tbuckley/cabot-search huggingface dataset:
Intensive Insulin Therapy in Hospitalized Patients
Authors: Rajesh Garg
Journal: Annals of Internal Medicine (2011)

Letters21 June 2011Intensive Insulin Therapy in Hospitalized PatientsRajesh Garg, MDRajesh Garg, MDFrom Brigham and Women's Hospital, Boston, MA 02115.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-154-12-201106210-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Qaseem and colleagues' clinical practice guideline for the management of hyperglycemia in hospitalized patients (1) is confusing and may do more harm than good. The guideline recommends against use of IIT in the ICU as well as in the non-ICU setting, regardless of the diabetes status of the patient. Intensive insulin therapy is defined as the use of intravenous insulin infusion; if intravenous insulin infusion should not be used in the ICU, what should be used to keep blood glucose levels in the target range of 7.8 to 11.1 mmol/L (140 to 200 mg/dL)? Should it be ...Reference1. Qaseem A, Humphrey LL, Chou R, Snow V, Shekelle P; Clinical Guidelines Committee of the American College of Physicians. Use of intensive insulin therapy for the management of glycemic control in hospitalized patients: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2011;154:260-7. [PMID: 21320941] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Rajesh Garg, MDAffiliations: From Brigham and Women's Hospital, Boston, MA 02115.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUse of Intensive Insulin Therapy for the Management of Glycemic Control in Hospitalized Patients: A Clinical Practice Guideline From the American College of Physicians Amir Qaseem , Linda L. Humphrey , Roger Chou , Vincenza Snow , and Paul Shekelle , for the Clinical Guidelines Committee of the American College of Physicians* Intensive Insulin Therapy in Hospitalized Patients Mary Korytkowski , Etie Moghissi , and Guillermo Umpierrez Intensive Insulin Therapy in Hospitalized Patients Devan Kansagara , Paul Shekelle , and Amir Qaseem Intensive Insulin Therapy in Hospitalized Patients Lynn Bentson Intensive Insulin Therapy in Hospitalized Patients Anthony P. Furnary Metrics Cited byManagement of Hyperglycemia During the Perioperative Period 21 June 2011Volume 154, Issue 12Page: 846KeywordsBloodConflicts of interestGlucoseHyperglycemiaInsulinIntensive care unitsSubcutaneous injectionsTreatment guidelinesType 1 diabetesType 2 diabetes ePublished: 21 June 2011 Issue Published: 21 June 2011 Copyright & PermissionsCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Skin necrosis induced by streptokinase
Authors: H. Dass, R. Fescharek
Journal: BMJ (1994)

EDITOR,—J Penswick and A L Wright report a case of skin necrosis possibly induced by treatment with streptokinase.1 Pathophysiologically they suspected “a variety of disturbances of the clotting and thrombolytic cascade,” but they fail to give any evidence for their suspicion. The clinical course of events is compatible with cholesterol crystal embolisation. Cholesterol crystal embolisation of the arteries of the skin may present as …
The prevalence of chronic knee injury in triathletes.
Authors: K Clements, B Yates, M Curran
Journal: British Journal of Sports Medicine (1999)

To add to the area of triathlon research by providing much needed prevalence data on knee injury in triathletes.An incidental "in field" sampling technique was used to interview 58 triathletes aged between 15 and 55 years about knee injury during a triathlon event. The sample comprised 46 men and 12 women.Most knee injuries occurred during the running event (72%) and affected the lateral side of the knee (38%). In all, 78% of the sample sought treatment from a healthcare professional.The study has provided much needed prevalence data on chronic knee injury in triathletes.
Pharmacological Inhibition of Poly(ADP-Ribose) Polymerases Improves Fitness and Mitochondrial Function in Skeletal Muscle
Authors: Eija Pirinen, Carles Cantó, Young Suk Jo, Laia Morato, Hongbo Zhang, Keir J. Menzies, Evan G. Williams, Laurent Mouchiroud, Norman Moullan, Carolina Hagberg, Wei Li, Silvie Timmers, Ralph Imhof, Jef Verbeek, Aurora Pujol, Barbara van Loon, Carlo Viscomi, Massimo Zeviani, Patrick Schrauwen, Anthony A. Sauve, Kristina Schoonjans, Johan Auwerx
Journal: Cell Metabolism (2014)
Prevention and Treatment of Diabetic Renal Disease in Type 2 Diabetes
Authors: Giuseppe Remuzzi, Manuel Macia, Piero Ruggenenti
Journal: Journal of the American Society of Nephrology (2006)

Diabetic nephropathy (DN) is the leading cause of end-stage renal failure in Western countries and carries an increased risk for cardiovascular mortality. Studies have identified a number of factors that play a part in the development of DN. Among them, hypertension and proteinuria are the most important. In the early stages of DN, when albumin is present in the urine in very low quantities (microalbuminuria) and an increase is seen in BP, there is no loss of filtrate and patients respond well to prophylactic measures. Microalbuminuria is considered an early marker of DN. Prevention of the onset of microalbuminuria, therefore, could be considered as the primary means of preventing DN. The Bergamo Nephrologic Diabetes Complication Trial (BENEDICT) was a prospective, randomized, double-blind, parallel-group study that was organized in two phases. Phase A included 1204 patients and was aimed at assessing the efficacy of the angiotensin-converting enzyme (ACE) inhibitor trandolapril, the non-dihydropyridine calcium channel blocker verapamil, and the trandolapril plus verapamil combination as compared with placebo in prevention of microalbuminuria in hypertensive patients with type 2 diabetes and normal urinary albumin excretion rate. Phase B was aimed at assessing the efficacy of the combination as compared with trandolapril alone in prevention of macroalbuminuria in patients with microalbuminuria. The BENEDICT Phase A study showed that DN can be prevented by ACE inhibitor therapy. The beneficial effect of ACE inhibition is not enhanced by combined non-dihydropyridine calcium channel blocker therapy. The apparent advantage of ACE inhibitors over other agents includes a protective effect on the kidney against the development of microalbuminuria, which is a major risk factor for cardiovascular events and death in this population.
The Incidence of Unrecognized Myocardial Infarction in Women with Coronary Heart Disease
Authors: Michael G. Shlipak, Darryl A. Elmouchi, David M. Herrington, Feng Lin, Deborah Grady, Mark A. Hlatky
Journal: Annals of Internal Medicine (2001)

Background: Several cohort studies in populations without coronary heart disease have demonstrated that up to 40% of incident myocardial infarctions are clinically unrecognized. Objective: To determine the incidence of unrecognized myocardial infarction in women with coronary heart disease in the Heart and Estrogen/progestin Replacement Study (HERS). Design: Randomized, double-blind, placebo-controlled trial of conjugated estrogens plus medroxyprogesterone or identical placebo with 4.1 years of follow-up. Settings: Outpatient and community settings at 20 U.S. clinical centers. Patients: 2763 postmenopausal women younger than 80 years of age with coronary heart disease and an intact uterus. Measurements: Annual electrocardiograms were obtained for all participants during follow-up (mean, 4.1 years) and were evaluated by using the NOVACODE computer algorithm and visual confirmation. A total of 13 715 electrocardiograms were obtained. Suspected unrecognized myocardial infarctions were investigated by comparing a participant's previous surveillance electrocardiograms with the electrocardiograms obtained from all of her intervening hospitalizations. Characteristics of patients with recognized and unrecognized myocardial infarction were compared. Results: Among the 256 nonfatal myocardial infarctions, 11 were unrecognized (4.3% [95% CI, 2.2% to 7.6%]). Seven occurred in women assigned to placebo and 4 occurred in women assigned to hormone therapy (P > 0.2). Women with unrecognized myocardial infarction were less likely to have diabetes mellitus or previous angina and were more likely to have had previous bypass surgery compared with women who had clinically recognized myocardial infarction. Conclusion: The incidence of unrecognized myocardial infarction in women with coronary disease was far lower than that observed in previous studies of populations without coronary heart disease.
Very-Low-Calorie Diets-Reply
Authors: Theodore B. Van Itallie
Journal: JAMA (1990)

<h3>In Reply. —</h3> The purpose of our commentary was to alert physicians that verylow-calorie diets (VLCDs) are not a panacea for obesity, contrary to the tenor of advertisements recently placed in this and other journals. We advised practitioners that they have an obligation not only to ensure the safe use of these diets, but also to help patients obtain access to skills needed to facilitate long-term weight control. We share Drs Flynn and Thompson's concerns about the long-term outcome of treatment by VLCD and behavior modification, but have a different view of this problem. A growing literature shows that a 10% reduction in pretreatment weight will greatly help 9 of 10 patients, specifically improving heart function, blood pressure, glucose tolerance, sleep disorders, respiratory function, and lipid profile.<sup>1-3</sup>Patients treated by VLCD and behavior modification typically lose 20% of their baseline weight. Thus, patients frequently enjoy improvements in health for
Potential of plant genetic systems for monitoring and screening mutagens
Authors: R. A. Nilan
Journal: Environmental Health Perspectives (1978)

Plants have too long been ignored as useful screening and monitoring systems of environmental mutagens. However, there are about a dozen reliable, some even unique, plant genetic systems that can increase the scope and effectiveness of chemical and physical mutagen screening and monitoring procedures. Some of these should be included in the Tier II tests. Moreover, plants are the only systems now in use as monitors of genetic effects caused by polluted atmosphere and water and by pesticides.There are several major advantages of the plant test systems which relate to their reproductive nature, easy culture and growth habits that should be considered in mutagen screening and monitoring. In addition to these advantages, the major plant test systems exhibit numerous genetic and chromosome changes for determining the effects of mutagens. Some of these have not yet been detected in other nonmammalian and mammalian test systems, but probably occur in the human organism.Plants have played major roles in various aspects of mutagenesis research, primarily in mutagen screening (detection and verification of mutagenic activity), mutagen monitoring, and determining mutagen effects and mechanisms of mutagen action. They have played lesser roles in quantification of mutagenic activity and understanding the nature of induced mutations.Mutagen monitoring with plants, especially in situ on land or in water, will help determine potential genetic hazards of air and water pollutants and protect the genetic purity of crop plants and the purity of the food supply. The Tradescantia stamen-hair system is used in a mobile laboratory for determining the genetic effects of industrial and automobile pollution in a number of sites in the U.S.A. The fern is employed for monitoring genetic effects of water pollution in the Eastern states. The maize pollen system and certain weeds have monitored genetic effects of pesticides. Several other systems that have considerable value and should be developed and more widely used in mutagen monitoring and screening, especially for in situ monitoring, are discussed. Emphasis is placed on pollen systems in which changes in pollen structure, chemistry, and chromosomes can be scored for monitoring; and screening systems which can record low levels of genetic effects as well as provide information on the nature of induced mutations.The value of plant systems for monitoring and screening mutagens can be improved by: greater knowledge of plant cell processes at the molecular and ultrastructural levels; relating these processes to mutagen effects and plant cell responses; improving current systems for increased sensitivity, ease of detecting genetic and chromosome changes, recording of data (including automation), and for extending the range of genetic and chromosome end points; and designing and developing new systems with the aid of previous and current botanical and genetic knowledge.
Biodistribution of free and N -(2-hydroxypropyl)methacrylamide copolymer-bound mesochlorin e 6 and adriamycin in nude mice bearing human ovarian carcinoma OVCAR-3 xenografts
Authors: Jane-Guo Shiah, Yongen Sun, C.Matthew Peterson, Jindřich Kopeček
Journal: Journal of Controlled Release (1999)
Type III Hyperlipoproteinemia: An Analysis of Two Contemporary Definitions
Authors: DONALD S. FREDRICKSON
Journal: Annals of Internal Medicine (1975)

Two current definitions of type III hyperlipoproteinemia, "floating beta" lipoproteins and an estimate of the relative content of cholesterol and triglyceride in lipoproteins of density less than 1.006 (very low-density [VLD] lipoproteins), have been compared. Over 3100 complete lipoprotein analyses of 182 adults with primary familial hyperglyceridemia, covering a wide range of plasma lipid concentrations, formed the data base for this retrospective analysis: The ratio of VLD lipoprotein cholesterol to the plasma triglyceride concentration (CVLDL/TG = r) proved capable of segregating an apparently unique subpopulation with persistently abnormal very low-density lipoprotein composition. Although floating beta lipoproteins were present in nearly all patients with a high r value, they also appeared inconsistently in many other patients. It is concluded that the chemical index to VLD lipoprotein composition is the better, albeit, temporary definition for this disorder. When the plasma triglyceride concentration is between 150 and 1000 mg/100 ml, an r not less than 0.25 should be considered as suggestive and a value not less than 0.30 as diagnostic of type III hyperlipoproteinemia.
The Most Primary of Care — Talking about Driving and Distraction
Authors: Amy N. Ship
Journal: New England Journal of Medicine (2010)

Imagine the scene: three young women are traveling in a car. It is a sunny morning, traffic is light, and all are wearing their seat belts and are not intoxicated. They are talking about a friend — "You like him, don't you?" It is happy, benign teenager chatter. Then the driver decides to include that other friend in the conversation. While steering, she sends him a short text message on her cell phone.Suddenly, the car swerves into oncoming traffic and metal hits metal at high speed. Bodies are thrown. Glass breaks. Blood splatters. When the car finally comes to . . .
The lymphatic vasculature revisited
Authors: Dontscho Kerjaschki
Journal: Journal of Clinical Investigation (2014)

Lymphatic vessels constitute a ubiquitous countercurrent system to the blood vasculature that returns interstitial fluid, salts, small molecules, resorbed fat, and cells to the bloodstream. They serve as conduits to lymph nodes and are essential for multiple physiologic activities. However, they are also hijacked by cancer cells to establish initial lymph node metastases, as well as by infectious agents and parasites. Despite these obvious important functions in human pathologies, a more detailed understanding of the molecular mechanisms involved in the regulation of the lymphatic vasculature has trailed that of the blood vasculature for many years, mainly because critical specific characteristics of lymphatic endothelial cells were discovered only recently. In this Review series, several major aspects of the active and passive involvement of the lymphatic vasculature in human disease and physiology are presented, with a focus on translational findings.
Use of the Self-Administered Eczema Area and Severity Index by parent caregivers: results of a validation study
Authors: T.S. Housman, M.J. Patel, F. Camacho, S.R. Feldman, A.B. Fleischer, R. Balkrishnan
Journal: British Journal of Dermatology (2002)

The Eczema Area and Severity Index (EASI) is used by dermatological investigators world-wide to assess eczema disease severity. EASI measures are, however, time-consuming and require trained personnel, thereby limiting its application to large-scale epidemiological studies. Additionally, the use of self-assessed severity indices in dermatology is restricted to adult subjects and conditions, thereby not addressing the needs of paediatric patients.To develop and validate an instrument for a caregiver's self-assessment of the severity of his/her child's atopic dermatitis (AD), the Self-Administered EASI (SA-EASI).Trained investigators performed a modified EASI assessment on the same day as an SA-EASI was obtained from 47 caregivers of children with AD.The SA-EASI was found to be a valid measure of the severity of AD. Total, acute and chronic SA-EASI scores predicted total, acute and chronic modified EASI scores (P < 0.0001). SA-EASI body surface area (BSA) scores predicted EASI BSA scores (P < 0.0001). SA-EASI pruritus scores correlated with the acute, chronic and total EASI scores (P = 0.0001).The SA-EASI may provide caregivers the means to report the severity of their child's skin disease objectively. The high correlation with the EASI score observed in this sample implies that statistical inferences with the SA-EASI will be valid for large populations. In future studies, this will permit analysis of the relationship of skin disease severity to such measures as quality of life, disability, patient satisfaction and the costs of various therapies. Moreover, this SA-EASI instrument may allow older children, over 12 years old, to assess the severity of their AD.
A CASE OF URAEMIA TREATED BY MORPHINE
Authors: A. H. Carter
Journal: BMJ (1912)

tRAEMIA TREATED WITH MORPHiNE.MBDI precipitated in t-he epidermis, as described subsequently, the n-illiamperage actually decreased after the first few moments, showing increased skin resistance and a lessened number of ions entering; to maintain the milliamperage at
Topical provocation of fixed drug eruption
Authors: K. ALANKO, S. STUBB, S. REITAMO
Journal: British Journal of Dermatology (1987)

To determine whether topical provocation could be used for the diagnosis of fixed drug eruption (FDE) instead of systemic provocation, we applied the suspected drug at various concentrations (1–10%,) in either petrolatum, 94% ethanol or dimethyl sulphoxide (DMSO)as an open test on both clinically normal skin and on previous FDE lesions in 24 patients with established FDE due to phenazone salicylate, a sulphonamide, doxycycline, trimethoprim, chlormezanone, a barbiturate, or carbamazepine. In 18 of the 24 patients, local provocation of FDE was seen at sites of previous eruption but never on clinically normal skin. With some drugs, e.g. phenazone salicylate, positive provocation of FDE was seen with all the vehicles used; with sulphamethoxazole and trimethoprim, a positive result was seen only in DMSO. To study cross-reactions to other phenazone derivatives in patients with an FDE caused by phenazone salicylate, we applied topical phenazone, aminophenazone and propyphenazone to sites of previous FDE lesions in three patients. In all three, a positive reaction was seen with phenazone, but only one patient showed positive results with aminophenazone and propyphenazone. The present study suggests that topical provocation is useful with several drugs causing FDE. Testing should always be performed on sites of previous FDE, and the sensitivity of the open topical testing can be increased in certain cases by using a vehicle which increases penetration of the drug.
Professor N. S. Davis, Editor Journal of the American Medical Association, No. 65 Randolph Street, Chicago, Ill.
Authors: C. H. Crane
Journal: JAMA (1883)

<h3>Sir:</h3> —Congress having appropriated a small sum for furnishing special surgical appliances to those disabled in the military or naval service, your co-operation is respectfully invited in order that this relief may reach the class of persons intended to be benefited. This office is desirous of obtaining authentic information regarding all existing cases of severe and unusual injuries. Should you have occasion to report such, it will be found useful to bear in mind the foliowing points: As no money commutation is authorized, only such cases need be presented as offer a fair prospect of being relieved by surgical or mechanical appliances. Artificial limbs and apparatus for disabled limbs being otherwise provided for by law, the injuries here in view are almost exclusively those affecting the head, face or trunk. As trusses are furnished under special legislation hernia, when not complicated with other injuries, is not to be understood as
The aging thyroid. The use of thyroid hormone in older persons
Authors: C. T. Sawin
Journal: JAMA (1989)

The overall prevalence of thyroid hormone use in an unselected population of older adults (n = 2575; average age, 68.6 years) was 6.9% (10.0% in women and 2.3% in men). Eighty-one percent of women taking it were doing so for appropriate indications, eg, hypothyroidism, while 12% were not, eg, for obesity or high serum cholesterol; more men (29%) were taking it inappropriately. Inappropriate use was associated with desiccated thyroid more than with thyroxine. After follow-up averaging 6.9 years, 58% of inappropriate users were still taking it. Underuse also occurred. Thirty-seven percent of those definitely hypothyroid had a clearly elevated serum thyrotropin level (greater than 10 mU/L) despite thyroid therapy. Thyroid therapy is common in the elderly; most is appropriate. When inappropriate use occurs, it is more common in men and more often associated with desiccated thyroid, still commonly used in this age group. In chronic users of thyroid hormone, it is important to review currently appropriate indications and to measure serum thyrotropin levels to assess the adequacy of treatment of primary hypothyroidism.
The usefulness property of biorobotic sensorimotor models: A natural source of prosthetic designs
Authors: Kristen N. Jaax
Journal: Behavioral and Brain Sciences (2001)

This commentary addresses an additional feature of biorobotic modeling: usefulness in prosthetic design. By implementing structurally and behaviorally accurate models as prosthetics, biologically accurate restoration can be approximated. This has potential to reestablish important peripheral elements of the sensorimotor control system, including limb biomechanics, proprioception, and vision. Examples given include musculoskeletal prosthetics and retinal implants.