tbuckley/cabot-search huggingface dataset:
Somogyi Effect in Treatment of Diabetes
Authors: Sidney G. Clayman
Journal: JAMA (1970)

To The Editor.—  The well-known Somogyi effect in insulin treatment of diabetes mellitus is frequently overlooked. This is the form of insulin resistance due to chronic overdosage, described by Somogyi in 1959.  Due to repeated insulin overdosage, recurrent insulin reactions occur. These lead to the release of pituitary and adrenal hormones which cancel or balance out the action of insulin. Hence, the hypoglycemia is followed by hyperglycemia. This hyperglycemia and accompanying glycosuria are often mistaken for insufficient insulin dosage and the cycle is inadvertently continued.  Report of a Case.—  A white 49-year-old man with diabetes was treated for grand mal seizures in October 1949. He was diagnosed as an epileptic—having frequent seizures which were rated as service connected. There were also well-documented episodes of alcoholism. Eventually his anticonvulsive regimen consisted of diphenylhydantoin sodium, phenobarbital, and mephenytoin. The well-documented seizures resulted in various bruises and fractures.  His non-service-connected diabetes mellitus came
Texting While Doctoring
Authors: Brian Pollak
Journal: Annals of Internal Medicine (2014)

Letters15 April 2014Texting While DoctoringBrian Pollak, MDBrian Pollak, MDFrom WellSpan Health, York, Pennsylvania.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5008-7 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITORI read Sinsky and Beasley's essay (1) with great interest. We asked for electronic systems that would help generate notes that would stand up in an audit, and that's what we got. We asked for electronic systems that would get us meaningful use dollars, and that's what we got. We never asked for electronic systems that promote value-based, patient-centered care. We never asked for electronic systems that are efficient to use.Sure, we can share the blame with incentives. In a time when we are primed to leverage team-based care, incentives ask more from the provider as ...Reference1. Sinsky CA, Beasley JW. Texting while doctoring: a patient safety hazard. Ann Intern Med. 2013;159:782-3. [PMID: 24297196] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From WellSpan Health, York, Pennsylvania.Disclosures: None. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L14-0019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTexting While Doctoring: A Patient Safety Hazard Christine A. Sinsky and John W. Beasley Texting While Doctoring Michael E. Miller Texting While Doctoring Christine A. Sinsky and John W. Beasley Texting While Doctoring Christine A. Sinsky and John W. Beasley Texting While Doctoring Michael E. Miller Metrics 15 April 2014Volume 160, Issue 8Page: 583KeywordsCaregiversDisclosureMotivationPrevention, policy, and public health ePublished: 15 April 2014 Issue Published: 15 April 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Antibiotic susceptibility of streptococci and related genera causing endocarditis: analysis of UK reference laboratory referrals, January 1996 to March 2000
Authors: A. P Johnson
Journal: BMJ (2001)

A combination of penicillin and gentamicin is recommended for streptococcal endocarditis by both the Endocarditis Working Party of the British Society for Antimicrobial Chemotherapy and the American Heart Association, with vancomycin replacing penicillin for those who are allergic to penicillin. 1 2 The Public Health Laboratory Service's Antibiotic Resistance Monitoring and Reference Laboratory and Streptococcus and Diphtheria Reference Unit routinely test bacteria referred from cases of endocarditis from a wide range of hospitals, representing about 15% of all UK isolates from endocarditis. We retrospectively analysed the species distribution and antimicrobial susceptibility of streptococci and related bacteria from patients with endocarditis received over 4.25 years; enterococci have been reviewed previously.3

Isolates from confirmed cases of endocarditis referred between January 1996 and March 2000 were identified from the reference laboratory's database, which provides antibiotic susceptibility as minimum inhibitory concentrations of each antibiotic for each isolate. Isolates were categorised as susceptible or resistant …
Suppression of Wnt Signaling by Dkk1 Attenuates PTH-Mediated Stromal Cell Response and New Bone Formation
Authors: Jun Guo, Minlin Liu, Dehong Yang, Mary L. Bouxsein, Hiroaki Saito, R.J. Sells Galvin, Stuart A. Kuhstoss, Clare C. Thomas, Ernestina Schipani, Roland Baron, F. Richard Bringhurst, Henry M. Kronenberg
Journal: Cell Metabolism (2010)
Ultrasound diagnosis of bile duct calculi.
Authors: M V Tobin, R M Mendelson, G H Lamb, I T Gilmore
Journal: BMJ (1986)

Investigation of choIinestsrase in amniotic fluidRecent attention focused on the fetal origin of many amniotc substances may cause us to forget the maternal orign ofmany amniotic fluid proteins. Case reportA 39 year old woman, the mother of three healthy children, underwent
Vicarious Excretion of Contrast Media
Authors: Everett M. Lautin
Journal: JAMA (1982)

WHEN contrast media are injected intravenously for an intravenous urogram (IVU), prompt opacification of the urinary tract is anticipated. With modern urographic contrast media, and in the presence of normal renal function, this expectation is usually realized. Although the kidneys constitute the primary route of excretion of urographic contrast media (almost totally via glomerular filtration, with the exception of a new contrast medium, iodamide meglumine [Renovue-65 and Renovue DIP], of which reportedly one third is excreted by tubular secretion), they are not the only route. Urographic contrast media may be excreted by the liver in the bile, or directly by small-bowel mucosa. These "vicarious" pathways become important as routes of excretion in the presence of diminished renal function. They may lead to unexpected opacification of the gallbladder or the colon after contrast has been administered for an IVU or an angiogram. The circumstances and possible reasons for this are discussed
Barriers to psychological care of the dying.
Authors: P Maguire
Journal: BMJ (1985)

Direct observation of doctors and nurses talking with real, stimulated, or role played patients suffering from a terminal illness has shown that they consistently use distancing tactics. These prevent them getting close to their patients' psychological suffering and are used to try to ensure their own emotional survival. Since these tactics discourage patients from disclosing their psychological concerns they are a serious barrier to effective psychological care. If those concerned in terminal care are to risk relinquishing these distancing tactics they will need better selection, more appropriate training, regular psychological support, and real opportunities for taking time out.Direct observation by video or audiotape recording of communication between doctors and nurses and real, simulated, and role-played terminally ill patients has shown that health personnel often use tactics such as false reassurance and selective attention to distance themselves from their patients' emotional suffering. The author attributes these tactics to the caregivers' fear of "burnout" caused by the overwhelming psychological problems of their dying patients. He suggests that doctors and nurses who provide terminal care be selected for psychological suitability, be trained in communication, receive adequate ongoing support and definition of their roles, and rotate periodically to less stressful duties.
What makes a population atypical–priorities or constraints?
Authors: Roberta L. Klatzky
Journal: Behavioral and Brain Sciences (1996)

Abstract Priorities for movement reflect constraints deriving from the motor system, task goals, and physical environment. Atypical and typical populations alike set and reset priorities in response to constraints, and they do so at many processing loci and time scales. Efforts to understand what is atypical about a population should focus first on the constraints it encounters.
The Survivin saga goes in vivo
Authors: John C. Reed
Journal: Journal of Clinical Investigation (2001)

Survivin is a bifunctional protein that suppresses apoptosis and regulates cell division (1). This protein has garnered great interest as a potential drug target because its expression is among the most tumor-specific of all human gene products (2). While fetal tissues contain abundant Survivin mRNA and protein, most normal adult tissues do not. In contrast, the vast majority of tumors express Survivin protein at high levels, suggesting that reactivation of SURVIVIN gene expression occurs commonly in cancers (3).

The mechanisms by which Survivin regulates cell death and cell division are highly controversial. Indeed, even the premise that Survivin regulates apoptosis has been challenged, primarily on the grounds that Survivin homologues in yeast and Caenorhabditis elegans operate as regulators of cell division but not cell survival (reviewed in refs. 4, 5). Heretofore, the preponderance of evidence that mammalian Survivin suppresses apoptosis was based on overexpression of the protein in cultured cell lines. The absence of in vivo data on this point has now been remedied with a paper in this issue of the JCI by Altieri and colleagues (6). In an accompanying paper (7), the same investigators show how emerging knowledge about Survivin regulation might be use to develop a new gene therapy strategy for cancer.

Seeking to model events in tumors, Grossman et al. (6) placed the Survivin cDNA under the control of the keratin 14 (K14) promoter and generated transgenic mice that produce Survivin constitutively in epidermal keratinocytes. The skin is an easily accessible tissue that displays the full gamut of events relevant to tumorigenesis, including cell proliferation, differentiation, and death. Betting persons might have placed their wagers on seeing a defect in cell division or differentiation in K14-Survivin mice, but such was not the case. Instead, the keratinocytes of these Survivin-overexpressing mice demonstrated resistance to apoptosis, thus providing the first evidence that Survivin can suppress cell death in vivo. Specifically, overexpression of Survivin significantly reduced the numbers of apoptotic cells generated in the epidermis following exposure to ultraviolet-B (UVB) radiation (sunburn). While these data do not go as far as to establish a role for Survivin in homeostatic programmed cell death, they do at least indicate that the overexpression of Survivin (which is seen in many tumors) can result in an antiapoptotic state in vivo.
Paradoxical Diaphoresis in Cyclobenzaprine Poisoning
Authors: Paul S. Heckerling, Thomas J. Bartow
Journal: Annals of Internal Medicine (1984)

Letters and Corrections1 December 1984Paradoxical Diaphoresis in Cyclobenzaprine PoisoningPAUL S. HECKERLING, M.D., THOMAS J. BARTOW, M.D.PAUL S. HECKERLING, M.D.Search for more papers by this author, THOMAS J. BARTOW, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-101-6-881_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Cyclobenzaprine (Flexeril; Merck Sharp & Dohme, West Point, Pennsylvania) is a central-acting skeletal muscle relaxant structurally related to the tricyclic antidepressant amitryptiline. Severe cyclobenzaprine poisoning from intentional overdose has been reported in only three previous cases (1). These patients presented with anticholinergic signs, including dry skin and mucous membranes, and an organic brain syndrome that reversed with treatment with physostigmine. We report the case of a patient with cyclobenzaprine poisoning who presented atypically with profound diaphoresis.A 22-year-old man ingested an unknown quantity of "yellow stop sign-shaped pills" in a suicide attempt approximately 1 hour...References1. LINDENMITCHINERLINDZONRUMACK CJRB. Cyclobenzaprine overdosage. J Toxicol-Clin Toxicol. 1983;20:281-8. CrossrefMedlineGoogle Scholar2. AMA Drug Evaluations. Philadelphia: W.B. Saunders Company; 1983:363. Google Scholar3. BALDESSARINI R. Tricyclic antidepressants. In: GOODMAN LS, GILMAN A, eds. The Pharmacologic Basis of Therapeutics. New York: Macmillan Publishing Company, Inc.; 1980:418-27. Google Scholar4. Poisindex. Denver, Colorado: Rocky Mountain Poison Center. Google Scholar5. NEWTON R. Physostigmine salicylate in the treatment of tricyclic antidepressant overdosage. JAMA. 1975;231:941-3. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: PAUL S. HECKERLING, M.D.; THOMAS J. BARTOW, M.D.Affiliations: Rush-Presbyterian-St. Luke's Medical Center Chicago, IL 60612 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byFive-year multicenter retrospective review of cyclobenzaprine toxicityNeuroleptic Malignant-Like Syndrome due to Cyclobenzaprine?Post-triathalon deliriumBiology of sweat glands and their disorders. II. Disorders of sweat gland functionOverdose of cyclobenzaprine, the tricyclic muscle relaxantNeuromuscular blocking agents and skeletal muscle relaxantsCyclobenzaprine OverdosageJOHN J. AMBRE, M.D., Ph.D. 1 December 1984Volume 101, Issue 6Page: 881-881KeywordsBrainMucous membranesSkeletal musclesSuicideTricyclic antidepressants ePublished: 1 December 2008 Issue Published: 1 December 1984 PDF downloadLoading ...
Management of Regional Nodes in Breast Cancer
Authors: N. Bundred, J. M. Dixon, J. Thomas
Journal: BMJ (2013)

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### Overview

Lymph drainage from the breast is via the axillary and internal mammary nodes (Figure 1). To a lesser extent, lymph also drains by intercostal routes to nodes adjacent to the vertebrae. The axillary nodes receive about 95% of the total lymph drainage, and this is reflected in the greater frequency of tumour metastases to these nodes.



Figure 1  
Lymph drainage of the breast.



The axillary nodes, which lie below the axillary vein, can be divided into three groups in relation to the pectoralis minor muscle: level I nodes lie lateral to the muscle; level II (central) nodes lie behind the muscle; and level III (apical) nodes lie between the muscle's medial border, the first rib, and the axillary vein (Figures 2 and 3). There are on average 20 nodes in the axilla, with about 13 nodes at level I, …
Modified Self-Expanding Plastic Stent for the Treatment of Refractory Benign Esophageal Strictures
Authors: A. Müldner, K. Reinshagen, M. Wüstner, G. Kähler
Journal: Endoscopy (2005)

Self-expanding plastic stents (SEPSs) are increasingly used for the treatment of benign gastrointestinal strictures, because they may be extracted with substantially less tissue damage compared with self-expanding metal stents. However, the problem of a high rate of premature dislocation is still unsolved, especially in strictures where there is also extended prestenotic or poststenotic dilatation, or both. Acutely waisted SEPS, which are so far not available, are required to stent these strictures.
28 A PROTEOMIC APPROACH TO IDENTIFY DYSREGULATED LIPID TRANSPORTER PROTEINS WHICH COULD PREDICT THE SEVERITY AND OUTCOME OF PATIENTS WITH ACUTE ON CHRONIC LIVER FAILURE
Authors: J.S. Maras, S. Das, S.S. Jaswal, C. Kumar, H.H.C. Gawda, G. Sathe, S. Srikanth, N.T. Pati, A. Pandey, S.K. Sarin
Journal: Journal of Hepatology (2013)
Abstract 729: Mechanism of action of a p53-derived peptide that targets a novel death pathway inducing selective necrosis in cancer cells
Authors: Wilbur B. Bowne, Ehsan S. Yazdi, Kelley A. Sookraj, Maly Fenelus, Victor Adler, Michael E. Zenilman, Josef Michl, Matthew R. Pincus
Journal: Cancer Research (2010)

Abstract In a series of preliminary in vitro and in vivo studies we have shown that p53-derived peptides consisting of residues 12-26 and 17-26 from the murine double minute binding domain (MDM-2) possess anti-cancer activity. These peptides are linked to a trans-membrane penetrating sequence (penetratin) derived from the antennapedia homeodomain of Drosophila and are designated PNC-27 and PNC-28, respectively. We also found that the previously determined 3D structure of these PNC residues are directly superimposeable on the same residues bound to MDM-2, suggesting that these peptide may target MDM-2 in cancer cells. These peptide constructs appear to promote cancer cell death through a novel pathway that leads to necrosis rather than apoptosis while sparing their untransformed counterparts. In our initial experiments, the critical role of the MDM-2 oncoprotein as a potential target molecule for these PNC peptides was elucidated when a sequence specific MDM-2 antibody blocked PNC-27 activity on cancer cells. To further elucidate this anti-cancer mechanism we then tested parent molecule PNC-27 against selected cancer cell lines (Panc-02, pancreatic; HT1080, fibrosarcoma; and MCF-7, breast) plus respective untransformed counterparts (BMRPA1, BJ, and MCF-10) which were treated with PNC-27 and control peptide. Subsequently, treatment with fluorescent labeled peptide, immunoprecipitation (IP), confocal, and time-lapse electron microscopy (EM) was employed as well as transfection of untransformed cells with the MDM-2 gene to study the anti-cancer mechanism. PNC-27 did not cause elevation of pro-apoptotic proteins but induced rapid dose-dependent tumor cell death with release of lactate dehydrogenase (LDH). This specific anti-cancer mechanism, in part, may be due to observed increased expression of MDM-2 found in cancer cells compared to their normal cellular counterparts which is consistent with abrogation of MDM-2 and stabilization of p53 protein levels after PNC-27 treatment. Moreover, following IP of fluorescent labeled PNC-27 from treated cancer cells; labeled MDM-2 was detected. Furthermore, confocal microscopy and EM revealed co-localization of PNC-27 and MDM-2 along with cancer cell membrane pore formation, respectively. Remarkably, transfection of the MDM-2 gene resulted with increased expression of MDM-2 and now untransformed cell susceptibility to PNC-27. These results suggest a mechanism of PNC-27 binding to MDM-2 in the cancer cell membrane, leading to pore formation and membrane disruption; a p53-independent pathway consistent with rapid selective cancer cell necrosis. 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 729.
Lethal epidermolytic epidermolysis bullosa: a new autosomal recessive type of epidermolysis bullosa
Authors: M.A. MSALIH, B.D. LAKE, M.A. HAG, D.J. ATHERTON
Journal: British Journal of Dermatology (1985)

A distinctive form of epidermolysis bullosa is reported among several members of a large Sudanese family. Although on ultrastructural grounds this appears to be simplex type, it is inherited as an autosomal recessive trait and is associated with a high mortality.
Use of a Proton-Pump Inhibitor for Metabolic Disturbances Associated with Anorexia Nervosa
Authors: Masaaki Eiro, Tetsuo Katoh, Tsuyoshi Watanabe
Journal: New England Journal of Medicine (2002)

For the spontaneous-labor category, the incremental risk was 2 percent (0.19 per 1000 above the overall perinatal mortality rate of 5.2 per 1000 in this study).This puts a very different face on the actual risk, which patients assess in terms of the "dread" factor that Greene so aptly describes.
Relief of Post-operative Pain
Authors: E. Cope, P. O. Jones
Journal: BMJ (1959)

Relief of pain following major surgery is necessary for two main reasons: (1) the patient's general comfort; and (2) to enable limb, trunk, and breathing exercises designed to prevent post-operative complications, particularly thrombosis and embolism, to be carried out satisfactorily.In an endeavour to find the best available means of relieving post-operative pain a study was made of three recently introduced analgesics-dihydrocodeine, dipipanone, and dextromoramide (R 875)-to determine if these offered any advantage over conventional analgesics, such as morphine.
Nail staining due to hydroquinone skin-lightening creams
Authors: R.J. MANN, R.R.M. HARMAN
Journal: British Journal of Dermatology (1983)

Staining of the nails due to hydroquinone‐containing creams is not a well‐recognized condition. We report two cases in older women in whom brown discoloration developed after the use of cosmetic skin‐lightening creams for actinic lentigines of the hands. The cause of the discoloration and its relation to light exposure is discussed.
EVALUATION OF NEUROGENIC CONTROL OF BLOOD PRESSURE IN HYPERTENSION WITH TETRAETHYLAMMONIUM CHLORIDE AND SPINAL ANESTHESIA 1
Authors: Albert A. Brust, Morton F. Reiser, Eugene B. Ferris
Journal: Journal of Clinical Investigation (1951)

tension. To determine the blood pressure effect of pharmacologic blockade of autonomic impulse transmission, TEAC in 3-5 cc. doses (300-500 mg.) was administered intravenously to all patients on from two to 12 occasions. All studies were conducted with the patients supine, and the injections were made rapidly, requiring no more than five seconds for administration. Observations of pupillary dilatation and abolition of sweating were accepted as clinical confirmation that autonomic blockade had been induced. In addition, in those patients who showed slight or moderate blood pressure depression following the drug, abolition of cold pressor reactivity was demonstrated to confirm autonomic block. Blood pressures were obtained by auscultation. The control blood pressure represents the mean of five or more measurements taken at oneminute intervals before TEAC administration and following stabilization of the pressure in the recumbent position. The lowest point to which the blood pressure descended in the first five minutes following injection has been termed the TEAC floor, and for the purposes of this study this has been accepted as indicating that portion of arteriolar tone which persists following the removal of active autonomic influence. Although multiple tests with TEAC were done on all patients, Table I includes only the results of the first test. The first experience with TEAC was selected since comparison was to be made with