tbuckley/cabot-search huggingface dataset:
Insulin to Inhibit Protein Catabolism after Injury
Authors: Anthony M. J. Woolfson, Richard V. Heatley, Simon P. Allison
Journal: New England Journal of Medicine (1979)

Using patients with varying degrees of trauma as their own controls we compared three isocaloric regimens in three-day crossover studies; 9.4 g of nitrogen as l-amino acids was also given daily. The urea production rate was used as an index of protein breakdown. We found that in catabolic patients, insulin and glucose produced a strikingly greater inhibition of protein breakdown than glucose alone, and that glucose alone was marginally more protein sparing than a regimen containing mainly fat (Intralipid and sorbitol). These differences were not seen in non-catabolic patients (urea production rate <15 g daily). In the catabolic patients (urea production rate >15 g daily) the protein-sparing effect of insulin was proportional to the initial urea production rate. We therefore concluded that insulin has important protein-sparing effects in severely ill traumatized patients, but little effect when there is no increased catabolic rate. (N Engl J Med 300:14–17, 1979)
Calcium and calciferol antagonise effect of verapamil in atrial fibrillation.
Authors: D Bar-Or, Y Gasiel
Journal: BMJ (1981)

in our patient, however, occurred in the absence of such stimulation.Myoclonus as defined by Gastaut3 may occur as a result of any lesion from the motor cortex to the spinal motor neurone, but these movements were not myoclonic in our patient.The patient described by Campbell and Garland1 with subacute myoclonic spinal neuronitis had more rapid myoclonus in the legs associated with fever and possible spinal cord infarction.Our patient's involuntary movements fit Hughlings Jackson's description of focal epilepsy.'Nittner5 states that epileptic seizures are rarely caused by spinal cord tumours but reviewing the case reports he found these seizures restricted to patients with tumours around the foramen magnum.Gowers5 cites Brown-Sequard's comment that "spinal epilepsy" is a suitable description for a violent muscle spasm followed by clonic movements occurring in a patient with a known spinal cord lesion.There is no other published description of spinal epilepsy with such a clear focal motor event occurring in a patient with a spinal lesion.Immediate cessation of these attacks after the removal of the meningioma emphasised the cause and effect relation.We acknowledge the help of Mr S G Galbraith, who performed the laminectomy, Dr E Teasdale, who performed the radiology, and Mrs M McColl for secretarial work.
Prospective randomised comparison of photocoagulation and rubber band ligation in treatment of haemorrhoids.
Authors: N S Ambrose, M M Hares, J Alexander-Williams, M R Keighley
Journal: BMJ (1983)

Two hundred and sixty eight patients with haemorrhoids were allocated at random to treatment by either photocoagulation (group 1, n=141) or rubber band ligation (group 2, n=127) and followed up for one year. There was no significant difference in the symptomatic outcome of treatment between the two groups at one, four, or 12 months, irrespective of whether first or second degree haemorrhoids were treated. Side effects of treatment (bleeding or severe pain) were significantly more common after rubber band ligation (n=11) than after photocoagulation (n=2; p less than 0.01). Further outpatient treatment, however, was required significantly more often after photocoagulation (n=23) than rubber band ligation (n=6) (p greater than 0.02), and 19 patients (14 in group 1 and five in group 2; NS) subsequently had a haemorrhoidectomy. At one year 26 of 103 patients were dissatisfied after photocoagulation compared with 20 of 88 after rubber band ligation. Photocoagulation is a safe and comfortable treatment which gives long term results that are as good as those of rubber band ligation. Complications are more common after rubber band ligation, but further treatment is required more commonly after photocoagulation.
Pharmacodynamics of Practolol in Chronic Renal Failure
Authors: J. B. Eastwood, J. R. Curtis, R. B. Smith
Journal: BMJ (1973)

Plasma levels of practolol were measured in advanced chronic renal failure. The plasma half life was found to be markedly prolonged. During haemodialysis considerable shortening of the half life occurred. Therapeutic blood levels of practolol can be achieved in maintenance haemodialysis patients by the administration of 200 mg of the drug by mouth at the beginning and end of each dialysis.
Journal agrees to retract paper after university found study was never done
Authors: C. Dyer
Journal: BMJ (2013)

<h3>Objectives</h3> E-cigarette companies and vendors claim the potential of e-cigarettes to help smokers reduce or quit tobacco use. E-cigarettes also have the potential to renormalise smoking. The purpose of this study was to describe the availability and in-store marketing of e-cigarettes in London, UK stores selling tobacco and alcohol. <h3>Design</h3> Observational study. <h3>Setting</h3> Small and large stores selling alcohol and tobacco in London, UK. <h3>Primary and secondary outcome measures</h3> The number of stores selling e-cigarettes, the number of stores with an interior or exterior e-cigarette advertisement, the number of stores with an e-cigarette point-of-sale movable display, store size, deprivation index score for store9s corresponding lower super output area. <h3>Results</h3> Audits were completed in 108 of 128 selected stores. 62 of the audited stores (57%) sold e-cigarettes. E-cigarette availability was unrelated to store size. There was a statistically non-significant trend towards increased availability in more deprived areas (p=0.069). 31 of the 62 stores (50%) selling e-cigarettes had a point-of-sale movable display, with all but one found in small stores. Two small stores had interior advertisements and eight had exterior advertisements. No advertisements were observed in large stores. <h3>Conclusions</h3> This audit revealed widespread availability of e-cigarettes and in-store marketing in London, UK. Even if e-cigarettes prove to be an effective cessation aid, their sale and use are resulting in an increasing public presence of cigarette-like images and smoking behaviour. After decades of work to denormalise smoking, these findings raise the question of whether e-cigarettes are renormalising smoking.
Hepatitis-Associated Myopathy
Authors: MARTIN S. KLEINMAN
Journal: Annals of Internal Medicine (1978)

Letters and Corrections1 March 1978Hepatitis-Associated MyopathyMARTIN S. KLEINMAN, M.D.MARTIN S. KLEINMAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-88-3-432_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In reading the article "Hepatitis-Associated Lipid Storage Myopathy" (Ann Intern Med 87:417-421, 1977), I was surprised that the authors ignored the patient's first episode of apparent myopathy.If that episode was a real finding, I do not see how one can conclude that her subsequent hepatitis had a casual role in her basic muscle disease.... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: The University of Rochester Medical Center Rochester, N.Y. 14642 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 March 1978Volume 88, Issue 3Page: 432-432KeywordsHepatitis ALipidsMuscles Issue Published: 1 March 1978 PDF DownloadLoading ...
Herrick's 1910 Case Report of Sickle Cell Anemia
Authors: Todd L. Savitt
Journal: JAMA (1989)

James B. Herrick's 1910 article presenting the case of an anemic West Indian student with peculiar-shaped red blood cells was the first description of sickle cell anemia in Western medical literature. However, he told only part of the story. Records in Chicago, Washington, DC, and Grenada, West Indies, reveal more information about the events surrounding Herrick's discovery and help put them in historical perspective. Herrick's intern, Ernest E. Irons, abreast of the latest developments in medicine, actually performed the blood work and alerted Herrick about the odd-looking cells. Changing patterns in American race relations allowed the patient, Walter Clement Noel, to study dentistry in Chicago. He continued to receive care from Irons for 2 1/2 years, then returned to Grenada to practice dentistry. Noel died nine years after his return to Grenada, at age 32.
Vasoconstriction After Coronary Stenting
Authors: Michael A. Kjelsberg, Michael E. Cothern, Campbell Rogers
Journal: Circulation (1998)

A n 83-year-old woman was transferred to Brigham and Women's Hospital with postinfarction angina and cardiogenic shock 24 hours after thrombolytic therapy for an inferior myocardial infarction.Coronary angiography showed a 90% stenosis in a dominant right coronary artery (Figure).She underwent successful percutaneous coronary angioplasty, including deployment of an articulated Palmaz-Schatz stent, leaving no residual stenosis.Six hours later, she developed hypotension and was treated with an intravenous infusion of dopamine.Repeat angiography demonstrated a patent vessel, with marked coronary vasoconstriction evident throughout, sparing only the stented segment.This case demonstrates that coronary stents can withstand vasoconstriction, which may lessen the incidence of abrupt vessel closure after coronary angioplasty for acute myocardial infarction.She recovered uneventfully and was discharged home on hospital day 15.A, Coronary arteriogram shows a 90% stenosis (arrow) in right coronary artery.B, Immediately after deployment of an articulated Palmaz-Schatz stent (between arrows), no residual stenosis is seen.C, During dopamine infusion with diffuse coronary artery vasoconstriction, the stent (straight arrows) remains patent aside from spasm evident at the central articulation site (curved arrow).Quantitative analysis with electronic calipers showed a 50% loss of lumen diameter throughout the vessel and 0% loss in the stented segment.
Flexibility emphasized in medical preparations for possible disasters
Authors: Kimberly Glasbrenner
Journal: JAMA (1985)

On Jan 13, 1982, at approximately 4:00 PM, Air Florida's flight 90 jet, a Boeing 737-222, took off from Washington (DC) National Airport during what was described as a "blinding snowstorm," crashed into the northbound span of the 14th Street Bridge, and plunged into the Potomac River. By nightfall, five of the 76 passengers had been rushed to area hospitals; 71 remained unaccounted for. Meanwhile, at around 4:30 PM that same day, near the Federal Triangle station in the city's downtown district, a crowded Metro subway train derailed, leaving three persons dead and at least 22 injured (<i>Washington Post</i>, Jan 14, 1982). The coupling of these accidents tested the city's disaster plan. Mentioned in the manual used for the American College of Emergency Physicians' (ACEP), Dallas, "Medical Management and Planning for Disasters" course are several problems that supposedly confronted officials coping with these events. One was communication. Many of the
Subjectivity in Science
Authors: HUGO J. ZEE
Journal: Annals of Internal Medicine (1975)

Editorials1 March 1975Subjectivity in ScienceHUGO J. ZEE, M.D.HUGO J. ZEE, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-82-3-417 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe other day a colleague told me about his experience with a depressed, hypochondriacal young mother who had been hospitalized after being found unconscious by one of her children. Apparently she had taken a drug overdose and collapsed on the living room floor. Now she complained to my friend of a severe pain in her shoulder. Just as he was about to explore further historical and physical concomitants to this symptom, he recalled some of the things she had told him the previous day when she had said in a depressed tone of voice that she felt dead-tired, lifeless, without...References1. GUNTRIP H: Personality Structure and Human Interaction. New York, International Universities Press, 1964 Google Scholar2. LAING R: The Divided Self. New York, Random House, 1969, p. 23 Google Scholar3. APPELBAUM S: Psychological-mindedness: word, concept, and essence. Int J Psychoanal 54:35-46, 1973 MedlineGoogle Scholar4. ZEE H: Blindspots in recognizing serious suicidal intentions. Bull Menninger Clin 36:551-555, 1972 MedlineGoogle Scholar5. ALVAREZ A: The Savage God—A Study of Suicide. New York, Random House, 1971 Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: HUGO J. ZEE, M.D.Affiliations: C. F. Menninger Memorial Hospital Topeka, Kansas PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThemes in PaleopathologyThe Book of Job and the Modern View of DepressionMORTON ALLAN KAPUSTA, M.D., F.R.C.P.(C), F.A.C.P., SOLOMON FRANK, M.A., Ph.D., LL.B. 1 March 1975Volume 82, Issue 3Page: 417-418KeywordsAddictionChildrenShoulders ePublished: 1 December 2008 Issue Published: 1 March 1975 PDF downloadLoading ...
OUTCOMES FOLLOWING OPEN BILIARY BYPASS FOR BENIGN BILIARY AND PANCREATIC DISEASES
Authors: D McCartan, B Dasari, J Ahmad, C Jones, L McKie, M A Taylor, T Diamond
Journal: Gut (2013)

<h3>Aims/Background</h3> The aim of this study was to evaluate the outcomes following open biliary bypass for benign biliary and pancreatic diseases. <h3>Method</h3> Sixty-four patients (M: F=34:30) aged 15 to 89 years (median age: 54 years) underwent biliary bypass for benign diseases between 2001 and 2011. Indications for surgery were choledocholithiasis (n=18), chronic pancreatitis (n=18), iatrogenic bile duct injury (n=12), distal bile duct strictures (n=11), choledochal cyst (n=2) and other causes (n=3). Thirty-eight patients (60%) had prior surgical or endoscopic intervention. <h3>Results</h3> Sixty hepaticojejunostomies and four choledochoduodenostomies were performed. Additional procedures during the same surgery included cholecystectomy (n=25), drainage of pseudocyst (n=4), gastroenterostomy (n=4), pancreatic biopsy (n=4), liver biopsy (n=4), cyst gastrostomy (n=2) and pancreatic necrosectomy (n=2). Postoperative complications were encountered in 12 patients – bile leak (n=2), bleeding (n=2), chest infection (n=2), MI (n =1), superficial surgical site infection (n=4) and superficial wound dehiscence (n=1). Three patients required further surgery–bile leak (n=1), bleeding (n=2). Two patients (3%) died of organ failure-one following biliary bypass for cholangitis; and one following ligation of a bleeding pseudo aneurysm. Five patients developed recurrent cholangitis requiring oral antibiotics. <h3>Conclusion</h3> In the era of minimally invasive options, open biliary bypass remains a very effective, reliable and safe option in the management of benign conditions of the biliary system and pancreas.
Histamine regulates cytokine production in maturing dendritic cells, resulting in altered T cell polarization
Authors: Alessandra Mazzoni, Howard A. Young, Jessica H. Spitzer, Alberto Visintin, David M. Segal
Journal: Journal of Clinical Investigation (2001)

Atopic diseases such as allergy and asthma are characterized by increases in Th2 cells and serum IgE antibodies. The binding of allergens to IgE on mast cells triggers the release of several mediators, of which histamine is the most prevalent. Here we show that histamine, together with a maturation signal, acts directly upon immature dendritic cells (iDCs), profoundly altering their T cell polarizing capacity. We demonstrate that iDCs express two active histamine receptors, H1 and H2. Histamine did not significantly affect the LPS-driven maturation of iDCs with regard to phenotypic changes or capacity to prime naive T cells, but it dramatically altered the repertoire of cytokines and chemokines secreted by mature DCs. In particular, histamine, acting upon the H2 receptor for a short period of time, increased IL-10 production and reduced IL-12 secretion. As a result, histamine-matured DCs polarized naive CD4(+) T cells toward a Th2 phenotype, as compared with DCs that had matured in the absence of histamine. We propose that the Th2 cells favor IgE production, leading to increased histamine secretion by mast cells, thus creating a positive feedback loop that could contribute to the severity of atopic diseases.
Socioeconomic Factors and All Cause and Cause-Specific Mortality among Older People in Latin America, India, and China: A Population-Based Cohort Study
Authors: Cleusa P. Ferri, Daisy Acosta, Mariella Guerra, Yueqin Huang, Juan J. Llibre-Rodriguez, Aquiles Salas, Ana Luisa Sosa, Joseph D. Williams, Ciro Gaona, Zhaorui Liu, Lisseth Noriega-Fernandez, A. T. Jotheeswaran, Martin J. Prince
Journal: PLoS Medicine (2012)

Even in low and middle income countries most deaths occur in older adults. In Europe, the effects of better education and home ownership upon mortality seem to persist into old age, but these effects may not generalise to LMICs. Reliable data on causes and determinants of mortality are lacking.The vital status of 12,373 people aged 65 y and over was determined 3-5 y after baseline survey in sites in Latin America, India, and China. We report crude and standardised mortality rates, standardized mortality ratios comparing mortality experience with that in the United States, and estimated associations with socioeconomic factors using Cox's proportional hazards regression. Cause-specific mortality fractions were estimated using the InterVA algorithm. Crude mortality rates varied from 27.3 to 70.0 per 1,000 person-years, a 3-fold variation persisting after standardisation for demographic and economic factors. Compared with the US, mortality was much higher in urban India and rural China, much lower in Peru, Venezuela, and urban Mexico, and similar in other sites. Mortality rates were higher among men, and increased with age. Adjusting for these effects, it was found that education, occupational attainment, assets, and pension receipt were all inversely associated with mortality, and food insecurity positively associated. Mutually adjusted, only education remained protective (pooled hazard ratio 0.93, 95% CI 0.89-0.98). Most deaths occurred at home, but, except in India, most individuals received medical attention during their final illness. Chronic diseases were the main causes of death, together with tuberculosis and liver disease, with stroke the leading cause in nearly all sites.Education seems to have an important latent effect on mortality into late life. However, compositional differences in socioeconomic position do not explain differences in mortality between sites. Social protection for older people, and the effectiveness of health systems in preventing and treating chronic disease, may be as important as economic and human development.
Abstract 5553: Low-dose carcinogenicity of 2-amino-3-methylimidazo[4,5-<i>f</i>]quinoline in rats: Evidence for the existence of no-effect levels and a mechanism involving p21Cip/WAF1
Authors: Min Wei, Anna Kakehashi, Shotaro Yamano, Shoji Fukushima, Hideki Wanibuchi
Journal: Cancer Research (2011)

Abstract The carcinogenicity of the low amounts of genotoxic carcinogens present in food is of pressing concern. The purpose of the present study was to determine the carcinogenicity of low doses of the dietary genotoxic carcinogen 2-amino-3-methylimidazo[4,5-f]quinoline (IQ) and to investigate mechanisms by which IQ exerts its carcinogenic effects. A total of 1595 male F344 rats were divided into 7 groups and administered IQ at doses of 0, 0.001, 0.01, 0.1, 1, 10 and 100 ppm in the diet for 16 weeks. We found that IQ doses of 1 ppm and below did not induce preneoplastic lesions in either the liver or the colon, while IQ doses of 10 and 100 ppm induced preneoplastic lesions in both these organs. These results demonstrate the presence of no effect levels of IQ for both liver and colon carcinogenicity in rats and indicate that the dose-response relationship for IQ carcinogenicity is nonlinear. The finding that p21Cip/WAF1 was significantly induced in the liver at doses well below those required for IQ mediated carcinogenic effects, suggests that induction of p21Cip/WAF1 is one of the mechanisms responsible for the observed no-effect of low doses of IQ. Furthermore, IQ administration caused significant induction of CYP1A2 at doses of 0.01 to 10 ppm, but administration of 100 ppm IQ induced CYP1A1 rather than CYP1A2. This result indicates the importance of dosage when interpreting data on the carcinogenicity and metabolic activation of IQ. Overall, our results argue for the existence of a practical carcinogenic threshold for this genotoxic compound. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 5553. doi:10.1158/1538-7445.AM2011-5553
An Independent Elderly Woman With Rapid Onset of Coma
Authors: Jindong Xu, Anthony T. Yachnis, Irene Malaty
Journal: JAMA Neurology (2014)

Report of a CaseA 75-year-old white woman with increasing lower back pain of 2 months' duration was diagnosed as having lumbar spinal stenosis and a vertebral compression fracture.She was treated with epidural corticosteroid injections but continued to experience back pain, impaired mobility, and falls.She was admitted to a rehabilitation facility for physical therapy but developed altered mental status.She was transferred to a local hospital and treated for a urinary tract infection and pneumonia.Her antibiotic regimen (meropenem, vancomycin hydrochloride, and acyclovir) was escalated to empirically treat multidrug-resistant pneumonia and meningitis.She was also treated with 4 mg of dexamethasone every 6 hours.Despite these measures, she quickly became comatose during the 10-day hospital admission and was transferred to our tertiary care hospital for further treatment.The patient had a medical history of hypertension, hyperlipidemia, anxiety disorder, and gastroesophageal reflux disease.She lived independently, followed up regularly with her primary care physician, and participated in routine health screenings.She had no significant family history, recent travel, or allergies.In addition, she did not use tobacco, alcohol, or illicit drugs.On admission, she was afebrile and unresponsive to verbal stimuli.Nuchal rigidity was present.Her pupils were equal and sluggishly reactive to light, and her eyes were tonically deviated to the right.Oculocephalic reflex was absent.Corneal reflex was weakly present bilaterally, gag reflex was intact, and nasolabial folds were symmetric at rest.She had weak withdrawal to noxious stimuli in all 4 extremities.Deep tendon reflexes were graded as 0, 1+, 2+, 3+, and 4+ in the upper extremities and trace in the lower extremities, with upgoing plantar reflexes bilaterally.She was admitted to the neurointensive care unit and intubated for airway protection.Her peripherally inserted central catheter (PICC) was removed and cultured.Acyclovir and vancomycin treatment was continued, and cefepime hydrochloride, doxycycline, and hydrocortisone were added to her treatment regimen.On the basis of the patient's imaging findings, poor clinical prognosis, and advanced directives, her family elected to provide comfort measures only.Neither lumbar puncture nor bronchoscopy with biopsy was performed.The patient died 3 days later.