tbuckley/cabot-search huggingface dataset:
A Case of Massive Diphenhydramine Abuse and Withdrawal From Use of the Drug
Authors: Marc D. Feldman
Journal: JAMA (1986)

<h3>To the Editor.—</h3> Antihistamines are the major components of most over-the-counter preparations promoted as daytime sedatives and sleep aids.<sup>1</sup>Self-medication with these preparations is common, although tolerance develops quickly.<sup>1</sup>Diphenhydramine hydrochloride, a histamine antagonist with both sedative and anticholinergic effects, is one agent found in some nonprescription soporifics. We wish to report a case of protracted massive diphenhydramine intake in a patient using an over-the-counter medication. <h3>Report of a Case.—</h3> A 34-year-old man with chronic residual schizophrenia was referred to our hospital for gradual reduction of diphenhydramine use. The patient had initiated use of the nonprescription medication Sominex 2 (diphenhydramine hydrochloride, 25 mg per tablet) six months prior to admission to assist with initial insomnia. He noted resultant sedation and mild euphoria and increased the dosage over ensuing months. Initial anticholinergic effects such as dry mouth and urinary hesitancy abated with continued use. At the time of admission,
Uric Acid Excretion
Authors: CRARY CJREENBERG
Journal: Annals of Internal Medicine (1979)

Letters and Corrections1 November 1979Uric Acid ExcretionCRARY CJREENBERG, M.D., BIJAY K. JAYASWAL, M.D.CRARY CJREENBERG, M.D.Search for more papers by this author, BIJAY K. JAYASWAL, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-91-5-796_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The article by Simkin and associates in the July issue (1) discussed a common problem in clinical medicine and provoked much conversation among the physicians here. Answers to the following questions may permit more complete acceptance of the spot uric-acid excretion ratio as clinically useful.What literature is available on the time course—relative and absolute—of uric acid and creatinine release and excretion over a 24-h period?What correlation was obtained in a paired t test between spot ratio results and the 24-h collection excretion ratios in the persons studied?What correlation was obtained in apaired t...Reference1. SIMKINHOOVERPAXSONWILSON PPCW. Uric acid excretion: quantitative assessment from spot, midmorning serum and urine samples. Ann Intern Med. 1979;91:44-7. LinkGoogle Scholar1. SIMKIN P. Uric acid excretion in patients with gout. Arthritis Rheum. 1979;22:98-9. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Glenville Health Association Cleveland, OH 44108 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 November 1979Volume 91, Issue 5Page: 796-796KeywordsCreatinineExcretionUric acid ePublished: 1 December 2008 Issue Published: 1 November 1979 PDF downloadLoading ...
Consider fledgling researchers
Authors: S. Singh, R. Meakin, S. Iliffe
Journal: BMJ (2010)

Undergraduates are tomorrow’s researchers, and we predict that many will be put off by the difficult, onerous, and ultimately demotivating procedures for research approval.1

For students undertaking the clinical intercalated degree in primary health care (iBSc) at UCL2 their dissertation based on original research makes up 37.5% of …
Propoxyphene Napsylate For Heroin Addiction
Authors: Forest S. Tennant
Journal: JAMA (1973)

<h3>To the Editor.—</h3> Preliminary results of treatment of heroin addicts with propoxyphene napsylate (Darvon-N) were recently reported.<sup>1</sup>Numerous reports have subsequently reached me that indicate propoxyphene napsylate treatment is spreading at a faster rate than current data on effectiveness and safety may warrant. Initial observations indicate that propoxyphene napsylate has minimal physical addiction liability, and low overdose and abuse potential. Consequently, this treatment has great appeal to many addicts, law enforcement agencies, and physicians. Despite early promise, however, clinical experience with propoxyphene napsylate treatment of heroin addicts is quite limited. As of Aug 1,1973, three Los Angeles programs have detoxified 280 heroin addicts, and an additional 92 addicts have been maintained on an out-patient basis with propoxyphene napsylate for periods ranging up to 300 days. Eight of the propoxyphene napsylate maintenance patients were directly transferred from methadone maintenance. Our detoxification schedule for in-patients is as follows: Daily medication is
148 A RANDOMIZED TRIAL OF THE SAFETY AND HEPATIC HEMODYNAMIC EFFECTS OF INTRAVENOUS CONIVAPTAN IN EUVOLEMIC OR HYPERVOLEMIC CIRRHOTIC PATIENTS
Authors: J. Bosch, E. Erice, E. Llop, A. Abeyratne, M. Tanaka, D. Whitcomb, F. Schepis, B. McNutt
Journal: Journal of Hepatology (2011)
P2-010: Associations of ABCB1, ABCC2, and ABCG2 polymorphisms with irinotecan-pharmacokinetics and clinical outcome in patients with advanced non-small cell lung cancer
Authors: Ji-Youn Han, Hyeong-Seok Lim, Sung Young Lee, Dae Ho Lee, Heung Tae Kim, Jin Soo Lee
Journal: Journal of Thoracic Oncology (2007)
Restenosis after directional coronary atherectomy: Differences between primary atheromatoes and restenosls lesions and influence of subintimal tissue resection
Authors: Kirk N. Garratt, David R. Holmes, Malcolm R. Bell, John F. Bresnahan, Urs P. Kaufmann, Ronald E. Vlietstra, William D. Edwards
Journal: Journal of the American College of Cardiology (1990)
UK doctors could save 2bn a year by cutting waste, says report
Authors: J. Wise
Journal: BMJ (2014)

The UK health services could save nearly £2bn (€2.6bn; $3.2bn) a year if doctors provided more appropriate care in 16 areas of clinical practice, a new report from the Academy of Medical Royal Colleges has claimed.1

The report calls for a cultural shift so that healthcare workers ask whether every treatment or procedure is really necessary and genuinely improves the quality of a patient’s life or their prospects for recovery. It identifies areas of waste such as the overuse of drugs, overuse of diagnostic or monitoring tests, and unplanned admissions.

The report says that prescribing costs could be reduced by using off-patent treatments whenever possible. For example, …
Removal of Foreign Body from the Left Bronchus
Authors: J. Walters
Journal: BMJ (1868)

why that lesion is unikely to happen frequenty.Be it noted, that the dsplacement o wsedw pnry, tag place t once in the original inury and of such a kinas coud Sm ly bprdced after lodgment Of the head of the humerus in the upper part of the axila, without in.jury to the thorcic walls or the shoulder-girdle.While the patient vas walking on cmtches, his right crutch sfIpped; he lost his footing; and, the whole weight of his body being thus thrown on the left crutch the head of that crutch gLided outwards from the axilla, and raised his elbow as he fell to the ground.This is the patient's story.The head of the crutch was the fulcrum on which the dislocation took place;
Abstract of a Report on the Vision of Children Attending London Elementary Schools
Authors: A. Lawson
Journal: BMJ (1898)

held during 1897, by the present writer, into the condition of the eyesight of children attending London elementary schools.The report was forwarded to the Education Department in December, 1897.As the education of the masses is one of the leading topics of the day, and defective vision, especially as regards myopia, is frequently said to be on the increase, owing to the strain of the present system of higher education, this abstract of the latest report on the subject may not be without some points of interest even to those who do not make a special study of ophthalmology.SELECTION OF SCHOOLS.
Head Trauma and Age of Onset of Dementia of the Alzheimer Type
Authors: P. Sullivan, D. Petitti, J. Barbaccia
Journal: JAMA (1987)

<h3>To the Editor.—</h3> Two recent epidemiologic case-control studies<sup>1,2</sup>have found a statistically significant association of premorbid head trauma with an increased risk of dementia of the Alzheimer type (DAT), although the largest study published to date<sup>3</sup>did not find such an association. To investigate this matter further, we conducted a case-control study of 17 DAT cases and 17 controls. <h3>Study.—</h3> Cases were from two DAT special care facilities, and controls were matched by age, sex, and race from Severe Head Injuries Reported by Surrogates of Cases and Controlsamong residents of the same nursing homes. The diagnosis of DAT was established by review of medical records following recently published clinical criteria.<sup>4</sup>History of head trauma was ascertained by telephone interviews with next-of-kin surrogates for both cases and controls. The average age of cases was 78.8 ±6.5 years (mean±SD) and 79.4 ± 6.1 years for controls, a difference
P738 NO CLINICALLY RELEVANT DRUG–DRUG INTERACTIONS BETWEEN FALDAPREVIR AND PEGYLATED INTERFERON a-2a PLUS RIBAVIRIN IN HCV-INFECTED PATIENTS: PHARMACOKINETIC ANALYSES FROM TWO PHASE II STUDIES
Authors: M. Bourlière, M. Sulkowski, M.P. Manns, T. Asselah, P. Ferenci, S. Pol, T. Berg, J. Lalezari, A.-M. Quinson, Y. Datsenko, J. Scherer, C.-L. Yong, F. Huang
Journal: Journal of Hepatology (2014)
Conservatives promise to end waiting lists
Authors: Owen Dyer
Journal: BMJ (2005)

Performance targets set by the government for NHS hospitals would be abolished under a new Conservative government, according to the party's health manifesto, released last week. Britain's 28 strategic health authorities would also go, while primary care trusts would have their number and functions reduced, in an effort “to restore the primacy of the doctor-patient relationship.”

But the manifesto drew criticism from health unions and the Labour party for its proposal to hand NHS money to private patients as a reward for seeking care outside the NHS. Under the plan, patients who sought a private operation would be entitled to 50% of the NHS cost for that procedure as a contribution towards their bill.

Efforts to stamp out hospital acquired …
Synthetic Serine Elastase Inhibitor Reduces Cigarette Smoke–induced Emphysema in Guinea Pigs
Authors: Joanne L. Wright, Stephen G. Farmer, Andrew Churg
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

To test whether a serine elastase inhibitor could prevent or reduce emphysema, we exposed guinea pigs to cigarette smoke acutely, or daily for 6 months, and treated some animals with the neutrophil elastase inhibitor ZD0892. Acute smoke exposure increased lavage neutrophils and increased desmosine and hydroxyproline, measures of elastin and collagen breakdown; all these measures were reduced by ZD0892. Long-term smoke exposure produced emphysema and increases in lavage neutrophils, desmosine, hydroxyproline, and plasma tumor necrosis factor α (TNF-α). ZD0892 treatment returned lavage neutrophils, desmosine, and hydroxyproline levels to control values, and decreased airspace enlargement by 45% and TNF-α by 30%. Animals exposed to smoke for 4 months and then to smoke plus ZD0892 for 2 months were not protected against emphysema. Mice exposed to smoke showed increases in gene expression of neutrophil chemoattractant macrophage inflammatory protein-2, macrophage chemoattractant protein-1, and TNF-α at 2 hours along with increased plasma TNF-α; ZD0892 prevented the increases in macrophage inflammatory protein-2 and macrophage chemoattractant protein-1 expression and reduced plasma TNF-α levels to baseline. These data demonstrate that a serine elastase inhibitor ameliorates the inflammatory and destructive effects of cigarette smoke, and that these effects are mediated in part by neutrophils and by smoke-driven TNF-α production.
A101: The Impact of Sleep and Cytokine Levels on Pain Perception in JIA
Authors: Deirdre I. De Ranieri, Linda Wagner-Weiner, Melissa Tesher, Hari Bandla, Karen Onel
Journal: Arthritis & Rheumatology (2014)

Background/Purpose:

Children with JIA experience more pain and disordered sleep than healthy children. JIA and poor sleep are associated with particular cytokine abnormalities, and the correlation between the two and how they relate to a patient's pain perception have not been studied. Elevation in TNF-a, IL-6, IL-17, and IFN-g have been found in the serum of children with JIA during active disease. Levels of proinflammatory cytokines are also increased during sleep loss. Indeed, blocking TNF-a has been shown in adults with RA to improve sleep the night after the first dose. We hypothesize that dysfunctional sleep enhances pain in our patients and may be associated with abnormal cytokine profiles. In this pilot study, we hope to identify a subgroup of children with JIA that could benefit from intervention in improving sleep patterns.



Methods:

We plan to enroll 60 patients with JIA. Sleep is assessed by the sleep self-report (SSR), the children's sleep habits questionnaire (CSHQ), and actigraphy. Good concordance in measurements of sleep duration has been established between PSG and actigraphy. Patients wear an actigraphy watch and keep a daily sleep and pain diary for 14 days. Disease activity is assessed using ESR, sum of active joints, patient/parent and physician global assessment of disease activity. Serum cytokine testing will be performed by flow cytometry.



Results:

31 patients are enrolled. We identified 7 children with disordered sleep using CSHQ/ SSR. These patients report having pain on most days, and they trend toward having elevated disease activity (increased physician and patient global assessments as well as number of active joints, ESR was non-contributory). To date, 9 of the 31 patients underwent actigraphy. Preliminary data does not indicate an association between disease activity and objective sleep dysfunction. There is not yet enough data to comment on the association of pain and disordered sleep in the absence of disease activity. Serum from 22 patients has been collected for cytokine studies.



Conclusion:

There is a trend toward an association of perceived poor sleep (as reported subjectively by SSR/CSHQ) with increased pain and disease activity in our patient population. Increased disease activity does not appear to be objectively related to disordered sleep using actigraphy, however. So far, actigraphy has been conducted on patients without subjective complaints of sleep dysfunction. We plan to collect more objective data (via actigraphy) on patients with subjective sleep complaints (with and without active disease) to better characterize the relationship of pain and sleep. When this has been accomplished, we plan to investigate cytokine profiles in these groups.
Proteus Syndrome: A Rare Cause of Hemihypertrophy and Macrodactyly on Bone Scanning
Authors: U Joshi, J A. van der Sluijs, G J. J. Teule, R Pijpers
Journal: Clinical Nuclear Medicine (2005)

Proteus syndrome is a rare, sporadic genetic disorder characterized by overgrowth of multiple different tissues in a mosaic pattern. It is associated with connective tissue nevi, epidermal nevi, disproportionate overgrowth of multiple tissues, vascular malformations, characteristic tumors, and specific facial anomalies. Joseph Merrick, popularly known as the Elephant Man, is now believed to have suffered from Proteus syndrome. A case of Proteus syndrome and associated findings on bone scintigraphy are presented.
Fertility after hysteroscopic myomectomy
Authors: F Ubaldi
Journal: Human Reproduction Update (1995)

Journal Article Fertility after hysteroscopic myomectomy Get access Filippo Ubaldi, Filippo Ubaldi Centre for Reproductive Medicine, University Hospital, Vrije Universiteit Brussel-VUBLaarbeeklaan 101, B-1090 Brussels, Belgium Search for other works by this author on: Oxford Academic PubMed Google Scholar Herman Tournaye, Herman Tournaye Centre for Reproductive Medicine, University Hospital, Vrije Universiteit Brussel-VUBLaarbeeklaan 101, B-1090 Brussels, Belgium Search for other works by this author on: Oxford Academic PubMed Google Scholar Michel Camus, Michel Camus Centre for Reproductive Medicine, University Hospital, Vrije Universiteit Brussel-VUBLaarbeeklaan 101, B-1090 Brussels, Belgium Search for other works by this author on: Oxford Academic PubMed Google Scholar Harry Van der Pas, Harry Van der Pas Centre for Reproductive Medicine, University Hospital, Vrije Universiteit Brussel-VUBLaarbeeklaan 101, B-1090 Brussels, Belgium Search for other works by this author on: Oxford Academic PubMed Google Scholar Elisabeth Gepts, Elisabeth Gepts Centre for Reproductive Medicine, University Hospital, Vrije Universiteit Brussel-VUBLaarbeeklaan 101, B-1090 Brussels, Belgium Search for other works by this author on: Oxford Academic PubMed Google Scholar Paul Devroey Paul Devroey 1 Centre for Reproductive Medicine, University Hospital, Vrije Universiteit Brussel-VUBLaarbeeklaan 101, B-1090 Brussels, Belgium 1 To whom correspondence should be addressed. Phone32-2-477-4111; Fax: 32 2-477-6549 Search for other works by this author on: Oxford Academic PubMed Google Scholar Human Reproduction Update, Volume 1, Issue 1, 1 January 1995, Pages 81–90, https://doi.org/10.1093/humupd/1.1.81 Published: 01 January 1995 Article history Received: 24 February 1994 Accepted: 29 July 1994 Published: 01 January 1995
Management of Spontaneous Esophageal Rupture-Reply
Authors: Robert H. Brown
Journal: JAMA (1979)

We offer the following response to Dr Laforet. First, the literature pertaining to Boerhaave's syndrome is often confusing with respect to the term surgical. Many authors define this as operative repair of the esophagus, while others define it as chest-tube drainage even without surgery. As indicated in our first paragraph, we think that chesttube drainage is, in the broadest sense, surgical, although our title was worded specifically to emphasize the nonoperative aspect of management in this case. Second, we agree that pleural fluid pH measurement may be useful. However, it certainly would not have obviated the other pleural fluid studies. Third, as stated, an important source of confusion in the diagnosis in this case was the variability of the location of the patient's pain, possibly attributable to the patient's behavioral disorder. The absence of shock and mediastinal air and the presence of intermittent complaints of right lower quadrant
Direct Radioimmunoassay of Nuclear 3,5,3′ Triiodothyronine in Rat Anterior Pituitary
Authors: P. R. Larsen, S. Z. Bavli, M. Castonguay, R. Jove
Journal: Journal of Clinical Investigation (1980)

Previous tracer studies have suggested that 5′-monodeiodination of l-thyroxine (T4) in anterior pituitary may contribute a substantial portion of specifically bound nuclear 3,5,3′ l-triiodothyronine (T3) in this tissue in rats. To evaluate this possibility, a radioimmunoassay for nuclear T3 in individual anterior pituitaries was developed. Animals received [125I]T3 60 min before removal of the anterior pituitary and isolation of the nuclei by differential centrifugation. This allowed calculation of the nuclear:serum T3 ratio and comparison of expected with measured T3. T3 was extracted in ethanol, dried, and reconstituted in assay buffer. In untreated hypothyroid rats, anterior pituitary nuclear T3 was 0.18 ± 0.06 pg/μg DNA which was 0.13 pg/μg DNA greater than expected from the serum T3 concentration and the pituitary nuclear:serum [125I]T3 ratio. In 10 hypothyroid rats given a single bolus of 400 ng T3/100 g body wt., the nuclear T3 by radioimmunoassay was 1.0 ± 0.06 pg/μg DNA, whereas that expected from the T3 specific activity calculations was 0.85 pg/μg DNA (P < 0.025). Serum T4 concentrations in these rats were < 0.25 μg/dl but the nuclear T3 derived from as little as 0.2 μg/dl T4 could explain a large portion of these small discrepancies between observed and measured nuclear T3. In 29 normal rats, anterior pituitary nuclear T3 was 0.63±0.04 pg/μg DNA, whereas that expected from the serum T3 concentration (55±2 ng/dl) was 0.23±0.02 pg/μg DNA (P < 0.001). Total pituitary T3 based on this measurement was 92±6 pg. Because the maximal nuclear binding capacity for T3 in rat anterior pituitary is 0.77 pg/μg DNA, these results suggest there is 82% occupancy of these nuclear receptors. The requirement for normal serum concentrations of both T4 and T3 to achieve normal nuclear T3 saturation in anterior pituitary is in marked contrast to the situation in liver, kidney, and heart muscle which appear to require only a normal serum T3. As a consequence, the anterior pituitary can monitor both serum T4 and T3 and respond appropriately to changes in their concentrations.
Bone Scintigraphy of a Liposarcoma Presenting as a Muscle Hematoma
Authors: HANS VAN DER WALL, AMANDA PALMER, I PROVAN C. MURRAY
Journal: Clinical Nuclear Medicine (1992)

Bone imaging with Tc-99m medronate has been reported to show uptake in a number of primary and secondary tumors. Uptake has also been reported in muscle hematomas after trauma. The authors describe a patient with a mass in the posterior aspect of the right thigh that developed after trauma and was thought to be a muscle hematoma. Bone scintigraphy showed uptake in the mass, and open biopsy of the mass revealed a liposarcoma.
From the authors:
Authors: A. Bush, P. Seddon
Journal: European Respiratory Journal (2010)

Paediatrics in Berlin'' [1] in a recent issue of the European Respiratory Journal, which summarised the paediatric topics of the European Respiratory Society's Annual Congress in Berlin.In this article, inert gas multiple breath washout (MBW) technique was highlighted as a promising tool for assessing parameters of ventilation inhomogeneity, such as the lung clearance index (LCI) for detecting early peripheral airway disease, e.g. in cystic fibrosis.However, equipment using mass spectrometry, the current ''gold standard'' for MBW, has no prospect to become commercially available.Alternatively, an ultrasonic flow sensor or an infrared analyser has been introduced for indirectly measuring gas concentrations during a washout procedure.Our recent study reporting within-test repeatability and between-test reproducibility of the LCI in healthy children and adolescents using a side-stream ultrasonic flow sensor [2] was cited in this article [1].
HIV Genotype and Phenotype—Arresting Resistance?
Authors: Charles Flexner
Journal: JAMA (2000)

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 EFFECT OF BENZEDRINE SULPHATE ON CERTAIN ABNORMAL MENTAL STATES
Authors: Purcell G. Schube, M. C. McManamy, C. E. Trapp, A. Myerson
Journal: American Journal of Psychiatry (1937)

1. A study of the effects of benzedrine on certain major psychoses is presented, thus corroborating a previous report by Myerson. 2 2. There was no improvement in any case. 3. In 15 of the 80 cases studied there was temporary accentuation of the psychosis. 4. Benzedrine sulphate was of no value in the alleviation of the psychoses in the cases studied.