tbuckley/cabot-search huggingface dataset:
Aminotransferase Elevations in Healthy Adults Receiving 4 Grams of Acetaminophen Daily
Authors: Paul B. Watkins, Neil Kaplowitz, John T. Slattery, Connie R. Colonese, Salvatore V. Colucci, Paul W. Stewart, Stephen C. Harris
Journal: JAMA (2006)

During a clinical trial of a novel hydrocodone/acetaminophen combination, a high incidence of serum alanine aminotransferase (ALT) elevations was observed.To characterize the incidence and magnitude of ALT elevations in healthy participants receiving 4 g of acetaminophen daily, either alone or in combination with selected opioids, as compared with participants treated with placebo.A randomized, single-blind, placebo-controlled, 5-treatment, parallel-group, inpatient, diet-controlled (meals provided), longitudinal study of 145 healthy adults in 2 US inpatient clinical pharmacology units.Each participant received either placebo (n = 39), 1 of 3 acetaminophen/opioid combinations (n = 80), or acetaminophen alone (n = 26). Each active treatment included 4 g of acetaminophen daily, the maximum recommended daily dosage. The intended treatment duration was 14 days. Main Outcomes Serum liver chemistries and trough acetaminophen concentrations measured daily through 8 days, and at 1- or 2-day intervals thereafter.None of the 39 participants assigned to placebo had a maximum ALT of more than 3 times the upper limit of normal. In contrast, the incidence of maximum ALT of more than 3 times the upper limits of normal was 31% to 44% in the 4 treatment groups receiving acetaminophen, including those participants treated with acetaminophen alone. Compared with placebo, treatment with acetaminophen was associated with a markedly higher median maximum ALT (ratio of medians, 2.78; 95% confidence interval, 1.47-4.09; P<.001). Trough acetaminophen concentrations did not exceed therapeutic limits in any participant and, after active treatment was discontinued, often decreased to undetectable levels before ALT elevations resolved.Initiation of recurrent daily intake of 4 g of acetaminophen in healthy adults is associated with ALT elevations and concomitant treatment with opioids does not seem to increase this effect. History of acetaminophen ingestion should be considered in the differential diagnosis of serum aminotransferase elevations, even in the absence of measurable serum acetaminophen concentrations.
Attempted suicide by insulin injection treated with artificial pancreas.
Authors: H Gin, B Larnaudie, J Aubertin
Journal: BMJ (1983)

An elderly woman with longstanding insulin dependent diabetes tried to commit suicide by injecting 400 units of insulin subcutaneously (usual total daily dose 56 units).She was admitted to hospital within the hour and treated with the aid of an artificial pancreas.This avoided the usual difficulty of the physician having to cope with rapid and substantial fluctuations in blood glucose concentrations and 67 hours after the overdose insulin was re- instituted.Using an artificial pancreas in insulin overdose is an important advance in management and may avoid the need for surgical intervention such as excising the site of injection.
Effects of verapamil and propranolol on changes in extracellular K+, pH, and local activation during graded coronary flow in the pig.
Authors: I Watanabe, T A Johnson, C L Engle, C Graebner, M G Jenkins, L S Gettes
Journal: Circulation (1989)

The beta-adrenergic and calcium channel blocking agents are known to reduce heart rate and alter myocardial contractility. More recent evidence suggests that both agents affect the metabolic consequences of ischemia, independent of their effects on heart rate and contractility. We used a low-flow model of ischemia in swine with heart rate held constant by atrial pacing. Blood was shunted from the carotid artery to the left anterior descending coronary artery through a controlled-flow roller pump to assess the threshold flow for the rise in extracellular potassium ([K+]e) and fall in extracellular pH (pHe) associated with ischemia during control situations and after the administration of either propranolol or verapamil. We also measured the changes in activation delay and contractility associated with graded flow reductions in the presence and absence of these drugs. We found that when heart rate is held constant, 1) verapamil shifts the threshold flow for [K+]e and pHe to lower levels, but propranolol does not; 2) verapamil lessens activation delay, while propranolol aggravates the delay; and 3) verapamil reduces afterload and selectively depresses contractility in the reperfused ischemic zone. We conclude that the calcium channel blockers and the beta-adrenergic-blocking agents have different effects and possibly different modes of action and should not be considered interchangeable when evaluating therapeutic options for patients with ischemic heart disease.
Therapeutic Application of Heat: Its Uses and Abuses
Authors: George Morris Piersol
Journal: New England Journal of Medicine (1952)

NO therapeutic procedure is more commonly employed in either a department of physical medicine and rehabilitation in a general hospital or the home than application of heat in some form. Numerous methods are available for the application of thermal stimuli to living human beings, heat, when'it is employed therapeutically, being derived from several sources of energy — radiant, electric or sonic.Radiant energy is the term applied to rays with wave lengths that in the electromagnetic spectrum are included between the "far" infrared energy band on the one hand (220,000 millimicrons) and the far ultraviolet portion of the spectrum on . . .
Press: Man, mission, rumpus
Authors: K. Abbasi
Journal: BMJ (2001)

One method of measuring a journal's influence is by counting the number of times it is mentioned in the general media. Last week, much to its surprise, a little known publication called Adverse Drug Reactions and Toxicology Reviews (circulation 350) topped the list. Oxford University Press, the publisher, readily admits that this is one of the smallest and least influential journals in its stable. But it reckoned without Andrew Wakefield, consultant gastroenterologist at the Royal Free Hospital, London, the main advocate for a link between the mumps, measles, and rubella triple vaccine (MMR) and autism ( Lancet 1998;351:637-41).

Wakefield's latest offering, “Mumps, measles, rubella vaccine: through a glass darkly,” was published on 22 January 2001 ( Adverse Drug React Toxicol Review 2000;19(4):265-83). The vaccine had, it is claimed, been introduced without sufficient evaluation, and this claim was swept up by a media storm that sucked in the UK's Department of Health, the World Health …
A 20-year perspective on the International Fanconi Anemia Registry (IFAR)
Authors: David I. Kutler, Bhuvanesh Singh, Jaya Satagopan, Sat Dev Batish, Marianne Berwick, Philip F. Giampietro, Helmut Hanenberg, Arleen D. Auerbach
Journal: Blood (2003)

Fanconi anemia (FA) is an autosomal recessive disorder characterized by cellular hypersensitivity to DNA cross-linking agents and cancer predisposition. Recent evidence for the interactions of ataxia-telangiectasia mutated protein ATM and breast cancer susceptibility proteins BRCA1 and BRCA2 (identified as FANCD1) with other known FA proteins suggests that FA proteins have a significant role in DNA repair/recombination and cell cycle control. The International Fanconi Anemia Registry (IFAR), a prospectively collected database of FA patients, allows us the unique opportunity to analyze the natural history of this rare, clinically heterogeneous disorder in a large number of patients. Of the 754 subjects in this study, 601 (80%) experienced the onset of bone marrow failure (BMF), and 173 (23%) had a total of 199 neoplasms. Of these neoplasms, 120 (60%) were hematologic and 79 (40%) were nonhematologic. The risk of developing BMF and hematologic and nonhematologic neoplasms increased with advancing age with a 90%, 33%, and 28% cumulative incidence, respectively, by 40 years of age. Univariate analysis revealed a significantly earlier onset of BMF and poorer survival for complementation group C compared with groups A and G; however, there was no significant difference in the time to hematologic or nonhematologic neoplasm development between these groups. Multivariate analysis of overall survival time shows that FANCC mutations (P =.007) and hematopoietic stem cell transplantation (P = <.0001) define a poor-risk subgroup. The results of this study of patients registered in the IFAR over a 20-year period provide information that will enable better prediction of outcome and aid clinicians with decisions regarding major therapeutic modalities.
Deoxycorticosterone and 17-Ketosteroids
Authors: Siang Y. Tan
Journal: JAMA (1978)

Plasma 11-deoxycorticosterone levels were manyfold elevated in three adult patients with hypertension and elevated urinary excretion levels of 17-ketosteroids but without Cushing's syndrome. Dexamethasone therapy resulted in suppression of these steroids and in improvement of blood pressure in two of the patients. A partial adrenal 11β-hydroxylase deficiency appears to best explain these findings. (<i>JAMA</i>240:123-126, 1978)
THE ODOR AS A GUIDE IN THE TREATMENT OF CHRONIC SUPPURATION OF THE MIDDLE EAR.
Authors: H. GRADLE
Journal: JAMA (1906)

In chronic suppuration of the middle ear the success or failure of conservative treatment can not often be predicted from the objective appearances at the first examination. Cases in which we can demonstrate caries, or necrosis or cholesteatoma or involvement of the mastoid cells can, as a rule, not be cured except by operation. But very often the existence of these lesions can only be suspected, not demonstrated. Any sign, therefore, which enables us to test quickly the efficacy of conservative treatment should be recognized as a valuable guide. I have repeatedly pointed out what important lessons can be learned from the odor of the discharge in the course of treatment.<sup>1</sup>It seems to me important enough to revert to this subject in the light of further experience. With scarcely an exception the discharge of chronic suppuration is characteristically fetid. It has been shown by bacteriologic research that this
Induction and detection of a human endothelial activation antigen in vivo.
Authors: R S Cotran, M A Gimbrone, M P Bevilacqua, D L Mendrick, J S Pober
Journal: The Journal of Experimental Medicine (1986)

We used a murine mAb, H4/18, raised by immunization with IL-1-treated human umbilical vein endothelial cell cultures, to localize an endothelial activation antigen in induced human delayed hypersensitivity reactions (DHR) and in pathological tissues. We used streptococcus varidase to elicit DHR in human skin and we examined sequential skin biopsies with the immunoperoxidase technique. There was no staining for H4/18 binding antigen in normal endothelium of skin and other tissues; strong positive staining, localized to vascular endothelium, was seen at 16 and 23 h but disappeared by 6 d, when the DHR had faded. H4/18 binding antigen, also confined to endothelium, was detected in lymph nodes, skin, and other tissues exhibiting immune/inflammatory reactions. The studies indicate that H4/18 is a useful marker for activated endothelium in vivo and they support the relevance of in vitro studies on inducible endothelial cell functions.
Psychiatric drugs are not inferior to other drugs, review concludes
Authors: J. Wise
Journal: BMJ (2012)

A review of meta-analyses has concluded that psychiatric drugs are, in general, as effective as drugs used in other medical specialties.

Researchers from the Technische Universitat Munchen in Germany said they carried out the review because there is a deep mistrust of psychiatry fostered by reports indicating that psychotropic drug efficacy is small.

The study, published in the British Journal of Psychiatry (2012;200:97-106), included 94 meta-analyses of 48 drugs in 20 medical diseases and 33 meta-analyses of 16 drugs in eight psychiatric disorders. The researchers chose reviews of classes of drugs rather than single drugs and excluded meta-analyses of subgroups such as older people. They also chose the most recent reviews.

For each meta-analysis the researchers looked at the absolute risk …
Long-term follow-up on overall survival from the MM-009 and MM-010 phase III trials of lenalidomide plus dexamethasone in patients with relapsed or refractory multiple myeloma
Authors: M A Dimopoulos, C Chen, A Spencer, R Niesvizky, M Attal, E A Stadtmauer, M T Petrucci, Z Yu, M Olesnyckyj, J B Zeldis, R D Knight, D M Weber
Journal: Leukemia (2009)
Effects of polybrominated biphenyl on milk production, reproduction, and health problems in Holstein cows.
Authors: M E Wastell, D L Moody, J F Plog
Journal: Environmental Health Perspectives (1978)

PBB found in relatively low levels among animals present on a cross-section of Michigan farms during the time PBB was inadvertantly added to dairy feeds had no effect upon these animals' milk production, body weight, weight gain, breeding and reproduction performance, incidence of commonly experienced health problems, calving rate, and the health of their calves. No significant differences in these vital areas could be seen between Michigan animals exposed to PBB and equivalent Wisconsin animals which had not been exposed to PBB when both groups were subjected to equivalent management practices. No pattern of gross of histopathological lesions was seen upon necropsy between test animals and control animals.
Ectopic bone formation in mice associated with a lactic acid/dioxanone/ethylene glycol copolymer–tricalcium phosphate composite with added recombinant human bone morphogenetic protein-2
Authors: Minori Kato, Takashi Namikawa, Hidetomi Terai, Masatoshi Hoshino, Shimpei Miyamoto, Kunio Takaoka
Journal: Biomaterials (2006)
<i>IN VITRO</i> HISTAMINE RELEASE FROM LEUKOCYTES IN PENICILLIN ALLERGIES
Authors: Y. SARAÇLAR, G. CILIV, K. ÖZKARAGÖZ
Journal: Allergy (1976)

The definite diagnosis of Type I allergy against penicillin is very important. The in vivo tests used for this purpose may have some disadvantages for the patient. Among the in vitro tests used for the evidence and differential diagnosis of Type I allergy against penicillin, the determination of histamine release from leukocytes and the detection of IgE by the RAST test are the most promising. We have used the test of histamine release from leukocyte in this study of 18 cases, nine of whom had Type I hypersensitivity reactions to penicillin and comprised the study group, the rest were control cases. The per cent of histamine release in the control group was "zero" while in the study group it ranged from 3.9 to 51.7 per cent. The results indicate that the method used in this study is a sensitive and reliable method for the diagnosis of Type I penicillin allergies.
Ernest John Wallace Gumpert
Authors: R. Gumpert
Journal: BMJ (2011)

John Gumpert (“Wally”) was a highly respected and much loved neurologist and neurophysiologist at the Royal Hallamshire Hospital until retirement in 1995.

He was born in Sheffield into a medical family. Both parents, his brother, and his uncle were doctors. He trained at Queens’ College, Cambridge, and Guy’s Hospital, London.

After pre-registration posts at Guy’s, he worked for Lord Brock, which was more than fitting because a decade earlier, in 1951, …
Acute effects of intravenous infusions of alcohol on baroreceptor sensitivity in essential hypertension
Authors: R CARRETTA, B FABRIS, M BARDELLI, S MUIESAN, F FISCHETTI, R CESANELLI, A PIZZOLITTO, A BIANCHETTI, L CAMPANACCI
Journal: Cardiovascular Research (1988)

To assess the acute effects of alcohol on baroreceptor reflex in moderate and heavy drinkers with essential hypertension and in healthy subjects who drank moderately, four groups of age and sex matched subjects were studied. Group 1 consisted of 10 healthy subjects (age range 21-50 (mean 37.4(10.5) years), who usually drank less than 200 g of alcohol per week; group 2 patients (age range 21-50 (mean 37.4(10.3) years) with mild or moderate essential hypertension and whose weekly alcohol consumption was less than 200 g; and groups 3 and 4 patients with mild or moderate hypertension (age range 21-50 (mean 37.2(10.2) years and 21-52 (mean 38.1(10.4) years respectively), who usually drank greater than 700 g of alcohol per week. In groups 1-3 an infusion of alcohol (7 mg.kg-1.min-1) in 500 ml of 5% glucose was administered for 1 h to keep blood concentrations constant (6-7 g.litre-1), whereas in group 4 the dose was doubled (blood concentration 10-11 g.litre-1). Baroreceptor sensitivity was measured by the phenylephrine method before and after alcohol infusion and one or two days later before and after infusion of 500 ml of 5% glucose. In healthy subjects and in moderate drinkers with hypertension the alcohol reduced baroreflex sensitivity significantly (from 17.5(9.5) to 13.8(8.4); p less than 0.01 and from 15(10) to 10.5(6.7) ms.mmHg-1, p less than 0.01 respectively), whereas in the heavy drinkers with hypertension it was significantly reduced only at the highest dose of alcohol (from 12.5(6) to 7.9(3.5) ms.mmHg-1; p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)
Tumor necrosis factor alpha decreases in vivo diaphragm contractility in dogs.
Authors: P G Wilcox, Y Wakai, K R Walley, D J Cooper, J Road
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

In this study, we hypothesized that tumor necrosis factor alpha (TNF alpha) is an important mediator of sepsis-related impairment in diaphragm contractility (1-2). In 12 anesthetized, ventilated dogs, bipolar stimulating electrodes were placed on the phrenic nerves and diaphragm electromyographic activity (EMG) and shortening were recorded with needle electrodes and piezoelectric crystals, respectively. Transdiaphragmatic pressure (Pdi) was also recorded using esophageal (Pes) and abdominal balloon catheters (Pdi = Pab-Pes). Dogs were randomized to receive saline injection (n = 6), or TNF alpha 60 micrograms/kg (n = 6). All parameters were recorded hourly for 6 h. Mean arterial blood pressure decreased 1 h after infusion in TNF alpha animals (p < 0.05) with no significant change thereafter. Cardiac output increased early after TNF alpha infusion (p < 0.05) and remained at greater than baseline values at study termination. Diaphragm pressure generation and costal shortening decreased progressively from 3 to 6 h post TNF alpha infusion (p < 0.05) with no significant change in control animals. Compound diaphragm action potential in response to supramaximal phrenic stimulation decreased in TNF alpha animals (p < 0.01) with no significant change in control animals 3 and 6 h postinfusion. We conclude that TNF alpha infusion was associated with significant declines in isotonic and quasi-isometric diaphragm contraction and that this could be explained, at least in part, by impaired neuromuscular transmission.
Thou shalt not strive officiously
Authors: P. J F Baskett, G. R Sowden
Journal: BMJ (1982)

case reported from this centre3 has highlighted the value of sigmoidoscopy in these circumstances.Visualisation of the characteristic pseudomembranes enabled immediate diagnosis, and treatment with vancomycin was started without waiting for stool or toxin assay.Rapid resolution of toxicity and mega- colon ensued.Sigmoidoscopy is considered hazardous in toxic megacolon because of the risks of perforation.Proctoscopy alone, however, may not show pseudomembranes, because of rectal sparing.4I would suggest that careful sigmoidoscopy with minimal insufflation performed in all cases of toxic megacolon may avoid delay in diagnosing the few cases so amenable to non-operative management.
Oral Electrolytes in Cholera
Authors: NATHANIEL F. PIERCE
Journal: Annals of Internal Medicine (1970)

Letters and Comments1 June 1970Oral Electrolytes in CholeraNATHANIEL F. PIERCE, M.D., JOHN G. BANWELL, D.M.NATHANIEL F. PIERCE, M.D.Search for more papers by this author, JOHN G. BANWELL, D.M.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-72-6-959_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: We would like to reply to the letter of Drs. Nalin and Cash (Ann Intern Med72:288-289, 1970) which offered several criticisms of our study of oral replacement of water and electrolytes in cholera (1). Drs. Nalin and Cash and associates have performed very useful studies demonstrating the effectiveness of oral maintenance therapy in cholera (2). Despite these and previous studies of the effects of glucose upon sodium absorption in cholera (3, 4), it is premature to conclude at this time that either they or we have established an "optimum" composition for the oral replacement solution. Except...References1. PIERCESACKMITRA NRR: Replacement of water and electrolyte losses in cholera by an oral glucose-electrolyte solution. Ann Intern Med 70:1173-1181, 1969 LinkGoogle Scholar2. NALINCASHISLAM DRR: Oral maintainance therapy for cholera in adults. Lancet 17:370, 1968 CrossrefGoogle Scholar3. PIERCEBANWELLMITRA NJR: Effect of intragastric glucose-electrolyte infusion upon water and electrolyte balance in Asiatic cholera. Gastroenterology 55:333, 1968 CrossrefMedlineGoogle Scholar4. HIRSCHHORNKINZIESACHAR NJD: Decrease in net stool output in cholera during intestinal perfusion with glucose-containing solutions. New Eng J Med 279:176, 1968 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: The Departments of Medicine Baltimore City Hospitals The Johns Hopkins Hospital Baltimore, Md. 21224 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1970Volume 72, Issue 6Page: 959-959KeywordsCholeraGlucoseSaltsSodium ePublished: 1 December 2008 Issue Published: 1 June 1970 PDF downloadLoading ...
GENDER-SPECIFIC OUTCOME OF EPICARDIAL ABLATION IN COMBINATION WITH THE ENDOCARDIAL APPROACH IN VENTRICULAR TACHYCARDIA PATIENTS WITH STRUCTURAL HEART DISEASE
Authors: Sanghamitra Mohanty, Prasant Mohanty, Luigi Di Biase, Rong Bai, David Burkhardt, Joseph G. Gallinghouse, Rodney Horton, Javier E. Sanchez, Shane Bailey, Jason Zagrodzky, Andrea Natale
Journal: Journal of the American College of Cardiology (2011)