tbuckley/cabot-search huggingface dataset:
Insulin resistance in uremia.
Authors: R A DeFronzo, A Alvestrand, D Smith, R Hendler, E Hendler, J Wahren
Journal: Journal of Clinical Investigation (1981)

Tissue sensitivity to insulin was examined with the euglycemic insulin clamp technique in 17 chronically uremic and 36 control subjects. The plasma insulin concentration was raised by approximately 100 microU/ml and the plasma glucose concentration was maintained at the basal level with a variable glucose infusion. Under these steady-state conditions of euglycemia, the glucose infusion rate is a measure of the amount of glucose taken up by the entire body. In uremic subjects insulin-mediated glucose metabolism was reduced by 47% compared with controls (3.71 +/- 0.20 vs. 7.38 +/- 0.26 mg/kg . min; P less than 0.001). Basal hepatic glucose production (measured with [3H]-3-glucose) was normal in uremic subjects (2.17 +/- 0.04 mg/kg . min) and suppressed normally by 94 +/- 2% following insulin administration. In six uremic and six control subjects, net splanchnic glucose balance was also measured directly by the hepatic venous catheterization technique. In the postabsorptive state splanchnic glucose production was similar in uremics (1.57 +/- 0.03 mg/kg . min) and controls (1.79 +/- 0.20 mg/kg . min). After 90 min of sustained hyperinsulinemia, splanchnic glucose balance reverted to a net uptake which was similar in uremics (0.42 +/- 0.11 mg/kg . min) and controls (0.53 +/- 0.12 mg/kg . min). In contrast, glucose uptake by the leg was reduced by 60% in the uremic group (21 +/- 1 vs. 52 +/- 8 mumol/min . kg of leg wt; P less than 0.005) and this decrease closely paralleled the decrease in total glucose metabolism by the entire body. These results indicate that: (a) suppression of hepatic glucose production by physiologic hyperinsulinemia is not impaired by uremia, (b) insulin-mediated glucose uptake by the liver is normal in uremic subjects, and (c) tissue insensitivity to insulin is the primary cause of insulin resistance in uremia.
New Incentive-Based Programs
Authors: E. Albert Reece, Anthony G. Brown, Joshua M. Sharfstein
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
Arsenic-related Bowen's disease, palmar keratosis, and skin cancer.
Authors: M Cöl, C Cöl, A Soran, B S Sayli, S Oztürk
Journal: Environmental Health Perspectives (1999)

Chronic arsenical intoxication can still be found in environmental and industrial settings. Symptoms of chronic arsenic intoxication include general pigmentation or focal "raindrop" pigmentation of the skin and the appearance of hyperkeratosis of the palms of the hands and soles of the feet. In addition to arsenic-related skin diseases including keratosis, Bowen's disease, basal-cell-carcinoma, and squamous-cell carcinoma, there is also an increased risk of some internal malignancies. Arsenic-related diseases are common in areas of the world where the drinking water has a high arsenic content. In this paper, we describe a 35-year-old male patient who had arsenic-related keratosis, squamous-cell carcinoma in the palmar area of his left hand, and Bowen's disease on his left thigh. The patient worked in a borax mine for 15 years, so he was exposed to arsenic in drinking water, airborne arsenic in his workplace, and had direct contact. The patient was treated for 11 months for arsenic-related keratosis until an axillary lymph node metastasis occurred; the lesion was excised and diagnosed to be malignant. Bowen's disease was detected when the patient was being treated for cancer. No other malignancy was found. The patient is still receiving regular follow-up care.
The Treatment of Graves's Disease by Ligation
Authors: L. Rogers
Journal: BMJ (1926)

EARLY ill tlle course of acuite Graves's disease effoits slhould be niade to abolisil, or at least reduice, the thlrotoxicosis, pi)ololigedl exposure to which has been shown to esuilt in defiiiito invocard.laldegeneration.If after fair rmedical mneasuir'es prove ineffective.more radical shouild be? adopted.lIn mv opinion botlh x-ray aiid raditum tlherapy uindesirable, anid tile method 'of choice is partial extirpation of the overactive gland.The Mayos have emphasized importance of performing this operation during pne periods of r emission, to which these patients are but even tilen, in verv severe cases, primary resection prove a formidable and dangernos operati'on involving liiljustifiable risk, becauise the reaction mav be great.How- ever, by gradually cuittinig off the blood supplv to the glanld
Some Effects of Sodium Salicylate on Muscle Metabolism
Authors: K. L. Manchester, P. J. Randle, G. H. Smith
Journal: BMJ (1958)

Reid, Macdougall, and Andrews (1957) have demon- strated anew that aspirin (acetylsalicylic acid) is capable of reducing hyperglycaemia, glycosuria, and ketonaemia in some diabetic patients.In the rat, both aspirin and sodium salicylate are capable of reducing glycosuria and hyperglycaemia in diabetes induced by partial pancrea- tectomy with forced feeding (Ingle, 1950), alloxan (Smith, Meade, and Bornstein, 1952), or cortisone (Smith, 1952).The mechanism of this action of salicy- late is not known.Salicylate is unlikely to act in diabetes by reducing gluconeogenesis, for in normal rats salicylate treatment produces negative nitrogen balance (Winters and Morrill, 1955), and it does not reduce the negative nitrogen balance of diabetes induced in rats with cortisone (Smith, 1952).Smith and Jeffrey (1956) found that salicylate slightly inhibited the uptake of glucose by the isolated rat dia- phragm, an observation which would seem to indicate that salicylate does not increase the utilization of glucose by muscle.However, the experiments of Smith and Jeffrey were carried out with diaphragm incubated in a phosphate-buffered medium.Randle (1956) and Randle and G. H. Smith (unpublished) have observed that oxygen lack and a number of compounds which inter- fere with the oxidative production of energy-rich phos- phate promote the uptake of glucose by diaphragm in- cubated in a medium buffered with bicarbonate, but not in a medium buffered with phosphate.Since sali- cylate is also believed to interfere with the oxidative pro- duction of energy-rich phosphate (Meade, 1954; Smith and Jeffrey, 1956; Brody, 1956; Penniall, 1956), it seemed important to reinvestigate the effect of salicylate on the uptake of glucose by diaphragm in a medium buffered with bicarbonate.When isolated rat diaphragm is incubated in the presence of a 14C-labelled amino-acid, 14C is incor- porated into the protein of the diaphragm (Sinex, Mac- Mullen, and Hastings, 1952; Krahl, 1953; Manchester and Young, unpublished).Since salicylate treatment produces negative nitrogen balance in the intact rat it was of interest also to investigate its influence on the incorporation of [4C]amino-acids into the protein of the isolated diaphragm. MethodsDiaphragm.-Thepreparation and incubation of dia- phragrn were as described by Randle (1956).Media.-Bicarbonate-buffered medium (Gey and Gey, 1936), gassed with 02 + COs (95:5), pH 7.4 at 37°C.Phosphate-buffered medium (Krebs-Ringer phosphate, after Umbreit, Burris, and Stauffer, 1949), gassed with 02, pH 7.4 at 370 C. Glucose was added to give a concentration of 2.5 mg.1/ml.The radioactive amino-acids [1-14C]glycine and
Management of cervical cancer: summary of SIGN guidelines
Authors: R M James, M E Cruickshank, N Siddiqui
Journal: BMJ (2008)

Despite a well organised cervical screening programme for preinvasive disease in the United Kingdom, there are still about 2800 new cases of and 1000 deaths from cervical cancer each year.1 Many patients still present to their general practitioner with symptoms associated with cervical cancer. The Joint Committee for Vaccination and Immunisation has announced the introduction of human papillomavirus vaccination for 12-13 year old girls next year, but it is predicted that it may take 40 to 60 years for an effect on the rates of cervical cancer to be seen. This article summarises the most recent guidance from the Scottish Intercollegiate Guidelines Network (SIGN) on the management of cervical cancer.2 The guideline aims to ensure that equitable standards of care are available to all women who develop cervical cancer and that the social and economic burden it places on women and their carers is minimised. SIGN recommendations are based on systematic reviews of best available evidence, and the strength of the evidence is indicated as A, B, C, or D (fig 1⇓). Recommended best practice ("good practice points") based on the clinical experience of the guideline development group is also indicated (as GPP). Fig 1 Explanation of SIGN grades of recommendations ### Presentation Intermenstrual bleeding, post-coital bleeding, and post-menopausal bleeding are common and non-specific symptoms and may be associated with cervical cancer or with other conditions such as genital Chlamydia trachomatis infection. The probability that a woman aged 45-54 developing post-coital bleeding in the community has cervical cancer is 1 in 2400 (which decreases with younger age to 1 in 44 000 for women aged 20-24).
Effects of Total Replacement of Atrial Myosin Light Chain-2 With the Ventricular Isoform in Atrial Myocytes of Transgenic Mice
Authors: Corinn M. Pawloski-Dahm, Guojie Song, Darryl L. Kirkpatrick, Joe Palermo, James Gulick, Gerald W. Dorn, Jeffrey Robbins, Richard A. Walsh
Journal: Circulation (1998)

Background —In contrast to their well-known and critical role in excitation-contraction coupling of vascular smooth muscle, the effects of the myosin light chains on cardiomyocyte mechanics are poorly understood. Accordingly, we designed the present experiment to define the cardiac chamber–specific functional effects of the ventricular isoform of the regulatory myosin light chain (MLC2v). Methods and Results —Postnatal transgenic cardiac-specific overexpression of MLC2v was achieved by use of the α-myosin heavy chain promoter. Enzymatically disaggregated atrial and ventricular mouse myocytes were field-stimulated at multiple frequencies, and mechanical properties and calcium kinetics were studied by use of video edge detection and FURA 2-AM, respectively. MLC2v overexpression resulted in complete replacement of the atrial with the ventricular isoform of the regulatory myosin light chain at the steady-state mRNA and protein levels in the atria of transgenic mice. Mechanical properties of transgenic atrial myocytes were enhanced to the level of ventricular myocytes of control animals in association with modest decreases in the amplitude of the calcium transient. Conclusions —MLC2v modulates chamber-specific contractility by enhanced calcium sensitivity and/or improved cross-bridge cycling of the thin and thick filaments of the cardiomyocyte.
Visual Hallucinations in Cranial Arteritis
Authors: M. J. Gilkes
Journal: BMJ (1967)

BRTAISL 863 logical findings.Forty-three cases were not x-rayed, and 10 had negative radiological findings.In contrast with this, Hutchinson's cases all had positive radiological findings.We have studied 415 infants with respira- tory distress since August 1963.Of these, 24 had rarer causes of respiratory distress such as diaphragmatic hernia and pneumothorax, 18 died from other causes, and 59 were not x-rayed.Of the remaining 314 cases 150 had radiographs which were normal or showed only localized areas of atelectasis, and the mortality in these cases was only 2%, the three deaths all being in infants of less than 28 weeks' gestation.The good prog- nosis in these cases shows the necessity of excluding them from studies of the effects on mortality of different methods of treatment.In your leading article, in discussing treat- ment of the respiratory distress syndrome with alkalis, you say that "further studies are required to determine the precise effects of these substances and the best way of giving them."We have carried out a study of the effects of intragastric sodium bicar- bonate in the respiratory distress syndrome and our findings are to be published.We found a mortality of 58% in 31 cases given intragastric sodium bicarbonate, and 39% in 69 cases given early milk feeds.These mortality figures are higher than those reported by Abraham and Brown, but refer only to cases with positive radiological find- ings, and are therefore more strictly com- parable with the mortality figures quoted by Hutchison et al.We would agree with the view expressed in your leading article that measures directed towards the relief of hypoxia have more effect in lowering mortality in the respiratory dis- tress syndrome than correction of metabolic acidosis alone.-Weare, etc.,
New-Onset Atrial Fibrillation Predicts Long-Term Mortality After Coronary Artery Bypass Graft
Authors: Mikhael F. El-Chami, Patrick Kilgo, Vinod Thourani, Omar M. Lattouf, David B. Delurgio, Robert A. Guyton, Angel R. Leon, John D. Puskas
Journal: Journal of the American College of Cardiology (2010)
The structural basis of molecular adaptation
Authors: G. B. Golding, A. M. Dean
Journal: Molecular Biology and Evolution (1998)

The study of molecular adaptation has long been fraught with difficulties, not the least of which is identifying out of hundreds of amino acid replacements those few directly responsible for major adaptations. Six studies are used to illustrate how phylogenies, site-directed mutagenesis, and a knowledge of protein structure combine to provide much deeper insights into the adaptive process than has hitherto been possible. Ancient genes can be reconstructed, and the phenotypes can be compared to modern proteins. Out of hundreds of amino acid replacements accumulated over billions of years those few responsible for discriminating between alternative substrates are identified. An amino acid replacement of modest effect at the molecular level causes a dramatic expansion in an ecological niche. These and other topics are creating the emerging field of "paleomolecular biochemistry."
Transcriptomic analysis reveals tomato genes whose expression is induced specifically during effector-triggered immunity and identifies the Epk1 protein kinase which is required for the host response to three bacterial effector proteins
Authors: Marina A Pombo, Yi Zheng, Noe Fernandez-Pozo, Diane M Dunham, Zhangjun Fei, Gregory B Martin
Journal: Genome biology (2014)

Abstract Background Plants have two related immune systems to defend themselves against pathogen attack. Initially, pattern-triggered immunity is activated upon recognition of microbe-associated molecular patterns by pattern recognition receptors. Pathogenic bacteria deliver effector proteins into the plant cell that interfere with this immune response and promote disease. However, some plants express resistance proteins that detect the presence of specific effectors leading to a robust defense response referred to as effector-triggered immunity. The interaction of tomato with Pseudomonas syringae pv. tomato is an established model system for understanding the molecular basis of these plant immune responses. Results We apply high-throughput RNA sequencing to this pathosystem to identify genes whose expression changes specifically during pattern-triggered or effector-triggered immunity. We then develop reporter genes for each of these responses that will enable characterization of the host response to the large collection of P. s. pv. tomato strains that express different combinations of effectors. Virus-induced gene silencing of 30 of the effector-triggered immunity-specific genes identifies Epk1 which encodes a predicted protein kinase from a family previously unknown to be involved in immunity. Knocked-down expression of Epk1 compromises effector-triggered immunity triggered by three bacterial effectors but not by effectors from non-bacterial pathogens. Epistasis experiments indicate that Epk1 acts upstream of effector-triggered immunity-associated MAP kinase signaling. Conclusions Using RNA-seq technology we identify genes involved in specific immune responses. A functional genomics screen led to the discovery of Epk1, a novel predicted protein kinase required for plant defense activation upon recognition of three different bacterial effectors.
TCT-706 A Collaborative Meta-analysis of the Impact of Mitral Regurgitation on Outcomes after Transcatheter Aortic Valve Replacement: 8 Studies involving 8919 patients
Authors: Tarun Chakravarty, eric van belle, Hasan Jilaihawi, Amit Noheria, Luca Testa, Francesco Bedogni, Andreas Rück, Marco Barbanti, Stefan Toggweiler, Martyn Thomas, Muhammed Z. Khawaja, Andrea Hutter, Yigal Abramowitz, Wen Cheng, Webb John, Martin Leon, Raj Makkar
Journal: Journal of the American College of Cardiology (2014)
Beta blocker treatment for angina with associated bradycardia.
Authors: M A James, M Papouchado, S C Jordan
Journal: BMJ (1986)

examination, including rectal examination, was unhelpful.Investigations showed atypical coliforms in the urine but no protein or pus cells.Intravenous pyelogram was reported as normal.A barium enema was performed because of the similarity of the pattern of the fever with that in case 2 and showed a rectosigmoid carcinoma.At laparotomy the tumour was found to be adherent to the bladder, but the liver was clear.A sigmoid colectomy and partial cystectomy were performed.Histology showed a Dukes's B carcinoma of the colon.The patient remained well for 11 years after surgery. CommentPyrexiaofunknownorigin remains unexplained in 10% ofthose who have it despite intensive investigation.3Colorectal cancer is not normally considered to be a possible cause because of the absence of gastrointestinal symptoms.The cases reported here show, however, that investigation of the large bowel in such circumstances can lead to relief of symptoms and may well be life saving.The fevers seem to be transient (30 minutes to two hours) and are often associated with rigors.This suggests that they may be caused by recurrent, transient bacteraemias, a theory substantiated by the growth of E coli on blood cultures in case 1.Interestingly, Streptococcus bovis bacteraemias in patients with endocarditis have recently been reported to have a strong association with colonic neoplasia.In those cases and the ones reported here the fever stopped after the neoplasm was removed.We thank Dr W B Thomson for his invaluable help in the preparation of this article.
Novel risk markers improved Framingham Risk Score cardiovascular event prediction in intermediate-risk adults
Authors: Daniel I. Steinberg
Journal: Annals of Internal Medicine (2012)

Source Citation Yeboah J, McClelland RL, Polonsky TS, et al. Comparison of novel risk markers for improvement in cardiovascular risk assessment in intermediate-risk individuals. JAMA. 2012;308:788-95. 22910756
THE RED-LIGHT TREATMENT OF SMALLPOX.
Authors: NIELS R. FINSEN
Journal: JAMA (1903)

In a former issue ofThe Journal<sup>1</sup>there appeared an article by Dr. J. F. Schamberg, entitled "An Examination into the Claims of the Red-Light Treatment of Smallpox." He criticises the treatment: 1, Because I called it a new one; 2, because he considers my theoretical views concerning smallpox and light to be wrong, and 3, because he is of the opinion that the red-light method has proved inefficacious, and that the good results in all former experiments may have been due to other factors; and he further suggests that the cases so treated were probably so mild in type that they would have escaped suppuration without the red-light treatent. <h3>I. "THE RED-LIGHT TREATMENT IS NOT NEW."</h3> I am surprised that Dr. Schamberg should consider the modern red-light treatment to be the same as the one employed in the middle ages by Gaddesden and
Folic Acid and Methotrexate in Rheumatoid Arthritis
Authors: Jeffrey B. Shiroky
Journal: Annals of Internal Medicine (1996)

Letters1 January 1996Folic Acid and Methotrexate in Rheumatoid ArthritisJeffrey B. Shiroky, MDJeffrey B. Shiroky, MDCleveland Clinic Florida; Ft. Lauderdale, FL 33309Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-124-1_Part_1-199601010-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Morgan and colleagues [1] evaluated folate supplementation during methotrexate therapy for rheumatoid arthritis. It is encouraging to see evidence that such supplementation can reduce the severity of common side effects related to methotrexate therapy. Some questions remain, however, regarding the study design, the conclusions, and the recommendations.First, patients in the high-dose arm of the study reportedly received 27.5 mg of folic acid per week (or approximately 5 mg/d as reported); however, previous interim reports of what I believe to be the same study stated that patients assigned to this arm received 50 mg weekly (10 mg/d ...References1. Morgan SL, Baggott JE, Vaughn WH, Austin JS, Veitch TA, Lee JY, et al. Supplementation with folic acid during methotrexate therapy for rheumatoid arthritis. A double-blind, placebo-controlled trial. Ann Intern Med. 1994; 121:833-41. Google Scholar2. Morgan SL, Baggott JE, Vaughn WH, Austin JS, Alarcon GS, et al. 5 or 50 mg/wk of folic acid (FA) supplementation does not alter the efficacy of methotrexate (MTX) treated rheumatoid arthritis (RA) patients [Abstract]. Arthritis Rheum. 1992; 35(Suppl 5):R18. Google Scholar3. Morgan SL, Baggott JE, Vaughn WH, Austin JS, Veitch TA, Krumdieck CL, et al. 5 or 50 mg/wk of folic acid (FA) supplementation does not alter the efficacy of methotrexate (MTX)-treated rheumatoid arthritis (RA) patients [Abstract]. Arthritis Rheum. 1993; 36(Suppl 9):S79. Google Scholar4. Shiroky JB, Neville C, Esdaile JM, Choquette D, Zummer M, Hazeltine M, et al. Low dose methotrexate with leucovorin (folic acid) in the management of rheumatoid arthritis. Arthritis Rheum. 1993; 36:795-803. Google Scholar Author, Article, and Disclosure InformationAuthors: Jeffrey B. Shiroky, MDAffiliations: Cleveland Clinic Florida; Ft. Lauderdale, FL 33309 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byTHE USE OF FOLATES CONCOMITANTLY WITH LOW-DOSE PULSE METHOTREXATE 1 January 1996Volume 124, Issue 1_Part_1Page: 73-74KeywordsCohort studiesFolic acidMethotrexateRheumatoid arthritis ePublished: 15 August 2000 Issue Published: 1 January 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...