tbuckley/cabot-search huggingface dataset:
Effect of intensive glycemic control on microalbuminuria in type 2 diabetes. Veterans Affairs Cooperative Study on Glycemic Control and Complications in Type 2 Diabetes Feasibility Trial Investigators.
Authors: S R Levin, J W Coburn, C Abraira, W G Henderson, J A Colwell, N V Emanuele, F Q Nuttall, C T Sawin, J P Comstock, C K Silbert
Journal: Diabetes Care (2000)

OBJECTIVE: Microalbuminuria can reflect the progress of microvascular complications and may be predictive of macrovascular disease in type 2 diabetes. The effect of intensive glycemic control on microalbuminuria in patients in the U.S. who have had type 2 diabetes for several years has not previously been evaluated. RESEARCH DESIGN AND METHODS: We randomly assigned 153 male patients to either intensive treatment (INT) (goal HbA(1c) 7.1%) or to standard treatment (ST) (goal HbA(1c) 9.1%; P = 0.001), and data were obtained during a 2-year period. Mean duration of known diabetes was 8 years, mean age of the patients was 60 years, and patients were well matched at baseline. We obtained 3-h urine samples for each patient at baseline and annually and defined microalbuminuria as an albumin:creatinine ratio of 0.03-0.30. All patients were treated with insulin and received instructions regarding diet and exercise. Hypertension and dyslipidemia were treated with similar goals in each group. RESULTS: A total of 38% of patients had microalbuminuria at entry and were evenly assigned to both treatment groups. INT retarded the progression of microalbuminuria during the 2-year period: the changes in albumin:creatinine ratio from baseline to 2 years of INT versus ST were 0.045 vs. 0.141, respectively (P = 0.046). Retardation of progressive urinary albumin excretion was most pronounced in those patients who entered the study with microalbuminuria and were randomized to INT. Patients entering with microalbuminuria had a deterioration in creatinine clearance at 2 years regardless of the intensity of glycemic control. In the group entering without microalbuminuria, the subgroup receiving ST had a lower percentage of patients with a macrovascular event (17%) than the subgroup receiving INT (36%) (P = 0.03). Use of ACE inhibitors or calcium-channel blockers was similarly distributed among the groups. CONCLUSIONS: Intensive glycemic control retards microalbuminuria in patients who have had type 2 diabetes for several years but may not lessen the progressive deterioration of glomerular function. Increases in macrovascular event rates in the subgroup entering without albuminuria who received INT remain unexplained but could reflect early worsening, as observed with microvascular disease in the Diabetes Control and Complications Trial.
The legacy of the tobacco colossus Richard Doll
Authors: M. Daube, S. Chapman
Journal: BMJ (2012)

Continues to increase 

In early 1947, Austin Bradford Hill suggested that Richard Doll, who was then a smoker, should be recruited to work on a study of smoking and lung cancer. He described Doll as “a very good worker to whom it is well worth while giving a wider experience of medical statistical work with an eye to the future.”1

In 1950 Doll and Hill published their initial findings in the BMJ (delayed for a year by faint hearts at the Medical Research Council),1 2 and Doll went on to become the tobacco colossus. Others had, as he often acknowledged, published important work. In a linked study (doi:10.1136/bmj.e7093), Sakata and colleagues examine the impact of smoking on overall mortality and life expectancy in Japan using data from a large population based cohort recruited in the same year as the first Doll and Hill publication.3

Countless scientific papers and reports on the many harms of smoking were published in the decades after 1950. In 1962, a BMJ editorial observed that “the causative link between cigarettes and lung cancer is undeniable, and no amount of …
Liposomal carfilzomib nanoparticles effectively target multiple myeloma cells and demonstrate enhanced efficacy in vivo
Authors: Jonathan D. Ashley, Jared F. Stefanick, Valerie A. Schroeder, Mark A. Suckow, Nathan J. Alves, Rikio Suzuki, Shohei Kikuchi, Teru Hideshima, Kenneth C. Anderson, Tanyel Kiziltepe, Basar Bilgicer
Journal: Journal of Controlled Release (2014)
707-3 CIBIS Left Ventricular Function Sub-study: Analysis of Predictive Factors of Initial Improvement and Prognostic Value
Authors: Philippe Lechat, Hervé Lardoux, Jean-Pierre Boissel, Serge Witchitz, Martin Hetzel, Luigi Ciampricotti, Eric Chanton, Christian Mésenge, Patrice Jaillon
Journal: Journal of the American College of Cardiology (1995)
Optimal Medical Therapy Is Superior to Transplantation for the Treatment of Class I, II, and III Heart Failure
Authors: R.S. Freudenberger, J. Kim, I. Tawfik, F.A. Sonnenberg
Journal: Circulation (2006)

Background— The survival benefit of heart transplantation (HT) compared with optimal medical therapy (OMT) has never been tested. Methods and Results— We created a decision analytic model that simulates a randomized clinical trial of OMT versus HT for each New York Heart Association (NYHA) class. The simulation calculates average life expectancy. The following assumptions were made for OMT annual mortality: class I no excess mortality from HF; class II and III based on MERIT-HF are 5.3% and 8.1%. Class IV is 12.8%, based on COPERNICUS. HT mortality rates were based on survival curves for HT 1982 to 2001. For classes I, II, and III, OMT demonstrated a life expectancy gain of 113 months (232±2.2 versus119±2.1), 38 months (152±2.1 versus 114±2.1), and 6 months (117±1.8 versus 111±2.2), respectively, over HT. Class IV favored HT with a life expectancy gain of 26 months (107±2.1 versus 81±1.4) over OMT. Sensitivity analysis revealed if improvement in OMT decreased mortality by 38% for class IV patients, OMT and HT would have equivalent life expectancies. If improvement in HT resulted in a 7% increase in post-HT survival, OMT and HT would be equivalent for class III patients. If improvement in HT resulted in a 30% increase in post-HT survival, OMT and HT would be equivalent for class II patients. Conclusions— Our model predicts that currently, OMT is superior to HT for classes I, II, and III, but HT is superior for class IV. However, future advances in OMT or HT may change the relative benefits of these treatment modalities.
Characterization of a Carrier-Mediated Transport System for Taurine in the Fetal Mouse Heart In Vitro
Authors: David S. Grosso, William R. Roeske, Rubin Bressler
Journal: Journal of Clinical Investigation (1978)

Cardiac taurine levels are elevated in hypertension and congestive heart failure. A possible mechanism for this increase in taurine is an alteration of its uptake. We sought to identify and characterize a carrier-mediated transport system for taurine in the mammalian myocardium utilizing the fetal mouse heart in organ culture. Hearts from fetuses of 16-19 days gestational age used in these studies had an endogenous taurine content of 14.1+/-0.5 nmol/mg tissue. The uptake of [(3)H]taurine was linear for up to 8 h. Taurine was accumulated against a concentration gradient as demonstrated by a net increase in taurine concentration when hearts were incubated in 0.5 mM taurine. [(3)H]Taurine uptake was saturable, K(m) = 0.44 mM, temperature dependent, and required sodium. The close structural analogues, hypotaurine and beta-alanine, reduced [(3)H]taurine uptake by 87% when present in 100-fold excess. The alpha-amino acids alanine, alpha-aminoisobutyric acid, glycine, leucine, and threonine did not inhibit uptake. Other taurine analogues tested were guanidinotaurine, guanidinopropionic acid, gamma-aminobutyric acid, 2-aminoethane phosphonic acid, aminomethane sulfonic acid, 3-aminopropane sulfonic acid, N-acetyltaurine, and isethionic acid. We conclude that a carrier-mediated transport system for taurine exists in the fetal mouse heart based on the demonstration of (a) temperature dependence, (b) saturability, and (c) structural selectivity of the uptake process. Transport was demonstrated to be mediated by a beta-amino acid uptake system. In addition, taurine uptake was observed to be sodium dependent, energy dependent, and capable of accumulating taurine against a concentration gradient.
Quality of medical services is in decline in Gaza, says UN official
Authors: J. Zarocostas
Journal: BMJ (2010)

The quality of medical services in the Gaza Strip has deteriorated since the attack last year by Israel, because of the continuing blockade, and the population is suffering from “a high level of misery,” a United Nations humanitarian official has said.

The blockade is affecting the delivery of drug supplies, spare parts for medical equipment, and fuel for back-up hospital generators to cope with frequent power cuts, he said, and patients awaiting specialist treatment in neighbouring Israel were not being allowed to go there.

Restriction in the import of essential construction materials is delaying the rebuilding of hospitals and primary health facilities damaged during the attack, the official said.

“When it comes to Gaza there is still a high level of undignified life for Palestinians and little reconstruction,” said Philippe Lazzarini, head of the UN Office for the Coordination of Humanitarian …
“The Medical Humanities,” for Lack of a Better Term
Authors: Rafael Campo
Journal: JAMA (2005)

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
Intrinsic hazard of breech presentation.
Authors: A W Banks
Journal: BMJ (1980)

prognosis, must naturally always take prece- dence over a desire to improve the mortality rate.For all these various reasons we would like to end with a plea that future investigations into the effectiveness of neonatal intensive care undertaken before 1975 should in parLicular focus on the outcome of the low birthweight group 1500-1999 g.Certainly infants of less than 1000 g are best excluded or dealt with separately.
The Role of Persuasion—Reply
Authors: David Shaw, Bernice Elger
Journal: JAMA (2013)

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
Hypersensitivity to Mechlorethamine
Authors: KENNETH S. WILSON
Journal: Annals of Internal Medicine (1981)

Letters1 June 1981Hypersensitivity to MechlorethamineKENNETH S. WILSON, M.B., SKARIA ALEXANDER, M.B.KENNETH S. WILSON, M.B.Search for more papers by this author, SKARIA ALEXANDER, M.B.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-94-6-823_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The recently published review by Weiss and Bruno (1) prompts us to report a second case of type 1 hypersensitivity to intravenous mechlorethamine.A 52-year-old white woman had upper abdominal discomfort and night sweats in June 1976. She had no history of allergies. Physical examination showed generalized superficial lymphadenopathy, hepatosplenomegaly and a mass of retroperitoneal lymph nodes in the left iliac fossa. Lymph node biopsy showed nodular well differentiated lymphocytic lymphoma. Bone marrow biopsy was positive for lymphocytic lymphoma. Initial hemoglobin was 12.2 g/dL; leukocytes, 9800/mm3(68% neutrophils, 23% lymphocytes), and platelets 162 000/mm3. Treatment with intravenous...References1. WEISSBRUNO RS. Hypersensitivity reactions to cancer chemotherapeutic agents. Ann Intern Med. 1981;94:66-72. LinkGoogle Scholar2. DEVITASERPICKCARBONE VAP. Combination chemotherapy in the treatment of advanced Hodgkin's disease. Ann Intern Med. 1970;73:881-95. LinkGoogle Scholar3. MCKELVEYGOTTLIEBHAUTLANE EJAM. Hydroxyldaunomycin combination chemotherapy in non-Hodgkin's lymphoma. Proc Amer Soc Clin Oncol. 1975;16:233. Abstract. Google Scholar4. ROSSCHABNER WB. Allergic reaction to cyclophosphamide in a mechlorethamine-sensitive patient. Cancer Treat Rep. 1977;61:495-6. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Saskatoon Cancer Clinic University Hospital Saskatoon, Saskatchewan Canada PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByAlkylating AgentsDrug ReactionsGrowing identity, growing a home: contrasting functions of two nineteenth-century gardensCutaneous complications of chemotherapeutic agents 1 June 1981Volume 94, Issue 6Page: 823-823KeywordsBiopsyHepatosplenomegalyHypersensitivityLymph nodesLymphocytesLymphomaMechlorethamineNeutrophilsPlateletsSweat Issue Published: 1 June 1981 PDF DownloadLoading ...
Screening for lung cancer in a high-risk group: but I still haven't found what I'm looking for...
Authors: G. A. Silvestri
Journal: European Respiratory Journal (2006)

It seems so intuitive. Find early disease, remove it, and people will live long, productive lives. Screening for other cancers is commonplace already, isn't it? So why can't the pulmonary community just get on with it? We even have the advantage of targeting a “high-risk” group, namely smokers. Don't we get it? People are dying here. The overall 5-yr survivorship for lung cancer is ∼14%, as opposed to 60–75% for those with resected early stage disease. Within the past several months, the International Early Lung Cancer Action Project (IELCAP), a single-arm observational study of >30,000 persons, screened with low-dose computed tomography (CT), reported an astounding 88–92% estimated 10-yr survival in 412 stage I patients resected with lung cancer discovered on screening 1. The results must have merit. Or do they?

For the seasoned respiratory physician, this must feel like deja vu . In the 1970s and 1980s, randomised controlled trials of screening with chest radiography were undertaken 2, 3. More early stage lung cancers were detected and more patients were operated on, but …
Porous-coated Acetabular Component Quantitative Assessment of Normal Radiophosphate Uptake as a Function of Implant Age
Authors: LEONARD ROSENTHALL, LUIS F. CHEN, MALCOLM E. GHAZAL, EMERSON BROOKS
Journal: Clinical Nuclear Medicine (1991)

A computer-assisted quantitative analysis was undertaken of normal radiophosphate bone uptake adjacent to the porous-coated acetabular component in asymptomatic patients. Implants ranged from 1.6 to 49 months of age. In 62 hips, it was found that implants newer than 12 months of age had uptakes that were significantly greater than those 12 months or older. Between 12 and 49 months, there was no correlation with age, indicating a stabilization of the remodeling process.
Concerted Activation of the AIM2 and NLRP3 Inflammasomes Orchestrates Host Protection against Aspergillus Infection
Authors: Rajendra Karki, Si Ming Man, R.K. Subbarao Malireddi, Prajwal Gurung, Peter Vogel, Mohamed Lamkanfi, Thirumala-Devi Kanneganti
Journal: Cell Host & Microbe (2015)
Chronic Active Hepatitis: The Challenge for a New Nomenclature
Authors: Albert J. Czaja
Journal: Annals of Internal Medicine (1993)

Objectives: To review the etiologic agents and pathogenic mechanisms of chronic active hepatitis, to describe the current nomenclature for this disease and highlight its shortcomings, and to propose guidelines for change. Data Sources: Relevant references were identified through a MEDLINE search (1982 to 1992), through prominent review articles and texts, and through a personal library of journals and reprints. Additional references were selected from the bibliographies of identified articles. Study Selection: All pertinent articles on the etiologic agents, pathogenic mechanisms, and nomenclature of chronic active hepatitis were studied. Data Synthesis: Subtypes of chronic active hepatitis can be defined by etiologic agent or immunoserologic marker, and these subtypes may have different clinical features, prognoses, pathogenic mechanisms, and treatments. An unauthorized jargon has evolved to accommodate these subtypes, and it may wrongly or prematurely connote their validity. Patients with cryptogenic disease, mixed viral and immunologic features, and atypical findings lack a formal designation. No established mechanism exists for modification of the nomenclature. Conclusions: Chronic hepatitis can be subclassified into different subtypes that are defined by etiologic agent or by predominate pathogenic mechanism. A new nomenclature must be based on this knowledge. Formal mechanisms must be established to revise the nomenclature and to promulgate change.
Severe IgE‐mediated anaphylaxis following consumption of fried frog legs: definition of α‐parvalbumin as the allergen in cause
Authors: C. Hilger, F. Grigioni, L. Thill, L. Mertens, F. Hentges
Journal: Allergy (2002)

Background: IgE‐mediated allergic reactions to bullfrog and edible frog have been reported. The implicated allergens have not been defined so far. The frog material and the patient's serum from a case of severe food‐induced anaphylaxis were used to define the implicated allergen at the protein and DNA level. Methods: Immunoblotting techniques and N ‐terminal protein microsequencing were used to define the allergen recognized by the patient's serum. Back translation from the identified protein sequence was used to design degenerated primers to amplify the allergen's cDNA by polymerase chain reaction (PCR). We defined the nucleotide sequence of the allergen from the frog of Indonesian origin that was consumed by the patient, and the homologous cDNA from Rana esculenta . Results: Protein microsequencing revealed that the implicated frog allergen belonged to the parvalbumin family. cDNAs coding for α‐ and β‐parvalbumin of R. esculenta and Rana species were cloned. Recombinant proteins were expressed in Escherichia coli . The patient's serum IgE antibodies recognized parvalbumin prepared from frog muscle and recombinant α‐parvalbumin from R. species but not from R. esculenta . Recombinant β‐parvalbumin was not recognized by the IgE antibodies. Conclusion: This work defines at the protein and DNA levels α‐parvalbumin as the allergen implicated in a case of IgE‐mediated anaphylaxis to frog muscle. It also shows that a protein belonging to the parvalbumin family is implicated in type I allergies outside the fish species.
A CASE OF FLAT RACHITIC PELVIS; PROLAPSE OF THE CORD WITH THE HEAD; VERSION AND EXTRACTION.
Authors: JOS. B. De LEE
Journal: JAMA (1897)

Mrs. H., iv-para; two forceps deliveries; one craniotomy; one spontaneous delivery, child living. Present labor at term, began Nov. 9, 1896, at 9 P.M. Dr. A. E. Coy was called before midnight and found the cervix admiting two fingers, cephalic presentation and a large loop of pulsating cord in the vagina. Pains were strong and soon dilated the cervix. At 2 A.M. Dr. Coy kindly invited me to see the case. Patient is a large, strong, apparently well-built Irish woman. Spines, 28½; crests, 31; trochanters, 34½; Baudelocque, 19; conj. diag., 11; conj. vera, estimated at 9 to 9¼ cm. Position, O. L. A.; heart tones, 140 per minute, strong and regular; head freely movable above the inlet. Internally—perineum torn deeply at some previous labor, cervix thick, os admits the hand easily, old scars in the vagina, head movable above the inlet, sagittal suture transverse, small fontanelle at left, large to
Neck sprains after car accidents.
Authors: G. Horne
Journal: BMJ (1989)

Some patients were given volume loading to improve cardiac output after the application of positive end expiratory pressure.Without measurements of wedge pressure the volume of fluid required is difficult to assess, and clinical indicators of volume state in this type of patient are not accurate.In addition, to maintain optimal oxygen delivery and cardiac output in the face of a high positive end expiratory pressure it mav be necessary to utilise vasoactive drugs.These drugs have unpredictable and sometimes deleterious effects on oxygen transport and respiratory func- tion (particularly pulmonary venous admixture).Unless mixed venous oxygen saturation and oxygen consumption are monitored these effects, which may make tissue hypoxia worse, will be missed.We agree that the study of Drs Singer and Bennett confirms the need for haemodynamic monitoring.Measurements should also be made to ensure that optimal global oxygen transport has been achieved, which, with our present under- standing and technical skill, will necessitate pulmonary artery catheterisation.