tbuckley/cabot-search huggingface dataset:
Use of a Fixed Combination β<sub>2</sub>-Agonist and Steroid Dry Powder Inhaler in Asthma
Authors: Peter J. Barnes, Brian J. O'Connor
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

In many countries the majority of patients with asthma are now treated with inhaled β2-agonists as required and regular inhaled steroids. Compliance with asthma medication is poor, particularly for inhaled steroids, which do not give immediate relief of symptoms. An inhaler combining a β2-agonist and a steroid may improve compliance and give better control of asthma. We have studied the effect of a fixed combination dry powder inhaler (Turbuhaler®) containing terbutaline (250 µg) with budesonide (200 µg) compared with each drug given alone in a double-blind, crossover study in 74 patients with mild to moderate asthma. This was a multicenter study performed in general practice. After a 1-wk run-in period with placebo inhaler, each treatment was given twice daily for 4 wk in randomized order. Patients measured symptom scores and rescue inhaled β2-agonist use and recorded peak expiratory flow (PEF) twice daily. In nine patients recruited to a hospital center, airway responsiveness was measured by the concentration of methacholine required to produce a fall in FEV1 of 20% (PC20) at the end of each treatment period. Of 74 patients randomized, 68 completed all three treatment periods. Their mean age was 37 (18–60) yr and PEF 80 (43–116) % predicted. Combination treatment gave a significant improvement in morning and evening PEF budesonide or terbutaline treatment periods (p < 0.01), and a significant reduction in asthma symptom scores and rescue β2-agonist use (p < 0.05). There was a significant patient preference for the combination inhaler. Measurement of compliance by counting unused doses showed good compliance with no significant difference between treatments. In nine patients who underwent methacholine challenge, both combination and budesonide treatment significantly improved PC20 by almost two doubling dilutions compared with baseline, whereas there was no protection after treatment with terbutaline. The acute protection 1 h after inhalation was significantly greater (p < 0.05) after combination than after terbutaline inhalation. We suggest that a fixed combination inhaler containing a low dose β2-agonist and an inhaled steroid provides a small but significant improvement in the control of mild asthma and may simplify its long-term management.
Lipoproteins, coagulation states, and risk of thrombotic events
Authors: C. R. Spillert
Journal: JAMA (1995)

<h3>To the Editor.</h3> —The results of clinical studies correlating lipoprotein levels with risk for thrombotic events like myocardial infarction are inconsistent and not sensitive indicators of risk.<sup>1</sup>One may assume that these thrombotic events are causally related to hypercoagulability and that protection from these events is associated with relative hypocoagulability. Regrettably, there is no coagulation test to detect a prothrombotic (high-risk) state or antithrombotic (low-risk) state as a marker of the effects of lipoproteins. We here describe the utilization of a modified recalcification time (MRT) test to document the adverse coagulation-accelerating effect of low-density lipoproteins (LDLs) and the beneficial coagulation-retarding property of high-density lipoproteins (HDLs). This test was described in detail in a recent article.<i>2</i>Unlike other tests, by using whole blood, the MRT incorporates the role of both cellular and chemical participants in coagulation. Also, incubating blood with an activator like a lipoprotein induces the monocyte to
Neurology
Authors: William K. Jordan, H. Houston Merritt
Journal: New England Journal of Medicine (1949)

DURING the past year, significant advances have taken place in many phases of neurology. Increased understanding of the physiology of the cerebral cortex has come from research into the sensory and motor organization of the neopallium of primate brains. New drugs of value in treating myasthenia gravis and states of increased muscular tone have been introduced, and more information concerning the use of antibiotics in treatment of infections of the central nervous system has accumulated. These and other studies are discussed under the following headings: biochemistry, physiology and anatomy; pharmacology; infections; cerebrovascular system; convulsive disorders; myasthenia gravis and familial periodic . . .
Pneumatosis Coli
Authors: T. Yusuf, S. Abraham, S. Trenkner
Journal: Endoscopy (2006)

Figure 1 A 47-year-old man presented with a 2-week history of mid-abdominal pain. He denied having any fever, chills, nausea, vomiting, or diarrhea. Computed tomography of the abdomen revealed numerous air-filled cysts involving the splenic flexure of the colon (arrow), a finding consistent with pneumatosis coli. A colonoscopy examination was then performed, which revealed sigmoid diverticulosis.
The Professions.
Journal: JAMA (1933)

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
Hepatocyte proliferation induced in rats by lead nitrate is suppressed by several tumor necrosis factor alpha inhibitors
Authors: Y KUBO
Journal: Hepatology (1996)

Lead nitrate induces liver cell proliferation in rats without accompanying liver cell necrosis. However, the mechanism of this proliferation and its effect on hepatocytes remain unknown. Therefore, we examined the liver and blood level of hepatocyte growth factor and tumor necrosis factor alpha (TNF-alpha) at various intervals to determine whether lead nitrate modifies hepatocyte proliferation by altering the production of these cytokines. We also administered several TNF-alpha inhibitors, dexamethasone, adenosine, (2E)-3-[5-(2,3- dimethoxy-6-methyl-1,4-benzoquinoyl)]-2-nonyl-2-propenoic acid (E 3330), and pentoxifylline, to rats to clarify whether pretreatment with these inhibitors suppresses the increase of TNF-alpha messenger RNA (mRNA) in the liver and prevents the hepatocyte proliferation induced by lead nitrate. Hepatocyte proliferation occurred by 24 hours and reached a peak 48 hours after a single intravenous injection of lead nitrate (100 mumol/kg). TNF-alpha mRNA expression in the liver was increased 1, 6, and 12 hours after the injection, whereas no alteration was observed in liver or blood level of hepatocyte growth factor. Pretreatment with dexamethasone (4.0 mg/kg), E3330 (100 mg/kg) adenosine (0.3 mmol/kg), and pentoxifylline (100 mg/kg), inhibited both TNF-alpha mRNA expression and hepatocyte proliferation 48 hours after the injection. These experimental results strongly support the hypothesis that TNF-alpha positively regulates the hepatocyte proliferation induced in rats by the mitogen, lead nitrate. (Hepatology 1996 Jan;23(1):104-14)
THE SHEPPARD-TOWNER BILL
Journal: JAMA (1921)

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
The Psychiatrist and the Emergency Room
Journal: JAMA (1970)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
C-Peptide
Authors: J B L Hoekstra, H J M van Rijn, D W Erkelens, J H H Thijssen
Journal: Diabetes Care (1982)

C-peptide is a polypeptide originating from proinsulin after its cleavage in the B-cell. It is secreted equimolarly with the other cleavage product, insulin, into the portal circulation. Only a minimal fraction of C-peptide is extracted by the liver; it is supposed to be mainly removed by the kidney. A small, constant proportion is excreted in the urine. C-peptide is measured in serum and urine by radioimmunoassay. The major sources of error of the assay are related to standard, tracer, antiserum specificity and reactivity with proinsulin, and to degradation of C-peptide. Many secretagogues are used to evaluate the B-cell function, of which glucagon is the most simple. Clinical applications of C-peptide include differentiating between endogenous and exogenous hyperinsulinism and establishing the need of insulin therapy in diabetic patients already treated with insulin. The primary value of C-peptide, however, is in clinical research, where it offers a unique opportunity to follow the B-cell secretion in diabetic subjects and to evaluate the difference that various factors may exert on its activity.
LCMV Implicated in Illness Among Organ Transplant Recipients
Journal: JAMA (2014)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors 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
INTESTINAL INDIGESTION.
Authors: A. P. BUCHMAN
Journal: JAMA (1895)

To treat of intestinal indigestion separately from gastric indigestion would seem almost impossible, since it can not well be conceived how the former can exist without being a sequence of the latter, as gastric indigestion invariably precedes intestinal indigestion and is therefore always a factor which mingles its phenomena with all that which follows in its wake. If proteolysis is not finished in the stomach and duodenum, the substances which have not run the gamut of complete proteolytic disintegration must pass the remaining intestinal length untouched, or undergo putrefactive changes at the instance of bacteria which provide the necessary elements, and hence, abnormal and deleterious substances arise which to a greater or less extent furnish fuel for general systematic disturbances. Intestinal putrefaction is then in its incipient stages, not due to a pathologic condition of the tube below the stomach and duodenum, but is dependent solely upon errors of gastric
Use of health services by African-American children with asthma on Medicaid
Authors: P. Lozano
Journal: JAMA (1995)

<h3>Objective.</h3> —To determine whether African-American children with asthma use more emergency department (ED) and inpatient medical services and fewer preventive services than white children with similar insurance coverage and family income. <h3>Design.</h3> —Historical cohort study using Medicaid claims data. <h3>Setting.</h3> —Aid to Families With Dependent Children enrollees aged 3 through 17 years in the Seattle-Tacoma, Wash, metropolitan area. <h3>Patients.</h3> —All 576 African-American children and 1369 white children receiving services for asthma between June 1988 and December 1992. <h3>Main Outcome Measures.</h3> —Utilization of asthma services (ED, inpatient, office visits, and pharmacy) and well-child services and associated Medicaid reimbursements. <h3>Results.</h3> —African-American children were more likely than white children to make ED visits or to be hospitalized for asthma; adjusted odds ratios (ORs) were 1.70 (95% confidence interval [CI], 1.34 to 2.15) and 1.42 (95% CI, 1.03 to 1.96), respectively. African-American children were less likely to have made an office visit for asthma; the adjusted OR was 0.48 (95% CI, 0.26 to 0.85). The two groups were similarly likely to have filled a prescription for an asthma medication and to have made a well-child visit. Per capita payments for asthma services were 24% higher for African-American children: $436 vs $350 per child-year. <h3>Conclusions.</h3> —Higher use of ED and inpatient services for asthma among African-American children using Medicaid (compared with white children) cannot be fully explained by poverty or inadequate health insurance. Furthermore, these children appear to make disproportionately few office visits for asthma, suggesting suboptimal use of preventive services for asthma. In contrast, the comparable use of well-child visits in the two groups suggests the problem may not be in access to care in general, but there may be specific problems in the successful management of chronic diseases such as asthma among African-American children. (<i>JAMA</i>. 1995;274:469-473)
(1) Whittaker's Anatomic Model. (2) The Anatomy of the Human Head and Neck.
Journal: JAMA (1896)

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
Training in flexible, intensive insulin management to enable dietary freedom in people with type 1 diabetes: dose adjustment for normal eating (DAFNE) randomised controlled trial
Journal: BMJ (2002)

Abstract Objectives: To evaluate whether a course teaching flexible intensive insulin treatment combining dietary freedom and insulin adjustment can improve both glycaemic control and quality of life in type 1 diabetes. Design: Randomised design with participants either attending training immediately (immediate DAFNE) or acting as waiting list controls and attending “delayed DAFNE” training 6 months later. Setting: Secondary care diabetes clinics in three English health districts. Participants: 169 adults with type 1 diabetes and moderate or poor glycaemic control. Main outcome measures: Glycated haemoglobin (HbA 1c ), severe hypoglycaemia, impact of diabetes on quality of life (ADDQoL). Results: At 6 months, HbA 1c was significantly better in immediate DAFNE patients (mean 8.4%) than in delayed DAFNE patients (9.4%) ( t =6.1, P&lt;0.0001). The impact of diabetes on dietary freedom was significantly improved in immediate DAFNE patients compared with delayed DAFNE patients ( t =−5.4, P&lt;0.0001), as was the impact of diabetes on overall quality of life ( t =2.9, P&lt;0.01). General wellbeing and treatment satisfaction were also significantly improved, but severe hypoglycaemia, weight, and lipids remained unchanged. Improvements in “present quality of life” did not reach significance at 6 months but were significant by 1 year. Conclusion: Skills training promoting dietary freedom improved quality of life and glycaemic control in people with type 1 diabetes without worsening severe hypoglycaemia or cardiovascular risk. This approach has the potential to enable more people to adopt intensive insulin treatment and is worthy of further investigation.
Fatigue of Workers: Its Relation to Industrial Production
Journal: JAMA (1942)

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
Guiding
Authors: Frederick W. Hund
Journal: Annals of Internal Medicine (2017)

On Being a Doctor7 February 2017GuidingFrederick W. Hund, MDFrederick W. Hund, MDFrom Affiliated Community Medical Centers, Willmar, Minnesota.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-1241 Audio Reading - “Guiding” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Guiding," by F.W. Hund. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail I went to medical school in New York. But some of the most important things about being a doctor I learned before that, at the Telluride Guide School. Now 32 years an MD, I often think this was some of my most valuable training.We learned mountaineering and river running: How to read a topographic map, tie a Prusik knot, stop a fall with an ice ax, ferry a raft, and know where not to sleep. We even learned checklists: “You forgot the water tabs!” In residency, I learned to take a history, dose vancomycin, and get central venous access ... Author, Article, and Disclosure InformationAffiliations: From Affiliated Community Medical Centers, Willmar, Minnesota.Corresponding Author: Frederick W. Hund, MD, Affiliated Community Medical Centers, 101 Willmar Avenue SW, Willmar, MN 56201; e-mail, [email protected]com. PreviousarticleNextarticle Advertisement Audio Reading - “Guiding” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Guiding," by F.W. Hund. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 7 February 2017Volume 166, Issue 3Page: 227-228KeywordsClimbingDrugsEdemaFearRiversSleepTongueVancomycinVeinsWilderness ePublished: 7 February 2017 Issue Published: 7 February 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...