tbuckley/cabot-search huggingface dataset:
Ion-Selective Electrodes and Inaccurate Serum Sodium Measurements
Authors: ELLEN D. BURGESS
Journal: Annals of Internal Medicine (1985)

Letters and Corrections1 November 1985Ion-Selective Electrodes and Inaccurate Serum Sodium MeasurementsELLEN D. BURGESS, M.D., LAWRENCE P. SCHNURR, M.D., PETER WILKES, Ph.D.ELLEN D. BURGESS, M.D.Search for more papers by this author, LAWRENCE P. SCHNURR, M.D.Search for more papers by this author, PETER WILKES, Ph.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-103-5-806_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: We were interested in the recent article by Anderson and colleagues (1) on the prevalence and prognosis of hyponatremia in hospitalized patients and write to offer some comments.We have recently found a systematic overestimation of serum sodium concentration as measured by an ion-selective electrode analyzer (Kodak Ektachem 400 Analyzer; Eastman Kodak Co., Rochester, New York) as compared with flame photometric determination (FLM 3 Flame Photometer; Radiometer, Copenhagen, Denmark). The overestimation is proportionate to the degree of hypoproteinemia, with discrepancy as great as 10 meq/L at total serum protein concentrations of 4 to 5 g/dL. The cause...References1. ANDERSON R, CHUNG H, KLUGE R, and SCHRIER R. Hyponatremia: a prospective analysis of its epidemiology and the pathogenetic role of vasopressin. Ann Intern Med. 1985;102:164-8. LinkGoogle Scholar2. GOLDBERG M. Hyponatremia. Med Clin North Am. 1981;65:251-69. CrossrefMedlineGoogle Scholar3. ARIEFF A and GUISADO R. Effects on the central nervous system of hypernatremic and hyponatremic states. Kidney Int. 1976;10:104-16. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ELLEN D. BURGESS, M.D.; LAWRENCE P. SCHNURR, M.D.; PETER WILKES, Ph.D.Affiliations: University of Calgary Calgary, Alberta, Canada T2N 2T9 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byReference Intervals for Anion Gap and Strong Ion Difference in Pregnancy: A Pilot StudyEktachem 1 November 1985Volume 103, Issue 5Page: 806-806KeywordsAttentionHyponatremiaHypoproteinemiaKidneysSerum proteinsSodium ePublished: 1 December 2008 Issue Published: 1 November 1985 PDF downloadLoading ...
P50 Facilitation of continued exercise via patient volunteers with chronic obstructive pulmonary disease (COPD) following a pulmonary rehabilitation programme: a feasibility study
Authors: C. A. Langley-Johnson, E. Jenkin, C. A. E. Dyer, K. Gruffydd-Jones, N. Harris, M. Reed, G. Taylor
Journal: Thorax (2010)

<h3>Introduction</h3> After pulmonary rehabilitation activity levels gradually decline, on average, back to baseline over 12–18 months. The NHS has highlighted the value of peer support for patients with chronic disease, but this has not been fully evaluated in patients with COPD. Therefore we designed an observational study with the aim of exploring and assessing an exercise maintenance programme with peer volunteer support over a 6-month period, in order to inform a future large-scale study. <h3>Methods</h3> Patients were recruited from a 7-week outpatient community pulmonary rehabilitation programme. Six peer volunteers with COPD were trained and allocated up to six patients each. A fortnightly exercise maintenance programme was set up in one locality led by a physiotherapist &amp; assistant. This was supported by a programme of home-based exercise, goal setting and feedback on activity levels. Peer volunteers met with their groups each month to encourage individual activity. The primary outcomes were participation levels and attendance rates; secondary outcomes were activity levels and health status. Qualitative interviews demonstrated the individual variance in exercise habits and motivations see Abstract P50 Table 1. <h3>Results</h3> There were 91 potential recruits who completed rehabilitation (13 didn9t meet criteria, six became unwell). 37 refused to participate, citing reasons such as poor health, no difficulty in exercising or problems travelling to the centre. Of the 35 that agreed to participate, the attendance rate at exercise was 70%, and 30 completed the 6-month programme. In this group Shuttle Walking Test distances were maintained at 6 months (mean 313.2 m post-rehabilitation compared with 317.8 m at 6 months, p=NS), and Chronic Respiratory Disease Questionnaire scores were also maintained. Qualitative analysis supported the concept of peer volunteers, while many individuals wanted flexibility and access to a range of activity programmes. <h3>Conclusions</h3> This study suggests that maintenance programmes need to be individually tailored rather than prescriptive, in order to maximise uptake and meet the challenges posed by exacerbations. The role of peer volunteers in promoting activity is supported by the qualitative analysis, while exercise classes may help those who wish to attend.
THE TREATMENT OF SUPPURATIVE AFFECTIONS OF THE FACE AND NECK EMANATING FROM THE MOUTH.
Authors: M. I. SCHAMBERG
Journal: JAMA (1905)

Early in the history of medical science, surgeons realized that to render the human economy a service meant to imitate and to anticipate Nature's own method of disposing of disturbing elements. Thus the evacuation of pus whenever it is found within the body became one of the cardinal principles of surgery. Suppuration is a cleansing process, an effort to throw off a virulent irritant. Unaided, the vital forces will ultimately effect an evacuation of a pus cavity, but the method is slow and is attended with certain dangers, prominent among which may be mentioned a change in the integrity of the surrounding structures. For a long time, the use of poultices which would bring boils "to a head" and cause abscesses "to point" was considered proper treatment. Now most surgeons advocate the prompt evacuation of suppurating areas as soon as the presence of pus is determined. Why many should fail
In Search of an Explanation
Authors: Richard L. Egan
Journal: JAMA (1973)

This fall, as another and larger freshman class matriculated in US medical schools, the number of  applicants also increased. By the standards that governed admission to medical school a few years ago, large numbers of applicants (perhaps almost as many as entered medical school) were qualified but now have been rejected by the profession they wished to follow. Not only these  applicants but also their parents, friends, and the public deserve an explanation.  Some of those who were  will find other satisfying occupations. Some will pursue with perseverance, at considerable cost, a usually inferior education at one of the few foreign schools that accepts foreigners. After attending a foreign school they will often have difficulty returning to US medicine. Some will, with their friends, parents, and others, criticize the AMA, alleging that it restricts educational opportunity for the selfish interests of its members. Some will resent vociferously
Acute delta superinfection in a previously unrecognised HBsAg carrier with transient loss of HBsAg simulating acute non-A, non-B hepatitis.
Authors: C M Chu, Y F Liaw
Journal: Gut (1988)

An 18 yr old previously well male Taiwanese was admitted with malaise, anorexia, and jaundice for two weeks. Results of liver tests were compatible with acute hepatitis. On day 1, he was seronegative for HBsAg, IgM anti-HAV, IgM anti-HBc, IgM anti-CMV, and IgM EBV capsid Ab, but positive for anti-delta in association with anti-HBc and anti-HBs. At follow up on day 5 HBsAg converted to positive with decreasing titre of anti-HBs. On day 19, the titre of HBsAg increased concomitantly with loss of anti-HBs. The results of these serological profiles indicated that this patient was a previously unrecognised HBsAg carrier, who developed acute hepatitis delta virus superinfection with transient loss of HBsAg. This phenomenon should be kept in mind in the serodiagnosis of acute viral hepatitis, especially in areas of high HBV prevalence.
Total Thyroidectomy Followed by Postsurgical Remnant Ablation May Improve Cancer Specific Survival in Differentiated Thyroid Carcinoma
Authors: Suhail A. R. Doi, Jessica M. Engel, Adedayo A. Onitilo
Journal: Clinical Nuclear Medicine (2010)

To determine the effect of the extent of thyroidectomy and additional postsurgical radioiodine remnant ablation (RRA) on the survival of patients with differentiated thyroid carcinoma (DTC) after adjustment for risk stage.We electronically identified 614 cases of DTC at our institution between 1987 and 2006. Two treatment variables were created, surgical extent dichotomized to total versus other and a composite of surgery and radioactive iodine ablation. The odds of cancer specific survival and disease-free survival (DFS) were determined using Cox proportional hazards model with adjustment for quantitative tumor-node-metastasis risk score.Of 614 patients with DTC during our period, 504 (83%) underwent total thyroidectomy and 104 (17%) underwent lesser surgery. Radioiodine administration was reported for 394 patients who underwent total thyroidectomy with a dose range of 24 to 297 mCi (mean of 116 mCi). Ten-year survival was higher for patients with total thyroidectomy compared with lobectomy: 96% versus 84% (P<0.001, Gehan's Wilcoxon test). Ten-year survival for complete versus incomplete surgery for tumor stages 1 and 2 was 99% versus 96%, and for stages 3 and 4 was 88% versus 52%. Cancer specific death tended to occur earlier in those without RRA postsurgery. There was no overall relationship between DFS and RRA or surgery, but in the higher risk categories surgery retained significance.Our data support the routine use of both total or near-total thyroidectomy followed by RRA over all risk categories in DTC. Although the effect of surgery is clear, there is also a trend toward improvement in outcome with RRA for cancer specific survival.
The red mixture
Authors: Suresh Kumar Pathak
Journal: BMJ (2008)

I was born and brought up in a small town near Agra in India. A small hospital, the Civil Hospital, served the 45 000-strong population of the town and surrounding rural area. The Civil Hospital had large grounds, used by the dhobiwalah (laundryman) to dry his washing and by the local lads to play cricket. In the early 1950s the hospital was well appointed and, as with many buildings constructed during the Raj, was quite imposing. 

It had a central hall, which was the outpatient department. On one side was the surgical section, where a male nurse known as the “compounder” (etymology obscure) ran a small, very clean and airy room. He was kept busy dressing wounds, and was competent to do minor surgery. On the …
Sources and fate of polychlorinated dibenzodioxins, dibenzofurans and related compounds in human environments.
Authors: T O Tiernan, M L Taylor, J H Garrett, G F VanNess, J G Solch, D J Wagel, G L Ferguson, A Schecter
Journal: Environmental Health Perspectives (1985)

Several of the major incidents resulting in potential human exposures to polychlorinated dibenzodioxins (PCDDs) and/or polychlorinated dibenzofurans (PCDFs), polychlorinated biphenyls (PCBs) and related compounds which have occurred in the U.S. in recent periods have resulted from improper disposal of hazardous chemical wastes. Prominent examples of such environmental contamination episodes are the Love Canal, into which ton quantities of chlorinated organic compounds containing substantial concentrations of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) were deposited; numerous sites in the State of Missouri which were contaminated by the dumping of chlorinated organic wastes containing various PCDDs and possibly PCDFs, and PCBs; and the environs of a 2,4-D/2,4,5-T manufacturing plant site in Arkansas, which were contaminated with PCDDs. Environmental assessments of such sites have revealed extensive contamination of soils, waterways, fish and other biological species with these toxic compounds, which in turn could lead to human exposures. Other recently identified sources of PCDDs, PCDFs and related compounds in human environments include stack effluents from municipal refuse incineration, and fires and explosions involving electrical devices containing PCBs and polychlorinated benzenes. Data obtained in assessments of such incidents are presented, and the implications of these findings with respect to the distribution and persistence of PCDDs, PCDFs and related chemicals in the environment and possible effects on humans are discussed.
Non-ulcer Dyspepsia and Duodenal Eosinophilia: An Adult Endoscopic Population-Based Case-Control Study
Authors: Nicholas J. Talley, Marjorie M. Walker, Pertti Aro, Jukka Ronkainen, Tom Storskrubb, Laura A. Hindley, W. Scott Harmsen, Alan R. Zinsmeister, Lars Agréus
Journal: Clinical Gastroenterology and Hepatology (2007)
A STUDY OF ANTIFIBRINOLYSIN ACTIVITY IN THE PLASMAS OF VARIOUS ANIMAL SPECIES 1
Authors: M. Mason Guest, Byrne M. Daly, Arnold G. Ware, Walter H. Seegers
Journal: Journal of Clinical Investigation (1948)

This report describes methods which have been developed in this laboratory for the determination of antifibrinolysin activity in plasma.Using these methods, studies have been made of the antifibrinolysin activity in the plasma of the alligator (Alligator inississippiensis), guinea pig (genus Cavia), cow (Bos taurus), rat (Rattus norvegicus, Sprague-Dawley strain), frog (Rana pipiens), man (white, male), cat (Felis domestica, dog (Canis familiaris, mongrel breeds), rabbit (genus Lepus, mixed strains), opossum (Didelphis vir-'Aided by a grant from the U. S. Public Health Service.
Surgery journal bans authors who hide conflicts of interest
Authors: Susan Mayor
Journal: BMJ (2006)

The Journal of Thoracic and Cardiovascular Surgery has announced that it will ban authors who deliberately fail to disclose any conflicts of interests from publishing again in the journal for at least a year, in an effort to emphasise how important it considers full disclosure.

The journal's editor, Andrew Wechsler, who is also chairman of the department of cardiothoracic surgery at Drexel University College of Medicine, Philadelphia, United States, has decided that any authors who are found to have failed to disclose conflicts of interests …
Continuing increase in respiratory symptoms and atopy in Aberdeen schoolchildren
Authors: M. Omran, G. Russell
Journal: BMJ (1996)

Chicken lymphocyte membrane immunoglobulins (Ig), were precipitated with mouse monoclonal antibodies specific for heavy and light chain isotypes and analyzed by polyacrylamide gel electrophoresis. Very little or no membrane-bound IgG and IgA was detected. After sequential precipitation and removal of IgM reactive with any of three monoclonal anti-mu antibodies, anti-light chain antibody precipitated residual Ig with a relative electrophoretic mobility similar to that of IgM. Under reducing conditions, these surface Ig molecules had a heavy chain that appeared slightly larger (approximately 81,000 daltons) than mu-chain (approximately 79,000 daltons), and light chains of approximately 25,000 daltons. Complete clearance of membrane-bound IgM reactive with an anti-mu allotype antiserum left similar molecules precipitate by monoclonal anti-light chain antibody. These non-IgM molecules could be detected on the surface of lymphocytes from blood, spleen, bursa and the B cell line RAV-1, but not from thymus or blood from an agammaglobulinemic chicken. After capping of B cell surface IgM with anti-mu, immunofluorescent staining with anti-light chain antibody revealed residual Ig molecules disturbed across the surface of more than 90% of the IgM-bearing cells. The data suggest the existence of an avian homologue of mammalian IgD. Affinity-purified goat anti-mu antibodies and a fourth monoclonal anti-mu antibody reacted with both IgM and the putative IgD molecules, which suggests that the IgD homologue shares at least one common determinant with chicken IgM.
Diagnosis and Treatment of Cholera in the United States
Authors: Richard E. Besser, Daniel R. Feikin, Jason E. Eberhart-Phillips, Laurene Mascola, Patricia M. Griffin
Journal: JAMA (1994)

To assess cholera recognition and treatment by US health care workers in the largest cholera outbreak in the United States this century.We reviewed the medical records of passengers from a flight on which a cholera outbreak occurred. To determine the availability of oral rehydration solutions, we surveyed treatment facilities and referral pharmacies.On February 14, 1992, more than 100 passengers on a flight from South America to Los Angeles, Calif, were infected with toxigenic Vibrio cholerae O1.Fifty-four of 67 passengers who sought care in California and Nevada.We reviewed the records of 54 passengers, including 39 with diarrhea and 15 without symptoms. All 17 persons who sought treatment before the outbreak was widely reported by the media had diarrhea. For 12 of these persons, recent travel to South America was noted, but only those four whose records listed cholera as a possible diagnosis were immediately hospitalized. Seven sought care again within 3 days; three were dehydrated, two of these three were hospitalized, and one of these two died. None of the 26 patients suspected to have cholera received appropriate fluids; severely dehydrated patients did not receive Ringer's lactate solution and those not severely dehydrated did not receive an oral rehydration solution. None of the facilities and pharmacies involved stocked World Health Organization oral rehydration salts solution, the preferred solution for treating cholera and other diarrheal diseases.Treatment of cholera in the United States was suboptimal. Oral fluids appropriate for the treatment of cholera and other diarrheal diseases were generally unavailable. Widespread cholera in the developing world means that US physicians should be prepared to treat "imported" cases. Physicians evaluating patients with diarrhea should obtain a travel history, should consider cholera in patients returning from countries with endemic or epidemic cholera, and should instruct patients in appropriate use of World Health Organization oral rehydration salts solution or other oral rehydration solutions containing 75 to 90 mmol/L of sodium. Pharmacies and medical facilities should stock these solutions.
Mechanisms of adaptation to chronic respiratory acidosis in the rabbit proximal tubule.
Authors: R Krapf
Journal: Journal of Clinical Investigation (1989)

The hyperbicarbonatemia of chronic respiratory acidosis is maintained by enhanced bicarbonate reabsorption in the proximal tubule. To investigate the cellular mechanisms involved in this adaptation, cell and luminal pH were measured microfluorometrically using (2",7')-bis(carboxyethyl)-(5,6)-carboxyfluorescein in isolated, microperfused S2 proximal convoluted tubules from control and acidotic rabbits. Chronic respiratory acidosis was induced by exposure to 10% CO2 for 52-56 h. Tubules from acidotic rabbits had a significantly lower luminal pH after 1-mm perfused length (7.03 +/- 0.09 vs. 7.26 +/- 0.06 in controls, perfusion rate = 10 nl/min). Chronic respiratory acidosis increased the initial rate of cell acidification (dpHi/dt) in response to luminal sodium removal by 63% and in response to lowering luminal pH (7.4-6.8) by 69%. Chronic respiratory acidosis also increased dpHi/dt in response to peritubular sodium removal by 63% and in response to lowering peritubular pH by 73%. In conclusion, chronic respiratory acidosis induces a parallel increase in the rates of the luminal Na/H antiporter and the basolateral Na/(HCO3)3 cotransporter. Therefore, the enhanced proximal tubule reabsorption of bicarbonate in chronic respiratory acidosis may be, at least in part, mediated by a parallel adaptation of these transporters.
Dietary Supplements-Reply
Authors: William R. Hendee
Journal: JAMA (1987)

In Reply.—  I appreciate Mr Jensen's and Dr Briggs' comments on the use of dietary vitamin supplements. The COUNCIL REPORT does state that (1) if the total energy intake falls below 1200 kcal (5040 kJ), it becomes increasingly difficult to obtain all of the protective nutrients in adequate amounts, and supplements may be needed; (2) certain weight-reduction diets may lead to inadequate vitamin intakes... and hence a modest supplement may be recommended; and (3) socioeconomic conditions and reduced physical activity among the aged may lead to a curtailment in total food intake. Under such restriction, the use of a vitamin preparation in the prevention of deficiency may be indicated.  A recent national dietary survey does show inadequate intakes of vitamins A, B 6 , and C compared with the recommended dietary allowances (RDA) 1 for some segments of the population. However, this finding does not mean these groups are at high
Familial keratoses of actinic distribution associated with internal malignancy and cellular hypersensitivity to UVA
Authors: D.J. ATHERTON, P.K. BOTCHERBY, A.J. FRANCIS, N.P. SMITH, R.S. WELLS, F. GIANNELLI
Journal: British Journal of Dermatology (1989)

In members of a family there appeared to be an association between the development of cutaneous pigmented keratoses in sun-exposed sites, and the later evolution of internal malignancies, particularly carcinoma of the uterus. Affected individuals were not clinically photosensitive, but their fibroblasts demonstrated gross cytopathic changes, low survival indices and an increased frequency of DNA single strand breaks following exposure to longwave ultraviolet radiation (UVA). These clinical and cellular features appear to identify an unrecognized syndrome that may not be uncommon. Recognition of this syndrome in a family may prevent certain malignancies developing in those affected.
Decreased vascular and increased adrenal and renal sensitivity to angiotensin II in the newborn lamb.
Authors: S R Siegel
Journal: Circulation Research (1981)

The effects of two doses of angiotensin II (0.025 micrograms/kg per min and 0.25 micrograms/kg per min) on plasma renin activity (PRA), aldosterone concentration, creatinine clearance, and sodium and potassium excretion were studied in two groups of 2- to 3-week-old lambs. The 0.025 micrograms/kg per min dose of angiotensin II also was studied in six adult ewes. In response to the angiotensin II infusions, PRA decreased in the newborns from baselines of 24.5 +/- 2.3 ng/ml per hr (mean +/- SE) and 22.9 +/- 3.5 to 13.6 +/- 0.8 and 13.0 +/- 2.2 at 30 minutes (P &lt; 0.01), respectively, and returned to baseline at 60 minutes; PRA decreased from 1.7 +/- 0.1 to 0.95 +/- 0.3 ng/ml per hr at 30 minutes (P &lt; 0.01) in the ewe and returned to baseline at 60 minutes. Plasma aldosterone increased in the newborns from baselines of 17.4 +/- 5.0 ng/dl and 14.7 +/0 3.9 to 33.1 +/- 6.9 and 32.5 +/- 6.3, respectively, at 15 minutes (P &lt; 0.01) and returned to baseline at 60 minutes. Plasma aldosterone increased from 4.3 +/- 0.7 to 9.2 +/- 2.0 ng/dl in the ewe, and returned to baseline at 60 minutes. The change in the PRA and aldosterone responses from baseline to peak for the low and high angiotensin dose was similar in the newborn lambs and greater than in the ewe (P &lt; 0.01). There was no change in the creatinine clearance, plasma sodium, or hematocrit. Urine sodium excretion increased from 0.16 +/- 0.04 total mEq/30 min to 0.87 +/- 0.27 (P &lt; 0.05) in the newborns during the 0.25 micrograms/kg per min angiotensin II infusion. We conclude that, under basal conditions, the newborn lamb has high PRA and aldosterone levels with decreased pressor and increased aldosterone and renin release responsiveness to angiotensin II compared to the adult.