tbuckley/cabot-search huggingface dataset:
To Pump or Not to Pump
Authors: David S. Schade, Virginia Valentine
Journal: Diabetes Care (2002)

First fully described in 1983, intensive insulin therapy attempts to match the levels of insulin in the blood with the physiologic needs of the diabetic patient (1). The results of the Diabetes Control and Complications Trial solidified the importance of this approach to the prevention of microvascular complications of diabetes (2). There are two primary approaches to intensive insulin therapy: 1 ) multiple daily injections (MDI), and 2 ) continuous subcutaneous insulin infusion utilizing an external insulin infusion pump (CSII). For the last 10 years, a scientific (and often emotional) debate has existed concerning which approach is superior. The answer is important, as it affects the lifestyle, financial reserves, safety, and glucose control of the diabetic patient.

Subcutaneous insulin does not reproduce the physiological delivery of insulin to the liver and systemic circulation. In humans, insulin is secreted directly into the hepatic portal vein such that the liver is exposed to higher concentrations of insulin compared with the systemic circulation. The liver subsequently removes ∼50% of this insulin, thereby lowering the exposure of the peripheral tissues to insulin. This differential insulin exposure has physiological ramifications, resulting in very fine control of intermediary metabolism. In contrast, both CSII and MDI deliver insulin subcutaneously, bypassing the liver and entering the systemic circulation. However, an insulin pump has one unique advantage over insulin injections: the ability to program changes in basal insulin dosage to meet an anticipated increase or decrease in need. This feature can be advantageous in controlling the normal rise in blood glucose concentration before breakfast (i.e., the dawn phenomenon) or preventing anticipated hypoglycemia from exercise or fasting. The ability to set basal profiles has been considered to be the major benefit of the CSII, but a recent study demonstrates that the use of the “dual wave” and “square wave” bolus delivery significantly …
Free Amino-acid Concentrations in Fetal Fluids
Authors: F. Cockburn, S. P. Robins, J. O. Forfar
Journal: BMJ (1970)

The pattern of free amino-acid concentrations in maternal venous plasma, fetal umbilical arterial plasma, fetal urine, and amniotic fluid at 15 to 20 weeks' gestation has been determined. Free amino-acid concentrations were greater in fetal plasma than in maternal plasma, amniotic fluid, or fetal urine.The ratios of amino-acid concentrations in fetal umbilical arterial plasma and urine indicate that the fetal kidney can effectively conserve amino-acids, possibly reaching an adult level of competence in this respect.There was little correlation between amino-acid concentrations in the fluids analysed with the exception of that between amniotic fluid and fetal urine.
1364 DEEP SEQUENCING REVEALS ACCUMULATION OF VIRAL VARIANTS IN HCV GENOTYPE 1 INFECTED PATIENTS DURING RIBAVIRIN MONOTHERAPY
Authors: J. Dietz, U. Mihm, S.-E. Schelhorn, D. Fitting, S. Susser, M.W. Welker, G. Teuber, M. Manns, T. Berg, T. Lengauer, S. Zeuzem, E. Herrmann, C. Sarrazin
Journal: Journal of Hepatology (2011)
Activated Endocannabinoid System in Coronary Artery Disease and Antiinflammatory Effects of Cannabinoid 1 Receptor Blockade on Macrophages
Authors: Koichi Sugamura, Seigo Sugiyama, Toshimitsu Nozaki, Yasushi Matsuzawa, Yasuhiro Izumiya, Keishi Miyata, Masafumi Nakayama, Koichi Kaikita, Toru Obata, Motohiro Takeya, Hisao Ogawa
Journal: Circulation (2008)

Cannabinoid 1 (CB1) receptor blockade with rimonabant represents a clinical therapeutic strategy for obesity. Recently, the role of the endocannabinoid system has been described in peripheral organs. We sought to determine whether the endocannabinoid system could be involved in human atherosclerosis and whether CB1 receptor blockade could modulate proinflammatory activity in macrophages.mRNA expression levels of CB1 receptor in coronary atherectomy samples were significantly higher in patients with unstable angina than in those with stable angina (3.62+/-2.96-fold; n=7; P<0.05). Immunoreactive area analysis of the coronary artery showed that CB1 receptor expression was greater in lipid-rich atheromatous plaques than in fibrous plaques, especially in CD68 macrophages (9.5+/-1.2% versus 0.6+/-0.6%; n=5; P<0.01). Levels of blood endocannabinoids were significantly higher in patients with coronary artery disease (n=20) than those without coronary artery disease (n=20) (median [interquartile range]: anandamide, 1.048 pmol/mL [0.687 to 1.387 pmol/mL] versus 0.537 pmol/mL [0.468 to 0.857 pmol/mL], P<0.01; 2-arachidonoyl glycerol, 13.30 pmol/mL [6.65 to 16.21 pmol/mL] versus 7.67 pmol/mL [6.39 to 10.03 pmol/mL], P<0.05). In cultured macrophages, expression of CB1 receptor was significantly increased during monocyte-macrophage differentiation (1.78+/-0.13-fold; n=6; P<0.01). CB1 receptor blockade in macrophages induced a significant increase in cytosolic cAMP (29.9+/-13.0%; n=4; P<0.01), inhibited phosphorylation of c-Jun N-terminal kinase (-19.1+/-12.6%, n=4; P<0.05), and resulted in a significant decrease in the production of proinflammatory mediators (interleukin-1beta, -28.9+/-10.9%; interleukin-6, -24.8+/-7.6%; interleukin-8, -22.7+/-5.2%; tumor necrosis factor-alpha, -13.6+/-4.8%; matrix metalloproteinase-9, -16.4+/-3.8%; n=4 to 8; P<0.01).Patients with coronary artery disease demonstrated the activation of the endocannabinoid system with elevated levels of blood endocannabinoids and increased expression of CB1 receptor in coronary atheroma. CB1 receptor blockade exhibited antiinflammatory effects on macrophages, which might provide beneficial effects on atherogenesis.
Assessing Clinical Skills with Standardized Patients
Authors: Samuel A. Brody
Journal: Annals of Internal Medicine (1987)

Letters and Corrections1 February 1987Assessing Clinical Skills with Standardized PatientsSAMUEL A. BRODY, M.D.SAMUEL A. BRODY, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-106-2-335_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Stillman and coworkers (1) are to be praised for their work in assessing the clinical skills of residents. If they are successful in establishing their technique as a valid tool, they may be credited with saving the physicians from themselves. Although the medical profession claims that it watches over its own, it has done very little to reassure the public that there is any uniformity in physician ability. Although board certification does offer a partial solution, many problems still remain. Among the problems are the following.1. Many physicians are not board certified.2. Recertification is not...Reference1. STILLMANSWANSONSMEE PDS. Assessing clinical skills of residents with standardized patients. Ann Intern Med. 1986;105:762-71. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: SAMUEL A. BRODY, M.D.Affiliations: 1450 Coolidge Avenue; Baldwin, NY 11510 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1987Volume 106, Issue 2Page: 335-336 ePublished: 1 December 2008 Issue Published: 1 February 1987 PDF downloadLoading ...
An Assessment of Dapsone Toxicity in the Guinea-pig
Authors: M. H. Williams, W. G. Bradley
Journal: British Journal of Dermatology (1972)

Journal Article An Assessment of Dapsone Toxicity in the Guinea‐pig Get access M. H. Williams, M. H. Williams Muscular Dystrophy Group Research Laboratories Newcastle Genral Hospital Newcastle upon Tyne Search for other works by this author on: Oxford Academic Google Scholar W. G. Bradley W. G. Bradley Muscular Dystrophy Group Research Laboratories Newcastle Genral Hospital Newcastle upon Tyne Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 86, Issue 6, 1 June 1972, Page 650, https://doi.org/10.1111/j.1365-2133.1972.tb05085.x Published: 01 June 1972
The MHC class Ib protein ULBP1 is a nonredundant determinant of leukemia/lymphoma susceptibility to γδ T-cell cytotoxicity
Authors: Telma Lança, Daniel V. Correia, Catarina F. Moita, Helena Raquel, Ana Neves-Costa, Cristina Ferreira, José S. Ramalho, João T. Barata, Luís F. Moita, Anita Q. Gomes, Bruno Silva-Santos
Journal: Blood (2010)
Risk of Proliferative Diabetic Retinopathy in Juvenile-Onset Type I Diabetes: A 40-yr Follow-up Study
Authors: A S Krolewski, J H Warram, L I Rand, A R Christlieb, E J Busick, C R Kahn
Journal: Diabetes Care (1986)

The development of proliferative diabetic retinopathy was studied in three cohorts consisting of 292 patients with recent juvenile-onset, type I (insulin-dependent) diabetes who were followed 20–40 yr beginning in 1939, 1949, and 1959. The risk of this severe eye complication was almost nonexistent during the first 10 yr of diabetes, rose abruptly to its maximum level (∼30/1000 person-years), and remained at that level for the next 25 yr. This pattern did not vary with sex, age at onset of diabetes, or level of glycemic control during the first 5 yr of diabetes. However, the risk of proliferative retinopathy was strongly related to the level of glycemic control during the several years preceding onset of this complication. This was a dose-dependent relationship, with patients in the highest quartile of the distribution of the index of frequency of hyperglycemia having a 10-fold higher risk than individuals in the lowest quartile. A virtually identical pattern was observed in patients who developed diabetes in 1959 as was observed in those who developed diabetes in 1949 or 1939. In contrast, diabetic nephropathy as evidenced by persistent proteinuria showed a lower incidence in the 1959 than in the 1939 cohort. In conclusion, these incidence data do not support the notion that the risk of proliferative retinopathy is mainly a function of duration of diabetes. Instead, the pattern of occurrence of this severe eye complication in type I diabetes suggests that the process leading to the development of proliferative retinopathy consists of two or more stages and that progression through each stage may be governed by different factors.
Expression of decay accelerating factor mRNA and complement C3 mRNA in human diseased kidney
Authors: Katsushige Abe, Masanobu Miyazaki, Takehiko Koji, Akira Furusu, Yoshiyuki Ozono, Takashi Harada, Hideto Sakai, Paul K. Nakane, Shigeru Kohno
Journal: Kidney International (1998)
5-Oxo-6,8,11,14-eicosatetraenoic acid is a potent chemoattractant for human basophils
Authors: Gunter J. Sturm, Rufina Schuligoi, Eva M. Sturm, Julia F. Royer, Doris Lang-Loidolt, Heinz Stammberger, Rainer Amann, Bernhard A. Peskar, Akos Heinemann
Journal: Journal of Allergy and Clinical Immunology (2005)
TCT-500 Effect of Renal Denervation (RDN) in "Real World" Patients with trHTN Compared to Simplicity HTN-2 Trial. First Results of the Luebeck RDN Registry
Authors: Tobias Graf, Christian Fatum, Anne U. Hansen, Kai Mortensen, Joachim Weil
Journal: Journal of the American College of Cardiology (2013)
Pancytopenia Following Low-Dose Oral Methotrexate Therapy for Psoriasis
Authors: Jerome L. Shupack
Journal: JAMA (1988)

Low-dose oral methotrexate therapy was associated with the onset of anemia, leukopenia, and thrombocytopenia in two patients with psoriasis. Both patients survived, but required prolonged hospitalization. No precipitating factor other than methotrexate could be identified.
Autophagic control of listeria through intracellular innate immune recognition in drosophila
Authors: Tamaki Yano, Shizuka Mita, Hiroko Ohmori, Yoshiteru Oshima, Yukari Fujimoto, Ryu Ueda, Haruhiko Takada, William E Goldman, Koichi Fukase, Neal Silverman, Tamotsu Yoshimori, Shoichiro Kurata
Journal: Nature Immunology (2008)
Surgery of the Eye. A Hand-Book for Students and Practitioners.
Authors: Ervin Török, Gerald H. Grout
Journal: JAMA (1925)

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
Serum creatine kinase MM isoenzyme sub-bands after acute myocardial infarction in man.
Authors: R L Morelli, C J Carlson, B Emilson, D R Abendschein, E Rapaport
Journal: Circulation (1983)

Using an isoelectric-focusing (IEF) method developed to quantitate MM isoenzyme-creatine kinase (CK) sub-band activity, we identified a reproducible time-varying pattern of these sub-bands in the serum of eight patients with acute myocardial infarction (MI). Our observations are consistent with the view that MM3-CK (the M2-CK dimer, the pure gene product) is converted intravascularly to MM2-CK, and then to MM1-CK (the M1-CK dimer, the pure postsynthetic sub-band). The MM3-CK reaches a peak first, 16 hours after infarction, followed by MM2-CK, and then by MM1-CK. The MM3-CK is the dominant sub-band in normal myocardium; there is much less MM2-CK and virtually no MM1-CK. The MM3-CK sub-band peak may indicate the time at which enzyme ceases to be released from the injured myocardium. The ratio MM3-CK:MM1-CK rises within 6 hours after onset of chest pain from a baseline of 0.38 and peaks 10 hours after MI. The peak ratio was between 1.1 and 4.2, and the value correlated with the time when total CK activity peaked after MI. The 10-fold change in the MM3:MM1 ratio after MI, as well as the early period at which this ratio peaks (10 hours), makes this an earlier and more sensitive indicator of enzyme release.
Review: Probiotics reduce<i>Clostridium difficile</i>–associated diarrhea in patients receiving antibiotics
Authors: Thomas Fekete
Journal: Annals of Internal Medicine (2013)

Source Citation Johnston BC, Ma SS, Goldenberg JZ, et al. Probiotics for the prevention of Clostridium difficile–associated diarrhea: a systematic review and meta-analysis. Ann Intern Med. 2012;157:878-88. 23362517
Serendipitous Diagnosis of Hyperthyroidism with Tc-99m Bone Scan
Authors: ALEXANDER M. NORBASH, STEPHEN R. DeLONG
Journal: Clinical Nuclear Medicine (1991)

A 23-year-old man with a history of Legg-Perthes' disease of the left hip was evaluated with Tc-99m MDP bone scan for left hip pain following a recent fall. Slight increased activity was shown in the left hip when compared with the right hip. This was thought to correspond with radiographically demonstrated degenerative changes of the left hip. Unexpected intense radionuclide activity was demonstrated in the thyroid gland, as was pertinent absence of relative increased activity in the stomach and salivary glands. Follow-up thyroid scan and RAI uptake demonstrated diffuse toxic goiter, which was subsequently treated with I-131.
378 A significant proportion of myofibroblasts in human liver cirrhosis are of bone marrow origin
Authors: S FORBES, F RUSSO, P BURRA, R MASSIMO, N WRIGHT, M ALISON
Journal: Hepatology (2003)

Mast cells (MCs) play a critical role in allergic inflammation. Although purinergic signalling is implicated in the regulation of various immune responses, its role in MC function is not fully understood. In this study, we investigated the regulatory role of purinergic signalling in MC degranulation, using mouse bone marrow-derived mast cells (BMMCs). Notably, BMMCs expressed various functional P2 adenosine triphosphate (ATP) receptors, including ionotropic P2X4 and P2X7, involved in the regulation of BMMC degranulation. Thus, P2X7 receptor activation induced a marked degranulation from BMMCs directly. Although P2X4 receptor activation did not independently induce degranulation, it significantly potentiated the degranulation triggered by antigen-induced, high-affinity IgE receptor (FcεRI) stimulation. In addition, ATP synergistically augmented degranulation induced by adenosine A3 receptor activation. Moreover, BMMCs highly expressed ecto-nucleotidase CD39, but not ecto-5′-nucleotidase (CD73), and were therefore unable to directly convert ATP to adenosine. However, in the presence of CD73-expressing cells, ATP-mediated BMMC stimulation caused a marked degranulation in a CD73- and adenosine-dependent manner. These results demonstrate that purinergic signalling plays an important role in MC degranulation through at least three distinct mechanisms: (1) higher ATP concentrations directly induce degranulation via P2X7 receptor activation, (2) lower ATP concentrations augment FcεRI-mediated degranulation via P2X4 receptor activation, and (3) in an ecto-nucleotidase-enrich environment, ATP and the converted product adenosine induce a synergistic degranulation by P1 and P2 receptor co-activation.
John Reginald Trounce
Authors: James Trounce
Journal: BMJ (2007)

John Trounce qualified from Guy's Hospital in 1943 with honours in medicine and pathology and obtained the MRCP in the following year. He served in the Royal Army Medical Corps from 1944 to 1947. During this time he showed effortless capacity to get on with people by, as an Englishman, becoming regimental medical officer in the Welsh Regiment, and he was mentioned in despatches. The reason for the latter remains uncertain and characteristically was never discussed.

On return to civilian life he worked successively at Guy's, the Brompton, and the National Heart Hospitals. He took on dual responsibilities in the departments of medicine and pharmacology in the medical school, and this important contribution was recognised by the school when he became the first reader in therapeutics in the University of London in 1958. In 1964 he became the first professor of clinical …
Jean Lorraine Watson
Authors: S. Murray
Journal: BMJ (2002)

Former general practitioner Edinburgh (b Ayr 1914; q Edinburgh 1938), died from a cerebral glioblastoma on 28 June 2001.

After war work (public health in the Western Isles and paediatrics in the Borders), she spent several years raising her two children, which she combined with marriage guidance counselling and locum work. From 1970 she became more involved in general practice at an Edinburgh health centre, where her main interest was the development of a baby clinic.
FAILURE TO KEEP APPOINTMENTS WITH THE ARMY PSYCHIATRIST : AN INDICATOR OF CONFLICT
Authors: L. JAMES GROLD, WILLIAM G. HILL
Journal: American Journal of Psychiatry (1962)

An investigation of failures to keep appointments and reluctance to refer individuals in obvious need of psychiatric assistance was conducted in an Army division psychiatric section. Making use of formal and informal channels of communication within the military community, the investigators were able to explore the basic question of failure to take advantage of the mental health facility. The study indicated that several interrelated factors appeared to be associated with the problem: 1. The attitude of the individual patient; 2. The attitude of the group within which the individual lived and worked; and 3. The attitude of the origin of the referral. These three sources contained a variety of fears, unrealistic expectations, and misconceptions about the psychiatric service. Where conflicts arose as a result of these misunderstandings, the end product was the failure to utilize the mental health facility. Because of these discoveries, a more intensive educational program and an increase of primary contacts with sources of referrals and units within the division were made. These efforts have resulted in a dramatic decrease in the number of appointment failures and an increase in new referrals. Even though this study was conducted in a military rather than a civilian setting, it appears the knowledge gained has applicability to both. It seems evident that consideration must be given to those forces outside the psychotherapeutic process which impede the use of available psychiatric assistance. Of equal importance is the necesity for the psychiatrist to be aware of the basic problem of failure to keep appointments in his own community and to ascertain what courses of action he might take to reduce these conflicting attitudes.
Substandard research or conspiracy?
Authors: M. Griffiths
Journal: BMJ (1995)

The modern history of contraception starts with the liberation of Western women and ends in a right wing American conspiracy to prevent population growth in the third world--at least according to the recent Horizon documentary, “The Human Laboratory.”

We are introduced to the long term contraceptive implant Norplant used by liberated Western women and claimed to be “the most widely studied contraceptive method.” Texan ophthalmologist Dr Tang presents a woman with “pseudotumor cerebri”; less threateningly known as benign intracranial hypertension. Two retinal photographs are mistakenly described as “cross sections of the optic nerve.” Dr Tang asks, “could Norplant have caused this?” but concedes that, although there is a possibility of a link, …
Neuropsychological inference using a microphrenological approach does not need a locality assumption
Authors: Wim E. Crusio
Journal: Behavioral and Brain Sciences (1997)

Although Farah makes a convincing case against the tenability of the locality assumption, she does not propose alternative research strategies that do not rest on this assumption. It is proposed here that we may profitably exploit individual differences in neuroanatomy and behavior. In combination with the use of adequate genetic methods, this approach – termed microphrenology – does not need a locality assumption.
Specialists or Generalists? The Medical Outcomes Study-Reply
Authors: Sheldon Greenfield
Journal: JAMA (1992)

<h3>In Reply.</h3> —We agree with Drs Lasker and Shapiro that describing the mix of patients seen in different systems of care and by different specialists is important. In our article on the mix of patients among medical specialties and systems of care,<sup>1</sup>we documented differences in socioeconomic status, number and type of chronic diseases, clinical severity of some of the more prevalent conditions, and finally, general health status in terms of functioning and well-being. Resource use was not equivalent in the cross-sectional part of the MOS even after applying these controls. However, until we know whether these different levels of utilization are associated with different patient outcomes, we cannot address the issue of appropriateness. Our conclusions regarding differences in resource utilization rest on the adequacy of case mix (or as we prefer to call it, patient mix) and adjustment, which Lasker and Shapiro question. Specifically, they express concern about