tbuckley/cabot-search huggingface dataset:
Literacy and Misunderstanding Prescription Drug Labels
Authors: Ali Jawaid
Journal: Annals of Internal Medicine (2007)

Letters21 August 2007Literacy and Misunderstanding Prescription Drug LabelsAli Jawaid, MBBSAli Jawaid, MBBSFrom Aga Khan University, Karachi, Pakistan.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-4-200708210-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Davis and colleagues (1) have very rightly highlighted the impact of patient literacy on understanding prescription instructions or labels and the subsequent correct use of the medication. Originating from a developing country, where general population illiteracy still remains a harsh reality, I can relate to the viewpoint. However, I also see the vagueness of instructions on prescription labels as an important contributing factor that must not be ignored when considering the issue. This has been pointed out earlier in Brazil (2), Germany (3), and the United States (4). There is a dire need to make the prescription ...References1. Davis TC, Wolf MS, Bass PF, Thompson JA, Tilson HH, Neuberger M, et al. Literacy and misunderstanding prescription drug labels. Ann Intern Med. 2006;145:887-94. [PMID: 17135578] LinkGoogle Scholar2. da Silva T, Dal-Pizzol F, Bello CM, Mengue SS, Schenkel EP. [Drug package inserts and the adequacy of patient's drug information]. Rev Saude Publica. 2000;34:184-9. [PMID: 10881155] MedlineGoogle Scholar3. Fuchs J, Hippius M, Schaefer M. Analysis of German package inserts. Int J Clin Pharmacol Ther. 2006;44:8-13. [PMID: 16425965] CrossrefMedlineGoogle Scholar4. Williams-Deane M, Potter LS. Current oral contraceptive use instructions: an analysis of patient package inserts. Fam Plann Perspect. 1992;24:111-5. [PMID: 1628713] CrossrefMedlineGoogle Scholar5. Abeysekera A, Bergman IJ, Kluger MT, Short TG. Drug error in anaesthetic practice: a review of 896 reports from the Australian Incident Monitoring Study database. Anaesthesia. 2005;60:220-7. [PMID: 15710005] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Aga Khan University, Karachi, Pakistan.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoLiteracy and Misunderstanding Prescription Drug Labels Terry C. Davis , Michael S. Wolf , Pat F. Bass III , Jason A. Thompson , Hugh H. Tilson , Marolee Neuberger , and Ruth M. Parker Literacy and Misunderstanding Prescription Drug Labels Munsey S. Wheby Literacy and Misunderstanding Prescription Drug Labels Christopher T. Parker Literacy and Misunderstanding Prescription Drug Labels David Katz Metrics 21 August 2007Volume 147, Issue 4Page: 280KeywordsAnestheticsConflicts of interestDrug administrationDrugsLiteracySafety ePublished: 21 August 2007 Issue Published: 21 August 2007 CopyrightCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Microfabricated microporous membranes reduce the host immune response and prolong the functional lifetime of a closed-loop insulin delivery implant in a type 1 diabetic rat model
Authors: Jason Li, Michael K L Chu, Claudia R Gordijo, Azhar Z Abbasi, Kuan Chen, Hibret A Adissu, Matthias Löhn, Adria Giacca, Oliver Plettenburg, Xiao Yu Wu
Journal: Biomaterials (2015)
Adjunctive Systemic Hyperbaric Oxygen Therapy in Treatment of Severe Prevalently Ischemic Diabetic Foot Ulcer: A randomized study
Authors: Ezio Faglia, Favales Favales, Aldeghi Aldeghi, Patrizia Calia, Antonella Quarantiello, Giorgio Oriani, Michael Michael, Pietro Campagnoli, Alberto Morabito
Journal: Diabetes Care (1996)

OBJECTIVE To evaluate the effectiveness of systemic hyperbaric oxygen therapy (s HBOT) in addition to a comprehensive protocol in decreasing major amputation rate in diabetic patients hospitalized for severe foot ulcer. RESEARCH DESIGN AND METHODS From August 1993 to August 1995, 70 diabetic subjects were consecutively admitted into our diabetologic unit for foot ulcers. All the subjects underwent our diagnostic-therapeutic protocol and were randomized to undergo s-HBOT. Two subjects, one in the arm of the treated group and one in the arm of nontreated group, did not complete the protocol and were therefore excluded from the analysis of the results. Finally, 35 subjects received s-HBOT and another 33 did not. RESULTS Of the treated group (mean session = 38.8 ± 8), three subjects (8.6%) underwent major amputation: two below the knee and one above the knee. In the nontreated group, 11 subjects (33.3%) underwent major amputation: 7 below the knee and 4 above the knee. The difference is statistically significant (P = 0.016). The relative risk for the treated group was 0.26 (95% CI 0.08–0.84). The transcutaneous oxygen tension measured on the dorsum of the foot significantly increased in subjects treated with hyperbaric oxygen therapy: 14.0 ± 11.8 mmHg in treated group, 5.0 ± 5.4 mmHg in nontreated group (P = 0.0002). Multivariate analysis of major amputation on all the considered variables confirmed the protective role of s-HBOT (odds ratio 0.084, P = 0.033, 95% CI 0.008–0.821) and indicated as negative prognostic determinants low ankle-brachial index values (odds ratio 1.715, P = 0.013, 95% CI 1.121–2.626) and high Wagner grade (odds ratio 11.199, P = 0.022, 95% CI 1.406–89.146). CONCLUSIONS s-HBOT, in conjunction with an aggressive multidisciplinary therapeutic protocol, is effective in decreasing major amputations in diabetic patients with severe prevalently ischemic foot ulcers.
Hypertension and Associated Metabolic Abnormalities — The Role of Insulin Resistance and the Sympathoadrenal System
Authors: Gerald M. Reaven, Hans Lithell, Lewis Landsberg
Journal: New England Journal of Medicine (1996)

Abnormalities of glucose, insulin, and lipoprotein metabolism are common in patients with hypertension. These changes can also be discerned in normotensive first-degree relatives of hypertensive patients. They are not present in patients with secondary forms of hypertension, do not necessarily improve when blood pressure is lowered pharmacologically, and may even be made worse by some forms of antihypertensive treatment. These metabolic abnormalities may play a part in both the pathogenesis and the complications of hypertension in many patients. We hypothesize that the metabolic abnormalities are linked to the hypertension by a pathophysiologic process that involves the sympathoadrenal system and exerts . . .
The Usefulness of Tc-99m-Tetrofosmin SPECT/CT in the Detection of Residual Tumors and Axillary Lymph Node Metastases in Breast Cancer Patients Following Neoadjuvant Therapy
Authors: Angela Spanu, Daniela Sanna, Francesca Chessa, Antonio Farris, Susanna Nuvoli, Giuseppe Madeddu
Journal: Clinical Nuclear Medicine (2011)

Single photon emission computed tomography (SPECT)/CT is emerging as a useful diagnostic tool in several oncological fields. In this prospective study, we assessed the usefulness of Tc-99m-tetrofosmin SPECT/CT in the detection of both residual breast tumors and axillary lymph node metastases following neoadjuvant therapy. Thirty-seven consecutive breast cancer patients scheduled to surgery following neoadjuvant therapy preoperatively underwent a Tc-99m-tetrofosmin SPECT/CT study, using a dual head gamma camera integrated with a x-ray tube for low-dose CT, including both breasts and axillary regions in the field of view. Within 1 week of SPECT/CT, all 37 patients had breast surgery with associated axillary lymph node dissection in 33/37 cases. At surgery, 31/37 patients had breast residues (microscopic in 4/31 cases and macroscopic in 27/31 cases). Axillary lymph node metastases were ascertained in 19/33 cases (N1mi: 2 cases, N1a: 8 cases, N2a: 6 cases, N2b: 3 cases). SPECT/CT sensitivity, specificity, and accuracy in detecting residual tumors were 87%, 100%, and 89.2%, respectively; the corresponding values in detecting axillary lymph node metastases were 36.8%, 92.8%, and 60.6%. SPECT/CT missed breast cancer residues in 4/31 patients, including 2 cases with microscopic residual disease. Moreover, lymph node metastases were missed in 12/19 patients (10/12 with pN1mi or pN1a metastases), all with lymph nodes with post-therapy fibrotic changes and small deposits of metastases. Tc-99m-tetrofosmin SPECT/CT proved a useful diagnostic tool in the detection and in the localization of residual breast tumors following neoadjuvant therapy. The procedure lacked in sensitivity in identifying axillary lymph node metastases, especially in patients with a limited lymph node involvement. According to our data, SPECT/CT may guide the surgeon to the most appropriate breast surgical treatment and to eventually select the most suitable axillary lymph node sampling (axillary lymph node dissection or sentinel node biopsy).
Participation of prostaglandin E2 in the endothelial protective effect of ischaemic preconditioning in isolated rat heart
Authors: J Bouchard
Journal: Cardiovascular Research (2000)

Objective: To assess whether the protective effect of ischaemic preconditioning (IPC) on endothelial function in coronary arteries of the rat involves prostaglandins. Methods: Isolated rat hearts perfused under constant flow conditions were exposed to 30 min of partial ischaemia (flow-rate 1 ml/min) followed by 20 min of reperfusion, after which coronaries were precontracted with U-46619 0.1 μM, and the coronary response to the endothelium-dependent vasodilator, serotonin (5-HT, 10 μM), was compared to that of the endothelium-independent vasodilator, sodium nitroprusside (SNP, 3 μM). Prostaglandin production was blocked with a perfusion of indomethacin 10 μM started 15 min before IPC or a corresponding sham period and stopped just before the 20-min reperfusion period. Results: In untreated hearts, ischaemia diminished selectively 5-HT-induced vasodilatation, compared to sham hearts. The vasodilatation by SNP was unaffected after ischaemia and reperfusion. IPC (5 min of zero-flow ischaemia followed by 10 min reperfusion before the 30-min partial ischaemia) preserved the vasodilatation produced by 5-HT. Enzymeimmunoassays showed an increased production of PGE2 in the IPC group. Treatment of hearts with indomethacin blocked the protective effect of IPC on the vasodilatation produced by 5-HT and decreased the production of PGE2. A 5-min perfusion with 3 nM PGE2 started 15 min before the partial ischaemia, protected the endothelium. This was blocked by 1 μM chelerythrine, but not by 0.3 μM glibenclamide. Conclusions: These results suggest that IPC affords protection to endothelial function in coronary arteries of the rat partially via the release of PGE2. Under our experimental conditions, the protective effect of PGE2 is mediated by PKC.
The expression of 16 genes related to the cell of origin and immune response predicts survival in elderly patients with diffuse large B-cell lymphoma treated with CHOP and rituximab
Authors: J-P Jais, C Haioun, T J Molina, D S Rickman, A de Reynies, F Berger, C Gisselbrecht, J Brière, F Reyes, P Gaulard, P Feugier, E Labouyrie, H Tilly, C Bastard, B Coiffier, G Salles, K Leroy
Journal: Leukemia (2008)
Pharmacological and Psychosocial Management of Mental, Neurological and Substance Use Disorders in Low- and Middle-Income Countries: Issues and Current Strategies
Authors: Jair de Jesus Mari, Luís Fernando Tófoli, Cristiano Noto, Li M. Li, Alessandra Diehl, Angélica M. Claudino, Mario F. Juruena
Journal: Drugs (2013)
Attitudes of Diabetic Men After Implantation of a Semi-Rigid Penile Prosthesis
Authors: Hugh R Peterson, James D Best, Richard Berger, Andrew Reenan, Daniel Porte, Jeffrey B Halter, Michael A Pfeifer
Journal: Diabetes Care (1985)

Erectile impotence is a common and distressing problem in diabetic men. In order to examine the impact of a penile prosthesis on the quality of life of the recipients, we mailed a questionnaire to all patients (N = 49) who received a semi-rigid (Small-Carrion) prosthesis at the Seattle VAMC from 1976 to 1981. Fourteen patients with diabetes and 23 without diabetes returned the questionnaire. Direct comparisons showed no statistically significant differences between the responses of the two groups. Based on a scale of 1–7 (1 = worst, 4 = no change, 7 = best), the general effect of the operation on the quality of life of the recipients was 5.7 ± 0.3 (X¯ ± SEM); the quality of intercourse was 5.1 ± 0.3; the patient's perception of his partner's response to the prosthesis was 5.2 ± 0.3; and the patient's perception of postoperative changes in his relationship with his partner was 5.6 ± 0.3. Eighty-three percent of the patients were satisfied with the performance of the prosthesis. Most of the patients (86%) felt that their preoperative expectations had been fulfilled and would elect to have the procedure if they had it to do over again. However, five patients (14%) stated that they would not elect the operation again because their partners did not appreciate the operation (N = 2); the operation produced severe, prolonged pain (N = 1); or the patient's expectations had not been fulfilled (N = 2). Preoperative counseling should be used to foster realistic patient and partner expectations. This operation, which appears to improve the quality of life for most diabetic patients with erectile impotence, should be considered a part of standard care and not as a cosmetic procedure or extraordinary care.
Ambulatory abdominal inductance plethysmography: towards objective assessment of abdominal distension in irritable bowel syndrome
Authors: Matthew Lewis, Brian Reilly, Lesley A. Houghton, Peter J. Whorwell
Journal: Gut (2001)

<h3>BACKGROUND</h3> Abdominal distension is one of the cardinal features of irritable bowel syndrome (IBS) with patients often ranking it as more intrusive than their pain or bowel dysfunction. If this symptom could be quantified accurately and reliably it would provide, for the first time, an objective way of assessing this disorder. Using the principle of inductance plethysmography we have developed a microprocessor based system capable of recording even minimal changes in girth over 24 hours and we describe its validation and establish normal ranges. <h3>METHODS</h3> Twenty four hour recordings were made in 20 healthy female volunteers (aged 23–58 years) to assess changes in abdominal girth with respect to time, posture, meals, and sleep. Normal daily activity was encouraged and meals were standardised. The feeling of abdominal distension was also assessed using a visual analogue scale. <h3>FINDINGS</h3> Measurement of abdominal girth using abdominal inductance plethysmography (AIP) at a static point in time showed a close relationship with that measured using a tape measure (rho=0.8910, p&lt;0.001). Furthermore, girth was significantly greater both in the sitting and standing postures compared with lying (p&lt;0.01). Measurement over a 24 hour period showed that girth was significantly greater at the end compared with the beginning of the day, and ingestion of a standard meal also increased its value (p&lt;0.05). Sleep was associated with a reduction in girth (p&lt;0.05). <h3>CONCLUSIONS</h3> AIP promises to add an objective dimension to the assessment of IBS which could prove invaluable in clinical trials. Furthermore, it should aid research into the pathogenesis of this symptom for which no satisfactory explanation has yet emerged.
The Development of Family Medicine
Authors: Donald C. Ransom
Journal: JAMA (1973)

The terms "family practice" and "family medicine" refer to different levels of activity and should be kept conceptually distinct. Using family practice and family medicine interchangeably blurs important differences between the two and encourages confusion between the issues of family medicine and those of primary care. This confusion, in turn, is contributing to a set of trends that threatens the continued development of family medicine as it is understood here. By developing family medicine as a discipline in its own right, the way is cleared for viewing the family as a vital system of medical concern and for putting the family into the center of medical-care delivery. The result would be a closer working relationship between family medicine and family practice than now exists.
Effect of physiologic hyperinsulinemia on skeletal muscle protein synthesis and breakdown in man.
Authors: R A Gelfand, E J Barrett
Journal: Journal of Clinical Investigation (1987)

Although insulin stimulates protein synthesis and inhibits protein breakdown in skeletal muscle in vitro, the actual contribution of these actions to its anabolic effects in man remains unknown. Using the forearm perfusion method together with systemic infusion of L-[ring-2,6-3H]phenylalanine and L-[1-14C]leucine, we measured steady state amino acid exchange kinetics across muscle in seven normal males before and in response to a 2-h intraarterial infusion of insulin. Postabsorptively, the muscle disposal (Rd) of phenylalanine (43 +/- 5 nmol/min per 100 ml forearm) and leucine (113 +/- 13) was exceeded by the concomitant muscle production (Ra) of these amino acids (57 +/- 5 and 126 +/- 9 nmol/min per dl, respectively), resulting in their net release from the forearm (-14 +/- 4 and -13 +/- 5 nmol/min per dl, respectively). In response to forearm hyperinsulinemia (124 +/- 11 microU/ml), the net balance of phenylalanine and leucine became positive (9 +/- 3 and 61 +/- 8 nmol/min per dl, respectively (P less than 0.005 vs. basal). Despite the marked increase in net balance, the tissue Rd for both phenylalanine (42 +/- 2) and leucine (124 +/- 9) was unchanged from baseline, while Ra was markedly suppressed (to 33 +/- 5 and 63 +/- 9 nmol/min per dl, respectively, P less than 0.01). Since phenylalanine is not metabolized in muscle (i.e., its only fates are incorporation into or release from protein) these results strongly suggest that in normal man, physiologic elevations in insulin promote net muscle protein anabolism primarily by inhibiting protein breakdown, rather than by stimulating protein synthesis.
Redesigning Residency Education in Internal Medicine
Authors: David C. Beck
Journal: Annals of Internal Medicine (2007)

Letters16 January 2007Redesigning Residency Education in Internal MedicineDavid C. Beck, MD, PhDDavid C. Beck, MD, PhDFrom University of Cincinnati College of Medicine, Cincinnati, Ohio.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-146-2-200701160-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR: I read with interest the article by Fitzgibbons and colleagues (1)—another discussion of what ails internal medicine residencies. It seems that few people are willing to accept the apparent. Most competitive applicants are choosing internal medicine as a bridge to the medical subspecialties. The best way to attract the best and brightest to internal medicine is to facilitate an easy transition to the subspecialties for those who choose to pursue them. I would propose a model where internal medicine training is limited to 2 years for persons interested in pursuing a subspecialty. The third year would be ...Reference1. Fitzgibbons JP, Bordley DR, Berkowitz LR, Miller BW, Henderson MC. Redesigning residency education in internal medicine: a position paper from the Association of Program Directors in Internal Medicine. Ann Intern Med. 2006;144:920-6. [PMID: 16785480] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Cincinnati College of Medicine, Cincinnati, Ohio.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRedesigning Residency Education in Internal Medicine: A Position Paper from the Association of Program Directors in Internal Medicine John P. Fitzgibbons , Donald R. Bordley , Lee R. Berkowitz , Beth W. Miller , and Mark C. Henderson Metrics 16 January 2007Volume 146, Issue 2Page: 149-150KeywordsAnesthesiaConflicts of interestDermatologyDiagnostic radiologyHospitalistsInpatientsOutpatientsResidencySub-specialty careSurgery ePublished: 16 January 2007 Issue Published: 16 January 2007 CopyrightCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Direct evidence that the hydroxyl radical plays a pathogenetic role in myocardial "stunning" in the conscious dog and demonstration that stunning can be markedly attenuated without subsequent adverse effects.
Authors: S Sekili, P B McCay, X Y Li, M Zughaib, J Z Sun, L Tang, J I Thornby, R Bolli
Journal: Circulation Research (1993)

Recent studies suggest that the hydroxyl radical (.OH) plays a pathogenetic role in postischemic ventricular dysfunction (myocardial "stunning"). This concept, however, is predicated exclusively on results obtained in anesthetized open-chest preparations, which are subject to the confounding influence of many unphysiological conditions and in which both myocardial stunning and free radical generation are greatly exaggerated. The lack of supporting evidence in more physiological animal models represents a major limitation of the .OH hypothesis of stunning. Furthermore, concern has been raised that myocardial stunning may be a period of "rest" necessary for full recovery, so that attenuation of the early phase of stunning by antioxidant therapy may have subsequent detrimental effects on the resting function and/or on the return of myocardial contractile reserve. To address these issues, in phase 1 of this study conscious unsedated dogs undergoing a 15-minute coronary artery occlusion received an intravenous infusion of normal saline (n = 22), of the .OH scavenger N-2-mercaptopropionyl glycine (MPG, n = 17), or of the iron chelator desferrioxamine (DF, n = 14). Compared with control dogs, the dogs treated with MPG or DF exhibited significantly greater postischemic wall thickening throughout the first 6 hours of reperfusion; the total deficit of wall thickening during this time interval was reduced 50% by MPG and 50% by DF. The magnitude of this beneficial effect was a function of the severity of ischemia, so that the dogs with the lowest collateral flows had the greatest improvement of wall thickening. The accelerated recovery produced by MPG and DF in the first 6 hours was not followed by any deterioration of resting wall thickening at 24 or 48 hours. Furthermore, in dogs treated with MPG or DF, the increase in wall thickening elicited by maximal inotropic stimulation (isoproterenol or dopamine) was similar before stunning and shortly after resting wall thickening had normalized (24 or 48 hours after reflow); thus, despite the fact that most of the early postischemic dysfunction had been eliminated by antioxidant therapy, there was no subsequent impairment of either resting function or contractile reserve. In phase 2, production of free radicals (measured with the spin trap alpha-phenyl N-tert-butyl nitrone) was markedly (> 80%) inhibited by the same doses of MPG and DF that attenuated stunning in phase 1.(ABSTRACT TRUNCATED AT 400 WORDS)