tbuckley/cabot-search huggingface dataset:
Radioiodine Uptake Following lodine-131 Therapy for Graves?? Disease: An Early Indicator of Need for Retreatment
Authors: WILLIAM R. CARPENTIER, PAUL F. GILLILAND, VERONICA K. PIZIAK, F CHARLES PETTY, BETTY G. MCCONNELL, CARLOS A. VERDONK, JESSE D. IBARRA, JOHN Q. THOMPSON
Journal: Clinical Nuclear Medicine (1989)

Forty-five patients with Graves' disease were studied prospectively to determine if 24-hour I-131 uptake measurements alone or in combination with serum thyroid hormone levels at six weeks would determine the necessity for retreatment of the thyrotoxicosis. All patients with an I-131 uptake greater than 30% at six weeks required retreatment. No patient with an I-131 uptake of less than 15% required retreatment. Patients with uptakes between 15% and 30% were variable. An elevated free thyroxin index at 6 weeks is not helpful to determine which patients will remain thyrotoxic. Patients with a free thyroxin index within the normal range at six weeks can be predicted to be euthyroid by 12 weeks if their 24-hour I-131 uptake is between 15% and 30% and to be hypothyroid if their 24-hour I-131 uptake is below 15%. There was no difference between patient groups treated initially with antithyroid medication and those who were not.
GP who saw Baby P can practise again after two and a half years
Authors: C. Dyer
Journal: BMJ (2011)

The GP who missed signs that the battered toddler Peter Connelly was being abused has been allowed to practise again after 12 months’ suspension.

A General Medical Council review panel found that Jerome Ikwueke had “gained considerable insight into his failings” since the original hearing last July ( BMJ 2010;341:c3692, doi:10.1136/bmj.c3692).

But the GP has had 18 conditions placed on his practice for a further 12 months. He can work only as a salaried GP in …
Deaths Due to Adverse Drug Reactions
Authors: Nelson S. Irey
Journal: JAMA (1975)

To the Editor.—  There is wide diversity in estimates on morbidity and mortality relating to adverse drug reactions (ADRs). Opinions on the frequency of ADRs in hospitalized patients range from 15% to 40%. 1 Estimates on mortality due to ADRs vary between 6,000 per year 2 and 30,000 to 140,000 per year. 3   These estimates have been derived from studies based on analysis of symptoms, signs, and clinical laboratory data, and for the most part have not included histopathologic findings.  Morphologic studies on biopsy and autopsy material on more than 2,500 cases of alleged drug-reaction cases have been proceeding for the past nine years at the Registry of Tissue Reactions to Drugs (RTRD) at the Armed Forces Institute of Pathology (AFIP). The pathologic findings on these cases were integrated with their associated clinical and laboratory data.  Three RTRD studies were used to estimate annual mortality from ADRs: (1) an analysis
Participants in research
Authors: David L Sackett
Journal: BMJ (2005)

Neither guinea pigs nor sacrificial lambs, but pointers to better health care 

Patients rightly worry that they risk being sacrificed in randomised trials whose results cannot be applied by clinicians in the front lines of real clinical practice. In a recent US survey, half the public considered trial participants to be “guinea pigs.” Altruistic goals such as “making a contribution to science” were judged far more likely to be achieved than personal benefits such as “getting the best possible treatment” or “having access to the best physician.”1 At the same time, many clinicians worry that the imposition of rigorous trial conditions on highly selected patients, especially in tertiary care settings, generates results that cannot be generalised to routine clinical practice.2

For the most part, these concerns originated from, and are perpetuated by, the examination of single trials or highly selective collections of them. Reports of the ghastly abuse of trial participants are sufficiently frequent and well publicised that they cause some to question …
Levamisole and Cell-Mediated Immunity
Authors: W. Hallowell Churchill, John R. David
Journal: New England Journal of Medicine (1973)

Current widespread interest in the contribution of host immunity to resistance to tumor growth is based on evidence from a variety of animal and human studies.1 Host resistance is mediated by sensitized lymphocytes, and in some cases, in vitro studies have indicated that serum factors may abrogate this protective function.2 In addition to the effect of cells sensitized to tumor antigens, protection may also result from nonspecific stimulation of the immune system such as that caused by BCG.Previous studies have shown that patients with cancer who have absent delayed-type hypersensitivity have a poorer prognosis than those with positive skin . . .
Use of Amiodarone
Authors: Michele Coceani
Journal: JAMA (2007)

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
924 ARE ANGIOTENSIN-RECEPTOR BLOCKERS CANDIDATES FOR THE FIRST CHOICE TREATMENT IN NON-ALCOHOLIC STEATOHEPATITIS (NASH) ASSOCIATED TO MILD-TO MODERATE HYPERTENSION?
Authors: E.F. Georgescu, R. Ionescu, M. Georgescu, G. Florescu, A. Dobrinescu, L. Vancica, M. Niculescu
Journal: Journal of Hepatology (2008)
Leslie James Park Duncan
Authors: Judith M Steel
Journal: BMJ (2005)

Leslie Duncan first qualified in veterinary medicine and served in the Royal Army Veterinary Corps from 1944 to 1946 in charge of a network of mules carrying supplies to the allies in Italy. He then studied medicine and after graduating went to the United States on a Rockefeller scholarship, returning to Edinburgh as a lecturer in the department of therapeutics. He became consultant in charge of Edinburgh Royal Infirmary's diabetic and dietetic department, as it then was, in 1962 and stayed until he retired in 1987.​1987.




Figure 1




In the early 1960s, several decades before the “modern” concept of diabetes centres was developed, he enlarged the diabetes and dietetic centre to include an area for several chiropodists and nurses, eye examination rooms, and a special education room. He also introduced annual eye screening for diabetic retinopathy and liaised closely with the department of ophthalmology. He rationalised the management of ketoacidosis at the Royal Infirmary. He taught that obese patients with type 2 diabetes should be treated with metformin rather than phenformin.

In the early 1970s he facilitated joint antenatal clinics and a joint adolescent clinic and was recommending blood glucose monitoring (with Dextrostix) for patients who were having problems with hypoglycaemia. The department became a centre of excellence, which attracted doctors from all over the world and produced hundreds of papers on all aspects of diabetes.

Leslie's style was unconventional and sometimes caused conflict with the establishment. He wore a blue anorak with a red lining in the days when consultants wore smart suits. When patients told him they would not be able to inject themselves he revealed his purple underpants, stuck a needle into his thigh, and injected saline while stating that the only people who could not inject were those with no hands or those who were seriously mentally deranged. He told obese patients that the only gland that had anything to do with their problem was the salivary gland and advised that they should buy themselves a muzzle. He had dogs with diabetes coming to the Saturday morning clinic mixed in with patients with diabetes who did not wish to miss work.

While in the army he represented Britain at show jumping and rode in the French Grand National.

He leaves a wife, Ann; two children; and three granddaughters.

Leslie James Park Duncan, former consultant diabetologist Royal Infirmary of Edinburgh (b Sumatra 1922; q Edinburgh 1951; BSc, MRCVS, FRCP Ed), died on 2 January 2005 after a stroke.
Kniest dysplasia is characterized by an apparent abnormal processing of the C-propeptide of type II cartilage collagen resulting in imperfect fibril assembly.
Authors: A R Poole, I Pidoux, A Reiner, L Rosenberg, D Hollister, L Murray, D Rimoin
Journal: Journal of Clinical Investigation (1988)

Epiphyseal and growth plate cartilages from four cases of Kniest dysplasia have been studied. In each case collagen fibril organization appeared abnormal by electron microscopy compared with age-matched normal cartilages: fibrils were much thinner, of irregular shape and did not exhibit the characteristic banding pattern. This was associated with the absence (compared with normal cartilage) of the C-propeptide of type II collagen (chondrocalcin) from the extracellular matrix of epiphyseal cartilages, although it was detected (as in normal cartilages) in the lower hypertrophic zone of the growth plate in association with calcifying cartilage. The C-propeptide was abnormally concentrated in intracellular vacuolar sites in Kniest cartilages and its total content was reduced in all cases but not in all cartilages. Moreover, it was not a part of the procollagen molecule. In contrast, type II collagen alpha-chain size was normal, indicating the formation of a triple helix. Also type II collagen content was normal and it was present in extracellular sites and only occasionally detected intracellularly. These observations suggest that the defect in Kniest dysplasia may result from the secretion of type II procollagen lacking the C-propeptide and abnormal fibril formation, and that the C-propeptide is normally required for fibril formation.
Abstract 4650: Pharmacokinetic and pharmacodynamic study of adjuvant gemcitabine therapy of biliary tract cancer following major hepatectomy (KHBO1101)
Authors: Yutaka Fujiwara, Shogo Kobayashi, Hiroaki Nagano, Masashi Kanai, Etsuo Hatano, Masanori Toyoda, Tetsuo Ajiki, Yuki Takashima, Akinobu Hamada, Hironobu Minami, Tatsuya Ioka
Journal: Cancer Research (2014)

Abstract Background: Gemcitabine at a standard dose of 1000 mg/m2 on Day 1, 8 and 15 every 4 weeks is not tolerated in biliary tract cancer (BTC) patients who have undergone surgical resection with major hepatectomy due to severe toxicities such as myelosuppression. Our dose-finding study of adjuvant gemcitabine therapy determined that the recommended dose is 1000 mg/m2 on Day 1 and 15 every 4 weeks. Here, we evaluated the pharmacokinetics and pharmacodynamics of gemcitabine at this recommended dose. Methods: This study evaluated BTC patients scheduled to undergo surgical resection with major hepatectomy followed by postoperative gemcitabine therapy. Pharmacokinetic evaluation of gemcitabine and 2′,2′-difluorodeoxyuridine (dFdU) was conducted at the initial administration of gemcitabine, which was given by intravenous infusion over 30 min at a dose of 800 to 1000 mg/m2. Physical examination and adverse events were assessed for two weeks. Results: Thirteen patients were enrolled from August 2011 to January 2013, with 12 completing the study. Eight patients had hilar cholangiocarcinoma, three had intrahepatic cholangiocarcinoma, and one had distal extrahepatic cholangiocarcinoma. Median interval from surgery to first administration of gemcitabine was 65.5 days (range, 43-83 days). In the twelve patients, the following disorders at all grades of severity were observed: leukopenia (83.3%), neutropenia (66.7%), and thrombocytopenia (50.0%). Further, Grade 3 of neutropenia was observed in 16.7% of these patients. The dose-normalized AUC of gemcitabine and dFdU in patients with major hepatectomy was 10.22 ± 2.54 and 94.38 ± 45.38 mg/L/hr, respectively. These values were generally similar to those of patients with pancreatic cancer who did not undergo hepatectomy in a previous study. Conclusion: This study demonstrated that major hepatectomy did not affect the pharmacokinetics of gemcitabine and dFdU, despite an increase in hematological toxicity. Citation Format: Yutaka Fujiwara, Shogo Kobayashi, Hiroaki Nagano, Masashi Kanai, Etsuo Hatano, Masanori Toyoda, Tetsuo Ajiki, Yuki Takashima, Akinobu Hamada, Hironobu Minami, Tatsuya Ioka. Pharmacokinetic and pharmacodynamic study of adjuvant gemcitabine therapy of biliary tract cancer following major hepatectomy (KHBO1101). [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4650. doi:10.1158/1538-7445.AM2014-4650
The Circulatory Response of Patients with Idiopathic Hypertrophic Subaortic Stenosis to Nitroglycerin and to the Valsalva Maneuver
Authors: EUGENE BRAUNWALD, H. NEWLAND OLDHAM, JOHN ROSS, JOSEPH W. LINHART, DEAN T. MASON, LYNN FORT
Journal: Circulation (1964)

The circulatory responses to nitroglycerin and to the Valsalva maneuver were studied in seven patients with idiopathic hypertrophic subaortic stenosis, in five patients with valvular aortic stenosis, and in three patients without obstruction to left ventricular outflow. In contrast to the patients with valvular stenosis who showed no changes or decreases in their aortic valvular pressure gradients, in all the patients with idiopathic hypertrophic subaortic stenosis an increased pressure gradient was observed following nitroglycerin administration. Similar effects on the pressure gradients were observed during the Valsalva maneuver, an augmentation occurring in patients with hypertrophic obstruction, and a fall being noted in patients with valvular stenosis. In one patient with idiopathic hypertrophic subaortic stenosis, the gradients across the right ventricular outflow tract were increased by nitroglycerin and the Valsalva maneuver. It is postulated that this increase in obstruction resulted primarily from a decrease in ventricular size secondary to the reduction in venous return induced by these interventions. It is proposed that reduction in the size of the left ventricle in patients with idiopathic hypertrophic subaortic stenosis, whether induced by changes in venous return, a decrease in arterial pressure, or by agents having a positive inotropic action, reduces the effective size of the outflow orifice. The administration of nitroglycerin and the performance of the Valsalva maneuver in the course of left heart catheterization provide simple methods for detecting the presence of latent obstruction in patients with idiopathic left ventricular hypertrophy and for differentiating idiopathic hypertrophic subaortic stenosis from other forms of obstruction to left ventricular outflow.
Few doctors believe NHS reforms will improve quality of patient care, shows BMA survey
Authors: Z. Kmietowicz
Journal: BMJ (2011)

A survey of doctors has found that few believe the government’s plans for the NHS in England will deliver the benefits envisaged by the health secretary, Andrew Lansley.

The Ipsos MORI survey of 1645 BMA members from all medical specialties (which represented a 9% response rate out of a total of 18 456 members), carried out in January, found that almost nine in 10 (88%) think the reforms are likely to lead to increased competition between providers, but only a fifth (21%) believe this will improve the overall quality of NHS care.

Similarly, although two thirds (67%) of the respondents …
HIV prevention trial in women is abandoned after drugs show no impact on infection rates
Authors: B. Roehr
Journal: BMJ (2011)

A trial to determine whether treating African women prophylactically with a drug used to treat HIV can prevent them becoming infected with the virus has been stopped early after an independent data monitoring committee said it was “highly unlikely” that the study would demonstrate effectiveness.

The FEM-PrEP study was being conducted at four sites in Kenya, South Africa, and Tanzania. It used orally available placebo or Truvada, a mainstay of HIV treatment in the US and Europe. Truvada is a single pill that combines the drugs emtricitabine and tenofovir disoproxil fumarate.

The monitoring committee conducted a planned interim analysis on 18 February after the trial accrued 56 infections or 75% of the planned 72 infection end points. On the basis of that analysis it recommended on 14 April that the trial …
Charities demand money back in Guy's changeover
Authors: O Dyer
Journal: BMJ (1994)

The future of a major new treatment and research centre at Guy's Hospital in London is now uncertain after charities that donated a large part of its £ 140m cost demanded their money back in protest at the government's plans to move most clinical services to St Thomas's Hospital nearby. The building, the third and final phase of a long running project of improvements to Guy's Hospital, was to be known as Philip Harris House. But the Philip and Pauline Harris Charitable Trust, which had planned to give £ 6m to the project, has demanded the return of the £ 2m already handed over and has withdrawn any further support.

Philip Harris House, which is largely completed, would have had 240 beds, an intensive care unit, …
Asymptomatic infection with hepatitis C virus
Authors: C A Seymour
Journal: BMJ (1994)

campaign should also target teenagers and emphasise that smoking is an important cause.Tobacco advertising should be banned.Secondly, a short course of teaching by oral surgeons should be introduced into the curriculums of all medical schools so that doctors, who are responsible for referring 40% of patients with oral cancer, are educated in examination and diseases of the mouth at the beginning of their careers.Finally, the free dental check up should be reintro- duced, as recommended by the House of Commons Select Committee on Health,22 so that casual patients with oral ulcers have no financial disincentives to attending a dentist for diagnosis.The treatment of advanced oral cancer entails long, costly surgical operations and prolonged courses of radiotherapy and chemotherapy.The disease puts an immense emotional and physical strain on patients and their families.Now is the time for the government and the Department of Health to institute the measures outlined above in a nationally co- ordinated campaign to reduce the burden of this crippling disease.
STUDIES ON THE SOLUBLE PRECIPITABLE SUBSTANCES OF VACCINIA
Authors: James Craigie, F. O. Wishart
Journal: The Journal of Experimental Medicine (1936)

1. Thermolabile (L) and thermostable (S) antigens occur in solution in suspensions of vaccine pulp. 2. These antigens are also present on the elementary bodies of vaccinia and participate in the agglutination of these bodies by antivaccinia serum.
The Mitochondrial Genome of the Lizard Calotes versicolor and a Novel Gene Inversion in South Asian Draconine Agamids
Authors: S. A. M. Amer, Y. Kumazawa
Journal: Molecular Biology and Evolution (2007)

A complete mitochondrial DNA (mtDNA) sequence was determined for the lizard Calotes versicolor (Reptilia; Agamidae). The 16,670-bp genome with notable shorter genes for some protein-coding and tRNA genes had the same gene content as that found in other vertebrates. However, a novel gene arrangement was found in which the proline tRNA (trnP) gene is located in the light strand instead of its typical heavy-strand position, providing the first known example of gene inversion in vertebrate mtDNAs. A segment of mtDNA encompassing the trnP gene and its flanking genes and the control region was amplified and sequenced for various agamid taxa to investigate timing and mechanism of the gene inversion. The inverted trnP gene organization was shared by all South Asian draconine agamids examined but by none of the other Asian and African agamids. Phylogenetic analyses including clock-free Bayesian analyses for divergence time estimation suggested a single occurrence of the gene inversion on a lineage leading to the draconine agamids during the Paleogene period. This gene inversion could not be explained by the tandem duplication/random loss model for mitochondrial gene rearrangements. Our available sequence data did not provide evidence for remolding of the trnP gene by an anticodon switch in a duplicated tRNA gene. Based on results of sequence comparisons and other circumstantial evidence, we hypothesize that inversion of the trnP gene was originally mediated by a homologous DNA recombination and that the de novo gene organization that does not disrupt expression of mitochondrial genes has been maintained in draconine mtDNAs for such a long period of time.
Long-term results of electrical stimulation of the lower esophageal sphincter for the treatment of gastroesophageal reflux disease
Authors: L. Rodríguez, P. Rodriguez, B. Gómez, J. Ayala, D. Oksenberg, A. Perez-Castilla, M. Netto, E. Soffer, M. Crowell
Journal: Endoscopy (2013)

In patients with gastroesophageal reflux disease (GERD), temporary electrical stimulation of the lower esophageal sphincter (LES) increases LES pressure without interference with LES relaxation. The aim of the current study was to investigate the safety and efficacy of long term LES electrical stimulation therapy (LES-EST), using a permanently implanted stimulator for the treatment of GERD.Patients with GERD who were at least partially responsive to proton pump inhibitors (PPIs) and who had hiatal hernia of ≤ 3 cm and esophagitis of Los Angeles Grade A, B, or C were included in the study. Stimulation electrodes were placed in the LES and a pulse generator (EndoStim LES Stimulation System; EndoStim BV, The Hague, The Netherlands) was implanted laparoscopically. LES stimulation was delivered at 20 Hz, 215 μs, 3 - 8 mA in multiple 30-minute sessions. Patients were evaluated at follow-up using the GERD Health-Related Quality of Life (HRQL) questionnaire, daily symptom and medication diaries, the SF-12 Health Survey, esophageal pH testing, and high resolution manometry.A total of 24 patients (mean age 53 ± 12 years; 14 men) were implanted and 23 completed the 12-month evaluation. No serious implantation or stimulation-related adverse affects or sensations were reported. Median composite GERD-HRQL score at 12 months was 2.0 (interquartile range [IQR] 0 - 3.0), which was significantly better than baseline scores both on PPI therapy (median 9.0, IQR 6.0 - 10.0; P = 0.002) and off PPIs (median 23.5, IQR 21 - 25.75; P < 0.001). The median percentage of the 24-hour period with esophageal pH < 4.0 at baseline was 10.1 % (IQR 7.7 - 15.5), which was reduced to 3.3 % (1.8 - 6.9) at 12 months (P < 0.001), with 69 % of patients showing either normalization or > 50 % improvement in their distal esophageal pH. At 12 months, 96 % of patients (22/23) were completely off PPI medication.During the long term follow-up of 12 months, LES - EST was safe and effective for the treatment of GERD. There was a significant and sustained improvement in GERD symptoms, reduction in esophageal acid exposure with elimination of daily PPI usage, and no stimulation-related adverse effects.