tbuckley/cabot-search huggingface dataset:
Biodistribution, pharmacodynamics and pharmacokinetics of insulin analogues in a rat model: Oral delivery using pH-Responsive nanoparticles vs. subcutaneous injection
Authors: Kiran Sonaje, Kun-Ju Lin, Shiaw-Pyng Wey, Che-Kuan Lin, Tzyy-Harn Yeh, Ho-Ngoc Nguyen, Chia-Wei Hsu, Tzu-Chen Yen, Jyuhn-Huarng Juang, Hsing-Wen Sung
Journal: Biomaterials (2010)
Combined suppressive drug treatment in severe refractory rheumatoid disease: an analysis of the relative effects of parenteral methylprednisolone, cyclophosphamide, and sodium aurothiomalate.
Authors: M T Walters, M I Cawley
Journal: Annals of the Rheumatic Diseases (1988)

A trial was designed to assess the effects of intramuscular sodium aurothiomalate or intravenous cyclophosphamide, or both, in combination with intravenous 9pulse9 methylprednisolone in severe intractable rheumatoid arthritis. Thirteen patients with severe, active rheumatoid arthritis, unresponsive to conventional therapeutic regimens showed improvement in synovitis after receiving a single intravenous bolus of methylprednisolone (15 mg/kg). Early morning stiffness and Ritchie articular index remained improved over pretreatment values after 12 weeks. There was an early fall in the erythrocyte sedimentation rate, which returned to baseline levels by four weeks. A concomitant intravenous pulse of cyclophosphamide (1 g/m2 body surface area) given to eight patients did not confer any additional benefit. Six patients received sodium aurothiomalate, up to 100 mg intramuscularly a week, and in these patients the early improvement in synovitis induced by methylprednisolone was maintained. Thus between 12 and 24 weeks the Ritchie articular index, visual analogue pain score, erythrocyte sedimentation rate, haemoglobin, and immunoglobin G were significantly better in the patients treated with gold and methylprednisolone than in those treated with methylprednisolone alone, irrespective of whether they had received cyclophosphamide. Methylprednisolone pulse therapy given at the start of gold treatment results in early improvement in synovitis, maintained until the usual delay in achieving a therapeutic effect from gold has elapsed.
Acarbose Treatment and the Risk of Cardiovascular Disease and Hypertension in Patients With Impaired Glucose Tolerance
Authors: Jean-Louis Chiasson, Robert G. Josse, Ramon Gomis, Markolf Hanefeld, Avraham Karasik, Markku Laakso, None for The STOP-NIDDM Trial Research Group
Journal: JAMA (2003)

The worldwide explosive increase in type 2 diabetes mellitus and its cardiovascular morbidity are becoming major health concerns.To evaluate the effect of decreasing postprandial hyperglycemia with acarbose, an alpha-glucosidase inhibitor, on the risk of cardiovascular disease and hypertension in patients with impaired glucose tolerance (IGT).International, multicenter double-blind, placebo-controlled, randomized trial, undertaken in hospitals in Canada, Germany, Austria, Norway, Denmark, Sweden, Finland, Israel, and Spain from July 1998 through August 2001. A total of 1429 patients with IGT were randomized with 61 patients (4%) excluded because they did not have IGT or had no postrandomization data, leaving 1368 patients for a modified intent-to-treat analysis. Both men (49%) and women (51%) participated with a mean (SD) age of 54.5 (7.9) years and body mass index of 30.9 (4.2). These patients were followed up for a mean (SD) of 3.3 (1.2) years.Patients with IGT were randomized to receive either placebo (n = 715) or 100 mg of acarbose 3 times a day (n = 714).The development of major cardiovascular events (coronary heart disease, cardiovascular death, congestive heart failure, cerebrovascular event, and peripheral vascular disease) and hypertension (> or =140/90 mm Hg).Three hundred forty-one patients (24%) discontinued their participation prematurely, 211 in the acarbose-treated group and 130 in the placebo group; these patients were also followed up for outcome parameters. Decreasing postprandial hyperglycemia with acarbose was associated with a 49% relative risk reduction in the development of cardiovascular events (hazard ratio [HR], 0.51; 95% confidence interval [CI]; 0.28-0.95; P =.03) and a 2.5% absolute risk reduction. Among cardiovascular events, the major reduction was in the risk of myocardial infarction (HR, 0.09; 95% CI, 0.01-0.72; P =.02). Acarbose was also associated with a 34% relative risk reduction in the incidence of new cases of hypertension (HR, 0.66; 95% CI, 0.49-0.89; P =.006) and a 5.3% absolute risk reduction. Even after adjusting for major risk factors, the reduction in the risk of cardiovascular events (HR, 0.47; 95% CI, 0.24-0.90; P =.02) and hypertension (HR, 0.62; 95% CI, 0.45-0.86; P =.004) associated with acarbose treatment was still statistically significant.This study suggests that treating IGT patients with acarbose is associated with a significant reduction in the risk of cardiovascular disease and hypertension.
Pseudo-Sylvian Aqueduct Syndrome
Authors: Marc P. Cruciger
Journal: JAMA (1981)

<h3>To the Editor.—</h3> Convergent nystagmus, paresis of upward gaze, and pupillary abnormalities are signs of the Sylvian aqueduct syndrome.<sup>1</sup>We wish to report an unusual case of myasthenic syndrome (Eaton-Lambert) demonstrating convergent nystagmus and pupillary abnormalities. Similar findings have been previously described in diseases affecting the dorsal midbrain. Our patient (who is a subject of a previous report<sup>2</sup>) is a 48-year-old man whose symptoms of lower extremity weakness and ptosis began in 1971. He was initially treated for myasthenia gravis. Because weakness persisted, electromyography was performed and the myasthenic syndrome was diagnosed. He began receiving guanidine, but chronic renal failure developed, necessitating long-term hemodialysis. At the present time he is receiving an experimental protocol of plasmapheresis, prednisone, azathioprine, and anticholinesterase medication. At the time of neuro-ophthalmologic examination, no anticholinesterase medication had been used for 12 hours. The examination showed no paresis of upward gaze. The pupils were sluggish
THE MOTOR ACTIVITY OF THE VENAE CAVAE
Authors: R. BURTON-OPITZ
Journal: JAMA (1922)

The question as to whether the establishment of a definite peripheral resistance requires active variations in the size of the venous blood-bed has been discussed repeatedly. In general, it may be stated that the resistance encountered by the arterial blood in its passage through the vascular system depends on: (<i>a</i>) the size of the arteriocapillary orifice as determined by vasomotor action; (<i>b</i>) the size of the capillary blood-bed, and (<i>c</i>) the viscosity of the blood. The second factor, in turn, embraces the tonicity and contractility of the lining cells of the capillaries as well as of those smooth muscle cells which are scattered through the deeper layers of the skin in the immediate vicinity of these delicate tubules. It is obvious that the size of the capillary blood-bed may be varied not only in an active manner by changes in the contractility of the walls of the capillaries, but also
Cooperative study of renovascular hypertension. Demographic analysis of the study
Authors: M. H. Maxwell
Journal: JAMA (1972)

This report on the Cooperative Study of Renovascular Hypertension, includes details of its purposes, organization, diagnostic studies, statistical methodology, and demographic data. Of 2,442 patients studied, 1,128 subjects were judged to have primary (essential) hypertension, 880 renovascular disease, 355 parenchymal kidney disease, and 79 miscellaneous disorders. There were 577 operative procedures in 502 patients with renal arterial disease. There were 384 patients with follow-up of at least one year postsurgery. A unique aspect of this multidisciplinary cooperative study was its decentralization into special study groups for analysis and refinement of data. This and subsequent publications should provide prospective definitions of "renovascular hypertension," as well as an objective basis for the diagnosis and treatment of this condition.
Long term management of duodenal ulcer in general practice: How best to use cimetidine?
Authors: A G Wade, D Rowley-Jones
Journal: BMJ (1988)

Two hundred and sixty seven patients with duodenal ulceration were entered into a five year study of two strategies of treatment with cimetidine. Two thirds were treated continuously with 400 mg at bedtime supplemented by temporary increases in dosage if they had symptomatic relapses (group 1), and the remaining third were given intermittent “healing” doses for four to eight weeks if a symptomatic recurrence was judged to have occurred (group 2). Life table analysis showed that the probability of remaining free of clinically important symptoms five years after the start of treatment was 24% (95% confidence interval (CI) 15·5% to 32·6%) in group 1 compared with nil in group 2 (p&lt;0·0001). The median values for the longest periods free from relapse for each patient were 108 weeks in group 1 and 32 weeks in group 2, respectively (p&lt;0·0001; 95% CI of the median difference 36 to 76). Over the five years 10 patients suffered major complications, two requiring emergency surgery, while a further nine had elective surgery because of the failure of medical treatment. There were no deaths that could be attributed either to ulceration or to treatment with cimetidine. Medical management was therefore very satisfactory for most patients, though those treated continuously with cimetidine suffered considerably less from their ulcer symptoms. As 80% of patients studied relapsed during the two years after a healing course of cimetidine, continuous treatment will benefit many patients treated in general practice.
Grand mal seizure induced by oral theophylline.
Authors: R A Matthay, M A Matthay, M M Weinberger
Journal: Thorax (1976)

A grand mal convulsion occurred in a patient with decompensated cor pulmonale. Although only modest doses of oral theophylline were being administered at the time of the convulsion the serum theophylline level was markedly raised and the theophylline clearance was very low. After treatment for cor pulmonale theophylline clearance improved; however, with the subsequent onset of fever and pneumonia the clearance decreased again, illustrating the potential lability of theophylline clearance.
Low doses of interferon alpha result in more effective clinical natural killer cell activation.
Authors: B S Edwards, J A Merritt, R C Fuhlbrigge, E C Borden
Journal: Journal of Clinical Investigation (1985)

To define critical parameters concerning interferon (IFN) effects upon natural killer (NK) cells in vivo, we gave cancer patients serial weekly intramuscular injections of purified lymphoblastoid IFN in six doses ranging from 10(5) to 3 X 10(7) U. Dose sequences were determined by randomly allocating patients to one of six levels in a latin square ordering scheme. NK cell stimulation, a threefold peak increase above preinjection levels of cytolysis (P = 0.022), occurred in peripheral mononuclear cells (PMC) sampled 24 h postinjection, of 3 X 10(6) U, but was not detectable at any dose in PMC sampled 7 d postinjection. No blunting occurred in NK cell responsiveness to repeated injection of IFN dosages a second time at or several weeks after study completion. At IFN doses of 3 X 10(6), 10(7), and 3 X 10(7) U, a negative correlation existed between the amount of IFN injected and the average extent of NK cell activation (r = -0.423, P less than 0.05). This contrasted with the progressively increasing response of NK cells to in vitro incubation with increasing concentration of up to 3,000 U/ml of IFN. Overnight culturing of PMC sampled before IFN injections resulted in a mean 1.9-fold increase in cytolytic activity (P = 0.0005) and a mean 53% decrease in variance (P = 0.024) between serial preinjection NK cell activity determinations. Cell separation procedures may, therefore, have resulted in NK cell inactivation, from which overnight culturing permitted recovery. We found that maximal NK cell activation at a low IFN dose, decreasing NK cell responsiveness at higher doses, and the need to culture PMC to efficiently detect NK cell boosting may account for disparities in reported effects of IFN on NK cell function.
Narcotic Bowel Syndrome Treated with Clonidine
Authors: JOHN E. SANDGREN
Journal: Annals of Internal Medicine (1984)

We describe the cases of five patients having a syndrome of chronic abdominal pain, vomiting, weight loss, and features of intestinal pseudo-obstruction associated with prolonged use or abuse of narcotic analgesics. In each patient, abdominal complaints were originally attributed to either mechanical bowel obstruction or an underlying gastrointestinal disorder often involving prior abdominal surgery. Symptoms resolved rapidly in all patients when narcotic administration was stopped. Clonidine therapy was used to alleviate symptoms of narcotic analgesic withdrawal. The narcotic bowel syndrome is a clinically important and frequently unrecognized cause of chronic abdominal pain.
Private transplantations of NHS organs to be banned in UK from October
Authors: M. Gould
Journal: BMJ (2009)

The government has announced a ban on patients paying for private transplant surgery using organs donated within the NHS.

Ministers have accepted the recommendations of an independent report commissioned by the government after concerns that foreign patients were bypassing lengthy NHS waiting lists by paying up to £75 000 (€90 000; $130 000) for a transplantation.

Earlier this year it was revealed that the livers of 50 British NHS donors were transplanted into foreign patients over a two year period, with the bulk of the operations taking place in London at King’s College Hospital and the Royal Free Hospital.

Of the patients …
Food Marketing to Youth
Authors: H. Mollie Grow, Marlene B. Schwartz
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 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
Community acquired infections and bacterial resistance
Authors: H. Goossens, M. J W Sprenger
Journal: BMJ (1998)

In this paper we review the problems of antibiotic resistance in community acquired infections. We discuss pathogens that have a large impact on morbidity and mortality in the community such as Streptococcus pneumoniae , Streptococcus pyogenes , Neisseria meningitidis , the enteric pathogens Salmonella spp and Campylobacter spp, and the urinary tract pathogen Escherichia coli .

#### Summary points

The frequency of resistance to antibiotics among community acquired pathogens and the number of drugs to which they are resistant is increasing

Resistance to antimicrobial drugs has been clearly linked to consumption of antibiotics

The boundaries between community and hospital environments are becoming more blurred and this may have consequences for the development of resistance to antimicrobial drugs

Strategies to limit the spread of resistant strains should include encouraging the judicious use of antimicrobial agents

Guidelines should be based on results derived from well designed surveillance studies

Infection with S pneumoniae is the biggest cause of potentially life threatening, community acquired diseases such as meningitis and pneumonia. It is also the leading bacterial cause of otitis media and sinusitis. However, this pathogen has evolved to reach unexpected levels of resistance to antibiotics. Before the early 1990s most pneumococci isolated in the European Union and the United States were susceptible to penicillin, with minimum inhibitory concentrations of <0.1 mg/l1; this concentration of penicillin killed these organisms rapidly. Since then, resistance to penicillin has increased substantially in certain European countries and in the United States. 2 3

Unfortunately, different authors have used different inhibitory concentrations to define penicillin resistance. However, susceptibility to penicillin is defined by many authors as a minimum inhibitory concentration of <0.1 mg/l; penicillin resistance is classed as intermediate when the minimum inhibitory concentration for S pneumoniae is 0.1-1.0 mg/l, and high when the minimum inhibitory concentration is 2.0 mg/l. Treatment regimens have been proposed …
Carbohydrates and Adiposity
Authors: A. A. Lewis
Journal: BMJ (1964)

missible daily dose of prednisone or its equivalent (" To-day's Drugs," B.M.7., 3 August, p. 299), for in amounts greater than this side-effects increase and control of the disease process becomes increasingly difficult in the face of them.The first proposition might be amended to allow small doses of corticosteroid given in the late evening to control the early-morning stiffness and dis- comfort, which is so often a major disability in these patients.A dose of only 5 mg.prednisone nightly may be sufficient, and at this level little harm occurs, the work of Shuster and Williams' indicating that with this and lower dosage corticosteroids are additive to, rather than suppressive of, normal adrenal cortical secretion.Short courses of corticotrophin, not discussed by Dr. Forestier, are also of assistance in selected cases, as they are less likely, not being corticosteroids, to cause the corticosteroid-dependency rightly
Intubation of the Trachea in the Critical Care Setting
Authors: Charles Natanson
Journal: JAMA (1985)

SKILL at intubation of the trachea is an essential part of the medical repertoire of any physician who has primary care responsibility for patients in a critical care setting. It is common practice in hospitals today to perform tracheal intubation on an emergency or elective basis for ventilatory assistance, high-flow oxygen administration, bronchial hygiene, or airway protection. This article will give the physician not experienced in intubation a general background in the considerations and decisions the experienced laryngoscopist may make when intubating a critically ill patient. This article cannot hope to cover all the materials and techniques used in intubation, but will briefly discuss the key anatomy of the upper airway and the equipment, drugs, and techniques in intubation of the trachea that might be used in a critical care setting. The practice of intubation and airway management should be acquired in a controlled setting under knowledgeable supervision. <h3>Anatomy</h3> The
Is There Tension in Hypertension?-Reply
Authors: Karen A. Matthews
Journal: JAMA (1994)

<h3>In Reply.</h3> —Drs Gross and Mann discuss the possibility of white coat hypertension confounding the results of our study, particularly among anxious individuals. The concept of white coat hypertension was not established until the mid 1980s, so it is possible that some individuals in this study who were given medication by their private physicians for hypertension had white coat hypertension. In addition, all blood pressures recorded for the Framingham Study were performed by the examining physician; therefore, it is possible that elevated clinic blood pressures were also attributable to white coat hypertension. By using the cutoff for hypertension traditionally used by the Framingham Study (160/95 mm Hg), we avoided the milder elevations of blood pressure that may have occurred. However, previous studies have not found evidence that trait anxiety plays a role in white coat hypertension.<sup>1,2</sup>In addition, white coat hypertension is more prevalent in women,<sup>3</sup>and no
THE SIGNIFICANCE OF IATROGENESIS
Authors: E. A. Hildreth
Journal: JAMA (1965)

Antisera prepared in animals were the first really effective therapeutic tools available to physicians for the management of active infections. However, it soon became apparent that the very phenomenon which produced immunity also produced an aberration of immunity: an allergic illness sometimes ensued, ranging in severity from a few benign skin lesions to rapidly fatal anaphylaxis or laryngeal edema. Thus, the first major therapy for control of active infections became a classic example of the two-edged sword, or iatrogenesis. A new item had been added to what Moser aptly called diseases of medical progress. In the early part of this century, when relatively crude serum products were used in large amounts, as many as 80% of all patients developed some form of allergic reaction when treated with antisera prepared in animals. Then, as purified antisera preparations were developed, the incidence of allergic reactions dropped to an insignificant figure.  Worldwide studies
Behring's Alleged Cure for Tuberculosis.
Authors: J. W. Kime
Journal: JAMA (1905)

shown, is, to my mind, a strong argument for its etiologic im¬ portance.The conditions are, therefore, just the same as in another protozoan disease, namely, malaria, where the first dose of quinin causes the parasites to disappear.The S. pallida can not very well be mistaken for anything else when we remember that it is an extremely fine corkscrew spiral, which is only seen with high magnification; I have used a four Lietz ocular and twelfth objective and the very brightest possible illumination and wide open diaphragm.It shows no structure whatever, and nothing but its form can be made out.