tbuckley/cabot-search huggingface dataset:
Risk of severe hypoglycaemia in insulin treated diabetic patients transferred to human insulin: a case control study.
Authors: M Egger, G D Smith, H Imhoof, A Teuscher
Journal: BMJ (1991)

OBJECTIVE--To examine whether transfer from animal insulin to human insulin is associated with an increased risk of severe hypoglycaemia. DESIGN--Matched case-control study of insulin treated diabetic patients admitted to hospital because of hypoglycaemia during 1984-7, the period when human insulin was introduced into treatment. SETTING--Case admissions and control admissions were obtained from eight public hospitals within the Swiss canton of Berne and a second control group comprised members of the Bernese section of the Swiss Diabetes Association. SUBJECTS--94 patients with insulin treated diabetes with a total of 112 admissions for hypoglycaemia during 1984-7 (case admissions), 182 patients with insulin treated diabetes seen in the same hospitals for reasons other than hypoglycaemia with a total of 225 admissions (control admissions), and 86 insulin treated diabetic patients who were members of the Bernese section of the Swiss Diabetes Association. MAIN OUTCOME MEASURES--Type of insulin used at time of admission, glycaemic control as measured by amount of glycated haemoglobin or glucose concentration; severity of hypoglycaemia. RESULTS--Treatment with human insulin at admission was more common in cases than controls (52/112 (46%) admissions v 77/225 (34%); p = 0.003). 116 out of 129 (90%) of admissions taking human insulin had been transferred from animal insulin, mainly because of non-availability of porcine insulins. The ratio of rate of hypoglycaemia in those taking human insulin to the rate in those taking animal insulin was 2.4 (95% confidence interval 1.3 to 4.4). Other risk factors for hypoglycaemia were a history of hypoglycaemic coma (rate ratio of history to no history 3.8, 2.3 to 6.4) and good glycaemic control (rate ratio of good to poor control 3.9, 1.4 to 7.5). With multivariate analysis the increase in rate ratio associated with use of human insulin rose to 3.0 (1.4 to 6.4). Comparison with the diabetes association controls also showed an increased risk associated with use of human insulin (2.2; 1.1 to 4.8). CONCLUSIONS--Transfer of treatment from animal insulin to human insulin was associated with an increased risk of severe hypoglycaemia. Caution should be exercised when transferring diabetic patients to human insulin. Further studies are required to elucidate why this effect occurs.
Implications of Combat Casualty Care for Mass Casualty Events
Authors: Eric A. Elster, Frank K. Butler, Todd E. Rasmussen
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
Diazepam-Induced Amnesia for Cardioversion
Authors: Richard L. Kahler
Journal: JAMA (1967)

DURING the past several years the treatment of various cardiac arrhythmias by synchronized directcurrent countershock (cardioversion) has become well established.<sup>1</sup>Although cardioversion has been performed in patients while they were awake,<sup>2</sup>this method has not become widely accepted because of the discomfort experienced. In most instances, general anesthesia induced by a short-acting barbiturate has been used for the procedure. Since this usually requires the presence of an anesthesiologist, and since respiratory depression requiring assisted respiration may sometimes occur, other means of producing amnesia and analgesia have been sought. In a brief report,<sup>3</sup>Nutter and Massumi described the intravenous use of diazepam (Valium) in 15 patients undergoing cardioversion, and reported that amnesia and analgesia for the procedure occurred in 14 cases. The present report describes the results of this approach in 35 patients. <h3>Procedure</h3> All patients undergoing emergency or elective cardioversion at the Yale-New Haven Hospital between January
Life, Death, and the American College of Physicians: The Cruzan Case
Authors: Lois Snyder
Journal: Annals of Internal Medicine (1990)

Editorials1 June 1990Life, Death, and the American College of Physicians: The Cruzan CaseLois Snyder, JDLois Snyder, JDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-112-11-802 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Excerpt"Have you ever seen a person in a persistent vegetative state?" Calling his own question "impertinent, " U.S. Supreme Court Justice Harry A. Blackmun hushed an already tense courtroom as he asked this of Missouri Assistant Attorney General Robert L. Presson at the Cruzan oral argument on 6 December 1989. Not providing the answer Justice Blackmun seemed to expect, Mr. Presson responded that he has seen Nancy Cruzan and others. Nonetheless, Justice Blackmun's question had highlighted the central fact in the first case before the Supreme Court about the refusal of life-sustaining treatment: the persistently vegetative patient.Nancy Cruzan is...References1. Brief for the American College of Physicians as Amicus Curiae in Support of Petitioners, Cruzan v. Director, Missouri Department of Health, et al, No. 88-1503 (U.S. Sup Ct). Google Scholar2. Schloendorff v. Society of New York Hospital, 211 N.Y. 125, 129, 105 N.E. 92, 93 (1914). Google Scholar3. United States v. Charters, 829 F.2d 479, 498 (4th Cir. 1987). Google Scholar4. In re Quinlan, 70 N.J. 10, 41, 355 A.2d 642, 664, cert. denied, 429 U.S. 922 (1976). Google Scholar5. Cruzan v. Harmon, 760 S.W. 2d 408, 420. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: American College of Physicians Philadelphia, PA 19106-1572 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByDecisions to Withdraw Extracorporeal Membrane Oxygenation Support: Patient Characteristics and Ethical ConsiderationsAmerican College of Physicians Ethics Manual Seventh EditionLois Snyder Sulmasy, JD and Thomas A. Bledsoe, MD, for the ACP Ethics, Professionalism and Human Rights Committee*American College of Physicians Ethics Manual Sixth EditionLois Snyder, JD, for the American College of Physicians Ethics, Professionalism, and Human Rights Committee*Ethics Manual Fifth EditionLois Snyder, JD and Cathy Leffler, JD, for the Ethics and Human Rights Committee, American College of Physicians*Guidelines for the Use of Parenteral and Enteral Nutrition in Adult and Pediatric PatientsPhysician-Assisted SuicideLois Snyder, JD and Daniel P. Sulmasy, OFM, MD, PhD, for the Ethics and Human Rights Committee, American College of Physicians–American Society of Internal Medicine*Beyond the Cruzan Case: The U.S. Supreme Court and Medical PracticeBernard Lo, MD, Robert Steinbrook, MD 1 June 1990Volume 112, Issue 11Page: 802-804KeywordsPersistent vegetative stateRacial and ethnic issues Issue Published: 1 June 1990 PDF DownloadLoading ...
Cytosolic calcium regulates liver regeneration in the rat
Authors: Laura Lagoudakis, Isabelle Garcin, Boris Julien, Kis Nahum, Dawidson A. Gomes, Laurent Combettes, Michael H. Nathanson, Thierry Tordjmann
Journal: Hepatology (2010)

Liver regeneration is regulated by growth factors, cytokines, and other endocrine and metabolic factors. Calcium is important for cell division, but its role in liver regeneration is not known. The purpose of this study was to understand the effects of cytosolic calcium signals in liver growth after partial hepatectomy (PH). The gene encoding the calcium-binding protein parvalbumin (PV) targeted to the cytosol using a nuclear export sequence (NES), and using a discosoma red fluorescent protein (DsR) marker, was transfected into rat livers by injecting it, in recombinant adenovirus (Ad), into the portal vein. We performed two-thirds PH 4 days after Ad-PV-NES-DsR or Ad-DsR injection, and liver regeneration was analyzed. Calcium signals were analyzed with fura-2-acetoxymethyl ester in hepatocytes isolated from Ad-infected rats and in Ad-infected Hela cells. Also, isolated hepatocytes were infected with Ad-DsR or Ad-PV-NES-DsR and assayed for bromodeoxyuridine incorporation. Ad-PV-NES-DsR injection resulted in PV expression in the hepatocyte cytosol. Agonist-induced cytosolic calcium oscillations were attenuated in both PV-NES–expressing Hela cells and hepatocytes, as compared to DsR-expressing cells. Bromodeoxyuridine incorporation (S phase), phosphorylated histone 3 immunostaining (mitosis), and liver mass restoration after PH were all significantly delayed in PV-NES rats. Reduced cyclin expression and retinoblastoma protein phosphorylation confirmed this observation. PV-NES rats exhibited reduced c-fos induction and delayed extracellular signal-regulated kinase 1/2 phosphorylation after PH. Finally, primary PV-NES–expressing hepatocytes exhibited less proliferation and agonist-induced cyclic adenosine monophosphate responsive element binding and extracellular signal-regulated kinase 1/2 phosphorylation, as compared with control cells. Conclusion: Cytosolic calcium signals promote liver regeneration by enhancing progression of hepatocytes through the cell cycle. (HEPATOLOGY 2010;)
Incidence of malignancy in patients with moderate-to-severe asthma treated with or without omalizumab
Authors: Aidan Long, Abdelkader Rahmaoui, Kenneth J. Rothman, Eva Guinan, Mark Eisner, Mary S. Bradley, Carlos Iribarren, Hubert Chen, Gillis Carrigan, Karin Rosén, Stanley J. Szefler
Journal: Journal of Allergy and Clinical Immunology (2014)

BackgroundThe Epidemiologic Study of Xolair (omalizumab): Evaluating Clinical Effectiveness and Long-term Safety in Patients with Moderate-to-Severe Asthma (EXCELS) assessed the long-term safety of omalizumab in a clinical practice setting as part of a phase IV US Food and Drug Administration postmarketing commitment.ObjectiveWe sought to evaluate long-term safety in omalizumab-treated and nonomalizumab-treated patients. Primary outcome measures focused on assessment of malignancies.MethodsEXCELS was a prospective observational cohort study in patients (≥12 years of age) with moderate-to-severe allergic asthma. There were 2 cohorts: omalizumab (taking omalizumab at baseline) and nonomalizumab (no history of omalizumab treatment). Primary outcomes included all confirmed, incident, study-emergent primary malignancies (malignancies), including and excluding nonmelanoma skin cancer (NMSC); all malignancies were externally adjudicated.ResultsThe omalizumab cohort had a higher proportion of patients with severe asthma compared with the nonomalizumab cohort (50.0% vs 23.0%). Median follow-up was approximately 5 years for both cohorts. Crude malignancy rates were similar in the omalizumab and nonomalizumab cohorts, with a rate ratio of 0.84 (95% CI, 0.62-1.13) for all malignancies and 0.98 (95% CI, 0.71-1.36) for all malignancies excluding NMSC. Kaplan-Meier plots of time to first confirmed study-emergent primary malignancy were similar for the 2 treatment cohorts. Cox proportional hazards modeling, adjusting for confounders and risk factors, resulted in a hazard ratio (omalizumab vs nonomalizumab) of 1.09 (95% CI, 0.87-1.38) for all malignancies and 1.15 (95% CI, 0.83-1.59) for all malignancies excluding NMSC.ConclusionResults from EXCELS suggest that omalizumab therapy is not associated with an increased risk of malignancy.
Biased J<sub>H</sub> usage in plasma cell immunoglobulin gene sequences from colonic mucosa in ulcerative colitis but not in Crohn’s disease
Authors: D K Dunn-Walters, L Boursier, M Hackett, J Spencer
Journal: Gut (1999)

Ulcerative colitis is an inflammatory disease of the colonic and rectal mucosa. Autoantibodies have been observed in ulcerative colitis which may have a role in the pathogenesis of the disease. Evidence also suggests that there is an hereditary predisposition towards the disease, although no individual genes have been identified.This is a pilot study of immunoglobulin heavy chain genes (IgH) in ulcerative colitis to determine whether they have any particular genetic characteristics which may lead to a better understanding of the disease aetiology.Colonic or rectal tissue was obtained from five children with ulcerative colitis. Tissue was also obtained from five children with Crohn's disease and five children who did not have inflammatory bowel disease as controls.B cells and IgD+ B cells were identified by immunohistochemistry on frozen sections. Areas of lamina propria containing plasma cells, and areas of IgD+ B cells were microdissected. The immunoglobulin genes were PCR amplified, cloned, and sequenced. Sequences were analysed for content of somatic mutations and composition of heavy chain.An increase in the use of JH6 and DXP'1, and a decrease in the use of JH4, gene segments in immunoglobulin genes from lamina propria plasma cells, and from virgin IgD+ B cells, was found in patients with ulcerative colitis. These biases were not present in the control groups.There is a fundamental difference in the immunoglobulin genes from patients with ulcerative colitis. Whether this is caused by a difference in content of immunoglobulin gene segments in the germline or a difference in the recombination mechanism is not known.
Immunochemical Studies of Plasma Kallikrein
Authors: Andranik Bagdasarian, Biswajit Lahiri, Richard C. Talamo, Pat Wong, Robert W. Colman
Journal: Journal of Clinical Investigation (1974)

A monospecific antibody against human plasma kallikrein has been prepared in rabbits with kallikrein further purified to remove gamma globulins. The antisera produced contained antikallikrein and also anti-IgG, in spite of only 8% contamination of kallikrein preparation with IgG. The latter antibody was removed by adsorption of antisera with either Fletcher factor-deficient plasma or with purified IgG. Both kallikrein and prekallikrein (in plasma) cross-react with the antibody with no apparent difference between the precipitation arcs developed during immunoelectrophoresis and no significant difference in reactivity when quantified by radial immunodiffusion.
Abacterial Pyuria and Reiter's Syndrome
Authors: G. H. Baines
Journal: BMJ (1947)

MEDBCRATS ORNA605well as in man-hours.Even better results would be obtain- able if patients could be seen in the earlier stages of infec- tion.Of the cases detailed in Table I, 65% needed imme- diate incision; in the three cases in Table II in which peni- cillin treatment was started less than three days after the onset of symptoms incision was unnecessary.This once again emphasizes the need for early diagnosis of the various infections of the hands and for appreciation of their serious nature. SummaryA review is presented of 185 cases of infected hands seen in the surgery of Westminster Hospital-168 treated without, and 17 with, penicillin.Cases treated without penicillin included 135 of paronychia and pulp-space infection, with an average loss of 21 days' duty; 16 cases of tenosynovitis, with an average loss of 17.5 days; and 17 cases of palmar-space infections, with an average loss of 16.5
Post-Progression Survival (PPS) and Overall Survival (OS) According to Treatment Type in Contemporary Phase III Trials in Advanced Breast Cancer (ABC).
Authors: E. Saad, A. Katz, K. Machado, M. Buyse
Journal: Cancer Research (2009)

Abstract Objective: Progression-free survival (PFS) and time to tumor progression (TTP) have been the most frequent primary endpoints in recent phase III trials in ABC. OS, the most frequent secondary endpoint (Katz ASCO 2009), is largely influenced by subsequent-line therapy, and the role of PFS/TTP as surrogates for OS is still uncertain, perhaps due to the influence of post-progression therapy. Thus, PPS is of interest as a determinant of OS, and may vary according to treatment type.Methods: Using the medical subject headings “breast neoplasms” and “drug therapy”, we searched PubMed for phase III trials on systemic antineoplastic therapies published between January 1, 1998, and December 31, 2007 in one of 11 leading medical journals (Ann Oncol, BCRT, Br J Cancer, Cancer, Clin Cancer Res, Eur J Cancer, JCO, JNCI, Lancet Oncol, Lancet and NEJM). We excluded trials with factorial design, studies on high-dose chemotherapy, papers reporting combined analyses of two or more trials, and companion studies on correlative biology or prognostic factors. PPS was calculated as median OS minus median PFS/TTP for each trial arm. The proportion of OS accounted for by PPS (PPS%OS) was calculated as 100 - [median PFS/TTP/median OS]% for each trial arm.Results: The search yielded 75 trials enrolling a total of 28,973 evaluable patients in 159 trial arms. The following table displays the results, considering trial arms with available medians for both PFS/TTP and OS. PPS%OS is larger in hormone-therapy trials than in chemotherapy trials (P&amp;lt;0.01). Overall, PPS has a stronger correlation with OS than do PFS/TTP (R-squares of 0.83 and 0.24, respectively; both P&amp;lt;0.01), at least in part because PPS is longer than PFS/TTP.Main results Mean ofmedians(months) Trial typeN armsPFS/TTPOSPPSMedian PPS%OSOVERALL1276.920.513.665.7%1. Chemotherapy96718.311.463.7%1.1 Chemo 1st line only597.820.712.964.4%1.2 Chemo 2nd line only146.715.28.559.8%1.3 Other (mixed lines)235.014.19.164.4%2. Hormone therapy296.927.420.574.4%2.1 Hormone 1st line only139.331.121.869.0%2.2 Hormone 2nd line only135.023.218.177.9% Conclusion: The contemporary average median OS in ABC is 20.7 months for first-line chemotherapy ± targeted agents and 31.1 months for first-line hormone therapy ± chemotherapy trials. Subsequent lines of therapy play a major role in determining OS in ABC, and further studies are needed to understand the role of PFS/TTP versus PPS in determining OS, since first-line PFS/TTP have not been convincingly shown to be good surrogates for OS in the literature on ABC. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5116.
Left ventricular function after transmural myocardial infraction: A blinded, randomized study comparing streptokinase and rt-PA
Authors: G.J. Taylor, F.L. Mikell, R.E. Katholi, H.W. Moses, J.T. Dove, R.C. Woodruff, B.D. Miller, D.L. Koester, L.A. Becker, H.A. Wellons, D.P. Hamm, J.A. Schneider
Journal: Journal of the American College of Cardiology (1991)
Hepatotrophic and Cardiotrophic Properties of Sex Hormones
Authors: V. Korenchevsky, K. Hall, R. C. Burbank, J. Cohen
Journal: BMJ (1941)

In earlier papers by Korenchevsky and co-workers (1933- 40) the manifold effects produced by sex hormones on the non-sex organs have been repeatedly emphasized on the basis of (1) the changes in weight of the organs of gonadectomized rats as compared with those of normal intact animals ; (2) the changes in weight of the organs of rats injected with various sex hormones as compared with those of uninjected litter-mates.The microscopical changes produced in some of the non-sex organs of the rats
Life-threatening hemorrhage following large-balloon endoscopic papillary dilation successfully treated with angiographic embolization
Authors: T. Lee, S. Park, C. Lee, I. Chung, S. Kim, C. Kang
Journal: Endoscopy (2009)

A 72-year-old man was admitted for removal of bile duct stones. He had undergone insertion of two 7-F double pigtail stents (Cook Medical, Bloomingdale, Indiana, USA) 2 months earlier due to a failed stone extraction. He was taking low-dose aspirin (100 mg/day), but had stopped this 1 week ago. Endoscopic retrograde cholangiopancreatography (ERCP) following removal of the biliary stents showed a round stone, approximately 1 cm in size, above a weblike stricture in the distal common bile duct ([Fig. 1]). Sphincteroplasty was carried out to 10 mm for 60 seconds, using a balloon dilator (CRE Wireguided, Boston Scientific International, La Garenne Colombes, France) over the guidewire ([Fig. 2]). However, the stone could not be extracted because of the weblike stricture and continuous bleeding from the ampulla. An epinephrine injection (1 : 10 000; 3 mL) was given and an endoscopic nasobiliary drainage tube inserted. Six hours later, the patient suddenly developed continuous hematemesis. His hemoglobin level fell from 14.5 g/dL to 10.2 g/dL, with a blood pressure of 90/60 mm Hg. An emergency duodenoscopy revealed active bleeding from the ampulla, and endoscopic hemostasis could not be achieved as the heavy bleeding was masking the source ([Fig. 3]). A double pigtail stent was inserted and emergency angiography carried out. This showed multiple points of extravasation of the contrast medium from three branches of the anterior superior pancreaticoduodenal artery ([Fig. 4]). The arteries were successfully embolized with an infusion of butyl cyanoacrylate (Histoacryl) ([Fig. 5]).
Production of Functional Classical Brown Adipocytes from Human Pluripotent Stem Cells using Specific Hemopoietin Cocktail without Gene Transfer
Authors: Miwako Nishio, Takeshi Yoneshiro, Masako Nakahara, Shinnosuke Suzuki, Koichi Saeki, Mamoru Hasegawa, Yuko Kawai, Hidenori Akutsu, Akihiro Umezawa, Kazuki Yasuda, Kazuyuki Tobe, Akira Yuo, Kazuo Kubota, Masayuki Saito, Kumiko Saeki
Journal: Cell Metabolism (2012)
CENTRALIZED, STEPPED, PATIENT PREFERENCE-BASED TREATMENT FOR PATIENTS WITH POST-ACUTE CORONARY SYNDROME DEPRESSION: CODIACS VANGUARD RANDOMIZED CONTROL TRIAL
Authors: Karina W. Davidson, J. Thomas Bigger, Matthew Burg, Robert Carney, William F. Chaplin, Susan Czajkowski, Joan Duer-Hefele, Nancy Frasure-Smith, Kenneth Freedland, Donald Haas, Allan Jaffe, Joseph Ladapo, Francois Lespérance, Vivian Medina, Jonathan Newman, Gabrielle Osorio, Faith Parsons, Joseph Schwartz, Jonathan Shaffer, Peter Shapiro, David S. Sheps, Viola Vaccarino, William Whang, Siqin Ye
Journal: Journal of the American College of Cardiology (2013)
Cold Urticaria and Photosensitivity Due to Griseofulvin
Authors: Te-Wen Chang
Journal: JAMA (1965)

GRISEOFULVIN, the most effective systemic antibiotic in the treatment of superficial infections due to dermatophytes, has been used extensively in recent years. The side effects ascribed to the drug have been generally mild and insufficient to warrant withdrawal of therapy. Gastrointestinal symptoms such as nausea and vomiting, flatulence, heartburn, or diarrhea have been observed occasionally. Other reported reactions are dizziness, insomnia, fatigue, temporary proteinuria, peripheral neuritis, lethargy, mouth dryness, thirst, mental confusion, and impairment of performance of routine activities. Photosensitivity has been noted on rare occasions. Hypersensitivity manifested by urticaria, skin rashes, "serum sickness," vesicular eruptions, or severe angioedema may occur.<sup>1-7</sup>The present report describes a case of cold urticaria and photosensitivity due to griseofulvin. <h3>Report of a Case</h3> A 44-year-old physician took griseofulvin for the second time because of a relapse of tinea pedis and tinea unguium due to<i>Trichophyton mentagrophytes</i>. In 1964 he had taken griseofulvin for