tbuckley/cabot-search huggingface dataset:
Free speech rights outweigh restrictions on promoting drugs off label, court rules
Authors: B. Roehr
Journal: BMJ (2012)

A federal appeals court in New York has ruled that regulations prohibiting the off-label promotion of prescription drugs are a violation of constitutionally protected free speech.1 The decision in the United States v Caronia case is likely to be appealed.

The drug at the center of the case is sodium oxybate (marketed in the US as Xyrem), which carries two label indications to treat conditions associated with narcolepsy. Data are insufficient to extend the label indication to children and elderly people, and it carries a “black box” warning of side effects.

A drug sales representative, Alfred Caronia, argued that regulations of the Food and Drug Administration limiting promotional activity only to the …
Immunochemical analysis of uridine diphosphate-glucuronosyltransferase in four patients with the Crigler-Najjar syndrome type I.
Authors: H H van Es, B G Goldhoorn, M Paul-Abrahamse, R P Elferink, P L Jansen
Journal: Journal of Clinical Investigation (1990)

The functional heterogeneity of uridine diphosphate-glucuronosyltransferase (UDPGT) and its deficiency in human liver were investigated. The monoclonal antibody (MAb) WP1, which inhibits bilirubin and phenol-glucuronidating activity, was used to immunopurify UDPGTs from human liver. Purified UDPGTs were injected into mice to obtain new MAbs. Immunoblotting of microsomes with MAb HEB7 revealed at least three polypeptides in liver (56, 54, and 53 kD) and one in kidney (54 kD). In liver microsomes from four patients (A, B, C, and D) with Crigler-Najjar syndrome type I (CN type I), UDPGT activity towards bilirubin was undetectable (A, B, C, and D) and activity towards phenolic compounds and 5-hydroxytryptamine either reduced (A and B) or normal (C and D). UDPGT activity toward steroids was normal. Immunoblot studies revealed that the monoclonal antibody WP1 recognized two polypeptides (56 and 54 kD) in liver microsomes from patient A and none in patient B. With HEB7 no immunoreactive polypeptides were seen in these two patients. Patient C showed a normal banding pattern and in patient D only the 53-kD band showed decreased intensity. These findings suggest considerable heterogeneity with regard to the expression of UDPGT isoenzymes among CN type I patients.
THE IMPACT OF SYSTEMATIC IMPLEMENTATION OF SPECT APPROPRIATENESS CRITERIA IN CARDIOLOGY AND PRIMARY CARE ON SPECT AND SUBSEQUENT invasive PROCEDURES: A PROSPECTivE AND RANDOMIZED CLINICAL TRIAL WITH ONE-YEAR FOLLOW-UP
Authors: Jaime Rodriguez, Kaelin E. DeMuth, Marlow Hernandez, Howard Bush, Kenneth Fromkin, Hermann Stubbe, Nemer Dabage Forzolli, Diana Galindo, Robert Piloto, Jerry Ciocon, Jesus Loquias, Andrew Russell, Jose A. Gascon, Paola Salguero, C. Martin Harris, Randall Starling, Michael Shen
Journal: Journal of the American College of Cardiology (2013)
As with tuberculosis, earlier identification and treatment is the way to tackle HIV
Authors: P. Mortimer
Journal: BMJ (2012)

After 30 years and thousands of scientific papers published on AIDS and its virus, can we see the wood for the trees? Would earlier diagnosis and treatment, by interrupting HIV transmission and limiting its rising incidence, better control its spread and ultimately reduce costs?

Analogies sometimes help. Even before HIV had been discovered AIDS was being compared with chronic hepatitis B. The groups at risk and the routes of transmission were similar, and in both infections a carrier state eventually led to the exhaustion of the target tissue. HIV has, however, proved itself unlike hepatitis B virus—it has continued to resist attempts to develop a vaccine against it, but is much more susceptible to antiviral treatment.

With the drug treatment of HIV now offering such promise, a better analogy lies in the conquest of tuberculosis by combined drug treatment in the 1950s. The stigma that attached to tuberculosis might have allowed case finding and contact tracing to be deemed too difficult, but it was generally accepted that intensified measures to find cases of active tuberculosis were justified …
Variability and associations of fibrinogen and C-reactive protein in the Framingham offspring study
Authors: I. Lipinska, D. Feng, P.W.F. Wilson, M.A. Mittleman, J.E. Muller, P. Sutherland, H. Silbershatz, R.B. D'Agostino, D. Levy, G.H. Tofler
Journal: Journal of the American College of Cardiology (1998)
Sir Archibald Garrod's Conception of Chemical Individuality: A Modern Appreciation
Authors: Barton Childs
Journal: New England Journal of Medicine (1970)

Abstract Discussions of the inborn errors of metabolism are usually prefaced by a reference to the original descriptions of these genetic aberrations by Sir Archibald Garrod. It is less well known that in reflecting on the inborn errors, Garrod was led to formulate ideas about what he called chemical individuality. He suggested that all human differences were chemical, taking their origin from variations in the amino acid composition of the cellular proteins, and evolutionary changes leading to interspecific differences could be explained in the same way. These molecular differences between people and species, he thought, must be a reflection of variations in the quality of the molecules of the chromosomes. Garrod's idea of the gene-enzyme relation expressed in his concept of the inborn errors was almost ignored for about 40 years. That he foreshadowed many other modern ideas of molecular biology is not generally known today.
Daunorubicine in Acute Myelogenous Leukemia in Adults
Authors: Richard S. Bornstein, Athanasios Theologides, B. J. Kennedy
Journal: JAMA (1969)

Daunorubicine (daunomycin, rubidomycin) is an antibiotic with antitumor activity in a wide variety of transplantable animal tumors. Its biologic mechanism of action is by inhibition of deoxyribonucleic acid synthesis with a lesser inhibition on ribonucleic acid synthesis. It is effective in certain solid tumors, and clinical investigations show a potent antileukemic activity. Twelve adult patients with acute myelogenous leukemia were given daunorubicine, 1 mg/kg of body weight, daily for five days. Three complete and two partial remissions were obtained. Bone marrow hypoplasia was the primary toxic reaction encountered. This drug appears to be an effective therapy for the induction of remissions in adults with acute myelogenous leukemia. Since cardiopulmonary toxic reactions have been reported with large total doses of daunorubicine, maintenance therapy with other chemotherapeutic agents has been employed.
196 PROCALCITONIN IS THE BEST DIAGNOSTIC AND PROGNOSTIC MARKER OF SEPSIS IN DECOMPENSATED CIRRHOTIC PATIENTS
Authors: F. Schepis, M. Bianchini, I. Ferretti, M. Marino, S. Bonfreschi, G. Dattomo, F. Agnello, M.L. Wratten, N. De Maria, E. Villa
Journal: Journal of Hepatology (2010)
Pleural effusion during bromocriptine exposure in two patients with pre-existing asbestos pleural plaques: a relationship?
Authors: C Knoop, M Mairesse, C Lenclud, PA Gevenois, P De Vuyst
Journal: European Respiratory Journal (1997)

Two patients with pleural plaques developed pleural effusion and subsequent diffuse pleural fibrosis 50 and 39 yrs after their first exposure to asbestos. The diagnosis of benign asbestos pleural effusion was suggested, but the work-up finally suggested bromocriptine-induced pleural disease in both patients. These two cases illustrate that drug-induced pleural effusion is an important differential diagnosis of benign asbestos pleural effusion. It is, moreover, possible that pre-existing asbestos pleural lesions, or even asbestos exposure, increases the risk of developing bromocriptine-induced pleural disease.
Vulval lichen planus in the practice of a vulval clinic
Authors: L. Micheletti, M. Preti, F. Bogliatto, M.C. Zanotto‐Valentino, B. Ghiringhello, M. Massobrio
Journal: British Journal of Dermatology (2000)

Journal Article Vulval lichen planus in the practice of a vulval clinic Get access L. Micheletti, L. Micheletti Department of Gynaecology and Obstetrics, University of Turin, Largo Mentana 11, 10133 Turin, Italy Search for other works by this author on: Oxford Academic Google Scholar M. Preti, M. Preti Department of Gynaecology and Obstetrics, University of Turin, Largo Mentana 11, 10133 Turin, Italy Search for other works by this author on: Oxford Academic Google Scholar F. Bogliatto, F. Bogliatto Department of Gynaecology and Obstetrics, University of Turin, Largo Mentana 11, 10133 Turin, Italy Search for other works by this author on: Oxford Academic Google Scholar M.C. Zanotto‐Valentino, M.C. Zanotto‐Valentino Department of Gynaecology and Obstetrics, University of Turin, Largo Mentana 11, 10133 Turin, Italy Search for other works by this author on: Oxford Academic Google Scholar B. Ghiringhello, B. Ghiringhello Department of Pathology, Sant'Anna Hospital, Turin, Italy Search for other works by this author on: Oxford Academic Google Scholar M. Massobrio M. Massobrio Department of Gynaecology and Obstetrics, University of Turin, Largo Mentana 11, 10133 Turin, Italy Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 143, Issue 6, 1 December 2000, Pages 1349–1350, https://doi.org/10.1046/j.1365-2133.2000.03935.x Published: 01 December 2000
Improved Glycemic Control and Enhanced Insulin Sensitivity in Type 2 Diabetic Subjects Treated With Pioglitazone
Authors: Yoshinori Miyazaki, Archana Mahankali, Masafumi Matsuda, Leonard Glass, Srikanth Mahankali, Eleuterio Ferrannini, Kenneth Cusi, Lawrence J. Mandarino, Ralph A. DeFronzo
Journal: Diabetes Care (2001)

OBJECTIVE—To elucidate the effects of pioglitazone treatment on glucose and lipid metabolism in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS—A total of 23 diabetic patients (age 30–70 years, BMI &amp;lt; 36 kg/m2) who were being treated with a stable dose of sulfonylurea were randomly assigned to receive either placebo (n = 11) or pioglitazone (45 mg/day) (n = 12) for 16 weeks. Before and after 16 weeks of treatment, all subjects received a 75-g oral glucose tolerance test (OGTT); and hepatic and peripheral insulin sensitivity was measured with a two-step euglycemic insulin (40 and 160 mU · min−1 · m–2) clamp performed with 3-[3H]glucose and indirect calorimetry. HbA1c was measured monthly throughout the study period. RESULTS—After 16 weeks of pioglitazone treatment, the fasting plasma glucose (FPG; 184 ± 15 to 135 ± 11 mg/dl, P &amp;lt; 0.01), mean plasma glucose during OGTT (293 ± 12 to 225 ± 14 mg/dl, P &amp;lt; 0.01), and HbA1c (8.9 ± 0.3 to 7.2 ± 0.5%, P &amp;lt; 0.01) decreased significantly without change in fasting or glucose-stimulated insulin/C-peptide concentrations. Fasting plasma free fatty acid (FFA; 647 ± 39 to 478 ± 49 μEq/l, P &amp;lt; 0.01) and mean plasma FFA during OGTT (485 ± 30 to 347 ± 33 μEq/l, P &amp;lt; 0.01) decreased significantly after pioglitazone treatment. Before and after pioglitazone treatment, basal endogenous glucose production (EGP) and FPG were strongly correlated (r = 0.67, P &amp;lt; 0.01). EGP during the first insulin clamp step was significantly decreased after pioglitazone treatment (P &amp;lt; 0.05), whereas insulin-stimulated total and nonoxidative glucose disposal during the second insulin clamp was increased (P &amp;lt; 0.01). The change in FPG was related to the change in basal EGP, EGP during the first insulin clamp step, and total glucose disposal during the second insulin clamp step. The change in mean plasma glucose concentration during the OGTT was strongly related to the change in total body glucose disposal during the second insulin clamp step. CONCLUSIONS—These results suggest that pioglitazone therapy in type 2 diabetic patients decreases fasting and postprandial plasma glucose levels by improving hepatic and peripheral (muscle) tissue sensitivity to insulin.
Influence of Sodium Balance on the Ability of Diuretics to Inhibit Tubular Reabsorption
Authors: LAURENCE E. EARLEY, JOSEPH A. MATRINO
Journal: Circulation (1970)

Chlorothiazide and ethacrynic acid were given to normal humans and patients with cirrhosis and ascites, with replacement of urinary losses, to obtain information on (1) the influence of different states of sodium balance and excretion on the effectiveness of the drugs in blocking tubular reabsorption and promoting excretion of sodium, and (2) the influence of different states of sodium balance on reabsorption of sodium by different segments of the nephron of man. The results demonstrated that in normal man the natriuretic response to these agents is markedly influenced by the existing state of sodium balance. The differences in response to the drugs related both to differences in the filtered load of sodium and to differences in the fraction of filtered sodium reabsorbed at the diuretic-sensitive distal tubular sites. Sodium loading in the presence of a mineralocorticoid was associated with a thiazideinduced increment in the excretion of sodium which was 10 times greater than that observed during sodium depletion. This effect is suggestive of decreased proximal tubular reabsorption. In patients with cirrhosis and sodium retention the fraction of filtered sodium reabsorbed at both diuretic-sensitive tubular sites was diminished, suggesting increased proximal tubular reabsorption. In addition to demonstrating a striking influence of sodium balance on the natriuretic response to the diuretics, the results suggest that in man sodium diuresis is associated with decreased fractional reabsorption by the proximal tubule and increased fractional and absolute sodium reabsorption by the distal tubule. In patients accumulating edema and ascites, an increase in the fractional reabsorption of sodium appears to occur in the proximal tubule and could account for limited effectiveness of the diuretic agents.
Perchance to Dream
Authors: Donna Pucciani
Journal: JAMA (2010)

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
NB1, a new neutrophil-specific antigen involved in the pathogenesis of neonatal neutropenia
Authors: Parviz Lalezari, Georgette B. Murphy, Fred H. Allen
Journal: Journal of Clinical Investigation (1971)

A new human antigen is reported which is present only on blood neutrophils. A neutrophil-specific antigen, designated NA1, has previously been identified in two unrelated families, and was shown to be involved in fetomaternal incompatibility and the development of isoimmune neonatal neutropenia in five newborns. In the present paper, a second antigen, designated NB1, is identified in four families with seven affected children. Antibodies that react with this second antigen are shown to produce selective agglutination of neutrophils but not other blood cells. They are neither absorbed by cells prepared from solid tissues nor by non-neutrophilic blood cells. By family and population studies, NB is shown to be distinct from NA, representing an independent genetic locus. 68% of the New York population are homozygous for NB1, 29% heterozygous, and 3% negative. The NB locus is shown to be independent from those of HL-A and other known leukocyte antigens. No evidence for linkage between NA, NB, and red cell antigens was obtained.
The end of the outpatient problem?
Authors: S Frankel, A Faulkner
Journal: BMJ (1994)

The outpatient problem in Britain has had a long and troubled history, but at last a solution seems to be in sight. This is happening by default rather than by design, not by tackling head on problems of delayed access to consultation for patients suffering from pain, anxiety, or illness, nor by substantially reducing unnecessary reattendances by patients, but by redefining the problem out of existence. The main problem has always remained constant: too many patients being seen in a system of care in which responsibility for outpatients is disputed by different sectors of the medical profession.

Towards the end of the 19th century general practitioners believed that too many people were gaining access to voluntary hospitals too easily. In 1887 one and a half million visits were recorded for the total London population of four million. General practitioners became reluctant to refer patients to hospital in case they were poached by consultants and they formed an association to try to stop abuse of the system. The inauguration of the NHS and the formalisation of the referral system unified the profession to a certain extent, but outpatients have remained in a contested terrain.

The problem of repeat attendances by outpatients was revived in the 1960s and 1970s with the publication of a survey funded by the Nuffield Provincial Hospitals Trust. Articles in the medical press deplored the thousands of season ticket holders. Through no fault of their own these patients were …
Impairment vs Disability
Authors: Karl Auerbach
Journal: JAMA (1988)

To the Editor.  —In discussing an article in the June 5, 1987, issue entitled  Physically Disabled Physician, 1 Dr Young 2 raises concerns about grouping that article with ones on impaired physicians.  He appears to be using disabled to mean physically disabled. He then tries to draw a distinction between that group and physicians impaired by drug or alcohol abuse. I can certainly understand his concern and would echo the importance of recognizing the different social and treatment issues that this distinction raises.  On the other hand, I do believe that this represents a misunderstanding of the terms involved.  In the American Medical Association's Guide to the Evaluation of Permanent Impairment (second edition), 3 on page x of the foreword, the difference between impairment and disability is highlighted:  The physician who makes a determination about impairment must keep in mind that a permanent impairment rating is not the same
<i>Neisseria gonorrhoeae</i>Antimicrobial Resistance Among Men Who Have Sex With Men and Men Who Have Sex Exclusively With Women: The Gonococcal Isolate Surveillance Project, 2005–2010
Authors: Robert D. Kirkcaldy, Akbar Zaidi, Edward W. Hook, King K. Holmes, Olusegun Soge, Carlos del Rio, Geraldine Hall, John Papp, Gail Bolan, Hillard S. Weinstock
Journal: Annals of Internal Medicine (2013)

This article has been corrected. The original version (PDF) is appended to this article as a supplement. Chinese translation Background: Gonorrhea treatment has been complicated by antimicrobial resistance in Neisseria gonorrhoeae. Gonococcal fluoroquinolone resistance emerged more rapidly among men who have sex with men (MSM) than men who have sex exclusively with women (MSW). Objective: To determine whether N. gonorrhoeae urethral isolates from MSM were more likely than isolates from MSW to exhibit resistance to or elevated minimum inhibitory concentrations (MICs) of antimicrobials used to treat gonorrhea. Design: 6 years of surveillance data from the Gonococcal Isolate Surveillance Project. Setting: Publicly funded sexually transmitted disease clinics in 30 U.S. cities. Patients: Men with a total of 34 600 episodes of symptomatic urethral gonorrhea. Measurements: Percentage of isolates exhibiting resistance or elevated MICs and adjusted odds ratios for resistance or elevated MICs among isolates from MSM compared with isolates from MSW. Results: In all U.S. regions except the West, isolates from MSM were significantly more likely to exhibit elevated MICs of ceftriaxone and azithromycin than isolates from MSW (P < 0.050). Isolates from MSM had a high prevalence of resistance to ciprofloxacin, penicillin, and tetracycline and were significantly more likely to exhibit antimicrobial resistance than isolates from MSW (P < 0.001). Limitations: Sentinel surveillance may not be representative of all patients with gonorrhea. HIV status, travel history, and antimicrobial use data were missing for some patients. Conclusion: Men who have sex with men are vulnerable to the emerging threat of antimicrobial-resistant N. gonorrhoeae. Because antimicrobial susceptibility testing is not routinely done in clinical practice, clinicians should monitor for treatment failures among MSM diagnosed with gonorrhea. Strengthened prevention strategies for MSM and new antimicrobial treatment options are needed. Primary Funding Source: Centers for Disease Control and Prevention.
The Treatment of Hyperthyroidism
Authors: Joseph B. Workman
Journal: JAMA (1967)

<h3>To the Editor:—</h3> Had a large volume of reports been summarized, the editorial would have cited a figure of 40% for the incidence of hypothyroidism ten years after<sup>131</sup>I therapy of hyperthyroidism rather than the extreme figure of 70%. More disturbing is the statement represented as fact: "Every major center uses repeated doses of<sup>131</sup>I until remission is secured and this often requires doses in excess of 100 mc and four or more doses." A recent nationwide study of the results of various modes of therapy of hyperthyroidism, in which 23 major centers contributed data, lists 82% of the patients as having received one or two doses of<sup>131</sup>I. This well-documented fact is difficult to reconcile with the statement that four or more doses of<sup>131</sup>I are "often" necessary. Less than 6% of the patients received four or more doses of radioactive iodine and few, if
Fracture of neck of the femur: changing incidence.
Authors: A F Lewis
Journal: BMJ (1981)

From 1959 to 1977 the numbers of hospital admissions for fracture of the neck of the femur increased by a factor of 2.7. Detailed analysis of data from the Hospital In-Patient Enquiry for 1968-77 showed that the increase applied to both sexes and at all ages over 45. The true incidence rate increased in parallel with the admission rate, and only a small part of the increased number of admissions was explained by the increasing numbers of the elderly. The increasing incidence of fracture of the neck of the femur imposes great strain on hospital resources, particularly trauma and orthopaedic departments, and merits urgent investigation. An explanation for the increase might be that the experience of one demand-led condition characterises a greater need for health care among the elderly for other conditions.