium (Vs mu,bala) in bronchial biopsies and the expression of mucin genes in bronchial brushings.Measurements and Main Results: Inhaled BIBW 2948 induced a dose-related inhibition of EGFR internalization (reflecting decreased EGFR activation) in epithelial cells from treated subjects. However, BIBW 2948 was associated with a dose-related increase in adverse events, including reversible liver enzyme elevation (n = 2), and reduction in FEV1. The changes in mucin stores and mucin gene expression were not significantly different in the pooled BIBW 2948 group versus placebo (volume of mucin per surface area of basal lamina = 0.22 ± 7.11 vs. 0.47 ± 8.06 μm3/μm2; P = 0.93). However, in the 30 mg twice a day group, the reduction in epithelial mucin stores was greatest in subjects with the greatest degree of EGFR inhibition (Pearson r = 0.98; 95% confidence interval, 0.71–0.99).Conclusions: Four-week treatment with BIBW 2948 did not significantly decrease epithelial mucin stores and was poorly tolerated in patients with COPD. Ex vivo analyses suggest that higher doses may be more effective at both EGFR inhibition and decreases in mucin stores but that adverse events should be expected.Clinical trial registered with www.clinicaltrials.gov (NCT00423137).
Are Current Regulations for Approval of In Vitro Diagnostic Devices Adequate?
Authors: Dorothy Levine
Journal: JAMA (1998)

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
P1066 IMPROVED HBeAg SEROCONVERSION BY SEQUENTIAL TELBIVUDINE THERAPY FOLLOWING PARTIAL RESPONSE TO PEGYLATED INTERFERON TREATMENT IN HBeAg-POSITIVE CHRONIC HEPATITIS B PATIENTS
Authors: Q. Zheng, Y.Y. Zhu, J. Chen, R.Y. Liu, J. Dong, W.D. Zeng, J.J. Jiang
Journal: Journal of Hepatology (2014)
Substance P-induced pulmonary vasoreactivity in isolated perfused guinea pig lung.
Authors: W M Selig, K E Burhop, J G Garcia, A B Malik
Journal: Circulation Research (1988)

We examined the effects of the neuropeptide substance P on pulmonary hemodynamic and transvascular fluid filtration in isolated Ringer's-perfused and blood-enriched Ringer's-perfused guinea pig lung and on albumin flux across bovine pulmonary artery endothelial monolayer. Mean pulmonary artery, left atrial, and capillary pressures were determined and used to calculate arterial and venous resistances, and lung weight was continuously monitored. Substance P (0.01-1.0 microM) caused marked increases in pulmonary arterial pressure, capillary pressure, venous resistance, and lung weight within 3-5 minutes after administration. These responses remained elevated above baseline at the end of the 30-minute experimental period in the Ringer's-perfused lungs but not in the blood-enriched Ringer's-perfused lungs. Substance P did not alter the capillary filtration coefficient in isolated lungs and transendothelial albumin permeability in the endothelial monolayer. Substance P resulted in an increase in venous effluent thromboxane B2 concentrations in perfused lungs but had no effect on 6-keto-prostaglandin F1 alpha concentrations. Papaverine (0.27 mM) (a smooth-muscle relaxant) abolished the pulmonary microvascular response to substance P in Ringer's-perfused lungs, and meclofenamate (0.15 mM) (a cyclooxygenase inhibitor) attenuated the pulmonary vasoconstriction and lung weight increase. Pyrilamine (1.0 microM) (a histamine1-receptor antagonist) did not alter the responses to substance P. In conclusion, substance P does not affect pulmonary vascular permeability to water and protein. Substance P induces an intense pulmonary vasoconstriction (due to greater constriction of postcapillary vessels) and an elevation in pulmonary capillary pressure that increases net transvascular fluid filtration.(ABSTRACT TRUNCATED AT 250 WORDS)
Chlormerodrin: Clinical Effectiveness and Absence of Toxicity in Congestive Heart Failure
Authors: W. A. Leff, H. E. Nussbaum
Journal: BMJ (1959)

Factors which contribute to sait and water retention in congestive heart failure are reviewed, with particular reference to the endocrine system.Clinical observation of 14 patients with chronic congestive heart failure suggested an initial coexistent endocrine overactivity followed subsequently by adrenocortical insufficiency.This premise was supported by the presence of hyponatraemia, a normal or elevated serum-potassium level with an increased blood urea in 14 patients with chronic heart failure which had become resistant to therapy with digitalis, a low-salt diet, and diuretics.The urinary excretion of 17-ketosteroids was estimated in four of these patients, and in two the corticoid excretion was also assessed.Subnormal values were obtained in each instance, and in one patient were consistent with a diagnosis of Addison's disease.Following corticotrophin administration the urinary excretion of these steroids increased in each patient and was accepted as evidence that hypoadrenocorticism was due to anterior pituitary rather than adrenocortical failure.Replacement therapy, using prednisolone, induced a greatly enhanced response to diuretics in all 13 patients who received this treatment.All were relieved of congestive heart failure and also, when coexistent, of left ventricular failure.Two patients died following pulmonary emboli.A hypothesis is advanced regarding the endocrine adjustments which occur in heart failure and which could lead to the formation of oedema.The importance of these adjustments is described in relation to the treatment of heart failure.The possible mode of action of prednisolone is discussed.Parallels are drawn between the oedema of late-stage congestive heart failure, nephrotic oedema, and starvation oedema.We thank Dr.
Validity of Screening for Glaucomatous Optic Nerve Damage Using Confocal Scanning Laser Ophthalmoscopy (Heidelberg Retina Tomograph II) in High-Risk Populations
Authors: Paul J. Harasymowycz, Demosthenes G. Papamatheakis, Alvine Kamdeu Fansi, Jacques Gresset, Mark R. Lesk
Journal: Ophthalmology (2005)
Gene transfer into coronary arteries of intact animals with a percutaneous balloon catheter.
Authors: G D Chapman, C S Lim, R S Gammon, S C Culp, J S Desper, R P Bauman, J L Swain, R S Stack
Journal: Circulation Research (1992)

Genetic manipulation of the vasculature may offer insights into the pathogenesis of coronary artery disease and may lead to gene therapy for disorders such as restenosis after percutaneous coronary angioplasty. The goal of this study was to develop a percutaneous method for gene transfer into coronary arteries of intact animals. Liposomes were used to facilitate transfection in coronary arteries with a plasmid containing the cDNA encoding luciferase. This reporter was chosen since it is not expressed in mammalian cells, and it can be quantified using a sensitive assay (light production). Mongrel dogs were catheterized, and DNA was delivered to coronary arteries via a porous perfusion balloon system. Luciferase expression was measured 3-5 days after the procedure, when the dogs were killed. Luciferase activity in control arteries (n = 12) was no higher than average background activity. Eight of 12 transfected arteries exhibited gene expression, averaging 4.3 +/- 2.1 pg luciferase (p less than 0.01, transfected versus control arteries). In addition, the ability to transfect DNA into femoral arteries without a transfection vehicle was tested. Five dogs were subjected to surgical transfection attempts in their femoral arteries with either DNA alone or DNA plus liposomes. Luciferase was expressed in all 10 femoral arteries; those treated with DNA alone expressed 35.6 +/- 8 pg luciferase, and those treated with DNA plus liposomes expressed 42.3 +/- 14 pg luciferase (p = 0.70). These results demonstrate the use of a percutaneous catheter to achieve gene transfer and expression in coronary arteries of intact dogs and suggest that the efficiency of intra-arterial gene transfer may be similar whether or not a transfection vehicle is used.
Actinomyces and Intrauterine Devices
Authors: Helen Duguid
Journal: JAMA (1982)

<h3>To the Editor.—</h3> It was with interest that we read the recent editorial on<i>Actinomyces</i>in vaginal smears (1982; 247:1175), suggesting that women who had<i>Actinomyces</i>-positive smears should use a contraceptive method other than the intrauterine device (IUD). This report was publicized in the British lay press. We have examined cervical material from 197 plastic-device users and 209 copper-device users, and have found<sup>1,2</sup>a significant difference in the prevalence of actinomycete infestation between the two groups (42% and 2%, respectively). In every case, the type of device and duration of use were noted, the comparison being almost exclusively between Saf-T-Coil and Gravigard. In the first retrospective study, actinomycetes were identified by morphological characteristics in direct cervical smears. In the second prospective study, they were identified on culture supported by specific immunofluorescence, positive results being obtained in 37 of 75 IUD users tested. Using our previously reported culture technique