tbuckley/cabot-search huggingface dataset:
Comparison of Human Regular and Lispro Insulins After Interruption of Continuous Subcutaneous Insulin Infusion and in the Treatment of Acutely Decompensated IDDM
Authors: Najya Attia, Timothy W Jones, John Holcombe, William V Tamborlane
Journal: Diabetes Care (1998)

OBJECTIVE To compare the rapidity of metabolic decompensation after interruption of CSII between human regular and lispro insulin and to compare these two insulins in the correction of the hyperglycemia and ketosis of mildly decompensated IDDM. Lispro insulin may be especially useful for insulin pump therapy (continuous subcutaneous insulin infusion [CSII]). RESEARCH DESIGN AND METHODS A total of 18 patients with well-controlled IDDM (HbA1c 7.7 ± 1.1%, age 30 ± 11 years) were studied. All were being treated with CSII (nine with human regular and nine with lispro insulin). The study consisted of two phases: 1) an insulin interruption phase, in which the basal insulin infusion was stopped (at 0300) and plasma insulin, glucose, and β-O-hydroxybutyrate (β-OHB) were measured every 15–60 min for 6 h after interruption of the insulin infusion and 2) an insulin replacement phase, which involved measuring plasma insulin, glucose, and (β-OHB for 2 h after a single injection of either human regular or lispro insulin to correct the hyperglycemia and ketosis that developed during the first phase of the study. RESULTS After interruption of the basal insulin infusion during the insulin interruption phase, plasma insulin levels fell gradually in both groups to nadir values of 1.6 ± 0.8 and 2.0 ±1.2 μU/ml in the regular insulin- and insulin lispro-treated groups, respectively. Plasma glucose concentrations rose to 13.8 ±1.9 and 16.0 ±1.7 mmol/1 in the regular insulin- and insulin lispro-treated groups, respectively. No significant differences were seen between the therapy groups at any time in the insulin levels or in the concentrations of plasma glucose or (β-OHB. In the insulin replacement phase, insulin levels rose more rapidly in those treated with lispro insulin, reaching a greater peak value (e.g., at 60 min, plasma insulin 25 ± 3.4 vs. 15.6 ± 2.6 μUsol;ml, P &amp;lt; 0.05). In association with this, plasma glucose decreased to a lower nadir after lispro insulin (9.7 ± 0.4 vs. 13.7 ± 0.7 mmol/1, lispro- vs. regular-treated groups at 120 min after insulin administration, P &amp;lt;0.01). β-OHB levels decreased rapidly in both groups. CONCLUSIONS In patients treated with CSII, interruption of the basal insulin infusion in the middle of the night does not result in more rapid metabolic decompensation in patients treated with lispro compared with those treated with regular human insulin. Lispro insulin is effective in treating mild ketosis and hyperglycemia, and its rapid action may be advantageous in the “sick day” management at home of patients with IDDM.
Simultaneous Diagnosis of Acute Cholecystitis, Intestinal Malrotation, and Duodenal Diverticulum by Cholescintigraphy
Authors: MARK W. ELLIOTT, MICHAEL R. WILLIAMSON, MICHAEL DAVIS, KIRK G. JORDAN, ANDREW J. MEHOLIC, FRED HASHIMOTO
Journal: Clinical Nuclear Medicine (1993)

A 68-year-old man presented with intermittent episodes of epigastric and right upper quadrant pain and an elevated white blood cell count, 3 months after a hemicolectomy for adenocarcinoma of the transverse colon. Hepatobiliary scintigraphy demonstrated nonvisualization of the gallbladder consistent with acute cholecystitis. In addition, activity within the proximal small bowel revealed malrotation. Delayed imaging also demonstrated a focal area of activity representing a large duodenal diverticulum. Subsequent barium small bowel series and laparotomy with cholecystectomy confirmed all three findings initially noted by scintigraphy.
Does transplantation in early infancy protect against Post-Transplant Coronary Artery Disease (PTCAD)? Evaluation by Intravascular Ultrasound (IVUS)
Authors: Micheal A. Kuhn, Aijaz Hashmi, Douglas D. Deming, James A. Fitts, Sharon L. Robie, Ranae L. Larsen
Journal: Journal of the American College of Cardiology (2002)
Doctors in the armed forces to get pound50 000 "golden hellos"
Authors: O. Dyer
Journal: BMJ (2002)

Doctors in the British armed forces can expect hefty pay rises in the new year after the government announced plans to bring military doctors' pay into line with NHS rates. The drive to improve military medical services will also include “golden hellos” worth £50 000 ($80 000; €80 000) to consultants in many specialities, as well as to GPs who have undergone appropriate vocational training.

It is hoped that the pay hikes will help to attract and retain specialists in areas that are currently seen to be understaffed. The specialties that will benefit from the …
Nuffield Council seeks views on ethics of caring for people with dementia
Authors: Zosia Kmietowicz
Journal: BMJ (2008)

Legislation to regulate the use of human embryos for research in the United Kingdom had its second reading in the House of Commons this week, but ministers face a fight to push the most contentious measures through.The Human Fertilisation and Embryology Bill, which updates 1990 legislation to take account of advances in technology, passed the second reading by 340 votes to 78, with only nine Labour MPs rebelling.
"MERCURIALS IN EXPERIMENTAL SYPHILIS"
Authors: Justina H. Hill
Journal: JAMA (1923)

<h3>To the Editor:</h3> —Supplementary to our article inThe Journal, May 12, page 1365, two of the node transfers from rabbits treated with red mercuric iodid have become positive, making the treatment with this drug subcurative in at least three of the four cases.
Strategy and cost in investigating solitary pulmonary nodules
Authors: M. K. Gould, G. A. Lillington
Journal: Thorax (1998)

OBJECTIVE: To compare the probability of cancer in a solitary pulmonary nodule using standard criteria with Bayesian analysis and result of 2- [F-18] fluoro-2-deoxy-D-glucose-positron emission tomographic (FDG-PET) scan. SETTING: A university hospital and a teaching Veteran Affairs Medical Center. METHODS: Retrospective analysis of 52 patients who had undergone both CT scan of the chest and a FDG-PET scan for evaluation of a solitary pulmonary nodule. FDG-PET scan was classified as abnormal or normal. Utilizing Bayesian analysis, the probability of cancer using "standard criteria" available in the literature, based on patient9s age, history of previous malignancy, smoking history, size and edge of nodule, and presence or absence of calcification were calculated and compared to the probability of cancer based on an abnormal or normal FDG-PET scan. Histologic study of the nodules was the gold standard. RESULTS: The likelihood ratios for malignancy in a solitary pulmonary nodule with an abnormal FDG-PET scan was 7.11 (95% confidence interval [CI], 6.36 to 7.96), suggesting a high probability for malignancy, and 0.06 (95% CI, 0.05 to 0.07) when the PET scan was normal, suggesting a high probability for benign nodule. FDG-PET scan as a single test alone was more accurate than the standard criteria and standard criteria plus PET scan in correctly classifying nodules as malignant or benign. CONCLUSION: FDG-PET scan as a single test was a better predictor of malignancy in solitary pulmonary nodules than the standard criteria using Bayesian analysis. FDG-PET scan can be a useful adjunct test in the evaluation of solitary pulmonary nodules.
Deletion of the Ron receptor tyrosine kinase domain in mice provides protection from endotoxin-induced acute liver failure
Authors: Mike A. Leonis, Kenya Toney-Earley, Sandra J. F. Degen, Susan E. Waltz
Journal: Hepatology (2002)

The targeted deletion of the cytoplasmic domain of the Ron receptor tyrosine kinase (TK) in mice leads to exaggerated responses to injury in several murine models of inflammation as well as increased lethality in response to endotoxin (lipopolysaccharide [LPS]). Using a well-characterized model of LPS-induced acute liver failure (ALF) in galactosamine (GalN)-sensitized mice, we show that Ron TK(-/-) mice display marked protection compared with control Ron TK(+/+) mice. Whereas control mice have profound elevation of serum aminotransferase levels (a marker of hepatocyte injury) and hemorrhagic necrosis of the liver, in dramatic contrast, Ron TK(-/-) mice have mild elevation of aminotransferase levels and relatively normal liver histology. These findings are associated with a reduction in the number of liver cells undergoing apoptosis in Ron TK(-/-) mice. Paradoxically, treatment of Ron TK(-/-) mice with LPS/GalN leads to markedly elevated (3.5-fold) serum levels of tumor necrosis factor (TNF) alpha, a key inflammatory mediator in this liver injury model, as well as reduced amounts of interleukin (IL) 10 (a suppressor of TNF-alpha production) and interferon (IFN)-gamma (a TNF-alpha sensitizer). These results show that ablation of the TK activity of the Ron receptor leads to protection from the development of hepatocellular apoptosis in response to treatment with LPS/GalN, even in the presence of excessive levels of serum TNF-alpha. In conclusion, our studies show that the Ron receptor TK plays a critical role in modulating the response of the liver to endotoxin.
Comparative Effects of Glibenclamide and Metformin on Ambulatory Blood Pressure and Cardiovascular Reactivity in NIDDM
Authors: Purnima Sundaresan, Denise Lykos, Ali Daher, Terence Diamond, Richard Morris, Laurence G Howes
Journal: Diabetes Care (1997)

OBJECTIVE To compare the effects of chronic glibenclamide and metformin therapy on blood pressure (BP) and cardiovascular responsiveness in patients with NIDDM. RESEARCH DESIGN AND METHODS Fourteen patients with NIDDM received metformin or glibenclamide for 1 month in a double-blind, randomized crossover study. At the end of each treatment period, patients were tested for forearm vascular responsiveness to intrabrachial arterial infusion of diazoxide (an ATP-sensitive potassium channel opener), acetylcholine, sodium nitroprusside, and norepinephrine, BP responses to intravenous infusions of NE and angiotensin II, BP responses to cold pressor testing and isometric exercise, and 24-h ambulatory BP monitoring. RESULTS Metformin and glibenclamide produced similar glycemic control. Mean 24-h BPs did not differ between the two groups, but mean 24-h heart rates were significantly lower (75 ± 6 bpm vs. 80 ± 6 bpm) on glibenclamide therapy than on metformin. Plasma norepinephrine levels were significantly higher on glibenclamide (6.41 ± 1.77 vs. 4.26 ± 1.54 mmol/l, P &amp;lt; 0.01), and systolic BP responses to intravenous norepinephrine and angiotensin II were significantly higher on glibenclamide than on metformin (P &amp;lt; 0.02 and P &amp;lt; 0.05, respectively). Systolic BP responses to cold pressor testing appeared higher on glibenclamide than on metformin, but the difference did not quite achieve statistical significance (P = 0.052). Baseline forearm vascular resistance did not differ between the two drugs, nor did forearm vascular resistance responses to diazoxide, acetylcholine, sodium nitroprusside, and norepinephrine differ. CONCLUSIONS Glibenclamide therapy is accompanied by greater systolic BP responses to norepinephrine and angiotensin II and higher plasma norepinephrine levels than those that occur on metformin therapy. Lower heart rates on glibenclamide therapy despite evidence of greater sympathetic activity suggests that glibenclamide may have negative chronotropic effects.
A FLUID AND ELECTROLYTE BALANCE SERVICE FOR CLINICAL USE
Authors: Harry Statland
Journal: JAMA (1952)

The importance of proper management of fluid and electrolytes in seriously ill patients in the prevention of morbidity and mortality due to electrolyte imbalance has been adequately stressed in the recent large volume of literature on this subject. Because the evaluation of the condition of patients with serious fluid or electrolyte imbalance involves a complete understanding of the intricacies of fluid physiology, it would obviously be of great value to have some system of preventing such imbalances that would not require a deep understanding of the subject on the part of physicians. The idea for such a fluid balance service is not new or original, and it has been used in various forms at several large medical centers. The fault of some of these plans, although simple in procedure, lies in the fact that they require a fine understanding of the subject and, in other than ordinary situations, may give
The use of ivermectin in controlling an outbreak of scabies in a prison
Authors: B. Leppard, A.E. Naburi
Journal: British Journal of Dermatology (2000)

Ivermectin is a potentially useful treatment for scabies.We aimed to evaluate the efficacy of ivermectin in the treatment of scabies in an institutional environment.A single dose of ivermectin 150 microg kg-1 was given under supervision to 1153 prisoners in a prison in northern Tanzania where there was an outbreak of scabies.Thirty per cent of the prisoners were cured after 1 week, 88% after 4 weeks and 95.5% after 8 weeks. Of 16 prisoners with crusted scabies, seven (44%) still had scabies after 8 weeks. Those who were not cured were then treated with 1% lindane lotion topically, as were the prison staff who had scabies. This regimen eradicated scabies from the prison for the next 2 years.Ivermectin is an effective and safe treatment for scabies, particularly in a closed community, such as a prison, where it is easy to administer and avoids problems with compliance. It was of limited efficiency in crusted scabies as a single dose and we recommend that for such patients oral ivermectin is used in combination with a topical scabicide.
Censorship of medical journals
Authors: Steve Hickey
Journal: BMJ (2006)

EDITOR—I was pleased to note that the influence of commercial interests on medical publications is being taken more seriously.1 However, another form of bias can limit the information available to doctors and scientists: the active exclusion of journals from Medline.

A year or so ago, I was asked by Dr Abram Hoffer to investigate the selection of journals to be included in Medline. A committee of internally selected experts, the Literature Selection Technical Review Committee, …
RANTES and macrophage inflammatory protein 1 alpha selectively enhance immunoglobulin (IgE) and IgG4 production by human B cells.
Authors: H Kimata, A Yoshida, C Ishioka, M Fujimoto, I Lindley, K Furusho
Journal: The Journal of Experimental Medicine (1996)

We studied the effects of various chemokines including neutrophil-activating peptide 2 (NAP-2), beta-thromboglobulin (beta-TG), platelet factor 4 (PF-4), melanoma growth stimulating activity (GRO), gamma interferon-induced protein (IP-10), regulated on activation, normal T expressed and secreted (RANTES), macrophage inflammatory protein 1 alpha (MIP-1 alpha), MIP-1 beta, and monocyte chemotactic protein 1 (MCP-1) on Immunoglobulin (IgE) and IgG4 production by human B cells. None of these chemokines with or without interleukin (IL-4), anti-CD40 or -CD58 monoclonal antibody (mAb), induced IgE and IgG4 production by B cells from nonatopic donors. However, RANTES and MIP-1 alpha selectively enhanced IgE and IgG4 production induced by IL-4 plus anti-CD40 or -CD58 mAb without affecting production of IgM, IgG1, IgG2, IgG3, IgA1, or IgA2, whereas other chemokines failed to do so. Enhancement of IgE and IgG4 production by RANTES and MIP-1 alpha was specifically blocked by anti-RANTES mAb and anti-MIP-1 alpha antibody (Ab), respectively, whereas anti-IL-5 mAb, anti-IL-6 mAb, anti-IL-10 Ab, anti-IL-13 Ab, and anti-tumor necrosis factor-alpha mAb failed to do so. Purified surface IgE positive (slgE4) and slgG4+ B cells generated either in vitro or in vivo spontaneously produced IgE and IgG4, respectively, whereas sIgE- and sIgG4- B cells failed to do so. RANTES and MIP-1 alpha enhanced spontaneous IgE and IgG4 production in slgE+ and slgG4- B cells, respectively, whereas neither RANTES nor MIP-1 alpha did so in sIgE- or sIgG4- B cells. Purified sIgE4+ and sIgG4+, but not sIgE- or sIgG4- B cells, generated in vitro and in vivo expressed receptors for RANTES and MIP-1 alpha, whereas they failed to express receptors for other chemokines. These findings indicate that RANTES and MIP-1 alpha enhance IgE and IgG4 production by directly stimulating sIgE+ and sIgG4+ B cells.
Initial management of immune thrombocytopenic purpura in adults: A randomized controlled trial comparing intermittent anti‐D with routine care
Authors: James N. George, Gary E. Raskob, Sara K. Vesely, Dennis Moore, Roger M. Lyons, Everardo Cobos, Brenda L. Towell, Panpit Klug, Troy H. Guthrie
Journal: American Journal of Hematology (2003)

Abstract We conducted a randomized clinical trial in adults with a new diagnosis of ITP and a platelet count &lt;30,000/μL to test the hypothesis that initial intermittent treatment with anti‐D may avoid or defer the need for splenectomy when compared to current routine care (glucocorticoid treatment, followed by splenectomy). Splenectomy was to be performed in the anti‐D group if patients failed to respond to three consecutive anti‐D treatments given within 10 days. The incidences of splenectomy were 14 of 37 (38%) in the routine care group and 14 of 33 (42%) in the anti‐D group (absolute risk reduction = 4.6% in favor of the routine care group, 95% CI, −18.4 to 27.6%). However, splenectomy was performed prematurely, not according to the protocol, in 11 of 14 patients in the anti‐D group. The median time to splenectomy was 36 days (range, 9–78) in the routine care group and 112 days (range, 19–558) in the anti‐D group ( P = 0.045 at 100 days after randomization, P = 0.840 at 1 year after randomization, using log‐rank analysis). Patients in the anti‐D group were treated with prednisone for fewer days (70 days) compared to the routine care group (112 days, P = 0.01). No major bleeding events occurred. In this study, initial treatment of patients with intermittent anti‐D initially deferred splenectomy. Whether our aggressive regimen of anti‐D could have prevented splenectomy if it had been adhered to in all patients remains uncertain. However, compliance with this anti‐D regimen was not feasible for many patients and/or their physicians. Am. J. Hematol. 74:161–169, 2003. © 2003 Wiley‐Liss, Inc.
Rapid Evolution of NK Cell Receptor Systems Demonstrated by Comparison of Chimpanzees and Humans
Authors: Salim I Khakoo, Raja Rajalingam, Benny P Shum, Kristin Weidenbach, Laura Flodin, David G Muir, Flávio Canavez, Stewart L Cooper, Nicholas M Valiante, Lewis L Lanier, Peter Parham
Journal: Immunity (2000)
A Review of Studies on Human Zinc Deficiency by the Vanderbilt University Nutrition Group.
Authors: Harold H. Sandstead
Journal: Annals of Internal Medicine (1967)

s1 May 1967A Review of Studies on Human Zinc Deficiency by the Vanderbilt University Nutrition Group.Harold H. Sandstead, M.D., Y. D. Coble Jr., M.D., J. P. Carter, M.D., Louis E. Grivetti, M.A., Z. Farid, M.D., A. R. Schulert, Ph.D., V. N. Patwardhan, Ph.D., W. J. Darby, M.D., F.A.C.P., A. S. Prasad, M.D., F.A.C.P., A. Miale Jr., M.D.Harold H. Sandstead, M.D.Search for more papers by this author, Y. D. Coble Jr., M.D.Search for more papers by this author, J. P. Carter, M.D.Search for more papers by this author, Louis E. Grivetti, M.A.Search for more papers by this author, Z. Farid, M.D.Search for more papers by this author, A. R. Schulert, Ph.D.Search for more papers by this author, V. N. Patwardhan, Ph.D.Search for more papers by this author, W. J. Darby, M.D., F.A.C.P.Search for more papers by this author, A. S. Prasad, M.D., F.A.C.P.Search for more papers by this author, A. Miale Jr., M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-66-5-1061_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptZinc, a ubiquitous cation in nature, is an integral part of at least nine metalloenzymes and plays an as yet undefined role in nucleic acid and protein synthesis. Deficiency of zinc in man may impair growth and delay puberty. The clinical features of extreme cases resemble idiopathic hypopituitarism. Specific abnormal endocrine function tests include low urinary excretion of pituitary gonadotropin and 17-ketosteroids. Base-line urinary 17-hydroxysteroids are usually normal, but pituitary adrenocorticotrophic hormone reserve assessed by metyrapone tests is decreased. Postinsulin plasma growth hormone levels are low. Intravenous glucose tolerance tests are normal; oral tests are compatible with impaired absorption of... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Harold H. Sandstead, M.D.; Y. D. CobleJr., M.D.; J. P. Carter, M.D.; Louis E. Grivetti, M.A.; Z. Farid, M.D.; A. R. Schulert, Ph.D.; V. N. Patwardhan, Ph.D.; W. J. Darby, M.D., F.A.C.P.; A. S. Prasad, M.D., F.A.C.P.; A. MialeJr., M.D.Affiliations: Nashville, Tennessee, Detroit, Michigan, and Washington, D. C. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1967Volume 66, Issue 5Page: 1061-1062KeywordsCationsExcretionGlucose tolerance testsGonadotropinsGrowth hormoneNucleic acidsNutritionProtein synthesisPubertyZinc ePublished: 1 December 2008 Issue Published: 1 May 1967 PDF downloadLoading ...
A tincture of hepcidin cures all: the potential for hepcidin therapeutics
Authors: Thomas B. Bartnikas, Mark D. Fleming
Journal: Journal of Clinical Investigation (2010)

Iron overload as a result of blood transfusions and excessive intestinal iron absorption can be a complication of chronic anemias such as β-thalassemia. Inappropriately low levels of hepcidin, a negative regulator of iron absorption and recycling, underlie the pathophysiology of the intestinal hyperabsorption. In this issue of the JCI, Gardenghi et al. demonstrate that increasing hepcidin expression to induce iron deficiency in murine β-thalassemia not only mitigates the iron overload, but also the severity of the anemia. These data illustrate the therapeutic potential of modulating hepcidin expression in diseases associated with altered iron metabolism.
Peripheral neuropathy and indomethacin.
Authors: O E Eade, E D Acheson, M F Cuthbert, C H Hawkes
Journal: BMJ (1975)

A patient with seronegative inflammatory polyarthritis developed a predominantly motorperipheral neuropathy associated with the use of indomethacin. Three other cases of peripheral neuropathy associated with indomethacin treatment have been reported to the Committee on Safety of Medicines. In all cases the neuropathy regressed when indomethacinwas stopped. Peripheral neuropathy should be recognized as a rare complication of indomethacin therapy and considered in the differential diagnosis of a neuropathy accompanyingrheumatoid arthritis.
Paraplegia After Surgery For Abdominal Aortic Aneurysms
Authors: Gerald T. Golden
Journal: JAMA (1975)

To the Editor.—  In 1973, we reported two cases of paraplegia following the resection of aneurysms of the infrarenal abdominal aorta, and we were able to find reports of an additional 17 cases in the literature.1Since that time, this complication has occurred in another patient in our institution, and five separate, additional cases have been reported.2-5We have also received letters from surgeons throughout the country about paraplegia following aneurysm resection. This complication, although not mentioned in standard surgical textbooks, is more common than has been appreciated.  The blood supply to the spinal cord is tenuous at best, coming from both the two-part anterior spinal arteries and the single posterior spinal artery.6All three vessels run the entire length of the spinal cord, but the anterior spinal artery is responsible for blood supply of the greater part of its cross section. It is variably reinforced by