tbuckley/cabot-search huggingface dataset:
Tear-test for Glucose
Authors: J. G. Lewis
Journal: BMJ (1957)

Here we present the personal perspectives of two authors on the important and unfortunately frequent scenario of ambulance clinicians facing a deceased individual and family members who do not wish them to attempt cardiopulmonary resuscitation. We examine the professional guidance and the protection provided to clinicians, which is not matched by guidance to protect family members. We look at the legal framework in which these scenarios are taking place, and the ethical issues which are presented. We consider the interaction between ethics, clinical practice and the law, and offer suggested changes to policy and guidance which we believe will protect ambulance clinicians, relatives and the patient.
Infection Control Reference Service: The Experts' Guide to the Guidelines
Authors: Rebecca Wurtz
Journal: Annals of Internal Medicine (2002)

Medical Writings: Book Notes15 January 2002Infection Control Reference Service: The Experts' Guide to the GuidelinesRebecca Wurtz, MD, MPHRebecca Wurtz, MD, MPHNorthwestern University, Chicago, Illinois.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-136-2-200201150-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Second edition. Abrutyn E, Goldmann DA, Scheckler WE, eds. 1578 pages. Philadelphia: WB Saunders; 2000. $329.00. ISBN 0721684688. Order phone 800-545-2522.Field of medicine: Infection control.Format: Hardcover book and searchable CD-ROM software. System requirements: Windows 95, 98, or NT; Pentium processor-based PC; 32 MB of available RAM; 10 MB of available hard-disk space; 8X or faster CD-ROM drive. Apple Power Macintosh or compatible computer: 32 MB of available RAM; 10 MB of available hard-disk space; 8X or faster CD-ROM drive.Audience: Health care providers in inpatient, outpatient, home care, and long-term care settings.Purpose: To gather and interpret infection ... Author, Article, and Disclosure InformationAffiliations: Northwestern University, Chicago, Illinois. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 January 2002Volume 136, Issue 2Page: 176KeywordsComputersEpidemiologyHIV preventionHealth careHealth care providersInfectious disease controlInpatientsLong-term careOutpatientsSoftware tools ePublished: 15 January 2002 Issue Published: 15 January 2002 Copyright & PermissionsCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
The Dissociation by Colchicine of Phagocytosis from Increased Oxygen Consumption in Human Leukocytes*
Authors: Stephen E. Malawista, Phyllis T. Bodel
Journal: Journal of Clinical Investigation (1967)

The effect of colchicine on the uptake of oxygen by human leukocytes during phagocytosis of live streptococci or of killed staphylococci was compared with the effect of colchicine on phagocytosis per se, measured in a sensitive bacterial system. The increase in oxygen consumption that normally accompanies phagocytosis was consistently diminished in leukocytes incubated with colchicine in concentrations as low as 2.5 x 10(-6) mole per L (1 mug per ml), and this inhibition was dosage dependent. Yet there was no evidence of decreased phagocytosis with concentrations of colchicine as high as 2.5 x 10(-4) mole per L (100 mug per ml). Furthermore, with measurements at 20, 40, and 60 minutes, the rate of phagocytosis was comparable with and without colchicine.A clue to the dissociation between oxygen consumption and phagocytosis was found in rapidly dried preparations of the incubated leukocytes. Ingested bacteria were present in both control and colchicine-treated granulocytes. In addition, control cells showed normal loss of granules (lysosomal particles) and prominent cytoplasmic vacuoles (digestive vacuoles). Colchicine-treated cells, however, showed less such degranulation and vacuolization. Measurements of granule-associated acid phosphatase activity after phagocytosis support the morphologic observations of less degranulation in colchicine-treated leukocytes. The muted metabolic and morpholgic response to phagocytosis in colchicine-treated cells may be important for the anti-inflammatory effect of colchicine in acute gouty arthritis. Colchicine may also find wider use in defining structure-function dependencies in metabolically stimulated cells.
Regulation of magnesium uptake and release in the heart and in isolated ventricular myocytes.
Authors: A Romani, C Marfella, A Scarpa
Journal: Circulation Research (1993)

Perfused rat hearts release or accumulate approximately 10% of total Mg2+ content when stimulated with norepinephrine (NE) or carbachol, respectively. Collagenase-dispersed rat ventricular myocytes increase or decrease total cell Mg2+ by 1 mM within 5 minutes when stimulated with these same transmitters. Measurements of Mg2+ transport using 28Mg or atomic absorbance spectrophotometry indicate that the rate and the extent of both stimulated Mg2+ efflux and influx are independent of the concentration of extracellular Mg2+ (0 to 1.2 mM). Mg2+ release induced by NE is rapidly reversed by the addition of carbachol, and Mg2+ uptake induced by carbachol is reversed by NE. Decreasing extracellular Na+ or Ca2+ decreases or abolishes Mg2+ efflux from myocytes. Cd2+ or other Ca2+ channel blockers also inhibit Mg2+ efflux in the presence of a physiological concentration of extracellular Ca2+. Replacement of extracellular Ca2+ with Sr2+ or with Mn2+ decreases or abolishes both stimulated efflux and influx of Mg2+. Redistribution of 85Sr in myocytes and in the supernatant indicates that under those conditions Sr2+ is released or accumulated by NE or carbachol in a manner similar to that of Mg2+. Hence, at least in the case of Sr2+, the inhibition of Mg2+ fluxes can be explained by the transport of Sr2+ rather than Mg2+ through the transport(s) systems. By contrast, replacement of extracellular Ca2+ with Ba2+ inhibits stimulated Mg2+ uptake but not Mg2+ release. These results indicate that cardiac myocytes have a major pool of Mg2+ that can be rapidly mobilized upon hormonal stimulation. The net uptake and release of Mg2+ are quantitatively similar and appear to be independent of the extracellular Mg2+ concentrations but are affected, to various degrees, by the presence of other cellular or extracellular cations.
Chronic mucocutaneous candidiasis treated with transfer factor
Authors: M. SOUSA, R. COCHRAN, R. MACKIE, D. PARRATT, M. ARALA-CHAVES
Journal: British Journal of Dermatology (1976)

A patient with chronic mucocutaneous candidiasis resistant to all tropical therapy has had extensive tests of immunological function carried out before and after administration of transfer factor. Immunological testing has been both specific, directed at responses to candida antigen, and non-specific, directed at general assessment of the patient's immune status. Transfer factor has been administered on three occasions in the past year. After each treatment temporary clinical improvement accompanied by changes in both specific and non-specific immunological responses have been observed. The possible mode of action of transfer factor in this case is discussed.
The effect of experimental insulin deficiency on glucagon secretion
Authors: Walter A. Müller, Gerald R. Faloona, Roger H. Unger
Journal: Journal of Clinical Investigation (1971)

Suppression of pancreatic glucagon secretion by hyperglycemia is a characteristic of normal alpha cell function. However, in diabetic subjects, plasma glucagon is normal or high despite hyperglycemia. It seemed possible that the presence of glucose or its metabolites within the alpha cell might be essential for suppression of glucagon secretion, and that in diabetes an intracellular deficiency of glucose secondary to insulin lack might be responsible for the nonsuppressibility. The present study was designed to determine the effect upon glucagon secretion of blockade of glucose metabolism and of experimental insulin deficiency. Blockade of glucose metabolism was induced in dogs by administration of 2-deoxyglucose or mannoheptulose. A striking rise in glucagon was observed despite accompanying hyperglycemia and hyperinsulinemia, which, in the case of mannoheptulose, was induced by infusing crystalline insulin. To determine if insulin lack also causes paradoxical hyperglucagonemia, dogs were made severely diabetic by alloxan. Fasting glucagon levels ranged from 3 to 22 times normal despite severe hyperglycemia, and were quickly restored to normal by infusing insulin. Diabetes induced in rats by anti-insulin serum was also associated with significant elevation in plasma glucagon. However, diazoxide-induced insulin lack did not increase glucagon in dogs. It is concluded that normal suppression of glucagon secretion by hyperglycemia does not occur when glucose metabolism is blocked or when severe insulin deficiency is produced. It is suggested that normal glucose metabolism within the alpha cell may be an insulin-requiring process without which hyperglycemic suppression of glucagon release cannot occur.
Low-Back Pain and a Vertebral Lesion
Authors: MERCEDES MITJAVILA, CONCEPCION NIETO, AUREA GARCIA, ANGEL CRESPO, LUIS DIEZ
Journal: Clinical Nuclear Medicine (1996)

A 54-year-old man had low-back pain for 5 months. Radiographs and planar bone imaging suggested no lesion. SPECT bone imaging demonstrated a focal area of increased uptake in the right pedicle of L3. A CT scan showed probable osteoid osteoma of the right pedicle of L3. The patient underwent surgery and the final histologic diagnosis was a metastatic bone lesion of a lung adenocarcinoma. This case demonstrates that 1) SPECT bone scanning may be very valuable in the setting of low-back pain in a normal or equivocal planar bone scan, and 2) a pedicle spine lesion should always raise the possibility of malignancy despite the results of other imaging modalities.
A Phase I Study of the Heat Shock Protein 90 Inhibitor Alvespimycin (17-DMAG) Given Intravenously to Patients with Advanced Solid Tumors
Authors: Simon Pacey, Richard H. Wilson, Mike Walton, Martin M. Eatock, Anthea Hardcastle, Anna Zetterlund, Hendrik-Tobias Arkenau, Javier Moreno-Farre, Udai Banerji, Belle Roels, Heidi Peachey, Wynne Aherne, Johan S. de Bono, Florence Raynaud, Paul Workman, Ian Judson
Journal: Clinical Cancer Research (2011)

A phase I study to define toxicity and recommend a phase II dose of the HSP90 inhibitor alvespimycin (17-DMAG; 17-dimethylaminoethylamino-17-demethoxygeldanamycin). Secondary endpoints included evaluation of pharmacokinetic profile, tumor response, and definition of a biologically effective dose (BED).Patients with advanced solid cancers were treated with weekly, intravenous (i.v.) 17-DMAG. An accelerated titration dose escalation design was used. The maximum tolerated dose (MTD) was the highest dose at which ≤ 1/6 patients experienced dose limiting toxicity (DLT). Dose de-escalation from the MTD was planned with mandatory, sequential tumor biopsies to determine a BED. Pharmacokinetic and pharmacodynamic assays were validated prior to patient accrual.Twenty-five patients received 17-DMAG (range 2.5-106 mg/m(2)). At 106 mg/m(2) of 17-DMAG 2/4 patients experienced DLT, including one treatment-related death. No DLT occurred at 80 mg/m(2). Common adverse events were gastrointestinal, liver function changes, and ocular. Area under the curve and mean peak concentration increased proportionally with 17-DMAG doses 80 mg/m(2) or less. In peripheral blood mononuclear cells significant (P < 0.05) HSP72 induction was detected (≥ 20 mg/m(2)) and sustained for 96 hours (≥ 40 mg/m(2)). Plasma HSP72 levels were greatest in the two patients who experienced DLT. At 80 mg/m(2) client protein (CDK4, LCK) depletion was detected and tumor samples from 3 of 5 patients confirmed HSP90 inhibition. Clinical activity included complete response (castration refractory prostate cancer, CRPC 124 weeks), partial response (melanoma, 159 weeks), and stable disease (chondrosarcoma, CRPC, and renal cancer for 28, 59, and 76 weeks, respectively).The recommended phase II dose of 17-DMAG is 80 mg/m(2) weekly i.v.
Subcutaneous terbutaline and control of brittle asthma or appreciable morning dipping.
Authors: J Ayres, D R Fish, D C Wheeler, J Wiggins, G M Cochrane, C Skinner
Journal: BMJ (1984)

In a pilot study two patients with brittle asthma and two with morning dipping received terbutaline or a placebo administered subcutaneously either by continuous infusion or in injections every six hours. In two patients brittle asthma was completely suppressed by terbutaline 1 mg/day given by either method. In the two others early morning dipping responded only to continuous subcutaneous infusions of terbutaline 12 mg/day. Terbutaline administered subcutaneously may be an effective treatment in asthmatic patients who show important diurnal variations in air flow.
Prioritizing Comparative-Effectiveness Research — IOM Recommendations
Authors: John K. Iglehart
Journal: New England Journal of Medicine (2009)

Directed by Congress to rapidly develop a list of broad-based priorities for the Department of Health and Human Services (DHHS) to consider as it implements a new agenda for comparative-effectiveness research (CER), the Institute of Medicine (IOM) released a report recommending a portfolio of 100 study topics related to a range of diseases, research methods, and care models that are important to the health of the U.S. population. The IOM report,1 released June 30, also recommends research studies on rare diseases that disproportionately affect certain subgroups of the population, such as women, racial or ethnic minorities, and particular age groups. . . .
Abstract P6-05-20: Designing biomarker panels for pre- and post-menopausal breast cancer diagnostic testing using MSD technology
Authors: MC Henderson, T-F Yeh, DE Reese, S Borman, A Hollingsworth
Journal: Cancer Research (2013)

Abstract At Provista Diagnostics, we have developed a breast cancer diagnostic test (dtectDx Breast) that analyzes serum levels of five protein biomarkers (IL-8, IL-12, CEA, HGF, and VEGF), which are then used in a proprietary algorithm to generate a score that can be characterized as either “normal” or “elevated”. The dtectDx Breast test has demonstrated a sensitivity/specificity of 90%/95% in a full retrospective training and validation set and 86%/87% in a recent post-market analysis. Though this test performs well in women under age 50, sensitivity and specificity both decrease when analyzing serum from women over age 50. We hypothesize that mean biomarker concentrations differ between pre-menopausal and post-menopausal women, in such a way that an ideal biomarker panel for breast cancer diagnosis in post-menopausal women may involve different analytes and a novel algorithm. To test this, we have partnered with the Mercy Women's Center in Oklahoma City to utilize prospectively-collected serum from women undergoing biopsy for a suspicious mass (all serum was drawn pre-biopsy) and from women with no evidence of a mass (to serve as a control). All patients self-reported menopausal status, thus allowing us to categorize samples as pre- or post-menopausal and determine how analyte levels vary between the populations. We determined mean concentrations for 10 protein biomarkers, all of which have previously been shown to be associated with breast cancer. All analytes were measured using Meso Scale Discovery (MSD) technology, which is highly sensitive and reliably demonstrates a low coefficient of variance between replicates. We have determined that mean serum biomarker concentrations are significantly different between pre- and post-menopausal populations in several analytes, thus suggesting that breast cancer diagnostic biomarker panels perform best when designed specifically for a target population. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-05-20.
Medical America Seen with Foreign Eyes
Authors: K. Jaffé
Journal: JAMA (1913)

FETISHPor pharmacy al its best we I urn to the Druggists Cir¬ cular.The following, from the May, 1918, issue, is one of the reasons we do so: "Compound Extract of Sarsaparille.-P,P. V., New Jersey, writes: 'Can you suggest a formula for a compound extract of sarsaparilla that could be retailed for about ,r>0 cents a pinl .''"We can, but know of no reason why we should, and do not believe that we shall.We think pharmacists should practice pharmacy, and if they do not lind ihis sufficiently remunerative and so decide to go info the handling of mer¬ chandise, they should select lines (hat will not, bring discredit on their vocation.There are already too many lake cure-alls on the market.It would be belter for pharmacy ¡is a pro¬ fession and for the drug business as a mercantile pursuit if the whole nostrum out lit were relegated to what someone has spoken of as the 'category of iiiiindexcd oblivion.'Lakers trill fake; they don't seem to care; but druggists, as followers of an honorable calling, cannot, afford to play grim jokes on trustful seekers after health."Sanitary Flood Survey To the Editor:\p=m-\The first sanitary flood survey of the Ohio and Wabash rivers was made during the week of April 7, 1913, and is a good example of emergency sanitation.The United States government is better fitted than any of the states to initiate emergency sanitation, and on this account on April 7 the Indiana State Health Commissioner, Dr. Hurty, was notified that a boat survey expedition would start from Louisville, Ky., April 8, and that the government wished rep- resentatives of the states of Indiana, Kentucky and Illinois to accompany this expedition.Major James A. Logan, Jr., of the Quartermaster's Department of the U. S. Army chartered a steam packet, the Ed Myer, on which were placed several car-loads of lime in 40-pound sacks, this size being the easiest handled, a large quantity of potassium permanganate in 1-pound cans, several thousand units of typhoid vaccine, several thousand small-pox vaccine points and several thousand units of diphtheritic antitoxin.For emergency work a ration consisting of sitl pork, flour, cotice, sugar and condensed milk was added.Major V. C. Hutton, surgeon, U. S. Army, was put in com¬ mand of the expedition.Dr. W. L. Heiser of Bowling Green
NIH’s Undiagnosed Diseases Program Expands
Authors: Bridget M. Kuehn
Journal: JAMA (2014)

Louise Benge, of Brodhead, Kentucky, enjoyed a normal, active childhood, including playing running games with friends, the 51-year-old woman explained at a National Institutes of Health (NIH) press briefing in July. Then in her teens, Benge developed crippling pain in her hands.
Risking Health to Avoid Injections
Authors: A. Brett Hauber, F. Reed Johnson, Luc Sauriol, Benedicte Lescrauwaet
Journal: Diabetes Care (2005)

Improved glycemic control reduces the risk of long-term diabetes complications (1–3). However, subcutaneous insulin injections represent a barrier to achieving “optimal” blood glucose levels, particularly among type 2 diabetic patients (4). Indeed, some patients even delay initiation of therapy to avoid injections (5). This study used conjoint analysis to quantify the relative importance that Canadian patients with type 2 diabetes place on short-term treatment outcomes and on the frequency of insulin injections.

A total of 1,886 patients enrolled in a Canadian consumer panel ( n = 70,000) were mailed a questionnaire. Study entry criteria were age ≥18 years and self-reported type 2 diabetes.

The choice format conjoint questionnaire was designed to reveal the relative importance patients place on various health outcomes and treatment attributes associated with insulin therapy. This format offers advantages over other methods of quantifying health care preferences (6–11). The questions comprised 12 hypothetical treatment choices, including varying numbers of daily insulin injections using an insulin pen (one to three injections), levels of glucose control (optimal, suboptimal, and poor as fasting plasma glucose levels of 4–7, 7.1–10, and >10 mmol/l, respectively), HbA1c (A1C) levels  8.4%), and numbers of mild-to-moderate hypoglycemic events per month ( 2). Insulin pens were chosen over other methods of subcutaneous insulin delivery because they are the predominant method used in Canada (12). One alternative in each question was a constant reference condition. …
Methods to identify and characterize developmental neurotoxicity for human health risk assessment. III: pharmacokinetic and pharmacodynamic considerations.
Authors: D C Dorman, S L Allen, J Z Byczkowski, L Claudio, J E Fisher, J W Fisher, G J Harry, A A Li, S L Makris, S Padilla, L G Sultatos, B E Mileson
Journal: Environmental Health Perspectives (2001)

We review pharmacokinetic and pharmacodynamic factors that should be considered in the design and interpretation of developmental neurotoxicity studies. Toxicologic effects on the developing nervous system depend on the delivered dose, exposure duration, and developmental stage at which exposure occurred. Several pharmacokinetic processes (absorption, distribution, metabolism, and excretion) govern chemical disposition within the dam and the nervous system of the offspring. In addition, unique physical features such as the presence or absence of a placental barrier and the gradual development of the blood--brain barrier influence chemical disposition and thus modulate developmental neurotoxicity. Neonatal exposure may depend on maternal pharmacokinetic processes and transfer of the xenobiotic through the milk, although direct exposure may occur through other routes (e.g., inhalation). Measurement of the xenobiotic in milk and evaluation of biomarkers of exposure or effect following exposure can confirm or characterize neonatal exposure. Physiologically based pharmacokinetic and pharmacodynamic models that incorporate these and other determinants can estimate tissue dose and biologic response following in utero or neonatal exposure. These models can characterize dose--response relationships and improve extrapolation of results from animal studies to humans. In addition, pharmacologic data allow an experimenter to determine whether exposure to the test chemical is adequate, whether exposure occurs during critical periods of nervous system development, whether route and duration of exposure are appropriate, and whether developmental neurotoxicity can be differentiated from direct actions of the xenobiotic.
A matter of public interest
Authors: S. Garattini, V. Bertele'
Journal: BMJ (2010)

Bevacizumab is better than no treatment, photodynamic treatment, or six weekly intravitreal pegaptanib sodium in neovascular age related macular degeneration (AMD).1 Its long term safety and whether it is as effective as ranibizumab are unknown,2 but available data should be sufficient for the European Medicine Agency (EMA) to …