tbuckley/cabot-search huggingface dataset:
Intensive Therapy Preserves Insulin Secretion
Authors: David M. Nathan
Journal: Annals of Internal Medicine (1998)

Letters1 December 1998Intensive Therapy Preserves Insulin SecretionDavid M. Nathan, MDDavid M. Nathan, MDFor the DCCT Research GroupSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-11_Part_1-199812010-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate Dr. Gumpel's historical perspective on the preservation of insulin secretion in type 1 diabetes and Dr. Charles-Marcel's suggestion of another potential mechanism to explain our findings. With regard to the historical perspective, J.M. Brush reported the uncontrolled results of a therapeutic regimen that grew out of an “effort to simplify the management of diabetic children” [1]. Comparison of his observations with the controlled experiment of the DCCT reveals the enormous strides made in clinical research, in general, and diabetes clinical research and care, in particular, in the past 50 years. Brush reported experience with a 1-month ...References1. Brush JM. Initial stabilization of the diabetic child. American Journal of Diseases in Children. 1944; 67:429-44. Google Scholar2. Medical Research Council. Streptomycin treatment of pulmonary tuberculosis. Br Med J. 1948; 2:769-82. Google Scholar3. Yalow RS, Berson SA. Immunoassay of endogenous plasma insulin in man. J Clin Invest. 1960; 39:1157-63. Google Scholar4. Leaming R, Johnson A, Hook G, Hanley R, Baron A. Amylin modulates insulin secretion in humans [Abstract]. Diabetalogia. 1995; 38:A113. Google Scholar Author, Article, and Disclosure InformationAffiliations: For the DCCT Research Group PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 December 1998Volume 129, Issue 11_Part_1Page: 914KeywordsChildrenGlucoseHemoglobinHypoglycemicsInpatientsInsulinInsulin secretionShockType 1 diabetesUrine Issue Published: 1 December 1998 CopyrightCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
An ethical dilemma: availability of antiretroviral therapy after clinical trials with hiv infected patients are ended
Authors: P. E Cleaton-Jones
Journal: BMJ (1997)

Guidelines on good clinical practice for drug trials clearly state that ethics committees must ensure that the safety, integrity, and human rights of the subjects participating in a particular trial are protected.1 Fundamental concepts are informed consent and risk or benefit to participants in a trial. For many clinical trials, ethical clearance is straightforward but those involving people infected with HIV generally are not.

Here, we are dealing with a condition that is presently incurable with variable progression, drug treatment is expensive, and emotions run high. These matters are common to all countries, but those of us living in Africa have an added burden–Third World conditions and an estimated 13 million people infected with HIV, usually from heterosexual sex.2 In South Africa the most recent published results for the fifth unlinked anonymous national HIV survey show that HIV infection in women attending antenatal clinics has risen from a national average of 1.35% in 1991 to 7.57% in 1994.3 In some parts of the country the rate is as high as 14.35% and is increasing.3 Because of a shortage of resources, antiretroviral drugs for treating HIV are not provided by South African public …
Squamous Cell Carcinoma of the Eyelids
Authors: Marcos T. Doxanas, W. Jackson Iliff, Nicholas T. Iliff, W. Richard Green
Journal: Ophthalmology (1987)

A clinicopathologic study of 31 squamous cell carcinomas of the eyelid was conducted. The tumor was encountered less frequently than in previous reports, due largely to the refinement of the pathologic diagnosis. Eighteen cases originally diagnosed as squamous cell carcinoma were eliminated because the diagnoses were changed to sebaceous gland carcinoma (10), basal cell carcinoma (4), seborrheic keratosis (2), inverted follicular keratosis (1), and papilloma (1). One of our 31 patients experienced tumor metastasis and tumor-related mortality. Despite the low incidence of metastasis, management recommendations include complete surgical excision using intra-operative frozen-section monitoring of the surgical margins.
STUDIES ON THE IMMUNOCHEMISTRY OF STREPTOCOCCAL MUCOPEPTIDE
Authors: Walter W. Karakawa, Richard M. Krause
Journal: The Journal of Experimental Medicine (1966)

Streptococcal mucopeptide, solubilized by either ultrasonic treatment or lysozyme, gave a precipitin reaction with rabbit antimucopeptide serum. A haptenic inhibitor of this reaction, which was composed of alanine, glutamic acid, and lysine in a mole ratio of 4:1:1, was isolated from a Streptomyces albus enzymes digest of Group D cell walls by ion exchange chromatography. When selected antisera were employed, greater than 90% inhibition of the mucopeptide quantitative precipitin reaction was achieved with 2 mg/ml of this inhibitor, whereas a hexosamine fraction with minimal concentrations of amino acid residues was inactive in this respect. These results suggest that the peptide moiety is an antigenic determinant of mucopeptide. Preliminary results indicate that the hexosamine polymer of the mucopeptide is a secondary antigenic determinant.
In Vivo Effects of Illicit Hallucinogens on Human Lymphocyte Chromosomes
Authors: David Dorrance
Journal: JAMA (1970)

Fourteen subjects exposed to illicit lysergic acid diethylamide (LSD) and nine exposed to marihuana were compared to age-matched controls for effects upon lymphocyte chromosomes. Eight out of 1,284 in the group given LSD, or 0.76%, exhibited chromosomal abnormalities; seven out of 816, or 0.86%, in the group given marihuana; and eight out of 1,018, or 0.79%, in the control group. Cells were grown in medium unenriched with nucleotide precursors. Thus, our negative results mitigate against medium deficiency as contributing toward positive effects. Similarly, our results on individuals whose last dosage was within an hour or so of specimen procurement indicates that this factor may not explain conflicting results.
Randomized controlled trial testing the effects of weight loss on nonalcoholic steatohepatitis
Authors: Kittichai Promrat, David E. Kleiner, Heather M. Niemeier, Elizabeth Jackvony, Marie Kearns, Jack R. Wands, Joseph L. Fava, Rena R. Wing
Journal: Hepatology (2009)

Nonalcoholic steatohepatitis (NASH) is a chronic progressive liver disease that is strongly associated with obesity. Currently, there is no approved therapy for NASH. Weight reduction is typically recommended, but efficacy data are lacking. We performed a randomized controlled trial to examine the effects of lifestyle intervention using a combination of diet, exercise, and behavior modification, with a goal of 7% to 10% weight reduction, on clinical parameters of NASH. The primary outcome measure was the change in NASH histological activity score (NAS) after 48 weeks of intervention. Thirty-one overweight or obese individuals (body mass index [BMI], 25–40 kg/m2) with biopsy-proven NASH were randomized in a 2:1 ratio to receive intensive lifestyle intervention (LS) or structured education (control). After 48 weeks of intervention, participants assigned to LS lost an average of 9.3% of their weight versus 0.2% in the control group ( P = 0.003). A higher proportion of participants in the LS group had a reduction of NAS of at least 3 points or had posttreatment NAS of 2 or less as compared with the control group (72% versus 30%, P = 0.03). NAS improved significantly in the LS group (from 4.4 to 2.0) in comparison with the control group (from 4.9 to 3.5) ( P = 0.05). Percent weight reduction correlated significantly with improvement in NAS ( r = 0.497, P = 0.007). Participants who achieved the study weight loss goal (≥7%), compared with those who lost less than 7%, had significant improvements in steatosis (−1.36 versus −0.41, P &lt; 0.001), lobular inflammation (−0.82 versus −0.24, P = 0.03), ballooning injury (−1.27 versus −0.53, P = 0.03) and NAS (−3.45 versus −1.18, P &lt; 0.001). Conclusion: Weight reduction achieved through lifestyle intervention leads to improvements in liver histology in NASH. (Hepatology 2009.)
Outcome After Leg Bypass Surgery for Critical Limb Ischemia Is Poor in Patients With Diabetes
Authors: Jonas Malmstedt, Karin Leander, Eric Wahlberg, Lars Karlström, Lars Alfredsson, Jesper Swedenborg
Journal: Diabetes Care (2008)

OBJECTIVE—Our aim was to assess the risk of major amputation or death after leg bypass surgery for critical limb ischemia in patients with diabetes versus those without. RESEARCH DESIGN AND METHODS—We did a population-based cohort study by linking nationwide databases in Sweden. We identified 1,840 patients in the Swedish Vascular Registry who had their first leg bypass procedure for critical lower-limb ischemia between 1 January 2001 and 31 December 2003—742 with and 1,098 without diabetes. Our primary end point was first major amputation of the limb on which bypass was done or death. Individuals were followed up until 31 December 2005 through the National Hospital Patient Registry and the Cause-of-Death Registry. RESULTS—Incidence of ipsilateral amputation or death was higher in patients with diabetes than in patients without (30.2 vs. 22 events/100 person-years; crude hazard ratio [HR] 1.32 [95% CI 1.17–1.50]). Similarly, individuals with diabetes had a shorter amputation-free survival period than individuals without (2.3 years, range 1.9–2.8 vs. 3.4 years, range 3.1–3.7). Adjustment for demographic characteristics, comorbidities, and risk factors for amputation or death did not substantially affect the risk (HR 1.46 [95% CI 1.26–1.69]). The effect was more pronounced in male (1.75 [1.47–2.08]) than in female (1.35 [1.11–1.64]) patients after adjustment for age. CONCLUSIONS—Diabetes is associated with lower amputation–free survival after leg bypass for critical limb ischemia. Patients with diabetes and limb ischemia need intensified treatment of diabetes-related risk factors to improve outcome.
Risk score for identifying adults with CSF pleocytosis and negative CSF Gram stain at low risk for an urgent treatable cause
Authors: Rodrigo Hasbun, Merijn Bijlsma, Matthijs C. Brouwer, Nabil Khoury, Christiane M. Hadi, Arie van der Ende, Susan H. Wootton, Lucrecia Salazar, Md Monir Hossain, Mark Beilke, Diederik van de Beek
Journal: Journal of Infection (2013)
Studies of Venereal Disease
Authors: King K. Holmes, David W. Johnson, Thomas M. Floyd
Journal: JAMA (1967)

Treatment of gonorrhea in men with a single intramuscular dose of 2,400,000 units of procaine penicillin G, recommended by the US Public Health Service and the armed forces in 1965, continues to result in 20% to 30% treatment failures among military personnel in the Far East. In studies of confined populations aboard air-craft carriers, 63 men with gonorrhea received 2,400,000 units of procaine penicillin G with 18 (29%) treatment failures; 58 men received 2,400,000 units procaine penicillin G<i>plus probenecid</i>orally, with only one failure. Resistance to 0.06 units of penicillin per milliliter of medium was noted in 26 of 41 (63%) and 57 of 74 (77%)<i>Neisseria gonorrhoeae</i>isolates from the respective groups. Thirty men received tetracycline hydrochloride orally, with no failures. In areas where treatment of gonorrhea with large parenteral doses of penicillin G is becoming less effective, adequate therapy is possible with probenecid plus penicillin or with tetracycline.
Hypothalamic Regulation of Thyrotrophic and Somatotrophic Hormone Secretion.
Authors: S. Reichlin
Journal: Annals of Internal Medicine (1961)

s1 May 1961Hypothalamic Regulation of Thyrotrophic and Somatotrophic Hormone Secretion.S. Reichlin, M.D.St. Louis, Mo. (CI)S. Reichlin, M.D.St. Louis, Mo. (CI)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-54-5-1047_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAmong other endocrine abnormalities that follow hypothalamic destruction in the rat, lesions in specific areas lead to a depression of thyroid function and to impaired growth.Anterior lesions cause low thyroidal I131uptake, I131release rate, and plasma PBI; normal responses to increased and decreased blood levels of thyroid hormone are maintained, however. This finding is interpreted to mean that the pituitary is autonomously responsive to thyroxine concentration but that its level of reactivity is "set" by a hypothalamic mechanism acting via the pituitary stalk. Since the "thyrotrophic area" was shown to be anatomically close to the temperature regulating area,... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1961Volume 54, Issue 5Page: 1047-1047KeywordsAttentionBlood plasmaHormonesLesionsPituitary glandTemperatureThyroidThyroid hormonesThyroxine ePublished: 1 December 2008 Issue Published: 1 May 1961 PDF downloadLoading ...
ACUTE IMMUNE COMPLEX DISEASE IN RABBITS
Authors: P. M. Henson, C. G. Cochrane
Journal: The Journal of Experimental Medicine (1971)

By depletion of C3 from rabbits undergoing acute experimental immune complex disease with an anticomplementary factor in cobra venom, it has been possible to demonstrate that deposition of the complexes in arteries and glomeruli does not require the complement components reacting after C2. Immunological reactions, in which platelets release their vasoactive amines, have been examined in rabbits undergoing immune complex disease. A correlation was obtained between the presence of a complement-independent reaction which required blood leukocytes, antigen and platelets, the deposition of immune complexes, and the induction of glomerulonephritis. C3 depletion did, however, have a marked alleviating effect on the severity of the arterial lesions. Neutrophil accumulation and the subsequent necrotizing arteritis were prevented. In contrast, the character and severity of the glomerulonephritis was not altered by depletion of later-acting complement components.
Surgeon is only one influence on outcome
Authors: F. A Frizelle
Journal: BMJ (2003)

EDITOR—Carter's editorial on the surgeon as risk factor is an interesting assessment of the various determinants of surgical outcome.1 The surgeon is not, however, an isolated factor but one of many interrelated factors determining surgical outcome. Good surgical results are the result of interdependent multiple factors, including anaesthetic, intensive care, medical, nursing, and paramedical support, and …
Postgraduate Training in Developing Countries
Authors: A. G. Quinlan
Journal: BMJ (1973)

sounds and cannot be silenced until the oxygen runs out of the cylinder or pipeline completely.The button can be reset when a full cylinder is installed or pipeline pressure re-established.The patient failsafe system consists of pipelines connected from the oxygen regulators to each of the other gas regulators, the oxygen pressure acting in place of the usual spring.When oxygen fails the regulators shut off.At the same time as the supply of gases is cut of from the patient an inspiratory valve (which is normally kept closed by these gases) is allowed to vent to atmosphere, en- suring that the patient can still breathe.-I
RT-02 * COMPARISON OF 3DCRT, IMRT AND VMAT FOR POST SURGERY RADIOTHERAPY FOR PITUITARY MACROADENOMAS
Authors: R. Arauz, M. Rodriguez
Journal: Neuro-Oncology (2014)

BACKGROUND: Radiotherapy is usually used in postoperative setting of pituitary macroadenomas. Neurocognitive disorders have been associated to the radiation dose received by temporal lobes (TL). In this work we compare dose to PTV and critical organs produced by three different radiotherapy techniques, namely Volumetric Modulated Arc Therapy (VMAT), Intensity Modulated Radiation Therapy (IMRT) and Three Dimensional Conformal Radiotherapy (3DRT). METHODS: Two patients with pituitary macro adenoma were treated postoperatively using VMAT. Treatments were simulated using facial thermoplastic masks as immobilizers and plans were elaborated with the Eclipse version 10 Treatment Planning System (TPS). Three different plans were created for each patient using IMRT (5 fields), VMAT and 3DCRT (3 fields). Prescription dose to PTV was 45.9 Gy in 27 fractions in both cases. PTV mean size was 33.3 cc. Patients were treated using the VMAT plan. Suitability of the plans was evaluated in terms of the Conformity and Homogeneity Indexes and the dose to OARs. Particularly, the mean dose and the percentage volume receiving a dose of 25Gy (V25) were analyzed in the case of TLs. Analogously, V20 and V40 were analyzed for brain stem (BS) and normal brain tissue (NBT), respectively. RESULTS: IMRT and VMAT improve CI95% compare to 3DRT, 1.06 and 1.17 vs. 1.38 without compromise the means dose to PTV, 46.95 and 47.35 vs. 47.2 Gy, respectively. A wide difference is seen between 3DRT vs. IMRT or VMAT about V25Gy for RTL & LTL, IMRT is a little better than VMAT protecting TL. VMAT reduce better BS V20Gy than IMRT, 32.5 vs. 78%. VMAT protect better the NBT from low doses V20Gy. CONCLUSION: IMRT and VMAT protect better OARs than 3DRT without compromise the coverage dose to PTV. We recommend making the comparative dosimetric analysis between IMRT and VMAT for to choose the best plan.
Allogeneic transplantation of CD34+selected cells from peripheral blood from human leukocyte antigen–identical siblings: detrimental effect of a high number of donor CD34+ cells?
Authors: Alvaro Urbano-Ispizua, Enric Carreras, Pedro Marı́n, Montserrat Rovira, Carmen Martı́nez, Francesc Fernández-Avilés, Blanca Xicoy, Juan-Carlos Hernández-Boluda, Emili Montserrat
Journal: Blood (2001)
New method for accurate calculation of regurgitant flow rate based on analysis of doppler color flow maps of the proximal flow field validation in a canine model of mitral regurgitation with initial application in patients
Authors: Ehud Schwammenthal, Chunguang Chen, Martin Giesler, Alex Sagie, J. Luis Guerrero, José Antonio Vazquez de Prada, Vinzenz Hombach, Arthur E. Weyman, Robert A. Levine
Journal: Journal of the American College of Cardiology (1996)
Rapid assessment of chest pain
Authors: D. Wood, A. Timmis, M. Halinen
Journal: BMJ (2001)

<h3>Abstract</h3> <h3>Introduction</h3> Disparities and their geospatial patterns exist in coronavirus disease 2019 (COVID-19) morbidity and mortality for people who are engaged with clinical care. However, studies centered on viral infection cases are scarce. It remains unclear with respect to the disparity structure, its geospatial characteristics, and the pre-infection determinants of risk (PIDRs) for people with the infection. This work aimed to assess the geospatial associations between PIDRs and COVID-19 infection at the county level in South Carolina by different timepoints during the pandemic. <h3>Method</h3> We used global models including spatial error model (SEM), spatial lag model (SLM), and conditional autoregressive model (CAR), as well as geographically weighted regression model (GWR) as a local model to examine the associations between COVID-19 infection rate and PIDRs. The data were retrieved from multiple sources including USAFacts, US Census Bureau, and Population Estimates Program. <h3>Results</h3> The percentage of males and the percentage of the unemployed population were statistically significant (p values &lt; 0.05) with positive coefficients in the three global models (SEM, SLM, CAR) throughout the time. The percentage of white population and obesity rate showed divergent spatial correlations at different times of the pandemic. GWR models consistently have a better model fit than global models, suggesting non-stationary correlations between a region and its neighbors. <h3>Conclusion</h3> Characterized by temporal-geospatial patterns, disparities and their PIDRs exist in COVID-19 incidence at the county level in South Carolina. The temporal-geospatial structure of disparities and their PIDRs found in COVID-19 incidence are different from mortality and morbidity for patients who are connected with clinical care. Our findings provided important evidence for prioritizing different populations and developing tailored interventions at different times of the pandemic. These findings provided implications on containing early viral transmission and mitigating consequences of infectious disease outbreaks for possible future pandemics.
Case of Thyrotoxicosis Presenting as Hypoproteinaemic Oedema
Authors: G. Pincherle
Journal: BMJ (1965)

DISCUSSIONThis small study fails to give support to the suggestion that menopausal women might have a peculiar hepatic sensitivity to mestranol or Enavid.Since both of the previous reports of uniform liver impairment (see introduction) originated in a single city (Helsinki), it is possible that differences in climate, nutrition, or endemic hepatitic virus explain our failure to confirm their findings.None of the patients reported herein gave clinical evidence of hepatic impairment, and the minority who had marginal abnormalities on test probably would not exceed the expected incidence in a control group of the same age.It was not thought necessary to discontinue treatment in any case because of these test results.About one-third of the menopausal women in this series had a subjective preference for the oestrogen- progestin combined therapy (Enavid) rather than the placebo or mestranol alone.There seems to be no reason why they should not remain on this treatment indefinitely.Another source of information about the possible hepatotoxicity of oral oestfogen-progestin therapy in older women is its experimental use in the treatment of rheumatoid arthritis.These studies differ significantly in that the patients already had a serious illness and the dose was often much larger than that used for contraception or to replace ovarian deficiency.Waine et al. (1963), in nine patients treated with 15 to 50 mg.of Enavid daily for 8 to 300 days, found " no major changes in serum bilirubin, prothrombin time, alkaline phosphatase, thymol turbidity, bromsulphalein retention, cephalin flocculation, or the S.G.O.T." Similarly, in 17 patients, Gilbert et al. (1964), using 40 mg. of Enavid daily, report no significant changes in the S.G.O.T.Although ages were not reported, personal communication revealed that many were in the menopausal age range.It is concluded that there is not enough evidence to implicate mestranol either alone or in combination with an oral progestin, such as Enavid, as a cause of impaired liver function either in younger women using it for contraception or in menopausal women.
FDA Seeks Swifter Approval of Drugs for Some Life-Threatening or Debilitating Diseases
Authors: Charles Marwick
Journal: JAMA (1988)

THE FOOD AND DRUG Administration (FDA) is seeking to accelerate approval of drugs for patients with life-threatening or debilitating diseases. Obvious candidates are drugs against acquired immunodeficieny syndrome (AIDS) and anticancer treatments. The agency issued an interim rule, published in the<i>Federal Register</i>, that expands Phase II clinical trials to provide enough data on safety and efficacy of designated drugs to enable them to bypass Phase III studies and be considered for approval. Although there are provisions for comment on the rule, it actually took effect on the publication date a month ago. If the FDA staff considers it necessary, such drugs would continue to be monitored by a postmarketing surveillance system. This will be decided on a case-by-case basis. To further speed the approval process, the agency will convene advisory committees as needed to consider the data from the expanded Phase II studies. Studies ready for consideration thus won't