tbuckley/cabot-search huggingface dataset:
Estrogen and Postmenopausal Osteoporosis
Authors: Olga Petrovic
Journal: Annals of Internal Medicine (1993)

Letters15 January 1993Estrogen and Postmenopausal OsteoporosisOlga Petrovic, MDOlga Petrovic, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-2-199301150-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Although the recent study by Lufkin and colleagues [1] was most interesting, the conclusions of the article and of the accompanying editorial [2] may be overdrawn.Nearly one third of patients had taken estrogen as recently as 4 years earlier, and a few had received estrogen 6 months before the study began. How many of the previous estrogen users had not taken it for more than 15 to 20 years before entering the study? What was the average duration of use, especially in patients 65 to 75 years old? How many took it continuously or nearly continuously ...References1. Lufkin EG, Wahner HW, O'Fallon WM, Hodgson SF, Kotowicz MA, Lane AW, et al. Treatment of postmenopausal osteoporosis with transdermal estrogen. Ann Intern Med. 1992; 117:1-9. Google Scholar2. Ott SM. Estrogen therapy for osteoporosis—even in the elderly (Editorial). Ann Intern Med. 1992; 117:85. Google Scholar3. Kiel DP, Felson DT, Anderson JJ, Wilson PWF, Moskowitz MA. Hip fracture and the use of estrogens in postmenopausal women. The Framingham Study. N Engl J Med. 1987; 317:1169. Google Scholar4. Quigley MET, Martin PL, Burnier AM, Brooks P. Estrogen therapy arrests bone loss in elderly women. Am J Obstet Gynecol. 1987; 156: 1516. Google Scholar Author, Article, and Disclosure InformationAuthors: Olga Petrovic, MDAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byFast and long acting neoflavonoids dalbergin isolated from Dalbergia sissoo heartwood is osteoprotective in ovariectomized model of osteoporosis: Osteoprotective effect of DalberginAnthocyanin-Rich Blackcurrant Extract Attenuates Ovariectomy-Induced Bone Loss in MiceEffects of Remifemin Treatment on Bone Integrity and Remodeling in Rats with Ovariectomy-Induced OsteoporosisStrontium fructose 1,6-diphosphate prevents bone loss in a rat model of postmenopausal osteoporosis via the OPG/RANKL/RANK pathway 15 January 1993Volume 118, Issue 2Page: 155-156KeywordsBoneBone remodelingBone resorptionElderlyEstrogensHip fracturesMenopauseOsteoporosis ePublished: 15 August 2000 Issue Published: 15 January 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Combined Confocal Scanning Laser Ophthalmoscopy and Spectral-Domain Optical Coherence Tomography Imaging of Reticular Drusen Associated with Age-Related Macular Degeneration
Authors: Steffen Schmitz-Valckenberg, Julia S. Steinberg, Monika Fleckenstein, Sivatharisini Visvalingam, Christian K. Brinkmann, Frank G. Holz
Journal: Ophthalmology (2010)
Health Care at Risk: A Critique of the Consumer-Driven Movement
Authors: Richard L. Kravitz
Journal: JAMA (2007)

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
Telomere Length of Circulating Leukocytes Is Decreased in Patients With Chronic Heart Failure
Authors: Pim van der Harst, Gerrit van der Steege, Rudolf A. de Boer, Adriaan A. Voors, Alistair S. Hall, Marcel J. Mulder, Wiek H. van Gilst, Dirk J. van Veldhuisen
Journal: Journal of the American College of Cardiology (2007)
Decreased GLUT-4 mRNA content and insulin-sensitive deoxyglucose uptake show insulin resistance in the hypertensive rat heart
Authors: G. Paternostro, K. Clarke, J. Heath, A.-M. L. Seymour, G. K. Radda
Journal: Cardiovascular Research (1995)

Insulin resistance in skeletal muscle and adipose tissue often accompanies hypertension; however, it has not been shown that heart muscle is similarly affected. The aims of this study were to determine whether basal and insulin-stimulated glucose transport and glucose transporter mRNA content are altered in the spontaneously hypertensive rat (SHR) heart.Hearts from 16-18-month-old SHRs were compared to their normotensive (WKY) controls. The accumulation of 2-deoxyglucose-6-phosphate (2DG6P), detected using 31P nuclear magnetic resonance spectroscopy, was used to assess glucose uptake before and during insulin stimulation in the isolated perfused heart. The mRNA levels of both the insulin-sensitive glucose transporter (GLUT-4) and the transporter responsible for basal glucose uptake (GLUT-1) were quantified by Northern blot analysis.The hypertensive rat hearts exhibited hypertrophy in that the heart/body weight ratio was increased by 59%. In these hearts, the basal rate of glucose uptake was 3-fold greater and hexokinase activity was 1.6 fold greater than that of the control rat hearts. On exposure to insulin, accumulation of 2DG6P increased 5-fold in the control hearts, but only 1.4-fold in the SHR hearts. Thus, in the presence of insulin, the rate of glucose uptake by the hypertensive rat heart was significantly (P < 0.05) reduced, being 82% of control. GLUT-4 mRNA content was decreased was no significant difference in the GLUT-1 mRNA content.We have demonstrated insulin resistance in the hypertrophied heart of the hypertensive rat that may have a molecular basis in a lower GLUT-4 content.
Morphometric study of early postnatal development of the thoracic aorta in the rat.
Authors: G Olivetti, P Anversa, M Melissari, A V Loud
Journal: Circulation Research (1980)

Tissue, cellular, and subcellular morphometry of the thoracic aorta in 1-, 5- and 11-day-old rats was used to quantify the cellular hypertrophy and proliferation of smooth muscle cells and the absolute increases in volume of elastic laminase and collagen during the early postnatal period. In the 1- to 5-day interval, total wall volume increased 2.9-fold, wall thickness and the number of smooth muscle cells doubled, mean cell volume increased by 40%, and the volumes of elastic laminae and collagen increased 3.7- and 3.3-fold, respectively. From 5 to 11 days, circumferential growth of the aortic wall, without further thickening, produced smaller and unequal growth increments of each of its component structures, with increases in collagen (3.2-fold) > elastic laminae (2.3-fold) > muscle cells (1.6-fold). In the overall growth of smooth muscle cells (4.6-fold) from 1 to 11 days, only the cytoplasmic volume fractions of glycogen aggregates and rough endoplasmic reticulum were altered significantly (-76%, +32%). Certain aspects of normal postnatal aortic growth paralleled the response of adult aorta to experimentally induced hypertension.
Place of medical qualification and outcomes of UK General Medical Council "fitness to practise" process: cohort study
Authors: C. Humphrey, S. Hickman, M. C. Gulliford
Journal: BMJ (2011)

<b>Objectives</b> To evaluate whether country of medical qualification is associated with "higher impact" decisions at different stages of the UK General Medical Council's (GMC's) "fitness to practise" process after allowing for other characteristics of doctors and inquiries. <b>Design</b> Retrospective cohort study. <b>Setting</b> Medical practice in the United Kingdom. <b>Participants</b> 7526 inquiries to the GMC concerning 6954 doctors. <b>Main outcome measures</b> Proportion of inquiries referred for further investigation at initial triage by the GMC, proportion of inquiries investigated that were subsequently referred for adjudication, and proportion of inquiries resulting in doctors being erased or suspended from the medical register; relative odds of higher impact decisions, by country of qualification, adjusted for doctors' sex, years since primary medical qualification, medical specialty, source and type of inquiry, and nature of allegations. <b>Results</b> Of 7526 inquiries, 4702 concerned doctors who qualified in the UK, 624 concerned doctors who qualified elsewhere in the European Union (EU), and 2190 concerned doctors who qualified outside the EU. At the initial triage, 30% (n=1398) of inquiries concerning doctors who qualified in the UK had a high impact decision, compared with 43% (267) for doctors who qualified elsewhere in the EU and 46% (998) for those who qualified outside the EU. The adjusted relative odds of an inquiry being referred for further investigation were 1.67 (95% confidence interval 1.28 to 2.17) for doctors who qualified elsewhere in the EU and 1.61 (1.38 to 1.88) for those who qualified outside the EU, compared with doctors who qualified in the UK. At the investigation stage, 5% (228) of inquiries received concerning UK qualified doctors were referred for adjudication, compared with 10% for EU (63) or non-EU (221) qualified doctors. The adjusted relative odds of referral for adjudication were 2.14 (1.46 to 3.16) for doctors who qualified elsewhere in the EU and 1.68 (1.31 to 2.16) for those who qualified outside the EU. At the adjudication stage, 1% (69) of inquiries received concerning UK qualified doctors led to erasure or suspension, compared with 4% (24) for doctors who qualified elsewhere in the EU and 3% (71) for non-EU qualified doctors. The adjusted relative odds of erasure or suspension were 2.16 (1.22 to 3.80) for doctors who qualified elsewhere in the EU and 1.48 (1.00 to 2.19) for those who qualified outside the EU. <b>Conclusions</b> Inquiries to the GMC concerning doctors qualified outside the UK are more likely to be associated with higher impact decisions at each stage of the fitness to practice process. These associations were not explained by measured inquiry related and doctor related characteristics, but residual confounding cannot be excluded.
Contemporary results of anatomic radical prostatectomy
Authors: W. J. Catalona, C. G. Ramos, G. F. Carvalhal
Journal: CA A Cancer Journal for Clinicians (1999)

With current clinical practice, most newly diagnosed cases of prostate cancer are potentially life-threatening yet still curable. The anatomical (nerve-sparing) radical prostatectomy has dramatically improved the results of surgical treatment. Other new management options, including conformal (three-dimensional) external beam radiation therapy, radioactive seed implantation (brachy-therapy), cryoablation, and hormonal therapy, may be useful in some patients, but they are all probably less effective than radical prostatectomy. Suitability for radical prostatectomy generally requires a clinically localized, potentially life-threatening tumor [as defined by Gleason grade, tumor stage, and serum prostate-specific antigen (PSA) level], a life expectancy of 10 years, and no serious co-morbid medical conditions. With contemporary radical prostatectomy, about 70% of men with clinically localized disease will be cured, depending on tumor grade, tumor stage, and the serum PSA level. Urinary continence and sexual potency can be preserved in most patients, but substantially better results have been reported from centers of excellence than from community-based series. Other complications occur in about 10% of patients and with greater frequency in older patients. The operative mortality rate is less than 0.5%. Neoadjuvant hormonal therapy does not appear to affect treatment failure rates in patients undergoing radical prostatectomy. Prostatectomy may be beneficial in patients with microscopic lymph node metastases. Postoperative adjuvant radiotherapy may also be beneficial for patients with adverse pathologic findings. Salvage radical prostatectomy after radiation failure is associated with a 10-fold higher risk of complications and limited prospects for cure. Prospective, randomized clinical trials are underway to compare the results of radical prostatectomy with other treatments. Currently, radical prostatectomy is considered the preferred treatment for men with localized disease and a 10-year life expectancy.
Sickle Cell Trait and Scuba Diving
Authors: Junius G. Adams
Journal: JAMA (1984)

To the Editor.—  The letter entitled Complications of Sickle Cell Trait by Lowbeer 1 states that persons with sickle cell trait should avoid situations that produce absolute hypoxia and presents  as an example. All of the other examples clearly involve a hypobaric environment. However, since the term diving usually refers to scuba diving, the reason for the ban on such activity is obscure, since the scuba diving environment is clearly hyperbaric. Dr Lowbeer is not alone in his contention that scuba diving should be forbidden to those persons with sickle cell trait (see reference 2 for other references). These authors, like Dr Lowbeer, fail to offer any evidence to support their contention.  A few basic facts about scuba diving might be helpful in the elimination of obvious misinformation.  scuba diving, the ambient pressure increases 1 atm for every 10 m of saltwater. Dalton's law states: In a mixture
Health Plan Accountability Still a Long-term Goal
Authors: Charles Marwick
Journal: JAMA (1996)

ASSURING THE QUALITY of managed care plans as they become increasingly prominent in the provision of health care means mounting pressure on measuring their performance. The demand comes from potential plan purchasers, consumers, and purveyors of the plans themselves. The immediate driving force may be cost—the best service for the least money—but the ultimate goal is to achieve accountability and maintain high-quality service. This goal is a long way off, maybe as long as 8 or 10 years, according to speakers at a spring meeting of the American Peer Review Association held in Arlington, Va. Although there is no agreement yet on how to achieve health care plan accountability, it was clear from presentations at the meeting that discussions on the issue are well under way. Concern about rising expenditures for health care has fostered the growth of managed care. But "there is a wide variation in what we call
A hypercoagulable state follows orthotopic liver transplantation
Authors: Robert L. Stahl, Alexander Duncan, Michael A. Hooks, Michael J. Henderson, William J. Millikan, Dean W. Warren
Journal: Hepatology (1990)

Orthotopic liver transplantation may be associated during the postoperative period with hepatic artery thrombosis, a catastrophic occurrence generally necessitating emergency retransplantation. To assess the contribution of the coagulation mechanism to this complication, the levels of procoagulant and anticoagulant proteins were followed in 41 liver transplant patients during the first 10 postoperative days. The mean activities of all procoagulant factors reach normal values on day 1 except for factors V and VII, which achieve normal activity by day 3. Supernormal levels of factór VIII activity and antigen are noted (peak values on day 5 of 334% ± 113% and 481% ± 260%, respectively). The anticoagulant proteins show delayed recovery, with deficient antithrombin III levels seen in 81% of patients on day 3 and 57% on day 5. Similarly, proteins C and S are subnormal in 24% and 21%, respectively on day 3, and 20% and 10%, respectively, on day 5. During this period, elevated levels of thrombin/antithrombin complexes are encountered, reflecting in vivo activation of the coagulation mechanism. Activated thrombin is, therefore, being generated at a time when a decrease in the major regulatory anticoagulant proteins exists. These data suggest an imbalance between the hemostatic and thrombotic mechanisms and indicate a sustained prothrombotic state that may contribute to the risk for hepatic artery thrombosis. Using a regimen of low-dose heparin and fresh frozen plasma infusion, no thromboses have been seen in 65 consecutive liver transplants. (Hepatology 1990;12:553-558).
RhoA Mediates Angiotensin II–Induced Phospho-Ser536 Nuclear Factor κB/RelA Subunit Exchange on the Interleukin-6 Promoter in VSMCs
Authors: Ruwen Cui, Brian Tieu, Adrian Recinos, Ronald G. Tilton, Allan R. Brasier
Journal: Circulation Research (2006)

The vasoconstrictor angiotensin II (Ang II) accelerates atherosclerosis by inducing vascular gene expression programs, producing monocyte recruitment, and vascular remodeling. In vascular smooth muscle cells (VSMCs), Ang II signaling activates interleukin (IL)-6 expression, a cytokine producing acute-phase inflammation, mediated by the transcription factor nuclear factor kappaB (NF-kappaB). The classical NF-kappaB activation pathway involves cytoplasmic-to-nuclear translocation of the potent RelA transactivating subunit; however, because nuclear RelA is present in VSMCs, the mechanism by which NF-kappaB activity is controlled is incompletely understood. In this study, we focus on early activation steps controlling RelA activation. Although Ang II only weakly induces approximately 1.5-fold RelA nuclear translocation, RelA is nevertheless required because short interfering RNA-mediated RelA knockdown inhibits inducible IL-6 expression. We find instead that Ang II stimulation rapidly induces RelA phosphorylation at serine residue 536, a critical regulatory site in its transactivating domain. Chromatin immunoprecipitation assays indicate no significant changes in total RelA binding to the native IL-6 promoter, but an apparent increase in fractional binding of phospho-Ser536 RelA. Inactivation of RhoA by treatment with Clostridium botulinum exoenzyme C3 exotoxin or expression of dominant negative RhoA blocks Ang II-inducible RelA Ser536 phosphorylation and IL-6 expression. Finally, enhanced phospho-Ser536 RelA formation in the aortae of rats chronically infused with Ang II was observed. Together, these data indicate a novel mechanism for Ang II-induced NF-kappaB activation in VSMCs, mediated by RhoA-induced phospho-Ser536 RelA formation, IL-6 expression, and vascular inflammation.
Payment reform needed to promote integrated care, says Nuffield Trust
Authors: J. Wise
Journal: BMJ (2011)

Radical models of payment across clinical pathways, such as global capitated budgets, should be piloted to encourage integrated care, a report from the Nuffield Trust says.

With global capitated budgets a provider is given a total budget for a defined population to maintain health and provide services in order to reduce costly hospital admissions.

The trust’s report, Integration in Action; Four International Case Studies , is based on a detailed study of four separate organisations in Europe and the US that have made good progress integrating health and, in one case, social care services. The report concludes that good governance, leadership, and information technology are all needed for greater integration in healthcare.

The report welcomes the plan to develop “best practice pathways,” …
Death of Smooth Muscle Cells and Expression of Mediators of Apoptosis by T Lymphocytes in Human Abdominal Aortic Aneurysms
Authors: E. Lynne Henderson, Yong-Jian Geng, Galina K. Sukhova, Anthony D. Whittemore, James Knox, Peter Libby
Journal: Circulation (1999)

Background —Thinning of the tunica media and rarefaction of smooth muscle cells (SMCs) characterize aneurysmal aortas. Apoptosis determines the cellularity and morphogenesis of tissue. Macrophages and T lymphocytes infiltrate the wall of abdominal aortic aneurysms (AAAs) and produce death-promoting proteins (perforin, Fas, and FasL). This study investigated whether apoptosis occurs in association with the expression of these proteins. Methods and Results —We examined signs of apoptosis and expression of death-promoting mediators in segments of AAAs from patients undergoing elective repair (n=20). Anti–α-actin immunostaining showed a reduced number of SMCs in AAAs. In situ terminal transferase-mediated dUTP nick end-labeling (TUNEL) showed higher levels of DNA fragmentation in AAAs than in controls (n=5). The AAA walls contained more cells bearing markers of apoptosis than normal aorta ( P &lt;0.05, Student’s t test). Double immunostaining identified SMCs and macrophages as the principal cell types displaying fragmented DNA. Immunohistochemistry revealed that AAAs but not normal aorta contained CD4 + and CD8 + T cells that expressed well-characterized cytotoxic mediators: perforin, which produces membrane damage, and Fas, which acts by ligand-receptor interaction. Double immunostaining also identified SMCs that expressed Fas. Immunoblotting confirmed the presence and, in the case of Fas, activation of these proteins in aneurysmal tissue. Conclusions —Many medial SMCs in AAAs bear markers of apoptosis and signals capable of initiating cell death. Apoptotic death may contribute to the reduction of cellularity and to the impaired repair and maintenance of the arterial extracellular matrix in AAAs. Macrophages and T lymphocytes infiltrate the wall of AAAs, where they can produce cytotoxic mediators such as cytokines, perforin, and Fas/FasL. These death-promoting products of activated immune cells may contribute to elimination of SMCs, a source of elastin and collagen, during the pathogenesis of AAAs.
The chicken or the egg: Adipocytes and hepatic insulin resistance
Authors: Lionel Hebbard, Jacob George
Journal: Hepatology (2010)

Abstract Adipose tissue inflammation is linked to the pathogenesis of insulin resistance. In addition to exerting death-promoting effects, the death receptor Fas (also known as CD95) can activate inflammatory pathways in several cell lines and tissues, although little is known about the metabolic consequence of Fas activation in adipose tissue. We therefore sought to investigate the contribution of Fas in adipocytes to obesity-associated metabolic dysregulation. Fas expression was markedly increased in the adipocytes of common genetic and diet-induced mouse models of obesity and insulin resistance, as well as in the adipose tissue of obese and type 2 diabetic patients. Mice with Fas deficiency either in all cells or specifically in adipocytes (the latter are referred to herein as AFasKO mice) were protected from deterioration of glucose homeostasis induced by high-fat diet (HFD). Adipocytes in AFasKO mice were more insulin sensitive than those in wild-type mice, and mRNA levels of proinflammatory factors were reduced in white adipose tissue. Moreover, AFasKO mice were protected against hepatic steatosis and were more insulin sensitive, both at the whole-body level and in the liver. Thus, Fas in adipocytes contributes to adipose tissue inflammation, hepatic steatosis, and insulin resistance induced by obesity and may constitute a potential therapeutic target for the treatment of insulin resistance and type 2 diabetes. © 2010 American Society for Clinical Investigation.