tbuckley/cabot-search huggingface dataset:
Correction: Drug Prescribing in Renal Failure
Authors: M. David Cohen
Journal: Annals of Internal Medicine (1988)

Letters and Corrections1 July 1988Correction: Drug Prescribing in Renal FailureM. David Cohen, MDM. David Cohen, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-109-1-85_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor: I wish to commend Dr. William Bennett, his collaborators, and the American College of Physicians for their outstanding publication, Drug Prescribing in Renal Failure (1).I have discovered one error on page 27 under the heading "Antiparasitic Antibiotics." The adjusted dosage regimen for quinine administration in renal failure shows a transposition of the values of the dosage reduction method (D) and the interval extension method (I). Dr. Bennett's work is of exceptional merit and will be of invaluable benefit to many in clinical practice....Reference1. BennettAronoffGolperMorrisonSingerBrater WGTGID. Drug Prescribing in Renal Failure: Dosing Guidelines for Adults. Philadelphia: American College of Physicians; 1987. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Saint Francis Memorial Hospital San Francisco, CA 94109 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByCritical Care of the Cancer Patient with Pulmonary InfiltratesThe Effect of Magnesium Ions on Bone Bonding to Hydroxyapatite Coating on Titanium Alloy Implants 1 July 1988Volume 109, Issue 1Page: 85-85KeywordsAntibioticsDrugsQuinineRenal failure Issue Published: 1 July 1988 PDF DownloadLoading ...
THE PATHOLOGY OF SUMMER DIARRHEAS OF CHILDREN.
Authors: G. W. BOOT
Journal: JAMA (1903)

The following classification of diarrheas of children, while not perfect, will give some idea of the relation of the summer diarrheas of children to other diarrheas: 1. Mucous disease. 2. Diarrheas of indigestion. 3. Diarrheas due to food infection. A. The result of preformed poisons, e. g., tyrotoxicon, etc. B. Diarrheas due to bacterial or other infection in which the medium of infection is the food, and in which the poisons causing the diarrhea are elaborated within the body. <i>a</i>. Tuberculosis of the intestine. <i>b</i>. Typhoid fever. <i>c</i>. Amebic dysentery. <i>d</i>. Cholera. <i>e</i>. Entero-colitis due to Shiga's bacillus. <i>f</i>. Miscellaneous infections. Mucous disease, tuberculosis, typhoid fever, amebic dysentery and cholera do not fall within the class of diseases under discussion, so will be dismissed at once. Diarrheas of indigestion are more common in summer because improper feeding is more easily accomplished in summer than in winter. Many cases where diarrhea
MANNOSE-RESISTANT HAEMAGGLUTINATION AND P ANTIGEN RECOGNITION ARE CHARACTERISTIC OF ESCHERICHIA COLI CAUSING PRIMARY PYELONEPHRITIS
Authors: Vuokko Väisänen, LeifG. Tallgren, P. Helena Mäkelä, Gunilla Källenius, Hans Hultberg, Jaakko Elo, Anja Siitonen, Catharina Svanborg-Edén, StefanB. Svenson, Timo Korhonen
Journal: The Lancet (1981)
Occupational asthma due to formaldehyde.
Authors: P S Burge, M G Harries, W K Lam, I M O'Brien, P A Patchett
Journal: Thorax (1985)

Bronchial provocation studies on 15 workers occupationally exposed to formaldehyde are described. The results show that formaldehyde exposure can cause asthmatic reactions, and suggest that these are sometimes due to hypersensitivity and sometimes to a direct irritant effect. Three workers had classical occupational asthma caused by formaldehyde fumes, which was likely to be due to hypersensitivity, with late asthmatic reactions following formaldehyde exposure. Six workers developed immediate asthmatic reactions, which were likely to be due to a direct irritant effect as the reactions were shorter in duration than those seen after soluble allergen exposure and were closely related to histamine reactivity. The breathing zone concentrations of formaldehyde required to elicit these irritant reactions (mean 4.8 mg/m3) were higher than those encountered in buildings recently insulated with urea formaldehyde foam, but within levels sometimes found in industry.
THE ACTION OF CALCIUM SALTS
Authors: C. O. Jones
Journal: BMJ (1915)

There is at the present time a certain vagueness as to the powers of the animal organism to excrete calcium 3aifcs, some authorities even prohibiting milk as a diet in certain conditions, supposing that the calcium is liable to accumulate owing to faulty excretory powers. The work here described was undertaken to endeavour to estimate the excretory powers of animals for calcium salts, and also to find out the channels whereby the animal is enabled to protect itself against any excess. Rabbits were used in all the experiments, and all doses were given intravenously, as it was found that when given by the mouth there was some vagueness as to how much liad been absorbed, while hypodermic injections were . unsatisfactory owing to slow absorption and consequent abscess formation. The salt used was pure calcium chloride in 10 per cent. solution ; the calcium was in all cases estimated gravi mefcrically. The first rabbit was given 1 gram of calcium chloride intravenously; death was instantaneous. Clotting was found to have occurred from the point of injection to the heart, which had stopped in diastole. A second rabbit was given the same dose, and died at once with a con vulsion. Coagulation was found extending from the point of injection to the heart. The other vessels were found normal. * It was found that 0.5 gram of calcium chloride was a maximum dose ; this is equal to 0.252 gram of calcium oxide. All results are calculated to calcium oxide. Each column in the tables shows a daily excretion in cubic centimetres or grams.
Immunotherapy in Leprosy-Reply
Authors: Chapman H. Binford
Journal: JAMA (1982)

<h3>In Reply.—</h3> We appreciate Dr Fusaro's discussion of research on the use of transfer factor in efforts to enhance the immunity of lepromatous patients. Our article cited the work of Hastings and Job,<sup>1</sup>who treated four lepromatous patients and one borderline patient with transfer factor obtained from approximately 7.4×10<sup>9</sup>lymphocytes given in 36 divided doses during 12 weeks. Clinical reversal reactions (immunologic upgrading) were observed in the four lepromatous patients but not in the borderline patient.<sup>2</sup>Histopathologically, skin biopsy specimens of the four lepromatous patients showed a reduction of acid-fast bacilli and proliferation of epithelioid and giant cells. In one lepromatous patient, the reversal reaction persisted 14 months after the injections were stopped. In two lepromatous patients, they continued to appear four to 28 months after the last transfer factor injection was given. In the remaining lepromatous patient, the reversal reaction continued five months after the last injection,
Pramlintide as an Adjunct to Insulin Therapy Improves Long-Term Glycemic and Weight Control in Patients With Type 2 Diabetes
Authors: Priscilla A. Hollander, Philip Levy, Mark S. Fineman, David G. Maggs, Larry Z. Shen, Susan A. Strobel, Christian Weyer, Orville G. Kolterman
Journal: Diabetes Care (2003)

OBJECTIVE—Mealtime amylin replacement with the human amylin analog pramlintide, as an adjunct to mealtime insulin replacement, reduces postprandial glucose excursions in patients with type 2 diabetes. The aim of the present study was to assess the long-term efficacy and safety of pramlintide in this patient population. RESEARCH DESIGN AND METHODS—In a 52-week, double-blind, placebo-controlled, parallel-group, multicenter study, 656 patients with type 2 diabetes (age 57 ± 10 years, diabetes duration 12 ± 7 years, BMI 34.0 ± 7.0 kg/m2, HbA1c 9.1 ± 1.2%, mean ± SD) treated with insulin (alone or in combination with sulfonylureas and/or metformin) were randomized to receive additional preprandial subcutaneous injections of either placebo or pramlintide (60 μg TID, 90 μg BID, or 120 μg BID). RESULTS—Treatment with pramlintide 120 μg BID led to a sustained reduction from baseline in HbA1c (−0.68 and −0.62% at weeks 26 and 52, respectively), which was significantly greater than that seen with placebo (P &amp;lt; 0.05). The proportion of patients achieving an HbA1c &amp;lt;8% was approximately twofold greater with pramlintide (120 μg BID) than with placebo (46 vs. 28%, P &amp;lt; 0.05). The glycemic improvement with pramlintide 120 μg BID was accompanied by a mean weight loss (−1.4 kg vs. +0.7 kg with placebo at week 52, P &amp;lt; 0.05) and occurred without an overall increase in the severe hypoglycemia event rate. The most common adverse event associated with pramlintide use was transient, mild-to-moderate nausea. CONCLUSIONS—Mealtime amylin replacement with pramlintide 120 μg BID, as an adjunct to insulin therapy, improves long-term glycemic and weight control in patients with type 2 diabetes.
Why patients should complain
Authors: K. Patel
Journal: BMJ (2010)

I’ve started a new job. I’m excited, full of anticipation, and slightly nervous, learning what the consultants are like, where the canteen is, and how to arrange a liver biopsy. Unfortunately what inevitably accompanies this is the inanity of the induction. It’s one of the tribulations of being a junior doctor, moving from hospital to hospital at the whim of the deanery.

Yes: I know it’s a mortal offence to label a blood transfusion sample with a preprinted label (punishable by several gallons of vitriol poured down the telephone from haematology). Yes: …
A Reappraisal of Exercise Electrocardiographic Indexes of the Severity of Ischemic Heart Disease: Angiographic and Scintigraphic Correlates
Authors: Peter Bogaty, Jean Guimond, N-Michelle Robitaille, Léon Rousseau, Serge Simard, Jacques R Rouleau, Gilles R Dagenais
Journal: Journal of the American College of Cardiology (1997)
Choice of bone marrow donors could improve
Authors: A. Berger
Journal: BMJ (1998)

The identification of the DNA structure of a cell surface antigen may help to improve the selection of suitable donors of bone marrow transplants.

Despite careful matching of donors and recipients, up to 30% of people who undergo sibling bone marrow transplants suffer severe graft versus host disease. The disease occurs when donor cytotoxic T lymphocytes attack host organs such as the skin, gut, and liver, and it can be fatal. Immunologists in the Netherlands and the United States have identified the DNA structure of a cell surface antigen, which is the only one so far recognised to correlate with the development of …
Fungal Levels in the Home and Lower Respiratory Tract Illnesses in the First Year of Life
Authors: Paul C. Stark, Harriet A. Burge, Louise M. Ryan, Donald K. Milton, Diane R. Gold
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

The association between home dampness and lower respiratory symptoms in children has been well documented. Whether fungal exposures contribute to this association is uncertain. In a prospective birth cohort of 499 children of parents with asthma/allergies, we examined in-home fungal concentrations as predictors of lower respiratory illnesses (LRI) (croup, pneumonia, bronchitis, and bronchiolitis) in the first year. In multivariate analyses, we found a significant increased relative risk (RR) between LRI and high levels (more than the 90th percentile) of airborne Penicillium (RR = 1.73, 95% confidence interval [CI], 1.23, 2.43), dust-borne Cladosporium (RR = 1.52; CI, 1.02, 2.25), Zygomycetes (RR = 1.96; CI, 1.35, 2.83), and Alternaria (RR = 1.51; CI, 1.00, 2.28), after controlling for sex, presence of water damage or visible mold/mildew, born in winter, breastfeeding, and being exposed to other children through siblings. In a multivariate analysis, the RR of LRI was elevated in households with any fungal level at more than the 90th percentile (RR = 1.86; CI, 1.21, 2.88). Exposure to high fungal levels increased the risk of LRI in infancy, even for infants with nonwheezing LRI. Actual mechanisms remain unknown, but fungi and their components (glucans, mycotoxins, and proteins) may increase the risk of LRI by acting as irritants or through increasing susceptibility to infection.
THE EFFECTS OF UPHILL TREADMILL RUNNING AND COLLAGENASE ON RODENT ACHILLES TENDONS
Authors: R C Dirks, A M Fearon, A Scott, M R Galley, L G Koch, S L Britton, S J Warden
Journal: British Journal of Sports Medicine (2013)

Introduction Overuse conditions of the Achilles tendon likely develop due to a combination of extrinsic and intrinsic risk factors. The purpose of this study was to investigate the individual and combined effects of uphill treadmill running (extrinsic risk factor) and collagenase injection (intrinsic risk factor) on the histological appearance of rodent Achilles tendons. Previous studies have shown that collagenase injection leads to inflammation of the tendon,1 while exercise can lead to adaptation and tendon hypertrophy.2 Our hypothesis was that collagenase injection would result in initial tendon inflammation which would become degenerative when combined with mechanical loading. Methods Twenty-four mature high-capacity running rats were studied. All rats received a collagenase injection into one Achilles tendon at baseline. After 1 week, animals were randomly divided into either a run or cage-control group. The run group ran on a treadmill at a 15° incline, 5 days/week at increasing duration and speed. Tendons were harvested at either 4 or 10 weeks after the start of the running regimen. Specimens were fixed in formalin and embedded in paraffin. H&amp;E stained sections were evaluated using a modified Bonar scale by two blinded and independent assessors, with a third to resolve disputes. Results At 4 weeks, higher levels of pathology were seen in the injected tendons than in the non-injected tendons (ANOVA: p=0.007). No side to side difference was seen at 10 weeks (ANOVA: p=0.309). There was no difference between running and non-running groups at 4 weeks (ANOVA: p=0.579) or 10 weeks (ANOVA: p=0.429). No interaction effects were seen between injection and running at 4 weeks (ANOVA: p=0.934) or 10 weeks (ANOVA: p=0.847). Discussion In high capacity running rats, uphill treadmill running using these experimental parameters did not independently create histopathology of the Achilles tendon. Furthermore, the effect of collagenase did not have a long-term effect and was not influenced by running. Therefore, the combination of collagenase injection and uphill treadmill running does not seem to create a histological presentation similar to the degeneration seen in human Achilles tendinopathy.
Hyperglycaemia is associated with poor outcomes in patients admitted to hospital with acute exacerbations of chronic obstructive pulmonary disease
Authors: E H Baker
Journal: Thorax (2006)

Hyperglycaemia is associated with poor outcomes from pneumonia, myocardial infarction and stroke, but the effect of blood glucose on outcomes from acute exacerbations of chronic obstructive pulmonary disease (AECOPD) has not been established. Recent UK guidelines do not comment on measurement or control of blood glucose in AECOPD. A study was therefore undertaken to determine the relationship between blood glucose concentrations, length of stay in hospital, and mortality in patients admitted with AECOPD.Data were retrieved from electronic records for patients admitted with AECOPD with lower respiratory tract infection in 2001-2. The patients were grouped according to blood glucose quartile (group 1, <6 mmol/l (n = 69); group 2, 6.0-6.9 mmol/l (n = 69); group 3, 7.0-8.9 mmol/l (n = 75); and group 4, >9.0 mmol/l (n = 71)).The relative risk (RR) of death or long inpatient stay was significantly increased in group 3 (RR 1.46, 95% CI 1.05 to 2.02, p = 0.02) and group 4 (RR 1.97, 95% CI 1.33 to 2.92, p < 0.0001) compared with group 1. For each 1 mmol/l increase in blood glucose the absolute risk of adverse outcomes increased by 15% (95% CI 4 to 27), p = 0.006. The risk of adverse outcomes increased with increasing hyperglycaemia independent of age, sex, a previous diagnosis of diabetes, and COPD severity. Isolation of multiple pathogens and Staphylococcus aureus from sputum also increased with increasing blood glucose.Increasing blood glucose concentrations are associated with adverse clinical outcomes in patients with AECOPD. Tight control of blood glucose reduces mortality in patients in intensive care or following myocardial infarction. A prospective study is now required to determine whether control of blood glucose can also improve outcomes from AECOPD.
Continuing medical education for BMJ readers
Authors: S. Kawczak, K. Patrick
Journal: BMJ (2010)

Obtain CME credits through a new collaboration between the BMJ and Cleveland Clinic

The BMJ has joined forces with the Cleveland Clinic to offer certified continuing medical education (CME) credits to all of its readers. We hope that this collaboration will benefit doctors and other health professionals around the world. 

Both parties in the collaboration have long histories of involvement in the education of doctors. We share a common vision: to improve patient outcomes by engaging and informing health professionals with the latest research, policy, and best practice in medicine.

The BMJ ’s mission is to lead the debate on health and to engage, inform, and stimulate doctors, researchers, and other health professionals in ways that will improve outcomes for patients. When deciding what articles to publish our aim is to help doctors make better decisions. 

The Cleveland Clinic’s Center …
Genetic structure and heterogeneity of hepatitis C virus: A vaccine impediment?
Authors: Daryl Daugherty
Journal: Hepatology (1992)

The nucleotide sequence of the RNA genome of the human hepatitis C virus (HCV) has been determined from overlapping cDNA clones. The sequence (9379 nucleotides) has a single large open reading frame that could encode a viral polyprotein precursor of 3011 amino acids. While there is little overall amino acid and nucleotide sequence homology with other viruses, the 5′ HCV nucleotide sequence upstream of this large open reading frame has substantial similarity to the 5′ termini of pestiviral genomes. The polyprotein also has significant sequence similarity to helicases encoded by animal pestiviruses, plant potyviruses, and human flaviviruses, and it contains sequence motifs widely conserved among viral replicases and trypsin–like proteases. A basic, presumed nucleocapsid domain is located at the N terminus upstream of a region containing numerous potential N–linked glycosylation sites. These HCV domains are located in the same relative position as observed in the pestiviruses and flaviviruses and the hydrophobic profiles of all three viral polyproteins are similar. These combined data indicate that HCV is an unusual virus that is most related to the pestiviruses. Significant genome diversity is apparent within the putative 5′ structural gene region of different HCV isolates, suggesting the presence of closely related but distinct viral genotypes. The nucleotide sequences of cDNAs (275 base–pairs) in the non–structural protein 5 regions of Japanese isolates of hepatitis C virus (HCV–J) from the plasma of 11 patients with non–A, non–B hepatitis and the livers of five patients with hepatocellular carcinoma were analyzed. Approximately 14 to 17% of nucleotide sequences of the HCV–Js examined differed from that of the original isolate in the United States (HCV–US). Furthermore, 2.5 to 11% sequence diversity was found among the HCV–Js. The nucleotide sequences of the HCV–Js showed characteristic common differences from that of HCV–US, although they also showed some random substitutions. Plural HCV–J genomes were found in two of the cDNAs derived from liver specimens, and a deletion of 102 nucleotides was found in the eDNA derived from one plasma specimen. These results suggest that HCV–J is a strain different from the HCV–US and that mutation of the viral genome occurs at as high a frequency as in that of the human immunodeficiency virus.
CD4 T cell count as predictor of Pneumocystis carinii pneumonia in children born to mothers infected with HIV
Authors: D Dunn, M L Newell, T Ades, C Peckham, A D Maria
Journal: BMJ (1994)

<h3>Abstract</h3> <b>Objective</b> : To assess the value of CD4 T cell count in predicting Pneumocystis carinii pneumonia in infants born to mothers infected with HIV, with reference to the guidelines from the Centers for Disease Control on prophylaxis against pneumocystis. <b>Design</b> : Prospective birth cohort study. <b>Setting</b> : Hospitals in 10 European cities participating in the European collaborative study. <b>Subjects</b> : 924 children born to mothers known to be infected with HIV at or before delivery. Main outcome measures - The incidence of P carinii pneumonia. CD4 T cell counts in children before diagnosis of the pneumonia. The proportions of children infected and uninfected with HIV who fulfilled the criteria for primary prophylaxis. <b>Results</b> : Fourteen children were diagnosed with P carinii pneumonia. The cumulative incidence by the age of 6 years was 2% (95% confidence interval 0.9 to 3.0%). Of the 11 children with a CD4 T cell count predating diagnosis, only three fulfilled the criteria from the Centers for Disease Control for prophylaxis. Prophylaxis was indicated by 1 year of age for 62% of infected children who had not developed P carinii pneumonia and for at least 10% of uninfected children. <b>Conclusions</b> : Monitoring CD4 T cell count seems to be of limited value in deciding when to start prophylaxis against P carinii pneumonia in children born to mothers infected with HIV. The alternative approach of giving prophylaxis to all children born to infected mothers would be difficult to justify given the low incidence of the pneumonia.
Interferon-producing killer dendritic cells provide a link between innate and adaptive immunity
Authors: Camie W Chan, Emily Crafton, Hong-Ni Fan, James Flook, Kiyoshi Yoshimura, Mario Skarica, Dirk Brockstedt, Thomas W Dubensky, Monique F Stins, Lewis L Lanier, Drew M Pardoll, Franck Housseau
Journal: Nature Medicine (2006)
Air is Food; Nitrogen; Correction.
Authors: Ephraim Cutter
Journal: JAMA (1898)

New York City. <h3>To the Editor:</h3> —In your issue of Feb. 12, 1898, there were omissions in "Air is Food; Nitrogen": page 365, column 1, lines 46 to 52; page 366, column 1, lines 1 to 5, 6 to 9, 16 to 20, 25 to 29, 34 to 39. These were quotations from the late Dr. W. Thornton of Boston. My explanation is that said quotations were in Prof. W. B. McVey's contribution and that I did not know they were Dr. Thornton's. Professor McVey says that he thought he had given credit. As he is now investigating N. on these lines, it is to be hoped that Dr. E. C. Hebbard of Boston (who kindly brought the matter to my attention and whom I thank), and all who feel that N. is not given its due dynamic influence, will work together, especially now when the whole world has been
BERIBERI, ITS ETIOLOGY AND PREVENTION.
Authors: LOUIS H. FALES
Journal: JAMA (1907)

Beriberi being a disease more particularly of the tropics and rarely seen in America, it may be well at the beginning of this paper to give a short description of the disease, so that those who are unfamiliar with its manifestations may bear in mind a picture of its principal characteristics. <h3>PATHOLOGY.</h3> Beriberi may be described as an acute or subacute infectious disease occurring endemically or epidemically usually in tropical countries. Its chief characteristic is a sensory-motor paralysis due to an involvement of the peripheral terminations of the sensory and motor nerves. The peripheral terminations are usually affected in the following order: The terminations of the vagus in the heart and lungs, the cardiac accelerator, those which have to do with the knee jerk, the branches of the peronei and anterior tibial, the muscles of leg and thigh, the extensors of the wrists and fingers, etc. After an incubation period