tbuckley/cabot-search huggingface dataset:
Combination Therapy With Insulin and Sulfonylureas for Type II Diabetes
Authors: Timothy S Bailey, Nicholas H E Mezitis
Journal: Diabetes Care (1990)

Combination therapy for type II (non-insulin-dependent) diabetes mellitus with insulin and sulfonylureas has been a topic of interest since the latter were introduced to clinical use. In recent years, improved understanding of potential complications associated with hyperinsulinemia has led to resurgent interest in alternatives to insulin monotherapy for patients who have failed on a regimen of diet and sulfonylureas. A plethora of clinical trials have reported on the efficacy of oral hypoglycemic agents in limiting insulin requirements while achieving glycemic control in this subset of diabetic patients. However, few studies have been appropriate in both design and duration to provide convincing results. The randomized placebo-controlled double-blind trials that have used a parallel design and study periods of up to 1 yr have uniformly investigated second-generation sulfonylureas and yielded the most reliable information. In all instances, the combination regimen achieved reduction in insulin requirement with varying evidence of a pancreatic effect as the responsible mechanism. This treatment modality is becoming more widely accepted in the effort to achieve optimal glycemic control with minimum risk to the patient.
Extranodal sinus histiocytosis with massive lymphadenopathy presenting as an intramedullary spinal cord tumor: A case report
Authors: Matthew P. Jones, M. Eugenia Rueda-Pedraza
Journal: American Journal of Hematology (1997)

Involvement of the central nervous system by sinus histiocytosis with massive lymph-adenopathy (SHML) is rare. Less than 30 cases have been reported. To the best of our knowledge, we describe the first case of an intramedullary spinal cord lesion which occurred in a 34-year-old black male, causing paraplegia. Laboratory evaluation revealed anemia, increased erythrocyte sedimentation rate, and polyclonal gammopathy. Microscopic examination of the lesion revealed lymphocytes within the cytoplasm of the histiocytic cells, a phenomenon known as emperipolesis. Immunohistochemical stains showed the large eosinophilic histiocytic cells to be positive for S-100 protein and Kp1 antigen. Special stains for fungi and acid-fast organisms were negative. There was no evidence of clonality in the lymphocytic aggregates. Glial fibrillary acidic protein was negative in the lesion, although positive in the surrounding tissue. These features confirmed the diagnosis of extranodal SHML involving the intramedullary spinal cord. Am. J. Hematol. 54:253–257, 1997 © 1997 Wiley-Liss, Inc. 1 This article is a U.S. Government work and, as such, is in the public domain in the United States of America.
Genetic Testing in the Diagnosis and Management of Multiple Endocrine Neoplasia Type II
Authors: Gregory A. Ledger
Journal: Annals of Internal Medicine (1995)

Purpose: To review significant advances in the early diagnosis and treatment of medullary thyroid carcinoma in patients with the multiple endocrine neoplasia II (MEN II) syndromes, advances made possible by the application of recently discovered genetic information. Data Sources: Recently published English-language literature on linkage analysis and DNA analysis in the MEN II syndromes. Study Selection: Articles on familial and sporadic forms of medullary thyroid carcinoma; pentagastrin-calcitonin determination; and genetic testing. Data Extraction: Information from recent studies on 1) the usefulness and limitations of genetic testing, especially DNA and linkage analysis, in the early diagnosis of the familial form of thyroid carcinoma and 2) the correlation between the results of genetic testing and the results of biochemical screening. Data Synthesis: Medullary thyroid carcinoma accounts for most of the morbidity and mortality among patients with the familial medullary thyroid carcinoma syndromes. Multiple endocrine neoplasia IIa and IIb and familial medullary thyroid carcinoma are inherited conditions with autosomal dominance and incomplete penetrance. Traditionally, diagnosis of and screening for these conditions have been done using pentagastrin stimulation tests and plasma calcitonin determinations. Recent genetic mapping, however, has assigned the genes responsible for these tumors to the pericentromeric region of chromosome 10. Available data suggest that mutations in exon 10, 11, or 16 of the RET proto-oncogene are responsible for MEN IIa and IIb and familial non-MEN medullary thyroid carcinoma. Thus, genetic testing can identify affected members of a kindred and will probably lead to early thyroidectomy and possible cure for gene carriers. Conclusions: Early studies confirm the usefulness of DNA analysis in the diagnosis and treatment of patients with familial forms of medullary thyroid carcinoma. We review changes in the diagnosis and treatment of these patients and offer a strategy for operative intervention based on results of genetic testing.
HARMFUL EFFECT OF JOGGING
Authors: GENE G. HUNDER
Journal: Annals of Internal Medicine (1969)

Letters and Comments1 September 1969HARMFUL EFFECT OF JOGGINGGENE G. HUNDER, M.D., F.A.C.P.GENE G. HUNDER, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-71-3-664 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor: Regular, moderate physical exercise such as jogging is generally accepted as being beneficial to health (1, 2). Recently, I saw a patient who jogged regularly in whom changes of degenerative joint disease rapidly developed in one hip. It appeared that the excessive stress on the hip joint during jogging may have caused the accelerated erosion of the articular cartilage.The patient, a 47-year-old white businessman, was seen in September 1968 because of right-hip pain of 1 year's duration. In 1965 he had begun to jog a mile each morning. In the fall of 1967 he had experienced...References1. : Exercise and fitness. JAMA 188: 433, 1964. CrossrefMedlineGoogle Scholar2. HARRISBOWERMANMCFADDENKEARNS WEWRBTA: Jogging: an adult exercise program. JAMA 201: 759, 1967. CrossrefMedlineGoogle Scholar3. HOLLANDER JL: Arthritis and Allied Conditions. A Textbook of Rheumatology, 7th ed., Lea & Febiger, Philadelphia, 1966, 1355 pp. Google Scholar4. DANIELSSON LG: Incidence and prognosis of coxarthrosis. Acta Orthop. Scand. (suppl. 66): 9, 1964. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Mayo Clinic and Mayo Foundation Rochester, Minn. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 September 1969Volume 71, Issue 3Page: 664-665KeywordsArticular cartilageDegenerative joint diseaseExerciseFallsHip Issue Published: 1 September 1969 PDF DownloadLoading ...
Atlas of Clinical Hematology
Authors: Laura C. Michaelis
Journal: JAMA (2008)

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
Abstract 1352: Macrophage specific regulation reveals both pro- and anti-tumor effects of NF-kappaB during mammary tumor progression
Authors: Linda Connelly, Whitney Barham, Hala M. Onishko, T Zabuawala, Michael C. Ostrowski, Timothy S. Blackwell, Fiona E. Yull
Journal: Cancer Research (2010)

Abstract An increased level of macrophages in human tumors is associated with a poorer prognosis. The transcription factor Nuclear Factor-kappaB (NF-kappaB) is an important regulator of gene expression within macrophages. Recent studies point to a pro-tumorigenic role for NF-kappaB activity in macrophages; however NF-kappaB also regulates expression of genes such as inducible nitric oxide synthase which are associated with anti-tumor effects. We believe that NF-kappaB activity in macrophages can have both anti- and pro-tumor effects depending on tumor stage. We have developed novel murine models to determine the effects of modulation of NF-kappaB activity specifically within macrophages during primary mammary tumor growth and metastasis. We have used the cfms promoter to specifically express the reverse tetracycline transactivator (rtTA) protein in macrophages. The rtTA can drive tet operon regulated gene expression in the presence of doxycyline (dox). We have used this with a dominant negative IkappaBalpha to inhibit NF-kappaB signaling in the Polyoma mouse mammary tumor model, this model is termed DNFP. We have also used the cfms-rtTA in combination with a constitutively active IKK2 transgene to activate NF-kappaB signaling, this model is termed IKFM. When NF-kappaB is inhibited in macrophages during primary tumor growth in our DNFP model there is a reduction in primary tumor growth accompanied by a reduced level of lung metastasis. This data suggests that NF-kappaB in macrophages is acting in a pro-tumor manner, in agreement with recently published data. In contrast, we have found that activation of NF-kappaB in macrophages by treating IKFM mice with dox for 1 week before and during two weeks following tail vein injection of polyoma mammary tumor cells leads to a significant reduction in surface lung tumor formation. In additional studies, IKFM mice were pretreated with dox for 1 week but treatment was stopped two days after tumor injection. A similar reduction in tumor number was observed, suggesting an inhibition of cell seeding. Real time PCR analysis of lungs from mice with activation of NF-kappaB in macrophages suggests an anti-tumor “M1” macrophage phenotype. In summary, our data indicates that NF-kappaB activity in macrophages can have both anti- and pro-tumor effects dependent on tumor stage. This data would suggest that cell specificity and timing of treatment are important considerations with regards to the use of NF-kappaB inhibitors in cancer treatment. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1352.
Atorvastatin Dose-Dependently Decreases Hepatic Lipase Activity in Type 2 Diabetes
Authors: Ingrid I.L. Berk-Planken, Nicoline Hoogerbrugge, Ronald P. Stolk, Aart H. Bootsma, Hans Jansen
Journal: Diabetes Care (2003)

Hepatic lipase (HL) is involved in the metabolism of several lipoproteins and may contribute to the atherogenic lipid profile in type 2 diabetes. Little is known about the effect of cholesterol synthesis inhibitors on HL activity in relation to sex and the hepatic lipase gene, the LIPC promoter variant in type 2 diabetes. Therefore, we studied the effect of atorvastatin 10 mg (A10) and 80 mg (A80) on HL activity in 198 patients with type 2 diabetes.Patients (aged 45-75 years, without manifest coronary artery disease, total cholesterol 4.0-8.0 mmol/l, and fasting triglycerides [TG] 1.5-6.0 mmol/l) were included in a double-blind, randomized, placebo-controlled trial for 30 weeks (Diabetes Atorvastatin Lipid Intervention study).HL activity at baseline was significantly higher in our population compared with an age-matched control group without type 2 diabetes (406 +/- 150 vs. 357 +/- 118 units/l). HL activity in men versus women (443 +/- 158 vs. 358 +/- 127 units/l), in carriers of the LIPC C/C allele versus carriers of the T/T allele (444 +/- 142 vs. 227 +/- 96 units/l), and in Caucasians versus blacks (415 +/- 150 vs. 260 +/- 127 units/l) all differed significantly (P < 0.001). Atorvastatin dose-dependently decreased HL (A10, -11%; A80, -22%; both P < 0.001). Neither sex nor the LIPC C-->T variation influenced the effect of atorvastatin on HL activity.Sex, LIPC promoter variant, and ethnicity significantly contribute to the baseline variance in HL activity. Atorvastatin treatment in diabetic dyslipidemia results in a significant dose-dependent decrease in HL activity, regardless of sex or the LIPC promoter variant.
The Association Between Age and Nephrosclerosis on Renal Biopsy Among Healthy Adults
Authors: Andrew D. Rule, Hatem Amer, Lynn D. Cornell, Sandra J. Taler, Fernando G. Cosio, Walter K. Kremers, Stephen C. Textor, Mark D. Stegall
Journal: Annals of Internal Medicine (2010)

Background: Chronic kidney disease is common with older age and is characterized on renal biopsy by global glomerulosclerosis, tubular atrophy, interstitial fibrosis, and arteriosclerosis. Objective: To see whether the prevalence of these histologic abnormalities in the kidney increases with age in healthy adults and whether histologic findings are explained by age-related differences in kidney function or chronic kidney disease risk factors. Design: Cross-sectional study. Setting: Mayo Clinic, Rochester, Minnesota, from 1999 to 2009. Patients: 1203 adult living kidney donors. Measurements: Core-needle biopsy of the renal cortex obtained during surgical implantation of the kidney, and medical record data of kidney function and risk factors obtained before donation. Results: The prevalence of nephrosclerosis (≥2 chronic histologic abnormalities) was 2.7% (95% CI, 1.1% to 6.7%) for patients aged 18 to 29 years, 16% (CI, 12% to 20%) for patients aged 30 to 39 years, 28% (CI, 24% to 32%) for patients aged 40 to 49 years, 44% (CI, 38% to 50%) for patients aged 50 to 59 years, 58% (CI, 47% to 67%) for patients aged 60 to 69 years, and 73% (CI, 43% to 90%) for patients aged 70 to 77 years. Adjustment for kidney function and risk factor covariates did not explain the age-related increase in the prevalence of nephrosclerosis. Limitation: Kidney donors are selected for health and lack the spectrum or severity of renal pathologic findings in the general population. Conclusion: Kidney function and chronic kidney disease risk factors do not explain the strong association between age and nephrosclerosis in healthy adults. Primary Funding Source: National Institutes of Health, U.S. Public Health Service.
Nonstationary Vortexlike Reentrant Activity as a Mechanism of Polymorphic Ventricular Tachycardia in the Isolated Rabbit Heart
Authors: Richard A. Gray, José Jalife, Alexandre Panfilov, William T. Baxter, Cándido Cabo, Jorge M. Davidenko, Arkady M. Pertsov
Journal: Circulation (1995)

Background Ventricular tachycardia may result from vortexlike reentrant excitation of the myocardium. Our general hypothesis is that in the structurally normal heart, these arrhythmias are the result of one or two nonstationary three-dimensional electrical scroll waves activating the heart muscle at very high frequencies. Methods and Results We used a combination of high-resolution video imaging, electrocardiography, and image processing in the isolated rabbit heart, together with mathematical modeling. We characterized the dynamics of changes in transmembrane potential patterns on the epicardial surface of the ventricles using optical mapping. Image processing techniques were used to identify the surface manifestation of the reentrant organizing centers, and the location of these centers was used to determine the movement of the reentrant pathway. We also used numerical simulations incorporating Fitzhugh-Nagumo kinetics and realistic heart geometry to study how stationary and nonstationary scroll waves are manifest on the epicardial surface and in the simulated ECG. We present epicardial surface manifestations (reentrant spiral waves) and ECG patterns of nonstationary reentrant activity that are consistent with those generated by scroll waves established at the right and left ventricles. We identified the organizing centers of the reentrant circuits on the epicardial surface during polymorphic tachycardia, and these centers moved during the episodes. In addition, the arrhythmias that showed the greatest movement of the reentrant centers displayed the largest changes in QRS morphology. The numerical simulations showed that stationary scroll waves give rise to monomorphic ECG signals, but nonstationary meandering scroll waves give rise to undulating ECGs characteristic of torsade de pointes. Conclusions Polymorphic ventricular tachycardia in the healthy, isolated rabbit heart is the result of either a single or paired (“figure-of-eight”) nonstationary scroll waves. The extent of the scroll wave movement corresponds to the degree of polymorphism in the ECG. These results are consistent with our numerical simulations that showed monomorphic ECG patterns of activity for stationary scroll waves but polymorphic patterns for scroll waves that were nonstationary.
The health of gypsies
Authors: M. McKee
Journal: BMJ (1997)

<b>1648</b> <b>Objectives: </b>Head motion is challenging for PET/SPECT studies that measure neuroreceptor BP using radioligands with slow kinetics. Scans require 2-3 hrs and restraints can produce discomfort that promotes head motion. Image-based realignment (SPM5) requires long frame durations (5-10 min) to obtain sufficient counts to delineate structural markers. Motion within frames causes small brain structures such as the basal ganglia (BG) to become blurred, decreasing measured activity. Shorter frames may limit within-frame motion, but counts may be insufficient for image-based realignment. This issue was addressed by comparing measured activity following image-dependent and image-independent motion correction in a PET study with short frame durations. <b>Methods: </b>[F18]fallypride PET data were acquired in 1-min frames for 2.5 hrs while an infrared optical tracker (Polaris) recorded the sec-by-sec position of a target fixed to the participant’s head. For each frame, images were realigned to the target’s mean position and orientation while the corresponding standard deviations (SDs) quantified movement. TACs obtained from the BG were generated following motion correction using the optical-tracker or realignment with SPM5. <b>Results: </b>Residual position uncertainty after motion correction with optical-tracker data was &lt;0.5mm (rms), comparable to SPM5 for late frames when BG are prominent and well-defined, but not early frames when counts are low. When frames with large SDs were removed, mean measured activity increased and TACs were significantly smoother. <b>Conclusions: </b>It is important to perform neuroligand studies with short frames to reduce blurring due to head motion. Optical tracking facilitates accurate realignment independent of frame duration and activity, quantifies within-frame head motion, and eliminates the need for uncomfortable head restraints.
Allergic Inflammation and Health Outcomes Of Comorbid Asthma and Obesity In Inner-City Black and Hispanic Schoolchildren
Authors: Perdita Permaul, William J. Sheehan, Carter Petty, Sachin N. Baxi, Jonathan M. Gaffin, Lianne S. Kopel, Watcharoot Kanchongkittiphon, Chunxia Fu, Diane R. Gold, Wanda Phipatanakul
Journal: Journal of Allergy and Clinical Immunology (2014)
Golden Gate to Health Care for All? San Francisco's New Universal-Access Program
Authors: Mitchell H. Katz
Journal: New England Journal of Medicine (2008)

Impatient with the lack of progress at federal and state levels in reducing the number of uninsured Americans, many counties across the United States are seeking their own solutions to the health care crisis. Unfortunately, local efforts to achieve universal coverage often encounter substantial obstacles, including the high cost of insurance plans, the loss of federal and state revenues that benefit the uninsured, and limited authority to mandate insurance coverage.To broaden access while avoiding these problems, the government of the City and County of San Francisco launched Healthy San Francisco (HSF) in April 2007. Building on the success of . . .
THE WILLIAM PEPPER LABORATORY OF CLINICAL MEDICINE.
Authors: ALFRED STENGEL
Journal: JAMA (1904)

The three great institutions that have been spoken of—the Carnegie Institution, the Rockefeller Institute and the Memorial Institute of Chicago—differ materially from that of the small affair for which I am called on to speak. To borrow a quotation, if one were to compare cubs with lions, the smaller institutions, the clinical laboratories, have a very important work to perform, and one which will in the end compare favorably with the work of the greater institutions in this particular, namely, that their work is so very much more far reaching. The clinical laboratory is intended to subserve a double purpose, not only to furnish facilities and a place for investigations, but to elevate the tone of the staffs of hospitals with which these laboratories are connected. The founder of this laboratory, who named it in honor of his distinguished father, professor of the practice of medicine in the University of
If it was your brother
Authors: Macherla Radhamanohar
Journal: BMJ (2004)

“Doctor, do what you would do if it was your father or brother,” requested the son of a patient who had been given a diagnosis of cancer of the pancreas with liver metastases. The patient's condition rapidly deteriorated that week, and I had a meeting with the relatives to update them and also to prepare them for the worst. But the son's request made me feel uneasy and set me thinking about events in my own family.

Two years ago I went to India to arrange medical care for my eldest brother, who was given a diagnosis of carcinoma of the tongue six years previously. Unfortunately radiotherapy had resulted in severe side effects. He had dysphagia, had become very thin, and had to be fed through a gastric tube. He had been experiencing severe pain in his throat and ear. In addition he developed lung cancer, though he seemed to have responded well to chemotherapy.

> I realised that I should act as a doctor, not as …
DO PATIENTS WITHOUT SIGNIFICANT CORONARY OBSTRUCTIONS HAVE BETTER OUTCOME IN THE LONG RUN POST-ACUTE MYOCARDIAL INFARCTION?
Authors: Jose C. Nicolau, Marcelo Franken, Thiago Ferraz, Luciano Baracioli, Felipe Gallego Lima, Roberto Giraldez, Remo Furtado, Natali Giannetti, Roberto Kalil-Filho, Jose Ramires
Journal: Journal of the American College of Cardiology (2014)
Pituitary Polypeptide with Hypoglycaemic Action in Diabetes Mellitus
Authors: J. McD. Armstrong, J. Bornstein, F. M. Ng, H. P. Taft
Journal: BMJ (1969)

A polypeptide isolated by the hydrolysis of growth hormone, studied in five patients with diabetes mellitus, has been shown able to produce hypoglycaemia, presumably by modifying the anti-insulin action of pituitary growth hormone. Possibly this substance may be suitable for treating cases of insulin resistance or when a circulating inhibitor of glucose uptake is present.