tbuckley/cabot-search huggingface dataset:
Pharmacokinetics of 125I-labeled insulin glargine (HOE 901) in healthy men: comparison with NPH insulin and the influence of different subcutaneous injection sites.
Authors: D R Owens, P A Coates, S D Luzio, J P Tinbergen, R Kurzhals
Journal: Diabetes Care (2000)

OBJECTIVE: To determine the subcutaneous absorption rates and the appearance in plasma of 3 formulations of the long-acting human insulin analog insulin glargine (HOE 901) differing only in zinc content (15, 30, and 80 microg/ml). RESEARCH DESIGN AND METHODS: We conducted 2 studies. Study 1 compared the subcutaneous abdominal injection of 0.15 U/kg of 125I-labeled insulin glargine[15], insulin glargine[80], NPH insulin, and placebo. In study 2, 0.2 U/kg of insulin glargine[30] was injected into the arm, leg, and abdominal regions. Both studies had a randomized crossover design; each enrolled 12 healthy men, aged 18-50 years. RESULTS: In study 1, the time in hours for 25% of the administered radioactivity to disappear after bolus subcutaneous injection (T75%) for NPH insulin indicated a significantly faster absorption rate compared with the 2 insulin glargine formulations (3.2 vs. 8.8 and 11.0 h, respectively P &amp;lt; 0.0001). Mean residual radioactivity with NPH insulin was also significantly lower at 24 h (21.9 vs. 43.8 and 52.2%, P &amp;lt; 0.0001). The calculated plasma exogenous insulin concentrations after NPH insulin were substantially higher than those with insulin glargine, reaching a peak within the first 6 h after administration before declining. Insulin glargine, however, did not exhibit a distinct peak. Weighted average plasma glucose concentration between 0 and 6 h was significantly lower after NPH compared with insulin glargine (P &amp;lt; 0.001). In study 2, there were no significant differences in the absorption characteristics of insulin glargine between the 3 injection sites (T75% = 11.9, 15.3, and 13.2 h for arm, leg, and abdomen, respectively) or in residual radioactivity at 24 h. CONCLUSIONS: Subcutaneous absorption of insulin glargine is delayed compared with NPH insulin. There is little or no difference in the absorption rate of insulin glargine between the main subcutaneous injection sites.
PTU-184 Unload the Burden of Unnecessary Investigations and Reduce the Delay in Diagnosing Bile Acid Malabsorption (BAM)
Authors: B Kok, R Malhotra, A Mistry, J Burdsall, A Milestone, R Ransford
Journal: Gut (2013)

<h3>Introduction</h3> BAM is an often forgotten cause for chronic diarrhoea and though it is easily diagnosed by means of the SeHCAT scan, the diagnosis is often made late in the day with SeHCAT used only as a third or fourth line investigation. In this observational study we aim to analyse the unnecessary investigations and chronological delay it took to diagnose BAM in our centre. <h3>Methods</h3> All patients who underwent a SeHCAT scan between the period January 2009-June 2012 were identified. Patient notes were retrieved and blood results, radiological imaging and endoscopy procedures performed prior to SeHCAT scan were reviewed. An abnormal SeHCAT was defined by bile acid retention &lt; 8%. <h3>Results</h3> A total of 112 patients underwent a SeHCAT scan during this period. 4 patients were excluded due to unavailability of notes. 53 patients (49%) had abnormal SeHCAT results. All 53 patients had normal inflammatory markers (normal white cell count, C reactive protein &lt; 5), 98% (52) had normal haemoglobin levels and 91% (48) had coeliac disease excluded by negative tissue transglutaminase antibodies. The median age at time of diagnosis was 52 years (range 26–80 years), 38 of the 53 patients being female. The average stool frequency was 7 times a day. In these 53 patients, a total of 5 hydrogen breath tests were performed prior to SeHCAT, 4 of them normal. A total of 19 barium studies were performed prior to SeHCAT, 15 were normal. A total of 18 CT Abdomen/Pelvis were performed prior to SeHCAT, 13 were normal. A total of 21 flexible sigmoidoscopies were performed, all of them normal. A total of 24 colonoscopies were performed, 21 of them normal. All abnormal results from the above summary apart from 2 abnormal CT Abdomens (which were detected in patients who were post-cholecystectomy) were found in patients who were known to be at risk of Type I BAM (previous TI Crohn's disease/previous ileal resection/previous pelvic radiotherapy). This includes the 3 abnormal colonoscopies from patients with known Crohn's disease with histology confirming active Crohn's inflammation. The average time from first clinic consultation to time of diagnosis was 4.8 months (range 2 – 34 months). <h3>Conclusion</h3> There is a significant time delay in diagnosing BAM and the study confirmed our suspicions that patients with BAM often undergo a whole barrage of investigations which yield negative results. Patients with Type I BAM, however, seem to yield abnormalities in most other investigations which might throw physicians off course initially, resulting in further diagnostic delay. BAM certainly needs to be thought of earlier in all patients and it merits a consideration even in patients who appear to have active inflammatory disease. <h3>Disclosure of Interest</h3> None Declared.
Congruent Mammalian Trees from Mitochondrial and Nuclear Genes Using Bayesian Methods
Authors: A. Reyes
Journal: Molecular Biology and Evolution (2003)

Analyses of mitochondrial and nuclear gene sequences have often produced different mammalian tree topologies, undermining confidence in the merit of molecular approaches with respect to "traditional" morphological classification. The recent sequencing of the complete mitochondrial genomes of two additional rodents (Spalax judaei and Jaculus jaculus) and one lagomorph (Ochotona princeps) has prompted us to reinvestigate the issue. Using Bayesian phylogenetics, we found phylogenetic relationships between mammalian species highly congruent with previous results based on nuclear genes. Our results show the existence of four primary lineages of placental mammals: Xenarthra, Afrotheria, Laurasiatheria, and Euarchontoglires. Relationships between and within these lineages strongly suggest that the gene trees may also be congruent with the underlying species phylogeny.
High-dose cyclophosphamide for severe aplastic anemia: long-term follow-up
Authors: Robert A. Brodsky, Allen R. Chen, Donna Dorr, Ephraim J. Fuchs, Carol Ann Huff, Leo Luznik, B. Douglas Smith, William H. Matsui, Steven N. Goodman, Richard F. Ambinder, Richard J. Jones
Journal: Blood (2009)
Amiodarone protection against myocardial injury and fibrosis induced by isoprenaline is abolished by thyroid hormone
Authors: G. Dussaillant, J. E Jalil, C. Cespedes
Journal: Cardiovascular Research (1994)

Catecholamines induce myocyte necrosis and myocardial fibrosis. These effects are probably related to beta adrenergic receptor stimulation and to thyroid hormonal status. The aim of the study was to test the hypothesis that amiodarone prevents myocardial damage induced by isoprenaline and that these effects are not observed when thyroid hormone is administered.Myocardial injury was assessed in the first experiment. Isoprenaline (1 mg.kg-1 subcutaneously once) was given to two groups of rats which received monoclonal antimyosin. Group 1 (n = 5) was pretreated with amiodarone and group 2 (n = 6) received only isoprenaline. In the second experiment, the effects of amiodarone on isoprenaline induced myocardial fibrosis and of supplementary triiodothyronine (T3) were examined. Group 3 (n = 10) received only isoprenaline for 4 d. Group 4 (n = 10) received amiodarone for 14 d and isoprenaline during 4 d. Group 5 (n = 8) received amiodarone and isoprenaline like group 4, plus T3. Untreated rats served as controls (group 6; n = 10). Collagen volume fraction (CVF) was measured in each heart.No rats pretreated with amiodarone showed antimyosin labelling, while the mean score of rats receiving only isoprenaline was 2.8 (p < 0.05), indicating the presence of significant myocyte injury. In group 3, CVF was significantly higher than in controls, at 7.63(SEM 0.89)% v 1.74(0.07)%, p < 0.001, whereas rats pretreated with amiodarone (group 4) showed significantly less fibrosis [CVF 2.96(0.19)%]. This protective effect was lost when amiodarone and T3 were given together [CVF 7.92(1.8)%, p < 0.005 between groups 4 and 6].By preventing isoprenaline induced myocardial injury and fibrosis, amiodarone may have a cardioprotective role. This effect is completely abolished by thyroid hormone.
Antibody to transforming growth factor-β ameliorates tubular apoptosis in unilateral ureteral obstruction
Authors: Akira Miyajima, Jie Chen, Cathy Lawrence, Steve Ledbetter, Robert A. Soslow, Joshua Stern, Sharda Jha, Joseph Pigato, Matthew L. Lemer, Dix P. Poppas, E. Darracott Vaughan, Diane Felsen
Journal: Kidney International (2000)
Photobiology and genetics of malignant melanoma
Authors: J-P. Ortonne
Journal: British Journal of Dermatology (2002)

The current state of knowledge of melanoma genetics is reviewed. Mutations in the tumour suppressor gene CDKN2A and in the oncogenes N-ras and H-ras seem to play the most important roles in the development and progression of malignant melanoma. Experimental studies to determine the role of ultraviolet (UV) light in the induction of melanoma have been hampered by a lack of suitable animal models. The commonly used laboratory animals are not susceptible to the induction of melanoma upon exposure to UV radiation (UVR) alone. Recent observations with four different animals have suggested, however, that UVR may be involved in the induction of melanoma. The most recent model consists of human skin grafted onto immunodeficient mice. To date, using this model, only the combination of UVB (280-320 nm) exposure and topical promoter treatment has led to the development of malignant melanoma. The wavelength dependency of the induction of melanoma has been established in the fish model Xiphophorus. The application of such an action spectrum to humans looks possible.
Gastroenteritis-Related Deaths Increase
Authors: Bridget M. Kuehn
Journal: JAMA (2012)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Gli proteins and Hedgehog signaling: development and cancer
Authors: Ariel Ruiz i Altaba
Journal: Trends in Genetics (1999)

A surprising number of apparently unrelated human diseases, including familial and sporadic cancers and a number of syndromes and malformations, seem to be associated with abnormal function of the Hedgehog (Hh) signaling pathway. Zinc-finger transcription factors of the Gli family play critical roles in the mediation and interpretation of Hh signals. Elucidating how Gli proteins work will enable us to further our knowledge of how cells proliferate, differentiate or survive in response to Hh signals, as well as to design rational therapies for these Hh-signaling related diseases (HSDs).
Back Surgery — Who Needs It?
Authors: Richard A. Deyo
Journal: New England Journal of Medicine (2007)

Back surgery is not the final common pathway for everyone with persistent back pain. It offers specific therapy for specific anatomical derangements associated with specific complexes of symptoms. When surgery ranges beyond carefully defined situations, we can expect disappointed patients.A generation ago, "back surgery" usually meant removing the offending portion of a herniated disk (Figure 1). Times have changed, and both the indications and the surgical techniques have expanded enormously. Indeed, clinical science has struggled to keep pace with innovation, creating uncertainties about the efficacy and safety of some new surgical techniques. Patients and primary physicians now need a . . .
Fibre and enteral nutrition.
Authors: M R Lewin, A P Jayaraj
Journal: Gut (1989)

Fibre and enteral nutrition SIR,-We read with great interest Dr Silk's review,' but we were surprised at the omission of any detail on the effects of enteral nutrition on cholesterol metabolism.In our own experimental studies,' rats fed for 10 weeks with Vivonex develop severe fatty infiltration of the liver, similar to Kwashiorkor, with initial deposition of fat in the periportal regions with progressive involvement around the central vein with significant quantitative increases in total liver lipid and cholesterol.No such changes were detectable in the livers of animals fed for 10 weeks with Vivonex which was supplemented with 5% wheat bran.The accumulation of lipids and cholesterol in the livers of rats fed Vivonex has been reported by others.' We concluded that dietary bran thus appears to play a role in maintaining normal lipid metabolism and suggest that caution be exercised in those patients on longterm enteral feeding with careful monitoring of blood lipids.
Beneficial effects of the "open lung approach" with low distending pressures in acute respiratory distress syndrome. A prospective randomized study on mechanical ventilation.
Authors: M B Amato, C S Barbas, D M Medeiros, G de P Schettino, G Lorenzi Filho, R A Kairalla, D Deheinzelin, C Morais, E de O Fernandes, T Y Takagaki
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Alveolar overdistention and cyclic reopening of collapsed alveoli have been implicated in the lung damage found in animals submitted to artificial ventilation. To test whether these phenomena are impairing the recovery of patients with acute respiratory distress syndrome (ARDS) submitted to conventional mechanical ventilation (MV), we evaluated the impact of a new ventilatory strategy directed at minimizing "cyclic parenchymal stretch." After receiving pre-established levels of hemodynamic, infectious, and general care, 28 patients with early ARDS were randomly assigned to receive either MV based on a new approach (NA, consisting of maintenance of end-expiratory pressures above the lower inflection point of the P x V curve, VT < 6 ml/kg, peak pressures < 40 cm H2O, permissive hypercapnia, and stepwise utilization of pressure-limited modes) or a conventional approach (C = conventional volume-cycled ventilation, VT = 12 ml/kg, minimum PEEP guided by FIO2 and hemodynamics and normal PaCO2 levels). Fifteen patients were selected to receive NA, exhibiting a better evolution of the PaO2/FIO2 ratio (p < 0.0001) and of compliance (p = 0.0018), requiring shorter periods under FIO2 > 50% (p = 0.001) and a lower FIO2 at the day of death (p = 0.0002). After correcting for baseline imbalances in APACHE II, we observed a higher weaning rate in NA (p = 0.014) but not a significantly improved survival (overall mortality: 5/15 in NA versus 7/13 in C, p = 0.45). We concluded that the NA ventilatory strategy can markedly improve the lung function in patients with ARDS, increasing the chances of early weaning and lung recovery during mechanical ventilation.
AGAINST MEASURING THE CHEST GIRTH AT REST
Authors: HORACE GRAY
Journal: JAMA (1922)

Recent biometric evidence that body weight is more closely correlated with chest-girth than with stature 1 brings up anew the ancient questions as to technic.  The three levels cannot be entered on here save to state that the axillary has been generally discarded, the mammillary has been used by me in accordance with most medical men, and the xiphoid is very appealing for further study with reference to avoidance of the considerable pectoral muscle and gland tissue in men and women.  The moment of the respiratory cycle is the question aroused by the favor accorded by Dreyer 2 to the variously called resting, relaxed, talking, normally breathing, and not expanded chest circumference. The brief evidence so far presented 3 to indicate the inferiority of the resting girth to the halfway girth (arithmetical mean between the inspiratory and expiratory girths) has seemed to need amplification.  The subjects studied composed two
Quantitative detection of glaucomatous damage at the posterior pole by retinal thickness mapping
Authors: Ran Zeimer, Sanjay Asrani, Shazhou Zou, Harry Quigley, Henry Jampel
Journal: Ophthalmology (1998)

The posterior pole ganglion cell bodies form a substantial fraction of the retinal thickness, prompting the authors to study the feasibility of detecting, by scanning retinal thickness analysis, retinal changes at the posterior pole due to glaucomatous damage.Nonconsecutive case series.One or both eyes of patients with chronic open-angle glaucoma who presented with either a superoinferior asymmetry in visual fields or a localized field loss or a nerve fiber layer defect visible on photography were recruited. Twenty-nine eyes of 18 patients were studied.A laser slit was projected on the retina and scanned, in 400 msec, across a 2- x 2-mm area of the fundus, yielding optical cross-sections that were digitally recorded. Nine such scans covered the central 20 degrees of the fundus. The optical cross-sections were analyzed by an operator-free algorithm to yield a three-or two-dimensional color map. The asymmetry (difference) between the visual sensitivity of the upper and lower hemifields was compared with the asymmetry in retinal thickness deviation from normal.Large losses (up to 34%) in retinal thickness were detected at the posterior pole of patients with glaucoma due to the loss of ganglion cells and nerve fibers. A statistically significant correlation was found between the asymmetry in visual sensitivity loss and the asymmetry in deviation from normal thickness (r = 0.72; P < 0.0005).Mapping of the retinal thickness may provide a sensitive method for the detection and monitoring of early glaucomatous tissue loss in the posterior pole, which is unique due to the combination of (1) the direct measurement of neuroretinal loss in the central field of vision; (2) the mapping capability; and (3) the rapid image acquisition.
Hemobilia: endoscopic, fluoroscopic, and cholangioscopic diagnosis
Authors: Mansour A. Parsi
Journal: Hepatology (2010)

A 45-year-old man with chronic pancreatitis underwent transjugular liver biopsy for the evaluation of esophageal varices and ascites. A few days after the liver biopsy, he developed new-onset jaundice and melena. Computed tomography of the abdomen showed the presence of ascites, a liver with cirrhotic morphology, and a biliary tree that appeared normal. Upper endoscopy for the evaluation of the melena showed fresh blood in the duodenum without a clear source of bleeding. An evaluation with a duodenoscope (a side-view endoscope) showed slow oozing of blood from the ampulla (Fig. FigA). Endoscopic retrograde cholangiopancreatography (ERCP) revealed a large filling defect occupying the entire extrahepatic biliary tree from the confluence to the ampulla (Fig. FigB). Sweeps of the bile duct yielded a large number of blood clots. Cholangioscopy with a prototype video choledochoscope (CHF-Y0002, Olympus, Japan) showed slow oozing of blood into the left hepatic duct from a more proximal source (Fig. FigC). A fully covered metallic stent (WallFlex biliary stent, Boston Scientific, Natick, MA) was placed in the bile duct to ensure biliary drainage while the patient waited for the final treatment of embolization of the bleeding vessel. Subsequent angiography, however, did not show any bleeding (Fig. FigD). (A) Oozing of blood from the ampulla. (B) Filling defect from the confluence to the ampulla. (C) Slow oozing of blood into the left hepatic duct. (D) No bleeding on angiography. ERCP, endoscopic retrograde cholangiopancreatography. Hemobilia is an uncommon entity but is part of the differential diagnosis of upper gastrointestinal bleeding. It occurs when there is a fistula between a vessel of the splanchnic circulation and the intrahepatic or extrahepatic biliary system. The causes of hemobilia are numerous. Trauma was the most frequent cause in earlier years.1 More recently, however, most cases are due to medical procedures such as the creation of transhepatic biliary access, liver biopsy, cholecystectomy, and therapeutic ERCP.2 Other causes include gallstones, infections, malignancies, and vascular abnormalities of the hepatobiliary system. Jaundice as a result of hemobilia is uncommon. It has been suggested that bile has thrombolytic activity, and for clots to form, the bleeding has to be slow. With slow hemorrhaging, blood and bile do not mix because of their different specific gravities and surface tensions, which make clot formation possible.2 The treatment of jaundice associated with hemobilia usually requires a dual-track strategy: control of bleeding and relief of jaundice. Bleeding stops in approximately half of the cases with just supportive therapy. Embolization of the bleeding source is required if bleeding is persistent or severe. Relief of jaundice is achieved by ERCP. In selected cases, cholangioscopy at the time of ERCP can aid in the determination of the extent of clot formation and the localization of the bleeding source.3-5