tbuckley/cabot-search huggingface dataset:
Pheniformin and Pancreatitis
Authors: SHUH-MIN WU
Journal: Annals of Internal Medicine (1978)

Letters and Corrections1 January 1978Pheniformin and PancreatitisSHUH-MIN WU, M.D., JACK W. WOLF, M.D., F.A.C.P.SHUH-MIN WU, M.D.Search for more papers by this author, JACK W. WOLF, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-88-1-128_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: We have read "Pheniformin-Associated Pancreatitis" by Drs. Chase and Mogan in the September issue (Ann Intern Med 87:314-315, 1977). We wish to add a case to the five cases reported previously.A 75-year-old black man was first admitted to the hospital by another physician because of acute myocardial infarction. He was found to have elevated blood sugar levels and was initially treated on a "sliding scale" with regular insulin. Later he was treated with DBITD⌖, 50 mg three times daily. His diabetes became well controlled. His blood urea nitrogen (BUN) level was 53 mg/dl. His 3-week course... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Research Medical Center Kansas City, MO 64131 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByDrug induced pancreatitis: A systematic review of case reports to determine potential drug associationsDrug-Induced Acute PancreatitisDrug-induced pancreatitis: A critical review 1 January 1978Volume 88, Issue 1Page: 128-128KeywordsAcute myocardial infarctionBlood sugarBlood urea nitrogenInsulinPancreatitis Issue Published: 1 January 1978 PDF DownloadLoading ...
Medical Education and the Rise of Hospitals
Authors: George E. Miller
Journal: JAMA (1963)

IN AMERICAN MEDICAL EDUCATION, the 20th century opened with the wind generated by Johns Hopkins being felt as a breath of fresh air by some, and by others as an offensive draft potentially as dangerous as the vapors that had caused the yellow fever epidemics a century earlier. For good or evil, instructional programs slowly responded to this intellectual force, and one of the most significant evidences of change was the appearance of a new relationship between medical students and the hospitals in which they learned. The long-standing faculty practice of dispensing quantities of dry and detailed information which required rote learning had been modified much earlier when the locus of a substantial segment of instruction shifted from the medical school lecture hall to the hospital amphitheatre. But this theatre was used largely for demonstration of interesting cases or illustrative pathology to embryonic physicians who recorded dutifully what they
<i>N</i>-(2,6-Dimethoxypyridine-3-yl)-9-Methylcarbazole-3-Sulfonamide as a Novel Tubulin Ligand against Human Cancer
Authors: Yue-Ming Wang, Lai-Xing Hu, Zhen-Ming Liu, Xue-Fu You, Sheng-Hua Zhang, Jing-Rong Qu, Zhuo-Rong Li, Yan Li, Wei-Jia Kong, Hong-Wei He, Rong-Guang Shao, Liang-Ren Zhang, Zong-Gen Peng, David W. Boykin, Jian-Dong Jiang
Journal: Clinical Cancer Research (2008)

Abstract Purpose: We have synthesized a new tubulin ligand N-(2,6-dimethoxypyridine-3-yl)-9-methylcarbazole-3-sulfonamide (IG-105). This work investigates its anticancer effect and mechanism. Experimental Design: Anticancer efficacy was evaluated at the molecular target, cancer cells and nude mice. The mechanism was explored at submolecular, molecular, and cellular levels. Results: IG-105 showed a potent activity against human leukemia and solid tumors in breast, liver, prostate, lung, skin, colon, and pancreas with IC50 values between 0.012 and 0.298 μmol/L. It was also active in drug-resistant tumor cells and not a P-glycoprotein substrate. It inhibited microtubule assembly followed by M-phase arrest, Bcl-2 inactivation, and then apoptosis through caspase pathways. The colchicine pocket on tubulin is the binding site of IG-105. Nude mice experiments showed that IG-105 monotherapy at 100 mg/kg i.p. (q2d) yielded 81% inhibition of Bel-7402 hepatoma growth and at 275 mg/kg i.p. (q2d) completely inhibited the tumor growth. MCF-7 breast cancer in nude mice showed a similar therapeutic response to IG-105. Acute toxicity of IG-105 was not found even at 1,000 mg/kg i.p. In combination with oxaliplatin or doxorubicin, IG-105 converted each of these subcurative compounds into a curative treatment with complete inhibition for tumor growth in the hepatoma-bearing nude mice. The combination was more active than either drug. In no experiment was toxicity increased by combination chemotherapy. Conclusions: IG-105 inhibits microtubule assembly by binding at colchicine pocket. It shows a potent anticancer activity in vitro and in vivo and has good safety in mice. We consider IG-105 merits further investigation.
Prolonged Glucagon Administration in a Case of Hyperinsulinism Due to Disseminated Islet-Cell Carcinoma
Authors: Bernard R. Landau, Herbert J. Levine, Roy Hertz
Journal: New England Journal of Medicine (1958)

RECENT progress in glucagon research has made this hormone available in high purity, clarified its important role in carbohydrate metabolism and suggested its applicability in many clinical problems.1 Schulman and Greben2 have employed glucagon parenterally to terminate hypoglycemic coma associated with insulin-shock therapy, but the prolonged administration of glucagon for the control of chronic hypoglycemia has not been investigated. A case of severe and persistent hypoglycemia in a woman with functioning islet-cell carcinomatosis permitted such an attempt. Although epinephrine and ACTH were only transiently effective, the intravenous administration of glucagon¶ over a two-and-a-half-month period resulted in a decrease in both . . .
The Assessment and Treatment of Geezers
Authors: Franklin D. Aldrich
Journal: JAMA (1988)

<h3>To the Editor.—</h3> "The Assessment and Treatment of Geezers" by Drs Pankratz and Kofoed<sup>1</sup>omits mentioning that some of us who would qualify otherwise for the authors' definition of a geezer fail to do so because we do not have "limited formal education" and are not "unimpressed by diplomas and certificates." Those of us who affect geezerdom (-hood) from time to time do it in laconic protest against what we perceive as self-importance, long-windedness, and an inability or unwillingness to communicate with verbal economy.
Variation in lipoprotein(a) concentration associated with different apolipoprotein(a) alleles.
Authors: Y F Perombelon, A K Soutar, B L Knight
Journal: Journal of Clinical Investigation (1994)

Plasma lipoprotein(a) (Lp(a)) concentrations vary considerably between individuals. To examine the variation for products of the same and different apolipoprotein(a) (apo(a)) alleles, conditions were established whereby phenotyping immunoblots could be used to estimate the concentration of Lp(a) associated with the constituent apo(a) isoforms. In these studies 28 distinct isoforms were identified, each differing by a single kringle IV unit. Tracking the isoforms through 10 families showed that there could be up to 200-fold difference in the Lp(a) concentration associated with the same-sized isoform produced from different alleles. In contrast there was typically < 2.5-fold variation in the Lp(a) concentration associated with the same allele. However, there were four occasions where the concentration associated with a particular allele was reduced below the typical range from one generation to the next. A nonlinear, inverse trend with isoform size was apparently superimposed upon the other factors that determine Lp(a) concentration. Inheritance of familial hypercholesterolemia or familial-defective apoB100 had little consistent effect upon Lp(a) concentration. In both the families and in other unrelated individuals the distribution of isoforms and their associated concentrations provided evidence for the presence of at least two and possibly more subpopulations of apo(a) alleles with different sizes and expression.
Abstract 4033: MiR-21 upregulation in breast cancer cells leads to PTEN loss and Herceptin resistance
Authors: Sumaiyah K. Rehman, Wen-Chien Huang, Dihua Yu
Journal: Cancer Research (2010)

Abstract MicroRNAs (miRNA) are a class of small 22-nucleotides endogenous non-coding RNAs which serve as regulators of gene expression by targeting specific messenger RNAs (mRNA). Aberrant expression of certain microRNAs can lead to therapeutic drug resistance, such as Cisplatin resistance by miR-214 targeting PTEN. Our lab previously found that PTEN loss confers Herceptin resistance in ErbB2-overexpressing breast cancers. Other studies in hepatocellular carcinoma have shown that miR-21 targets the 3′UTR of PTEN mRNA leading to downregulation of PTEN protein levels. Based on these findings, we hypothesized that overexpression of miR-21 may confer Herceptin resistance in breast cancer patients by downregulation of PTEN. To test this hypothesis, mir-21 and/or control miRNA were transiently transfected and expressed in ErbB2-overexpressing AU565 and SKBr3 breast cancer cell lines, followed by Herceptin treatment. We found that cells with increased miR-21 had reduced PTEN expression and were significantly more resistant to Herceptin treatment versus control miRNA transfected cells. Conversely, when we knocked down miR-21 in high ErbB2 expressing BT474 cells, the cells showed increased PTEN expression and became more sensitive to Herceptin treatment versus control miRNA transfected cells. To determine the clinical relevance of our findings, we detected miR-21 level in patients’ breast cancers with ErbB2 expression that were treated with Herceptin and we found that high miR-21 level significantly correlated with patients’ poor response to Herceptin treatment and disease progression. We are currently identifying other targets of miR-21 to better understand the mechanisms of miR-21 mediated-Herceptin resistance, which may provide new insight on how to overcome Herceptin resistance. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4033.
Management of Juvenile Diabetes Mellitus
Authors: J. C. Haworth
Journal: JAMA (1966)

Diabetes mellitus is a chronic disease of inconvenience. Proper management of the child with this disorder ensures normal growth and development and delays the onset of the degenerative complications.  general medical care of the child with diabetes mellitus should differ in no way from the general medical management of his non-diabetic contemporary. These children should engage in full, unrestricted activity and receive the same health measures as the non-diabetic child. This quotation from the preface of the book summarizes the authors' philosophy about childhood diabetes.  To quote again from the preface, The purpose of this book is to provide a concise, practical method of management of juvenile diabetes mellitus. This is done briefly and clearly with short initial chapters on etiology, diagnosis, the insulins, and instruction of the patients and parents about diabetes, which includes an ABC on urine testing and insulin administration. By far the longest chapter is
Repeated self-poisoning with paracetamol.
Authors: L F Prescott, I Oswald, A T Proudfoot
Journal: BMJ (1978)

less readily considered.Furthermore, the fact that the fundal appear- ances of CMV retinitis so resemble malignant retinal deposits, particularly in a primed situation, as in this case, is likely to confuse.Reported cases of CMV retinitis mostly concern renal transplant recipients.The ophthalmic appearances in this case, we now realise, are very similar to published descriptions.3The CAT-scan appear- ances, which have not been previously described, are of interest.Interpretation of CSF cytocentrifuge preparations can be very difficult.In retrospect we realise that the cells we saw were reactive lymphocytes and not malignant cells.CMV may cause encephalitis.4Possibly our treatment, which would have produced further immuno- suppression, was causally related to the proliferation of the lesions.Corticosteroids enhance CMV infection in mice.5 Local radiotherapy clearly failed to halt the progression of disease.There is no effective treatment known for CMV disease, but had the true diagnosis been considered in this patient possibly management would have been different.
Echocardiography of right ventricular tumors.
Authors: T A Ports, N B Schiller, B L Strunk
Journal: Circulation (1977)

The clinical and echocardiographic findings of four patients with right ventricular tumors (three myxomas and one metastatic melanoma) are presented. All four patients previously had been evaluated by competent cardiologists, and the diagnosis of a right ventricular tumor was missed. The initial echocardiograms were interpreted as not showing any right ventricular tumor; but on review we found that the correct diagnosis could have been made. The presence of the right ventricular myxomas was confirmed at angiography and surgery. However, the attachment of the stalk of the mycoma could not be determined confidently by angiography alone, and in two of the three cases two-dimensional echocardiography was required to identify correctly the location of the base of the stalk. This paper emphasizes the usefulness and technical difficulties of M-mode and two-dimensional echocardiography in the diagnosis of a right ventricular tumor.
High level of resources for neonatal intensive care does not give US better outcomes
Authors: J. H. Tanne
Journal: BMJ (2002)

The United States has more neonatologists and neonatal intensive care beds per person than the United Kingdom, Canada, or Australia but higher rates of low birth weight and death among neonates, says a study from Dartmouth Medical School's Center for the Evaluative Clinical Sciences in Pediatrics (2002;109:1036-43).

The study compared neonatal intensive care resources, preconception care and prenatal care, rates of low birth weight and neonatal deaths (deaths within the first month), and infant mortality (deaths within the first year).

The United States has 6.1 neonatologists per …
Patients are to be given control of medical records under new IT plans
Authors: M. Cross
Journal: BMJ (2010)

<h3>BACKGROUND</h3> The magnitude of the association between <i>Helicobacter pylori </i>and incidence of gastric cancer is unclear.<i>H pylori</i> infection and the circulating antibody response can be lost with development of cancer; thus retrospective studies are subject to bias resulting from classification of cases as <i>H pylori</i> negative when they were infected in the past. <h3>AIMS</h3> To combine data from all case control studies nested within prospective cohorts to assess more reliably the relative risk of gastric cancer associated with <i>H pylori</i> infection. To investigate variation in relative risk by age, sex, cancer type and subsite, and interval between blood sampling and cancer diagnosis. <h3>METHODS</h3> Studies were eligible if blood samples for <i>H pylori</i>serology were collected before diagnosis of gastric cancer in cases. Identified published studies and two unpublished studies were included. Individual subject data were obtained for each. Matched odds ratios (ORs) and 95% confidence intervals (95% CI) were calculated for the association between <i>H pylori</i> and gastric cancer. <h3>RESULTS</h3> Twelve studies with 1228 gastric cancer cases were considered. The association with<i>H pylori</i> was restricted to non-cardia cancers (OR 3.0; 95% CI 2.3–3.8) and was stronger when blood samples for <i>H pylori</i> serology were collected 10+ years before cancer diagnosis (5.9; 3.4–10.3). <i>H pylori</i> infection was not associated with an altered overall risk of cardia cancer (1.0; 0.7–1.4). <h3>CONCLUSIONS</h3> These results suggest that 5.9 is the best estimate of the relative risk of non-cardia cancer associated with <i>H pylori</i>infection and that <i>H pylori</i> does not increase the risk of cardia cancer. They also support the idea that when <i>H pylori</i> status is assessed close to cancer diagnosis, the magnitude of the non-cardia association may be underestimated.
Randomized Trial of Optimal Treatment Strategies for In-Stent Restenosis After Drug-Eluting Stent Implantation
Authors: Hae-Geun Song, Duk-Woo Park, Young-Hak Kim, Jung-Min Ahn, Won-Jang Kim, Jong-Young Lee, Soo-Jin Kang, Seung-Whan Lee, Cheol Whan Lee, Seong-Wook Park, Seungbong Han, In-Whan Seong, Nae-Hee Lee, Bong-Ki Lee, Keun Lee, Seung-Wook Lee, Deuk-Young Nah, Seung-Jung Park
Journal: Journal of the American College of Cardiology (2012)
From the former Soviet Union: Socioeconomic health inequalities exist in post-communist Lithuania
Authors: Antanas Jurgelenas, Diana Mieliauskaite, Rima Filipaviciute
Journal: BMJ (2005)

A tale of two Germanys Health problems in eastern Germany are clearly related to transitionEditor-The fall of the Berlin Wall in 1989 marked the beginning of the end of communism in eastern Europe and in eastern Germany.As McKee and Fister point out, 1 certain constellations of epidemiological and demographic variables characterise the resultant process of political and economic transition: low or even decreasing life expectancy (especially for men) and higher prevalences of alcoholism and obesity.This has happened in the postcommunist Länder (federal states) of eastern Germany.East Germany is different from other east European countries in that its healthcare sector was not deconstructed, with periods of severe dysfunction: it simply adopted the healthcare system of West Germany.Despite this, life expectancy at birth is still lower in eastern Germany than in western Germany, although the difference had diminished at the end of the 1990s. 2 Alcoholic disease is a feature of the typical transition process.The number of people discharged from hospital with alcoholic disease was higher in eastern Germany in 1994 and 1999 than in western Germany. 3 Obesity is another transition related problem and a risk factor for many diseases. 4 The proportion of the population with obesity (body mass index > 29.9) is higher in eastern Germany than in western Germany.This difference has remained for over 10 years after the fall of the Berlin Wall.In the medium term, the situation is set to even out.But it is remarkable that in spite of the same, well equipped (curative) health system, health care does not strongly modify mainly lifestyle linked health effects in a population that is exposed to transition after communism.For eastern Germany, the end of this transition process is in sight.
Sleeping Beauty Transposition From Nonintegrating Lentivirus
Authors: Conrad A Vink, H Bobby Gaspar, Richard Gabriel, Manfred Schmidt, R Scott McIvor, Adrian J Thrasher, Waseem Qasim
Journal: Molecular Therapy (2009)

Lentiviral vectors enter cells with high efficiency and deliver stable transduction through integration into host chromosomes, but their preference for integration within actively transcribing genes means that insertional mutagenesis following disruption of host proto-oncogenes is a recognized concern. We have addressed this problem by combining the efficient cell and nuclear entry properties of HIV-1–derived lentiviral vectors with the integration profile benefits of Sleeping Beauty (SB) transposase. Importantly, this integration enzyme does not exhibit a preference for integration within active genes. We generated integrase-deficient lentiviral vectors (IDLVs) to carry SB transposon and transposase expression cassettes. IDLVs were able to deliver transient transposase expression to target cells, and episomal lentiviral DNA was found to be a suitable substrate for integration via the SB pathway. The hybrid vector system allows genomic integration of a minimal promoter-transgene cassette flanked by short SB inverted repeats (IRs) but devoid of HIV-1 long terminal repeats (LTRs) or other virus-derived sequences. Importantly, integration site analysis revealed redirection toward a profile mimicking SB-plasmid integration and away from integration within transcriptionally active genes favored by integrase-proficient lentiviral vectors (ILVs). Lentiviral vectors enter cells with high efficiency and deliver stable transduction through integration into host chromosomes, but their preference for integration within actively transcribing genes means that insertional mutagenesis following disruption of host proto-oncogenes is a recognized concern. We have addressed this problem by combining the efficient cell and nuclear entry properties of HIV-1–derived lentiviral vectors with the integration profile benefits of Sleeping Beauty (SB) transposase. Importantly, this integration enzyme does not exhibit a preference for integration within active genes. We generated integrase-deficient lentiviral vectors (IDLVs) to carry SB transposon and transposase expression cassettes. IDLVs were able to deliver transient transposase expression to target cells, and episomal lentiviral DNA was found to be a suitable substrate for integration via the SB pathway. The hybrid vector system allows genomic integration of a minimal promoter-transgene cassette flanked by short SB inverted repeats (IRs) but devoid of HIV-1 long terminal repeats (LTRs) or other virus-derived sequences. Importantly, integration site analysis revealed redirection toward a profile mimicking SB-plasmid integration and away from integration within transcriptionally active genes favored by integrase-proficient lentiviral vectors (ILVs).
Reduction of the mite‐allergen reservoir <i>within</i> mattresses by vacuum‐cleaning. A comparison of three vacuum‐cleaning systems
Authors: M. Wickman, S. Paues, G. Emenius
Journal: Allergy (1997)

Mattresses are considered to be the main source of house‐dust‐mite (HDM) allergen. This study aimed to investigate different types of vacuum cleaners for their ability to reduce this allergen reservoir. Three types of vacuum cleaners were examined: a conventional vacuum cleaner, a water‐trap cleaner, and a central vacuum cleaner. Cut out pieces of mattresses were analyzed for content of mite allergen after vacuum‐cleaning. Three polyester mattresses from the homes of three children were selected for the study. These three mattresses had earlier been found to be contaminated by group 1 HDM alhlergen (8–15 μg/g of dust). Each mattress was divided into three main sections, separated by a safety zone, and each main section was subdivided into four parts. The three main sections were cleaned by each vacuum‐cleaning system. Pieces 2–cm‐thick of the surface of the mattresses were cut out, and extracts were made to assess the amount of mite allergen still present after different intensities of vacuum‐cleaning. A considerable reduction in the level of mite allergen was found after using all three of the vacuum‐cleaning systems. Only 22% of the original mite‐allergen reservoir remained after intense vacuum‐cleaning. Since the number of mattresses in the investigation was low, and niche formations of group 1 HDM allergen within the mattresses were observed, the results must be interpreted with caution. Furthermore, allergen‐producing living dust mites were not affected by this method. However, intense vacuum‐cleaning seems to reduce considerably the level of the mattress‐bound mite‐allergen reservoir, a fact which may be important in mite‐allergic and mite‐exposed families.
RISK STRATIFICATION TOOL USING ELECTRONIC MEDICAL RECORD DATA AT ADMISSION PREDICTS 30-DAY READMISSION AMONG HEART FAILURE PATIENTS
Authors: Alicia Ross, Stephanie Fine, Tyler Gluckman, Karen Rydell, Suzanne Webber, Jacob Abraham, Maylene Buckendorf, Lian Wang, Katheryn Zerr, Gary Grunkemeier
Journal: Journal of the American College of Cardiology (2014)