tbuckley/cabot-search huggingface dataset:
Helping Physicians Recognize Bedside Rationing
Authors: Peter A. Ubel
Journal: Annals of Internal Medicine (1997)

Letters1 June 1997Helping Physicians Recognize Bedside RationingPeter A. Ubel, MD and Susan Goold, MD, MHSA, MAPeter A. Ubel, MDUniversity of Pennsylvania, Philadelphia, PA 19104University of Michigan Medical Center, Ann Arbor, MI 48109-0376Search for more papers by this author and Susan Goold, MD, MHSA, MAUniversity of Pennsylvania, Philadelphia, PA 19104University of Michigan Medical Center, Ann Arbor, MI 48109-0376Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-11-199706010-00033 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:It seems only fair to tell patients about the conditions that physicians work under and how this might affect the care they receive. Dr. Friedman should be commended for explicitly proposing how this can be done. However, we have several concerns about the physicians' code that Dr. Friedman proposes. We think it is unrealistic to ask physicians to say that they are under no pressure to provide anything other than “optimal” patient care. Physicians are increasingly under intense pressure to consider whether specific medical benefits are worth their costs. Although this pressure should not make physicians withhold necessary ...REFERENCE1. Avorn J. Benefit and cost analysis in geriatric care: turning age discrimination into health policy. N Engl J Med. 1984; 310:1294-1301. Google Scholar Author, Article, and Disclosure InformationAuthors: Peter A. Ubel, MD; Susan Goold, MD, MHSA, MAAffiliations: University of Pennsylvania, Philadelphia, PA 19104University of Michigan Medical Center, Ann Arbor, MI 48109-0376 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1997Volume 126, Issue 11Page: 921-922KeywordsDecision analysisElderlyPatients ePublished: 15 August 2000 Issue Published: 1 June 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Serotonin 5-HT<sub>2</sub>Receptor Interactions with Dopamine Function: Implications for Therapeutics in Cocaine Use Disorder
Authors: Leonard L. Howell, Kathryn A. Cunningham
Journal: Pharmacological Reviews (2014)

Cocaine exhibits prominent abuse liability, and chronic abuse can result in cocaine use disorder with significant morbidity. Major advances have been made in delineating neurobiological mechanisms of cocaine abuse; however, effective medications to treat cocaine use disorder remain to be discovered. The present review will focus on the role of serotonin (5-HT; 5-hydroxytryptamine) neurotransmission in the neuropharmacology of cocaine and related abused stimulants. Extensive research suggests that the primary contribution of 5-HT to cocaine addiction is a consequence of interactions with dopamine (DA) neurotransmission. The literature on the neurobiological and behavioral effects of cocaine is well developed, so the focus of the review will be on cocaine with inferences made about other monoamine uptake inhibitors and releasers based on mechanistic considerations. 5-HT receptors are widely expressed throughout the brain, and several different 5-HT receptor subtypes have been implicated in mediating the effects of endogenous 5-HT on DA. However, the 5-HT2A and 5-HT2C receptors in particular have been implicated as likely candidates for mediating the influence of 5-HT in cocaine abuse as well as to traits (e.g., impulsivity) that contribute to the development of cocaine use disorder and relapse in humans. Lastly, new approaches are proposed to guide targeted development of serotonergic ligands for the treatment of cocaine use disorder.
Common variants in FOXP1 are associated with generalized vitiligo
Authors: Ying Jin, Stanca A Birlea, Pamela R Fain, Christina M Mailloux, Sheri L Riccardi, Katherine Gowan, Paulene J Holland, Dorothy C Bennett, Margaret R Wallace, Wayne T McCormack, E Helen Kemp, David J Gawkrodger, Anthony P Weetman, Mauro Picardo, Giovanni Leone, Alain Taïeb, Thomas Jouary, Khaled Ezzedine, Nanny van Geel, Jo Lambert, Andreas Overbeck, Richard A Spritz
Journal: Nature Genetics (2010)
Monitoring and Care in the Angiographic Suite
Authors: Errol F. Genet
Journal: JAMA (1980)

To the Editor.—  In the QUESTIONS AND ANSWERS section ofThe Journal(243:1951, 1980), several opinions were expressed concerning monitoring and care in the angiographic suite with which I disagree. At our institution, a 220-bed general hospital, virtually all the angiographic special procedures are performed by one of two radiologists who supervise a fully equipped special procedures room staffed by a full-time special procedures team. I wish to make the following points.   Is an intravenous (IV) line necessary? At our institution, an IV infusion is begun before every angiographic examination and is continued for at least one hour after the study for the following reasons: (a) to maintain good hydration in patients who have been receiving nothing by mouth for variable periods before the study. This helps to minimize the nephrotoxic effects of the contrast medium and has been associated with a decreased incidence of complications; (b) to provide a
Short chain fatty acids in the terminal ileum accelerate stomach to caecum transit time in the rat.
Authors: A Richardson, A T Delbridge, N J Brown, R D Rumsey, N W Read
Journal: Gut (1991)

We have previously shown that infusion of triglycerides and long chain fatty acids into the ileum of humans and rats delays small bowel transit time. The present studies have investigated the effect on the stomach to caecum transit time of a baked bean meal of the ileal infusion of 20 mM, 50 mM, and 100 mM acetic, butyric, hexenoic, and caprylic acids in rats. After an 18 hour fast either a control or a short chain fatty acid (SCFA) solution (pH 6.5) was infused into the ileum for 30 minutes (0.3 ml/hour). A test meal was given by gavage and the infusion continued for a further 150 minutes. The arrival of the meal in the colon was signalled by a rise in the exhaled hydrogen concentration. Acetic acid (20 mM, 50 mM, 100 mM), butyric acid (100 mM), and caprylic acid (100 mM) produced a significant acceleration of transit which was inversely proportional to SCFA chain length. In a separate experiment, infusion of 100 mM acetic acid, the most potent SCFA, into an isolated ileal Thirty-Vella loop failed to accelerate transit of the test meal. Our results suggest that SCFAs accelerate transit via a local enteric reflex.
An 87-Year-Old Woman Taking a Benzodiazepine, 1 Year Later
Authors: Richard A. Parker
Journal: JAMA (1999)

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
Advice to a new editor
Authors: Christopher Martyn
Journal: BMJ (2007)

Congratulations on your appointment as editor of the Journal of Amazing Medical Advances . I'm sure that you have already gathered an enthusiastic new editorial team and that you're bursting with ideas for improving the journal. The last thing that I want to do is to dampen that enthusiasm but, as someone who has played the publishing game for a while, I felt a word of warning might be useful.

You'll find, if you haven't done so already, that the first thing potential authors ask you about the journal you edit is: “What's its impact factor?” Indeed, it will usually be the only thing they ask you. If you can reply with a double digit figure, they'll immediately try to interest you in a manuscript they are writing. If you have to admit a low number, your plans to liven up the book reviews and to redesign the journal's website won't be enough to compensate. Potential authors will make an excuse and walk away. If you think I exaggerate how much notice authors take of impact factors, take …
MicroRNA-194 is a target of transcription factor 1 (Tcf1, HNF1α) in adult liver and controls expression of frizzled-6
Authors: Jan Krützfeldt, Nora Rösch, Jean Hausser, Muthiah Manoharan, Mihaela Zavolan, Markus Stoffel
Journal: Hepatology (2011)

Transcription factor 1 (Tcf1; hepatocyte nuclear factor 1α [HNF1α]) is critical for hepatocyte development and function. Whether Tcf1 also regulates hepatic microRNAs (miRNAs) has not been investigated yet. Here we analyzed Tcf1-dependent miRNA expression in adult mice in which this transcription factor had been genetically deleted (Tcf1−/−) using miRNA microarray analysis. The miR-192/-194 cluster was markedly down-regulated in liver of Tcf1−/− mice. MiR-192/-194 levels were also decreased in two other tissues that express Tcf1, kidney and small intestine, although to a lesser extent than in liver. In order to identify targets of miR-192/-194 in vivo we combined Affymetrix gene analysis of liver in which miR-192/-194 had been silenced or overexpressed, respectively, and tested regulated messenger RNAs (mRNAs) with multiple binding sites for these miRNAs. This approach revealed frizzled-6 (Fzd6) as a robust endogenous target of miR-194. MiR-194 also targets human FZD6 and expression of miR-194 and Fzd6 are inversely correlated in a mouse model of hepatocellular carcinoma (Dgcr8flox/flox p53flox/flox × Alb-Cre). Conclusion: Our results support a role of miR-194 in liver tumorigenesis through its endogenous target Fzd6. These results may have important implications for Tcf1-mediated liver proliferation. (HEPATOLOGY 2012;55:98–107)
The Prevalence of Conduction Defects and Cardiac Arrhythmias in Progressive Systemic Sclerosis
Authors: NIGEL K. ROBERTS
Journal: Annals of Internal Medicine (1981)

A prospective noninvasive electrocardiographic study was done on 50 patients with progressive systemic sclerosis. Thirty-two percent had abnormalities on the resting electrocardiogram, of which the commonest were left anterior fascicular block (16%) and first-degree heart block (8%). The 24-hour ambulatory continuous tape-recorded electrocardiograms showed serious abnormalities in 62% of the patients: supraventricular tachycardias (32%), conduction disturbances (14%), coupled ventricular extrasystoles (20%), and ventricular tachycardia (10%). Intracardiac electrophysiologic data were obtained in 20 of these patients, and functional abnormalities of the sinus node, atria, and atrioventricular node were noted in seven, nine, and 10 patients, respectively. One patient had prolonged His-Purkinje conduction time. Of the 20 patients who had electrophysiologic studies, only six had entirely normal findings. These results suggest a much higher degree of cardiac involvement in progressive systemic sclerosis than previously believed. We postulate that the first-degree heart block and supraventricular tachycardias may derive from a similar pathologic process, namely, fibrous atrophy of the proximal atrioventricular node.
A CASE REPORT OF GASOLINE SNIFFING
Authors: ROBERT V. EDWARDS
Journal: American Journal of Psychiatry (1960)

In comparing the 4 cases, it is apparent that gasoline sniffing over a prolonged period need not necessarily produce serious organic damage. Pleasant hallucinations appear to be a reward for sniffing gasoline. In two cases, a feeling of omnipotence and omniscience was clearly reported to be an important effect of gasoline sniffing. Gasoline sniffing may tend to occur in a child with the psychodynamics of a manic.
A recurrent dominant negative E47 mutation causes agammaglobulinemia and BCRâ€“ B cells
Authors: Bertrand Boisson, Yong-Dong Wang, Amma Bosompem, Cindy S. Ma, Annick Lim, Tatiana Kochetkov, Stuart G. Tangye, Jean-Laurent Casanova, Mary Ellen Conley
Journal: Journal of Clinical Investigation (2013)

Approximately 90% of patients with isolated agammaglobulinemia and failure of B cell development have mutations in genes required for signaling through the pre–B cell and B cell receptors. The nature of the gene defect in the majority of remaining patients is unknown. We recently identified 4 patients with agammaglobulinemia and markedly decreased numbers of peripheral B cells. The B cells that could be detected had an unusual phenotype characterized by the increased expression of CD19 but the absence of a B cell receptor. Genetic studies demonstrated that all 4 patients had the exact same de novo mutation in the broadly expressed transcription factor E47. The mutant protein (E555K) was stable in patient-derived EBV-transformed cell lines and cell lines transfected with expression vectors. E555K in the transfected cells localized normally to the nucleus and resulted in a dominant negative effect when bound to DNA as a homodimer with wild-type E47. Mutant E47 did permit DNA binding by a tissue-specific heterodimeric DNA-binding partner, myogenic differentiation 1 (MYOD). These findings document a mutational hot-spot in E47 and represent an autosomal dominant form of agammaglobulinemia. Further, they indicate that E47 plays a critical role in enforcing the block in development of B cell precursors that lack functional antigen receptors.
Bone Scan Images of a Giant Chondrosarcoma
Authors: EMILI MARTINEZ MIRALLES, ALFONS CUARTERO PLAZA, JOAN MINGUELLA MARTÍN, MANUEL PEDRO SANZ MARÍN
Journal: Clinical Nuclear Medicine (1992)

A 66-year-old man was hospitalized because of severe dyspnea caused by a giant left shoulder mass. Its growth had been slow and steady for more than 50 years, but it accelerated in the last few months. The radiographic image was partial because of the immensity of the tumor. Bone scan was the only diagnostic imaging modality able to show the whole lesion and its relationship to the proximal left humerus. No other scintigraphic anormalities were seen. Surgery revealed a low-grade malignant chondrosarcoma infiltrating the proximal humerus and the glenoid cavity.
Effect of altitude training on the renin-angiotensin-aldosterone system and blood pressure in women
Authors: J C Cruz-Márquez, J C Cruz-Campos, A Cruz-Campos, MªB Cueto-Martín, Mª García-Jiménez, MªT Campos-Blasco
Journal: British Journal of Sports Medicine (2011)

Background Altitude training produces advantages over sea level training, but athletes require acclimatization to avoid discomfort or mountain sickness, in which the blood pressure control is essential. Objective To investigate the influence of moderate altitude on blood pressure and renin-angiotensin-aldosterone systems in a women's volleyball team (Honor Division – Spain). Design We assessed 14 elite female volleyball players: 2 weeks under normoxia conditions (640 m above sea level), 2 weeks under relative hypoxia (2450 m, at the High Performance Centre of Sierra Nevada, Granada, Spain) and two final weeks back to normoxia. Setting and participants 14 women (mean age 23±2.8 years; height: 184.9±6.9 cm; weight: 73.1±6.2 kg). All players who started the study completed it. None of the participants reported ingesting contraceptives or hormonal treatments. Interventions The volleyball players trained twice/day (3 h/session). The blood pressure was measured at rest in the morning, during and after physical exercise (both in the morning and in the afternoon season), as well as in urine/24 h the renin, angiotensin and aldosterone, renal water excretion and urinary volume every 5 days. Independent variable: Altitude. Dependent variables: Renin, angiotensin, aldosterone 24/h urinary levels; rest, pre and posttraining blood pressure. Results The aldosterone levels decreased in the first hypoxic week (157.09 pg/ml; p&lt;0.05 respect to level), as well as renin levels (12.82 pg/ml p&lt;0.05 respect to level). There was an increase in renal water excretion (25 701.36 ml/day with a p&lt;0.05). The diastolic blood pressure posttraining showed changes between the hypoxia and normoxia (69.72±12.3 vs 73.45±14.9 mm Hg p&lt;0.05). Conclusions Renin is reduced under hypoxia. Post-exercise diastolic blood pressure changes significantly at altitude with less venous return and may explain symptoms of mountain sickness.
Retinoblastoma: a study of natural history and prognosis of 268 cases.
Authors: E L Lennox, G J Draper, B M Sanders
Journal: BMJ (1975)

The natural history and prognosis of retinoblastoma were analysed using data relating to the 268 cases registered during 1962-8 in England, Scotland, and Wales. The children were followed up for a minimum of four years; the proportion surviving for four years was 86%. The most important factors affecting survival rate were the stage of the tumour at diagnosis and the hospital of treatment. Of children surviving for three years after treatment only three died during the subsequent period of follow-up, which varied from one to seven years. Among children with retinoblastoma treated between 1949 and 1968 nine died between seven and 13 years later of other cancers: seven from osteosarcomas, one from angiosarcoma, and one from fibrosarcoma.
Histiocytosis X With Pericardial Effusion
Authors: Peter Vincent Pickens
Journal: JAMA (1981)

HISTIOCYTOSIS X is a proliferative disorder of histiocytes within various tissues, associated with a specific histopathologic entity, the eosinophilic granuloma. In its more benign form, the disease involves bones, skin, and other soft-tissue structures. More serious disease is associated with visceral infiltration, notably of the liver, spleen, and lung.<sup>1,2</sup>Cardiac involvement has rarely been reported. We describe a patient with skin involvement and a large pericardial effusion containing histiocytes. <h3>Report of a Case</h3> A 60-year-old woman was hospitalized for evaluation of nonpruritic, painless, maculopapular, erythematous rash on her chest, face, back, and arms, and submandibular masses of six months' duration. A skin biopsy specimen showed mature histiocytes with abundant eosinophilic, homogenous cytoplasm (Fig 1). Electron microscopic and histochemical examination confirmed the histiocytic nature of the lesion. A submandibular gland biopsy specimen showed focal aggregations of histiocytes identical to those in the skin. Cultures for acid-fast bacillus and fungus were
Nasal Secretion of lodine-131
Authors: IZZIE BOXEN, ZONG MEI ZHANG
Journal: Clinical Nuclear Medicine (1990)

A case of total-body I-131 imaging showing an abnormal collection of I-131 is presented. The site of uptake was initially thought to be a thyroid carcinoma metastasis in the upper right thigh but was subsequently shown to be due to the nasal secretion of I-131 contaminating a handkerchief. Other possible causes of I-131 contaminated handkerchiefs are also discussed.
Chronic on Acute Renal Failure
Authors: Sushrut S. Waikar, Wolfgang C. Winkelmayer
Journal: JAMA (2009)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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) 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
Tests of Pituitary ACTH Secretory Capacity.
Authors: N. M. Kaplan
Journal: Annals of Internal Medicine (1963)

s1 April 1963Tests of Pituitary ACTH Secretory Capacity.N. M. Kaplan, M.D. (Associate)N. M. Kaplan, M.D. (Associate)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-58-4-723_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptMetopirone (SU-4885) has been widely used as a test of pituitary ACTH reserve. Problems in the interpretation of the test remain, both in the definition of the normal response and in the meaning of the abnormal response.A comparison was made between the urine and plasma levels of both 17-hydroxycorticoids (Porter-Silber chromogens) and 11-desoxycorticosteroids (11-DOCS) in healthy subjects and patients with and without pituitary disease. The response to Metopirone could be interpreted best by the changes in urine 11-DOCS excretion, the normal response being a rise of at least 7 mg/day above the control level. The use of P-S chromogen... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byProbabilities of Pituitary-Adrenal Responsiveness After Steroid TherapyT. S. DANOWSKI, M.D., JAMES V. BONESSI, M.D., GEORGE SABEH, M.D., ROGER D. SUTTON, M.D., MARSHALL W. WEBSTER JR., MARGARET E. SARVER, M.D. 1 April 1963Volume 58, Issue 4Page: 723-723KeywordsAdrenocorticotropic hormoneBlood plasmaExcretionUrine ePublished: 1 December 2008 Issue Published: 1 April 1963 PDF downloadLoading ...
High doses of recombinant $alpha;-interferon or $gamma;-interferon for chronic hepatitis C: A randomized, controlled trial*1
Authors: F SAEZROYUELA
Journal: Hepatology (1991)

Chronic hepatitis C is often a progressive liver disease for which there is no satisfactory treatment. We studied the efficacy of recombinant alpha-interferon or gamma-interferon in the treatment of this disease in comparison with a control group. Thirty patients were randomly assigned to three groups. Ten patients received 7.5 MU alpha-interferon/m2 body surface three times weekly for 3 mo, then 5 MU/m2 for 3 mo and 2.5 MU/m2 for 6 mo. Ten patients were treated with gamma-interferon at a dose of 2 MU/m2 for 6 mo and the other 10 served as controls without treatment. The mean serum ALT levels and liver histological findings improved significantly only in the patients treated with alpha-interferon. No changes were observed in patients treated with gamma-interferon or in controls. Five of 10 patients treated with alpha-interferon had complete responses (mean ALT normal during therapy). After treatment ALT returned to pretreatment levels in two of 5 patients. The long-term response rate after alpha-interferon therapy was 30% at 18 mo. We conclude that alpha-interferon is effective in controlling disease activity in a portion of patients with chronic hepatitis C. High doses of alpha-interferon do not appear to add further benefit in the response rate or relapse rate. gamma-Interferon therapy is ineffective.