tbuckley/cabot-search huggingface dataset:
Metabolic Control Is Not Altered When Using Indwelling Catheters for Insulin Inactions
Authors: S Ragnar Hanas, Johnny Ludvigsson
Journal: Diabetes Care (1994)

OBJECTIVE To determine if the use of indwelling catheters for insulin injections affects the long- and short-term metabolic control of insulin-dependent diabetes mellitus (IDDM). RESEARCH DESIGN AND METHODS Sixteen children and adolescents 9–20 years of age were included in a randomized 10-week crossover study using indwelling catheters (Insuflon, Pharma-Plast, Lynge, Denmark; CHRONIMED, Minnetonka, Minnesota) for insulin injections. Their diabetes duration was 7.5 ± 3.3 years (range 2–14), and they used multiple injection therapy with 4–5 doses/day. C-peptide was &amp;lt;0.15 nM fasting and ≤0.30 nM postprandial. RESULTS We found no significant difference between those with and without Insuflon in degree of metabolic control reflected by HbA1c (with Insuflon, 7.3 ± 2.6%; without, 7.1 ± 2.2%), 24-h profiles of blood glucose and free insulin, 24-h samples of glucosuria, or ketonuria. Weight, insulin doses per kilogram per 24 h, and insulin antibodies were all the same in the two groups. CONCLUSIONS The long- and short-term metabolic control of IDDM was not altered by the use of indwelling catheters for insulin injections. Insuflon can be offered as an alternative to patients with IDDM who find regular injections uncomfortable.
488 EFFECT OF INTRA-OPERATIVE METHYLPREDNISOLONE ON POST LIVER TRANSPLANT (LT) INTENSIVE CARE UNIT (ITU) COURSE – FURTHER EVIDENCE FOR THE EXISTENCE OF HEPATO-ADRENAL SYNDROME?
Authors: S. Patel, R. Broomhead, A.K. Burroughs, S.V. Mallett, J. O'Beirne
Journal: Journal of Hepatology (2010)
Esophagoaortal Hiatus Hernia
Authors: Herbert D. Adams, Allan W. Lobb
Journal: New England Journal of Medicine (1954)

THE literature is replete with excellent accounts of the clinical aspects and the surgical management of all of the classic types of diaphragmatic hernia. With the excellent contributions of Harrington, Sweet, Allison and others available, it is not the purpose of this paper to restudy this entire subject. We wish to review only briefly our cases of diaphragmatic hernia of all types as a background for the description of a special type of diaphragmatic hernia. During the past five years we have come to recognize a new and distinct type, which we prefer to designate as esophagoaortal hiatus hernias.Table 1 presents . . .
Poverty gap for cancer survival widens
Authors: Katherine Burke
Journal: BMJ (2004)

The poverty gap for cancer survival in England and Wales widened throughout the 1990s, despite official efforts to help poor patients to access the best care, a government backed analysis of patient records shows.

Reporting in an advance online publication in the British Journal of Cancer this week (http://dx.doi.org/10.1038/sj.bjc.6601696), the researchers found that poor men and women have a significantly lower chance of surviving almost two in three of the most common cancers than their richer counterparts. And that gap is widening, according to the research, funded by the Office for …
ASSESSMENT OF RIGHT VENTRICULAR FUNCTION WITH LONGITUDINAL TWO DIMENSIONAL STRAIN: COMPARISON BETWEEN LOW AND INTERMEDIATE RISK PULMONARY EMBOLISM
Authors: Vincent DESCOTES GENON, Romain Chopard, Mathilde Morel, Joanna Dutheil, Nicolas Meneveau, Marie-France Seronde, Francois Schiele, Yvette Bernard
Journal: Journal of the American College of Cardiology (2010)
Xiphoid horn in pectus excavatum
Authors: E. F. Skinner
Journal: Thorax (1969)

In pectus excavatum there may be a cartilaginous horn on the inner surface of the xiphoid process rubbing on the heart, or the xiphoid process may be tipped inward, rubbing on the heart and causing anginoid pain. Being cartilaginous, these protrusions of the xiphoid cartilage are not visible on preoperative radiographs. Eight per cent of pectus excavatum patients have organic heart disease (Reusch, 1961). Funnel chest may cause anginoid pain (Poppe, 1965) which can be relieved surgically.
PTU-192 Role of the 75Sehcat Scan in Evaluating Chronic Diarrhoea
Authors: G Diana, A Jawhari
Journal: Gut (2013)

<h3>Introduction</h3> 75Se-HCAT nuclear medicine scanning is used to diagnose Bile Salt Malabsorption (BAM) in patients with chronic diarrhoea. Previous studies suggest that 30–60% of patients with previously unexplained chronic diarrhoea have impaired bile salt absorption <sup>(1,2).</sup>The aim of this study was to evaluate the prevalence of Bile salt malabsorption among patients with chronic diarrhoea, referred for 75SeHCAT scanning, and to evaluate the outcome of treatment with bile salt sequestrants in these patients. <h3>Methods</h3> This was a retrospective audit of patients tested in Nottingham University Hospital in 2011. The patient was given an oral dose of 370 kBq Selenium-75-Tauroselcholic acid, a radiolabelled bile acid analogue. The patient was scanned 7 days later to assess %age of radioactive dose retained. Retention of &lt; 15% was considered to be abnormal. This was further defined as mild (10–15%), moderate (5–10%) and severe ( &lt; 5%). <h3>Results</h3> N = 130 patients, medican age 49 yrs, F:M = 1.8:1. The clinical indication for scanning was chronic diarrhoea in all cases (mean 6 bowel actions per day, range 1 to 18). 65 patients (50%) had impaired salt retention. These included 11 with type I disease (Ileal resection or disease), 30 with type 2 disease (idiopathic) and 24 with type 3 disease (miscellaneous disorders eg diabetes or cholecystectomy). Interestingly only 47% of patients with previous terminal ileal resections had a positive 75SeHCAT scan. 47% of those patients with no predisposing factors in their history also had positive scans. 84% of cases with positive test responded to treatment with bile acid sequestrants. The response appeared to be independent from severity of BAM (p = 0.27) or seveity of diarrhoea (p = 0.28). In one third of cases the treatment was discontinued even though clinically effective, most commonly due to poor patient tolerance to its unpleasant taste. <h3>Conclusion</h3> The prevalence of BAM is high in patients suffering from chronic diarrhoea, both where a feasible organic precipitant is present (eg previous ileal resection), and where a functional disorder such as IBS was thought to be the likely diagnosis. BAM carries no specific symptoms or markers that can help the physician identify the condition. Bile acid sequestrants are effective, but often not well tolerated. SeHCAT scanning gives objective results and can potentially increase compliance to treatment. <h3>Disclosure of Interest</h3> None Declared. <h3>References</h3> S Pattini, JRF Walters. Recent advances in understanding of bile acid malabsorption. British Medical Bulletin 2009; 92:79–93. Marta K. Borghede, Jacob M Schlutter, Jorgen S Agnholt, Lisbet A Christensen, Lars C Gromsen, Jens F Dahlerup. Bile acid malabsorption investigated by selenium-75-homocholic acud taurin scans: Cases and treatment responses to cholestyramin in 298 patients with chronic water diarrhoea. Eur J Intern Med. 2011 Dec; 22(6):e137–40.
Assessing coronary risk
Authors: J. S Yudkin
Journal: BMJ (1995)

produce a tarry stool.2If there are, as it would be reasonable to expect, a fairly large number of small gastrointestinal bleeds then those who were alerted about what to look for could expect to detect a few more.Aspirin prophylaxisis is only recommended to be undertaken on medical advice.Presumably most doctors giving such advice would wam the patient of possible gastrointestinal bleeding and give advice on reporting it, if it occurs.The control groups would not be expected to have had similar advice.John Weil and colleagues could throw light on whether this confounding factor could be material to their results, by showing the breakdown of melaena and haematemesis in each of the three groups they studied.
Cardiac Involvement in Rheumatoid Arthritis
Authors: ABDEL-MOHSEN NOMEIR
Journal: Annals of Internal Medicine (1973)

The nature and extent of cardiac involvement in 30 patients with classic rheumatoid arthritis were studied. Physical examination showed no significant cardiac abnormalities in these patients. Electrocardiograms showed nonspecific ST-T-wave changes in six patients, left ventricular preponderance in two, and evidence of an old inferior myocardial infarction in one. Echocardiography demonstrated pericardial effusion, thickening, or both, in 14 patients (46.6%) and mitral valve abnormalities in 9 patients (30%). Vectorcardiography showed that the mean QRS voltage values in the patients with pericardial involvement were not significantly abnormal. This study has shown that a large number of rheumatoid arthritis patients have pericardial or mitral valve abnormalities, or both. Although there was no relation between the different modalities of study, echocardiography was the most sensitive method of detecting early cardiac involvement in patients with rheumatoid arthritis.
Sponsorship, Authorship, and Accountability
Authors: Alan F. Holmer
Journal: Annals of Internal Medicine (2002)

Letters5 February 2002Sponsorship, Authorship, and AccountabilityAlan F. Holmer, JDAlan F. Holmer, JDPharmaceutical Research and Manufacturers of AmericaWashington, DC 20005Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-136-3-200202050-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Academic researchers must have complete freedom to participate in and approve all aspects of industry-sponsored clinical trials, including any publication resulting from such a trial. The Pharmaceutical Research and Manufacturers of America encourages all authors to abide by the new rules outlined in the editorial by the International Committee of Medical Journal Editors (1).That having been said, the editorial has serious defects. Its biased tone slights the vital contributions of our industry to the clinical trial process. Throughout the editorial, the integrity of academic investigators is assumed, while the industry's integrity is constantly questioned. The editorial ...Reference1. Davidoff F, DeAngelis CD, Drazen JM, Hoey J, Hojgaard L, Horton R, et al . Sponsorship, authorship, and accountability [Editorial]. Ann Intern Med. 2001;135:463-6. [PMID: 11560460] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Pharmaceutical Research and Manufacturers of AmericaWashington, DC 20005 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSponsorship, Authorship, and Accountability Frank Davidoff , Catherine D. DeAngelis , Jeffrey M. Drazen , John Hoey , Liselotte Højgaard , Richard Horton , Sheldon Kotzin , Magne Nylenna , A. John P.M. Overbeke , Harold C. Sox , Martin B. Van Der Weyden , Michael S. Wilkes , and Sponsorship, Authorship, and Accountability, , , , , , and Sponsorship, Authorship, and Accountability Metrics Cited ByThe Pharmaceutical Industry's Use of Gifts and Educational Events to Influence Prescription Practices: Ethical Dilemmas and Implications for Psychologists. 5 February 2002Volume 136, Issue 3Page: 251KeywordsClinical trialsDrug research and development ePublished: 5 February 2002 Issue Published: 5 February 2002 CopyrightCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Expression profile of leukocyte genes activated by anti-neutrophil cytoplasmic autoantibodies (ANCA)
Authors: Jia Jin Yang, Gloria A. Preston, David A. Alcorta, Iwao Waga, William E. Munger, Susan L. Hogan, Stephen B. Sekura, Brian D. Phillips, Robin P. Thomas, J. Charles Jennette, Ronald J. Falk
Journal: Kidney International (2002)
Tuberculous pulmonary pneumatocele communicating extrathoracically
Authors: D D Duttaroy
Journal: Thorax (2006)

A 40 year old man presented with swelling over his right upper chest for the previous 8 months. He had also had low grade fever, cough with mucoid expectoration, weight loss, and breathlessness on exertion for 2 months. The swelling initially appeared in the right infraclavicular region and gradually increased in size. The swelling could be decreased in size on application of local pressure, but it regained its original size when the pressure was released. He had been treated elsewhere for pulmonary tuberculosis (TB) 3 …
A Randomized Trial of Low-Air-Loss Beds for Treatment of Pressure Ulcers
Authors: Bruce A. Ferrell
Journal: JAMA (1993)

To assess the effectiveness of low-air-loss beds for the treatment of pressure ulcers in nursing homes.Prospective, randomized, clinical trial.Three teaching nursing homes in Los Angeles, Calif.Eighty-four nursing home residents with trunk or trochanter pressure ulcers (Shea stage > or = 2).Subjects were randomly assigned to use either a low-air-loss bed (n = 43) or a 10-cm corrugated foam mattress (n = 41) throughout the healing of their ulcers.Ulcers were assessed twice weekly using surface area and two observational scales (median follow-up, 37.5 days; range, 4 to 571 days).Groups were similar with respect to demographics, medical variables, wound care, and early dropouts. Results indicate more than a threefold improvement in median rate of healing for low-air-loss beds compared with foam mattresses (9.0 vs 2.5 mm2/d; P = .0002). This finding was true for deep as well as superficial ulcers (deep ulcers, 9.9 vs 0.7 mm2/d; P = .02; superficial ulcers, 9.0 vs 3.2 mm2/d; P = .004). Cox regression models revealed that the bed, ulcer depth, and fecal continence had independent effects on healing. After controlling for fecal continence, the deep and superficial subgroups using low-air-loss beds remained 2.5 times more likely to heal in a given length of time compared with those using foam mattresses (combined cure probability ratio, 2.66; 95% confidence interval, 1.34 to 5.17; P < .004).Low-air-loss beds provide substantial improvement compared with foam mattresses despite other factors in pressure ulcer healing.
Digoxin reduces beta-adrenergic contractile response in rabbit hearts. Ca(2+)-dependent inhibition of adenylyl cyclase activity via Na+/Ca2+ exchange.
Authors: K Nagai, T Murakami, T Iwase, T Tomita, S Sasayama
Journal: Journal of Clinical Investigation (1996)

Whereas mobilization of intracellular Ca2+ stimulates neuronal adenylyl cyclase via Ca2+/calmodulin, mobilized Ca2+ directly inhibits adenylyl cyclase in other tissues. To determine the physiologic role of the Ca(2+)-dependent interaction between Na+/Ca2+ exchange and beta-adrenergic signal transduction in the intact heart, digoxin (0.3 mg/kg) was administered intravenously in rabbits. 30 min after the administration, digoxin impaired the peak left ventricular dP/dt response to dobutamine infusions by up to 38% as compared with control rabbits. This impairment was not caused by changes in either beta-adrenergic receptor number or in the functional activity of stimulatory guanine nucleotide-binding protein. It was associated with 33-36% reductions in basal and stimulated adenylyl cyclase activities. Animals treated with calcium gluconate (20 mg/kg/min for 30 min) also demonstrated similar reductions in adenylyl cyclase activities. In addition, increasing the free Ca2+ concentration progressively inhibited adenylyl cyclase activity in the control, digoxin-treated, and calcium gluconate-treated sarcolemma preparations in vitro. Moreover, digoxin and calcium gluconate pretreatment blunted the increase in cAMP in myocardial tissue after dobutamine infusion in vivo. Thus, digoxin rapidly reduces beta-adrenergic contractile response in rabbit hearts. This reduction may reflect an inhibition of adenylyl cyclase by Ca2+ mobilized via Na+/Ca2+ exchange.
Results from Scottish emergency care summary
Authors: L. M. M. Morris, J. Cameron, C. Brown, J. C. Wyatt
Journal: BMJ (2010)

<h3>Abstract</h3> <b>Objective</b> To assess the extent to which the prevailing model of smoking cessation (that smokers typically prepare their attempts to stop smoking in advance and that doing so increases their chances of success) is correct. <b>Design</b> Cross sectional household survey. <b>Setting</b> England. <b>Participants</b> 918 smokers who reported having made at least one quit attempt and 996 ex-smokers aged 16 and over. <b>Main outcome measures</b> Whether the most recent quit attempt was planned in advance and whether quit attempts made at least six months before resulted in at least six months9 abstinence. <b>Results</b> 48.6% of smokers reported that their most recent quit attempt was put into effect immediately the decision to quit was made. Unplanned quit attempts were more likely to succeed for at least six months: among respondents who had made a quit attempt between six months and five years previously the odds of success were 2.6 times higher (95% confidence interval 1.9 to 3.6) in unplanned attempts than in planned attempts; in quit attempts made 6-12 months previously the corresponding figure was 2.5 (1.4 to 4.7). The differences remained after controlling for age, sex, and socioeconomic group. <b>Conclusions</b> A model of the process of change based on “catastrophe theory” is proposed, in which smokers have varying levels of motivational “tension” to stop and then “triggers” in the environment result in a switch in motivational state. If that switch involves immediate renunciation of cigarettes, this can signal a more complete transformation than if it involves a plan to quit at some future point.
Weight-based determination of fluid overload status and mortality in pediatric intensive care unit patients requiring continuous renal replacement therapy
Authors: David T. Selewski, Timothy T. Cornell, Rebecca M. Lombel, Neal B. Blatt, Yong Y. Han, Theresa Mottes, Mallika Kommareddi, David B. Kershaw, Thomas P. Shanley, Michael Heung
Journal: Intensive Care Medicine (2011)
Legionnaires' disease not limited to lungs
Authors: Phil Gunby
Journal: JAMA (1980)

Much of the mystery has been stripped from Legionnaires' disease since its startling appearance in 1976, but the emerging clinical picture is no less ominous in several respects. Recent reports indicate that systemic spread from the lungs is more common than previously thought, that there may be more than 71,000 deaths in adults from unrecognized Legionnaires' disease in the United States annually (<i>JAMA</i>1980;243:2311-2313), and that diagnosis remains a challenge. The latest findings on systemic dissemination indicate that<i>Legionella pneumophila</i>spreads from the lungs to other organs in about one of every four patients, especially if there is concurrent disease. This conclusion comes from a retrospective study of 23 fatal cases of Legionnaires' disease conducted by Dennis D. Weisenburger, MD, Charles M. Helms, MD, PhD, and Edward D. Renner, PhD, and presented to the joint St Louis meeting of the College of American Pathologists and the American Society of Clinical
A Vigorous New Specialty
Authors: Leonard M. Riggs
Journal: New England Journal of Medicine (1981)

At the 1973 American Medical Association Conference on the Education of Emergency Physicians, non-emergency physicians met officially for the first time to discuss the possibility that emergency medicine might emerge as the next medical specialty. It did indeed attain that status, and it did so within a comparatively short time: the American Board of Medical Specialties recognized emergency medicine in September 1979, the American Board of Emergency Medicine offered its certifying examination for the first time in 1980, and there are now 248 board-certified emergency physicians. We anticipate many more.Those involved in emergency medicine's quest for specialty recognition in . . .
Tissue localization and kinetics of pit cells or large granular lymphocytes in the liver of rats treated with biological response modifiers
Authors: Luc Bouwens, Eddie Wisse
Journal: Hepatology (1988)

The numbers of Kupffer cells (macrophages) and pit cells (large granular lymphocytes) were counted by light and electron microscopy in perfusion-fixed liver sinusoids. After a single intravenous injection of the biological response modifiers zymosan, Propionibacterium acnes and OK-432, a 4- to 6-fold increase in the number of pit cells and a 2- to 4-fold increase in the number of Kupffer cells were observed within a period of 4 to 7 days. The mechanisms of the pit cell accumulation were further studied by the metaphase arrest method and by selective irradiation of the liver, or of the rest of the body, with a dose of 8.5 Gy. Stimulated pit cells showed mitotic activity in the liver and to a lesser extent in peripheral blood. The zymosan-induced increase in pit cell number was inhibited by irradiation of the liver but not by irradiation of the rest of the body (with shielded liver). It is concluded that the hepatic pit cell population, which has been shown to have natural tumoricidal activity, can be induced to expand by biological response modifiers, and local division of preexisting cells contributes significantly to this expansion.
THE HEALING OF RICKETS COINCIDENT WITH LOW SERUM INORGANIC PHOSPHORUS
Authors: Genevieve Stearns, Julian D. Boyd
Journal: Journal of Clinical Investigation (1931)

Within the past year, roentgenological evidence of healing of rickets coincident with a persistently low level of serum inorganic phosphorus has been observed in 2 children.These findings are of importance in relation to the theories of bone formation.The subjects of the study were 2 girls of 12 and 13 years of age, respectively, both of whom showed roentgenological, clinical and chemical evidence of active rickets.The serum calcium values of both children were within normal limits, the serum inorganic phos- phorus markedly depressed.The children were given dietary treat- ment and kept under observation for a period of several months.During this time roentgenological evidence of marked healing of the bone was observed, but the serum inorganic phosphorus of each child remained essentially at the same low level. METHODSBlood was drawn before breakfast and the serum separated from the clot as rapidly as possible.Calcium was determined by the method of Kramer and Tisdall (1), allowing the serum to stand 24 hours after the addition of the oxalate.The method of Fiske and Subbarow (2) was used for inorganic phosphorus: protein was determined by micro- Kjeldahl (3).All possible precautions were taken in order to insure accuracy in the determinations.RESULTS AND DISCUSSION Blood and metabolic studies of the 2 children were made at intervals during a period of several months.The values obtained for serum 591 LOW SERUM PHOSPHORUS IN HEALING RICKETS calcium and phosphorus are given in table I. Reproductions of the roentgenograms of the bones are shown in figures 1 and 2. The films, as interpreted by representatives of the departments of roentgenology, orthopedics, and pediatrics, show marked evidence of progressive healing.
Dr. René J. Dubos—A Tribute
Authors: Selman A. Waksman
Journal: JAMA (1960)

Dr. René Jules Dubos was born in Saint Brice, France, on Feb. 20, 1901. He studied agriculture at the Institut National Agronomique in Paris between 1919 and 1921, followed by another year at the Institut de Recherches Agronomiques. He came to the United States in 1924. He received his Ph.D. at Rutgers University in 1927. The universities that bestowed honorary degrees upon him include the University of Rochester, in 1941; Harvard University, in 1942; Rutgers University, in 1949; Paris University, in 1950; the New School for Social Research, in 1956; and an honorary M.D. from Liège University. His first assignment in the United States was as a research assistant in soil microbiology at the New Jersey Experiment Station at Rutgers University between 1924 and 1927. This was followed by a fellowship at the Rockefeller Institute for Medical Research in 1927. He remained at the Institute until 1942. In that year