tbuckley/cabot-search huggingface dataset:
P277 State of the Union - An Assessment of Current Adult Asthmatics, Their Demographics, Treatment and Outcomes in 210 Practises Across the UK
Authors: D Price, F Ryan, L Mascarenhas, D West, S Gould, C Hutton, D Ryan
Journal: Thorax (2012)

<h3>Introduction and Objectives</h3> Previous studies have shown that overall asthma care can vary greatly between practises. In this study we evaluate the recorded asthma prevalence and characterize asthma control and risk profiles of real-life asthma patients from 210 practises managed within UK primary care. <h3>Methods</h3> Electronic practise data was extracted from patients with asthma from 210 practises across the UK Patients included in the analysis were ≥18 years, had clinician-diagnosed asthma (defined as a diagnostic Read code compatible with the UK Quality and Outcomes Framework [QoF] for asthma) and were receiving current asthma therapy (≥1 asthma prescriptions within the last 2 years). Eligible patients were sent asthma management questionnaires to capture patient-reported outcomes. Pooled practise and patient data were used to characterize patients in terms of their control status (as classified by the Global INitiative for Asthma [GINA] and Royal College of Physician three questions [RCP3]) and risk status (stratified according to exacerbation frequency [Read code defined acute exacerbations and number of courses of acute oral steroids in previous 12 months], with high risk defined as ≥2 exacerbations annually). <h3>Results</h3> From 210 practises across the UK there was an asthma prevalence of 5.9%, comprising 80280 adult patients and comparing to a UK QoF-assessed prevalence of 5.8%. The percentage of patients per practise with uncontrolled asthma (Median [IQR]) was 18.8% (9.1, 26.7) while the percentage per practise with no recorded RCP3 data was 18.9 (12.4, 45.9). 3.2% (n=2594) of the patients were classified as being high risk. <h3>Conclusions</h3> A high proportion of patients managed in routine UK primary care have sub-optimal asthma control. More patients at BTS management stages 4 and 5 have uncontrolled asthma and suffer from a greater number of exacerbations. RCP3 recording varies between practises, and can be poorly recorded.
Closing the Evidence Gap in the Use of Emerging Testing Technologies in Clinical Practice
Authors: Kathryn A. Phillips
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
Epididymitis Caused by <i>Candida glabrata</i>
Authors: Aris Giannopoulos, Evangelos J. Giamarellos-Bourboulis, Ioannis Adamakis, Irene Georgopoulou, George Petrikkos, Nikolaos Katsilambros
Journal: Diabetes Care (2001)

Visceral candidiasis is uncommon in patients with type 2 diabetes (1). Here, we discuss the sixth known case report of fungal epididymitis in a diabetic patient and only the second one caused by Candida glabrata . Two cases of epididymitis caused by C . glabrata have been described in nondiabetic patients, one in an HIV-positive individual (2), and the other in a permanently catheterized patient (3).

An 81-year-old male type 2 diabetic patient who was on a twice-daily insulin regimen was admitted for intermittent fever and confusion over the previous 2 days. Past history revealed a stroke 2 years earlier that led to permanent urinary catheterization, along with several short courses of oral …
Drug companies advised to publish unfavourable trial results
Authors: D. Singh
Journal: BMJ (2003)

New guidelines aimed at increasing transparency and encouraging the responsible and ethical reporting of industry sponsored clinical trials have been published in Current Medical Research and Opinion (2003;19: 149-54), a peer reviewed international journal that focuses on evidence based clinical studies, research investigations, and experimental treatments.

Although not commissioned by the pharmaceutical industry itself, the article presents the first set of guidelines developed by members of the industry (as well as journal editors and academics) for the industry itself.

The “good publication practice” (GPP) guidelines seek greater …
CHEMICAL STUDIES IN HOST-VIRUS INTERACTIONS
Authors: Seymour S. Cohen, Catherine B. Fowler
Journal: The Journal of Experimental Medicine (1948)

Omission of a single constituent from a chemically defined medium approximating the virus growth-promoting properties of broth affects virus production in infected bacteria. This may be estimated by the one-step growth technique and the course of desoxyribose nucleic acid synthesis. Nine amino acids and one purine have been shown to be important by these tests. A combination of all constituents observed to be important by the single supplement and single omission techniques has approximated the virus growth-promoting properties of broth. Certain anomalous results have been commented upon.
Low incidence of fatal coronary heart disease in Pima Indians despite high prevalence of non-insulin-dependent diabetes.
Authors: R G Nelson, M L Sievers, W C Knowler, B A Swinburn, D J Pettitt, M F Saad, I M Liebow, B V Howard, P H Bennett
Journal: Circulation (1990)

The incidence of fatal coronary heart disease (CHD) was determined in a population of Pima Indians from the Gila River Indian Community in Arizona. Between 1975 and 1984, 394 deaths occurred among 4,828 subjects aged 5 years or older, and 199 of these occurred in the 1,093 persons with non-insulin-dependent diabetes. Only 28 deaths were attributed to CHD; all occurred among the 689 diabetic persons 45 years of age or older. No CHD deaths occurred among the 419 nondiabetic subjects 45 years of age or older. The rate of fatal CHD among the diabetic subjects was higher in men than in women and increased with advancing age and duration of diabetes. A higher incidence of fatal CHD was associated with proteinuria, renal insufficiency, medial arterial calcification, diabetic retinopathy, insulin therapy, and an abnormal electrocardiogram. In Pima Indians aged 50-79 years, the incidence of fatal CHD was less than half that found in the Framingham population after controlling for age, sex, and diabetes (incidence rate ratio, 0.4; 95% confidence interval, 0.2-0.7). Factors protecting Pima Indians from fatal CHD may include racial heritage, low serum concentrations of total and low density lipoprotein cholesterol, and rarity of heavy smoking. Among the diabetic subjects, mortality from diabetic renal disease, which shows many of the same risk factors, may selectively compete and remove those at risk for fatal CHD. This would not, however, explain the lack of fatal CHD among the nondiabetic subjects. Fatal CHD shares many of the risk factors associated with the specific microvascular complications of diabetes, and diabetes and its associated attributes are the major predictors of fatal CHD in this population.
Interpretation of fluctuation of transmural potential difference across the proximal small intestine
Authors: D. Wingate, R. Green, J. Symes, M. Pilot
Journal: Gut (1974)

The duodenal transmural potential difference (pd) has been studied in isolated vascular-perfused preparations of canine stomach and duodenum. There was no quantitative correlation between the magnitude of the intraluminal pressure change and pd but fluctuations of pd in these preparations were related to duodenal slow wave activity.
p53 Translocation to Mitochondria Precedes Its Nuclear Translocation and Targets Mitochondrial Oxidative Defense Protein-Manganese Superoxide Dismutase
Authors: Yunfeng Zhao, Luksana Chaiswing, Joyce M. Velez, Ines Batinic-Haberle, Nancy H. Colburn, Terry D. Oberley, Daret K. St. Clair
Journal: Cancer Research (2005)

Abstract The tumor suppressor gene p53 is activated by reactive oxygen species–generating agents. After activation, p53 migrates to mitochondria and nucleus, a response that eventually leads to apoptosis, but how the two events are related is unknown. Herein, we show that p53 translocation to mitochondria precedes its translocation to nucleus in JB6 skin epidermal cells treated with the tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA). Translocation of p53 to mitochondria occurs within 10 minutes after TPA application. In the mitochondria, p53 interacts with the primary antioxidant enzyme, manganese superoxide dismutase (MnSOD), consistent with the reduction of its superoxide scavenging activity, and a subsequent decrease of mitochondrial membrane potential. In contrast to the immediate action on mitochondria, p53 transcriptional activity in the nucleus increases at 1 hour following TPA application, accompanied by an increase in the levels of its target gene bax at 15 hours following TPA treatment. Activation of p53 transcriptional activity is preventable by application of a SOD mimetic (MnTE-2-PyP5+). Thus, p53 translocation to mitochondria and subsequent inactivation of MnSOD explains the observed mitochondrial dysfunction, which leads to transcription-dependent mechanisms of p53-induced apoptosis.
MONILIASIS OF THE SKIN IN DIABETES
Authors: E. F. TRAUT
Journal: JAMA (1934)

According to jacobson, 1 Laugenbeck in 1839 was the first to describe the relation of yeastlike fungi to human disease. They were found in the lesions of thrush in the mouth. Cutaneous moniliasis is common in many classes of patients.  Robin, 2 in 1853, recognized a variety of yeast as the cause of thrush. Since then, Castellani 3 and Stovall 4 have considerably enriched the literature with reports of fungous diseases in human beings. Clarity and simplification of classification of the yeastlike fungi are due to Stovall and his associates. Stovall identified the yeastlike fungi with the genus Monilia. He divides Monilia into three species: Species I, represented by Monilia parapsilosis, is nonpathogenic, species II is represented by M. albicans, and species III by M. candida. Both species II and species III have been repeatedly isolated from human vaginitis and thrush.  In textbooks and in the periodical literature on diabetes
Dose-response relation of inhaled fluticasone propionate in adolescents and adults with asthma: meta-analysis Commentary: Dosage needs systematic and critical
Authors: S. Holt, A. Suder, M. Weatherall, S. Cheng, P. Shirtcliffe, R. Beasley, A. Herxheimer
Journal: BMJ (2001)

<h3>Abstract</h3> <b>Objective:</b> To examine the dose-response relation of inhaled fluticasone propionate in adolescents and adults with asthma. <b>Design:</b> Meta-analysis of placebo controlled, randomised clinical trials that presented data on at least one outcome measure of asthma and that used at least two different doses of fluticasone. <b>Setting:</b> Medline, Embase, and GlaxoWellcome9s internal clinical study registers. <b>Main outcome measures:</b> FEV<sub>1</sub>, morning and evening peak expiratory flow, night awakenings, β agonist use, and major exacerbations. <b>Results:</b> Eight studies, with 2324 adolescents and adults with asthma, met the inclusion criteria. Data on doses of &gt;500 µg/day were limited. The dose-response curve for the raw data began to reach a plateau at around 100-200 µg/day and peaked by 500 µg/day. A negative exponential model for the data, without meta-analysis, indicated that 80% of the benefit at 1000 µg/day was achieved at doses of 70-170 µg/day and 90% by 100-250 µg/day. A quadratic meta-regression showed that the maximum achievable efficacy was obtained by doses of around 500 µg/day. The odds ratio for patients remaining in a study at a dose of 200 µg/day, compared with higher doses, was 0.73 (95% confidence interval 0.49 to 1.08). Comparison of the standardised difference in FEV<sub>1</sub> for an inhaled dose of 200 µg/day against higher doses showed a difference in FEV<sub>1</sub> of 0.13 of a standard deviation (−0.02 to 0.29). <b>Conclusions:</b> In adolescent and adult patients with asthma, most of the therapeutic benefit of inhaled fluticasone is achieved with a total daily dose of 100-250 µg, and the maximum effect is achieved with a dose of around 500 µg/day. However, these findings were limited by the lack of data on individual patients and by the paucity of dose-response studies that included doses of &gt;500 µg/day. <h3>What is already known on this topic</h3> Inhaled corticosteroids are recommended for most patients with asthma, with the dose being increased as required to obtain control A therapeutic dose range of fluticasone propionate of 200-2000 µg/day is recommended in the <i>British National Formulary</i> for adults with asthma <h3>What this study adds</h3> Published data are insufficient to determine with confidence the dose-response relation of inhaled fluticasone at doses of &gt;500 µg/day The dose-response curve for inhaled fluticasone in moderate to severe asthma in adolescents and adults, for all major clinical outcome measures, including exacerbations, begins to plateau at 100-200 µg/day and peaks at around 500 µg/day This study partially explains why adding a long acting β agonist to inhaled corticosteroids is more efficacious than increasing the dose of inhaled steroid beyond this dose range
Comparison of guidelines and self-management plans in asthma
Authors: RJ Meijer, HA Kerstjens, DS Postma
Journal: European Respiratory Journal (1997)

Since the rise in asthma mortality and morbidity, many guidelines and self-management plans have been published. Many of these guidelines and self-management plans are not, however, based on results of previous studies but on the opinion of experts. We compared the five most frequently cited asthma guidelines concerning treatment steps and self-management plans with special regard to peak expiratory flow (PEF)-guided plans in asthma. We also compared results of published studies with asthma-management in the context of the guidelines. Classification of asthma severity differed considerably between the guidelines. This was also true for PEF-guided patient self-management plans. Although there was agreement on the type of drug to be used, guidelines varied with respect to when to use the drug, the "best" strategy to increase the dose, and the maximum dose. The studies available on self-management do not make it possible to determine which part of the programme is most important or cost-effective. The latter is an important issue.
Disruptive Behaviors Among Physicians
Authors: Luis T. Sanchez
Journal: JAMA (2014)

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
Specific Inhibition of the Polymorphonuclear Leukocyte Chemotactic Response to Hydroxy-Fatty Acid Metabolites of Arachidonic Acid by Methyl Ester Derivatives
Authors: Edward J. Goetzl, Frank H. Valone, Vernon N. Reinhold, Robert R. Gorman
Journal: Journal of Clinical Investigation (1979)

The human polymorphonuclear (PMN) leukocyte chemotactic activity of the hydroxy-fatty acid metabolites of arachidonic acid, 12-l-hydroxy-5,8,10-heptadecatrienoic acid (HHT) and 12-l-hydroxy-5,8,10,14-eicosatetraenoic acid (HETE), is eliminated by methylation. Both methyl esters are specific competitive inhibitors of the PMN leukotactic responses to the parent stimuli, and exert no effect on the responses to formyl-methionyl peptides or chemotactic fragments of the fifth component of complement. 50% inhibition of the in vitro chemotactic responses of PMN leukocytes to HETE and HHT was achieved by an equimolar concentration of the corresponding methyl esters, whereas reciprocal cross-inhibition was observed at molar ratios of HETE methyl ester to HHT and HHT methyl ester to HETE which reflected the three- to fivefold greater chemotactic potency of HETE relative to HHT. Methyl esters of structurally related, but nonchemotactic, fatty acids did not competitively inhibit the chemotaxis elicited by HETE or HHT. The intraperitoneal injection of HETE in guinea pigs evoked an eosinophil response at 30 min and a neutrophil response at 5 h, which were prevented by a one-to twofold molar ratio of HETE methyl ester. The competitive inhibition of the in vitro chemotactic activity and the in vivo leukotactic effect of the unsaturated hydroxy-fatty acids by homologous methyl ester derivatives suggests that the cellular component of natural inflammatory reactions may be susceptible to specific regulation by receptor-directed modulation of the activity of the predominant chemotactic principles.
Simultaneous binding of heparin and platelet factor-4 to platelets: Further insights into the mechanism of heparin-induced thrombocytopenia
Authors: McDonald K. Horne, Karen J. Hutchison
Journal: American Journal of Hematology (1998)

Heparin-induced thrombocytopenia (HIT) is mediated by antibody against complexes of platelet factor-4 (PF4) and heparin. Although it has been assumed that these complexes bind to platelets and provide a target for the antibody, this has never been demonstrated. Furthermore, there is evidence suggesting that heparin-PF4 complexes do not bind to platelets. We have analyzed the effect of each ligand on the platelet binding of the other. We particularly focused on the result when heparin and PF4 are in equimolar concentration because we had previously shown that this was the condition under which HIT-IgG increased on the platelet surface. We found that when the molar concentration of PF4 approximates or exceeds that of heparin, the ligands bind simultaneously to the cells and HIT-IgG binds also. However, when heparin is in molar excess, both PF4 binding and HIT-IgG binding are diminished. Our data are consistent with the hypothesis that heparin-PF4 complexes bind via their heparin component to heparin binding sites on the platelet membrane rather than by their PF4 component to PF4 sites. The conditions promoting the binding of the complexes also lead to binding of HIT-IgG. Am. J. Hematol. 58:24–30, 1998. © 1998 Wiley-Liss, Inc.
Mortality in Danish patients with nonmelanoma skin cancer, 19782001
Authors: A.. Jensen, A. Bautz, A.B. Olesen, M.R. Karagas, H.T. Srensen, S. Friis
Journal: British Journal of Dermatology (2008)

Nonmelanoma skin cancer (NMSC) is a growing public health problem among Caucasians, thus mortality data that may provide insight into the clinical course and foster our understanding of NMSC are important.We examined total and cause-specific mortality among patients with NMSC registered in the Danish Cancer Registry from 1978 to 2001.A total of 82 837 patients with basal cell carcinoma (BCC) and 13 453 patients with squamous cell carcinoma (SCC) were followed through the National Death Registry for specific causes of death. Standardized mortality ratios (SMRs) were computed based on mortality rates in the general population.Among patients with BCC, we found a slightly reduced total mortality [SMR 0.97, 95% confidence interval (CI) 0.96-0.98] with decreased SMRs seen for chronic obstructive pulmonary disease (COPD), cardiovascular disease (CVD) and diabetes mellitus. The SMR for suicide was increased. Among patients with SCC, we found an increased total mortality (SMR 1.30, 95% CI 1.26-1.33) due primarily to excess deaths from cancers, COPD, CVD and infectious diseases.We found markedly different mortality patterns among patients with BCC and those with SCC, suggesting important differences in the clinical course of these patients.
Miscommunication with Physicians
Authors: STEVEN L. BERK
Journal: Annals of Internal Medicine (1985)

Letters and Corrections1 December 1985Miscommunication with PhysiciansSTEVEN L. BERK, M.D.STEVEN L. BERK, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-103-6-957_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Baron (1)reminds us to hear our patients as well as their breath sounds and to re-enter their world. I have found this advice to be important in a specific circumstance related to a patient's history of shortness of breath. Medical students quickly learn that they should ask their patients with heart failure about the number of pillows they need to sleep comfortably at night. Patients may answer that they use only one pillow. However, further discussion may reveal that they bend a foam pillow over its horizontal axis to prop their heads. Such manipulation raises the head...Reference1. BARON R. An introduction to medical phenomenology: I can't hear you while I'm listening. Ann Intern Med. 1985;103:606-11. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: East Tennessee State University Quillen-Dishner College of Medicine Johnson City, TN 37614-0002 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 December 1985Volume 103, Issue 6_Part_1Page: 957-957KeywordsDyspneaHeart failureSleep Issue Published: 1 December 1985 PDF downloadLoading ...
Treatment of Chronic Mucocutaneous Candidiasis with Ketoconazole
Authors: ESKlLD A. PETERSEN
Journal: Annals of Internal Medicine (1980)

Twelve patients with chronic mucocutaneous candidiasis were assigned by random allocation to a 6-month course of treatment with ketoconazole or placebo in a double-blind trial. All six recipients of ketoconazole had remission of symptoms and virtually complete regression of mucosal, skin, and nail lesions, whereas only two of the six receiving placebo had even temporary mucosal clearing, and none had improvement of skin or nail disease. The clinical outcome in the ketoconazole-treated group was significantly more favorable (p 0.001) than in the placebo-treated group. The six patients receiving placebo in the controlled trial were then treated with ketoconazole in an open trial, and all responded favorably. Hepatitis, probably drug induced, developed in one patient after 6 months of treatment but proved to be mild and reversible. Oral ketoconazole is an effective treatment for chronic mucocutaneous candidiasis.