tbuckley/cabot-search huggingface dataset:
Use of Inhaled Insulin in a Basal/Bolus Insulin Regimen in Type 1 Diabetic Subjects
Authors: Jay S. Skyler, Ruth S. Weinstock, Philip Raskin, Jean-François Yale, Eugene Barrett, John E. Gerich, Hertzel C. Gerstein
Journal: Diabetes Care (2005)

OBJECTIVE—Despite the demonstrated benefits of glycemic control, patient acceptance of basal/bolus insulin therapy for type 1 diabetes has been slow. We investigated whether a basal/bolus insulin regimen involving rapid-acting, dry powder, inhaled insulin could provide glycemic control comparable with a basal/bolus subcutaneous regimen. RESEARCH DESIGN AND METHODS—Patients with type 1 diabetes (ages 12–65 years) received twice-daily subcutaneous NPH insulin and were randomized to premeal inhaled insulin (n = 163) or subcutaneous regular insulin (n = 165) for 6 months. RESULTS—Mean glycosylated hemoglobin (A1C) decreased comparably from baseline in the inhaled and subcutaneous insulin groups (−0.3 and −0.1%, respectively; adjusted difference −0.16% [CI −0.34 to 0.01]), with a similar percentage of subjects achieving A1C &amp;lt;7%. Although 2-h postprandial glucose reductions were comparable between the groups, fasting plasma glucose levels declined more in the inhaled than in the subcutaneous insulin group (adjusted difference −39.5 mg/dl [CI −57.5 to −21.6]). Inhaled insulin was associated with a lower overall hypoglycemia rate but higher severe hypoglycemia rate. The overall hypoglycemia rate (episodes/patient-month) was 9.3 (inhaled) vs. 9.9 (subcutaneous) (risk ratio [RR] 0.94 [CI 0.91–0.97]), and the severe hypoglycemia rate (episodes/100 patient-months) was 6.5 vs. 3.3 (RR 2.00 [CI 1.28–3.12]). Increased insulin antibody serum binding without associated clinical manifestations occurred in the inhaled insulin group. Pulmonary function between the groups was comparable, except for a decline in carbon monoxide−diffusing capacity in the inhaled insulin group without any clinical correlates. CONCLUSIONS—Inhaled insulin may provide an alternative for the management of type 1 diabetes as part of a basal/bolus strategy in patients who are unwilling or unable to use preprandial insulin injections.
Standards of Medical Care in Diabetes–2006
Authors: Vivian Fonseca, Nathaniel G. Clark
Journal: Diabetes Care (2006)

We appreciate Dr. Tseng’s letter (1), as it identifies an error in our 2006 stated HDL cholesterol goals (2), when expressed in SI units, and allows us to comment further on our recommendation regarding the use of statins in those with type 2 diabetes.

Tseng is correct that the 2006 goals for HDL (2) should read 40 mg/dl (1.03 mmol/l) for men …
Plasma Concentration and Urinary Excretion Kinetics of Acetyl Strophanthidin
Authors: RICHARD SELDEN, MICHAEL D. KLEIN, THOMAS W. SMITH
Journal: Circulation (1973)

The pharmacokinetics of acetyl strophanthidin (AS) were studied in dogs and human subjects by the use of a newly developed radioimmunoassay. This method has a sensitivity of 0.1 ng of AS per ml and is applicable to direct measurement of AS in unextracted plasma, urine, or bile. After administration of a single intravenous (i.v.) dose of 1.0 mg of AS to 17-25-kg mongrel dogs, the principal exponential decline of plasma AS concentration began 20-60 min after the injection and had a mean half-life (T ½ ) of 83 ± 19 min ( sd ). Mean total urinary excretion of AS was 13.3 ± 4.8% of the i.v. dose and occurred with a mean T ½ of 79 ± 10 min. Biliary excretion of AS accounted for only 1.5-2.1% of the i.v. dose. After i.v. administration of 1.0 mg of AS to seven human subjects, the principal exponential decline of plasma AS concentration began 10-30 min after the infusion and had a mean T ½ of 2.3 ± 0.2 hours. Urinary excretion of AS, studied in two patients, accounted for an average of 21.8% of the i.v. dose and occurred with a mean T ½ of 2.4 hours. Thus the plasma level T ½ of AS in human subjects is about tenfold shorter than the 22-hour T ½ previously observed for the relatively short-acting cardiac glycoside ouabain, in agreement with the known brief duration of pharmacologic effects of acetyl strophanthidin.
The Normally Functioning Prosthetic Valve
Authors: WILLIAM C. REEVES
Journal: Annals of Internal Medicine (1982)

Letters and Corrections1 July 1982The Normally Functioning Prosthetic ValveWILLIAM C. REEVES, M.D.WILLIAM C. REEVES, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-97-1-144_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: I enjoyed the recent review article on auscultation of the normally functioning prosthetic valve by Smith and colleagues (1). Several points, however, need clarification.The authors mention that ball valves in the mitral area normally have an apical early to mid-systolic murmur at the lower left sternal border. They note in their Figure 2 that this is a grade 2 to 3/6 systolic ejection murmur. The references quoted to support this statement do not address this question. But in a later reference (2), an ejection mid-systolic murmur at the apex is said to occur in most persons...References1. SMITHRAIZADAABRAMS NVJ. Auscultation of the normally functioning prosthetic valve. Ann Intern Med. 1982;95:594-98. LinkGoogle Scholar2. NAJMISEGAL MB. Auscultatory and phonocardiography findings in patients with prosthetic ball valves. Am J Cardiol. 1965;16:794-9. CrossrefMedlineGoogle Scholar3. BJORKHOLMGRENOLINOVENFORS VACC. Clinical and haemodynamic results of aortic valve replacement with the Bjork-Shiley tilting disc valve prosthesis. Scand J Thorac Cardiovasc Surg. 1971;5:177-91. CrossrefMedlineGoogle Scholar4. WILTRAKISRAHIMTOOLAHARLANDEMOTS MSBH. Diastolic rumbles with porcine heterograft prosthesis in the atrioventricular position. Normal or abnormal prosthesis? Chest. 1978;74:411-3. MedlineGoogle Scholar1. BUSCHPECHACEKGARCIAHALL ULER. Acoustic changes in normally functioning mitral valve prostheses: echophonocardiographic observations. Cardiovasc Dis. 1978;5:107-12. MedlineGoogle Scholar2. CRAIGEHUTCHINSUTTON EPR. Impaired function of cloth-covered Starr-Edwards mitral valve prosthesis. Detection by photocardiography. Circulation. 1970;41:141-8. CrossrefMedlineGoogle Scholar3. BJÖRKHOLMGRENOLINOVENFORS VACC. Clinical and haemodynamic results of aortic valve replacement with the Björk-Shiley tilting disc valve prosthesis. Scand J Thorac Cardiovasc Surg. 1971;5:177-91. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 July 1982Volume 97, Issue 1Page: 144-145KeywordsAuscultationSystolic ejection murmur Issue Published: 1 July 1982 PDF downloadLoading ...
Use of Ring Pessaries
Authors: M. Reddington
Journal: BMJ (1948)

of disproportion.Factors which might contribute to this accident are those which depress the fornix.A shortened perineum from severe perineal tears would diminish the height of the vaginal vault.Uterine prolapse with or without rectocele would predispose similarly.Physiologically a simultaneous contraction of abdominal wall and diaphragm would raise intra-abdominal pressure and momentarily depress the pelvic diaphragm.Another factor to be considered is the part her recent pregnancy may have had in softening and vascularizing the parts.Since this case I have heard of another similar one at 6 weeks post partum.On the other hand a case is described by Nicholls of an adult female with similar injury 81 months post partum, when complete involution should have occurred.Three cases are described in the Medical Journal of Australia of 1919, two by D'Arcy, and one by Stokes.Other similar cases are described by Anspach, Ricciardi, and numerous others.All cases are characterized by haemorrhage severe enough to threaten life and which usually requires surgical repair for its arrest.The literature contains a goodly number of cases of this type, but most textbooks devote only a few, lines to this subject, if it is mentioned at all.The leading textbooks describe coital injuries as occurring primarily at the vulva and hymeneal areas, and sometimes extending upwards from this.Injuries high in the vagina are usually said to occur in old women or young girls.- I should like to express my thanks to Dr. C.
Cheese, toes, and mosquitoes
Authors: B. Dixon
Journal: BMJ (1996)

A whiff on the evening train announces that the person opposite you has sweaty feet. In a delicatessen, the same smell can be both wholesome and welcome—an indication that you are approaching the cheese counter. Bart Knols and Ruurd De Jong have another use for the reek that emanates alike from unwashed feet and delectable cheese. The Dutch entomologists think they can exploit it to trap mosquitoes and thus help to combat malaria.

Working at Wageningen Agricultural University, they have been investigating the chemical features of humans that attract vectors of malaria, especially Anopheles gambiae. Carbon dioxide in the breath is one powerful attractant. But there are …
"TISSUE HYPERSENSITIVENESS FOLLOWING TOXIN-ANTITOXIN"
Authors: William H. Park
Journal: JAMA (1927)

<h3>To the Editor:</h3> —InThe Journal, April 2, is an article by Drs. Gatewood and Baldridge on "tissue hypersensitiveness following the administration of toxin-antitoxin (phenomenon of Arthus)." The question of whether toxin-antitoxin with its minute amount of antitoxic globulin sensitizes individuals to such a degree that they develop accelerated or more serious serum reactions when they receive a later dose of serum is one of such importance that in reporting cases we should be careful to be certain to give suitable emphasis to the different factors involved. The patient showing severe symptoms with the second dose of antitoxin gave the following history: She had a negative Schick test in January, 1925, but in spite of this received three injections of toxin-antitoxin in February. In November, 1925, she had an acute infection involving the ethmoid, sphenoid and maxillary sinuses. There was also an acute adenitis. November 27, cultures from the nose
Lengthening of the Stargazin Cytoplasmic Tail Increases Synaptic Transmission by Promoting Interaction to Deeper Domains of PSD-95
Authors: Anne-Sophie Hafner, Andrew C. Penn, Dolors Grillo-Bosch, Natacha Retailleau, Christel Poujol, Amandine Philippat, Françoise Coussen, Matthieu Sainlos, Patricio Opazo, Daniel Choquet
Journal: Neuron (2015)
Thalidomide corrects impaired mesenchymal stem cell function in inducing tolerogenic DCs in patients with immune thrombocytopenia
Authors: Ji Ma, Yun-na Ning, Miao Xu, Yu Hou, Ning Wang, Xiao-yan Hou, Ying-yi Yu, Hui Li, Wei-dong He, Lin-lin Shao, Hai Zhou, Ya-nan Min, Xin-guang Liu, Yan Shi, Ping Qin, Cheng-shan Guo, Ming Hou, Jun Peng
Journal: Blood (2013)
Buying Gluten-Free Food
Authors: Yasuo Ishida
Journal: JAMA (1986)

<h3>To the Editor.—</h3> I am very sorry that Dr Turner's patient had to put up with those desiccated, nontasty puffed rice disks.<sup>1</sup>I would have sent her to the nearest Oriental store to purchase a rice cooker and a 25-lb bag of long- or short-grained rice. I would also have told her that potato, corn, and soy flour should be satisfactory, and furthermore, I would have recommended that she talk to a dietician about cooking a gluten-free diet. Many people live quite happily without gluten-containing food.<sup>2-4</sup>
Dicroceliasis: A Fluke Diagnosis or a False Infection?
Authors: Jose L. Bada
Journal: JAMA (1988)

<h3>To the Editor.</h3> —Drabick et al<sup>1</sup>have reported "the first human case of<i>Dicrocoelium dentriticum</i>infection in recent times or in the United States." Nevertheless, we believe that the description of the case does not allow such a statement since, as the authors themselves discuss, spurious infections are common. It seems that the diagnosis was made after only five<i>D dentriticum</i>eggs had been seen in one stool specimen from the patient. It is not clear whether he had followed a specially controlled diet previously. It seems, also, that a false infection was excluded only through information provided by the patient about his culinary habits. Clearly, this is an inadequate way to try to exclude false infection. I believe that these questions should be clarified before it is accepted that the patient was suffering from an authentic "waterborne" dicroceliasis, as Drabick et al suggest.
Computerised system for the continuous measurement of azygos venous blood flow.
Authors: P C Hayes, D Terrace, I Peaston, I A Bouchier, D Redhead, H M Brash
Journal: Gut (1992)

A computer assisted apparatus for the continuous measurement of azygos blood flow is described. The system was validated in vitro and changes in flow which occur with respiration and Valsalva manoeuvre are illustrated. This apparatus allows real time inspection of flow values which enables changes in flow over short periods to be readily studied.
Clinical and Echocardiographic Follow-up of Patients Previously Treated With Dexfenfluramine or Phentermine/Fenfluramine
Authors: Julius M. Gardin
Journal: JAMA (2001)

IMITED INFORMATION IS AVAIL-2][3] The only large, randomized controlled trial did not show progression or development of new valvular regurgitation approximately 1 year after discontinuation of dexfenfluramine, 4 but only included patients treated for up to 3 months.We previously reported in a multicenter, prospective controlled study a statistically significant increase in prevalence of echocardiographic aortic regurgitation (AR) meeting Food and Drug Administration (FDA) criteria of mild or more severe regurgitation among patients previously treated with dexfenfluramine (8.9%) and phentermine/ fenfluramine (13.7%) compared with untreated controls (4.1%) (PϽ.001). 5Among patients who took anorexigens for 3 months or less, there was no increase in AR prevalence by FDA criteria. METHODSThis was a 1-year follow-up study of 1466 patients who had an evaluable initial echocardiogram and clinical assessment. 5At baseline, treated patients had received at least 30 days of continuous anorexigen therapy and had not discontinued therapy more than 14 months previpously; untreated controls had not received anorexigens for 5 years.One-year assessment included a physical examination and an echocardiogram.Interim medical and cardiovascular histories were obtained from patient interviews and chart reviews.
Evaluation of Efficacy, Biodistribution, and Inflammation for a Potent siRNA Nanoparticle: Effect of Dexamethasone Co-treatment
Authors: Marc T Abrams, Martin L Koser, Jessica Seitzer, Stephanie C Williams, Martha A DiPietro, Weimin Wang, Andrew W Shaw, Xianzhi Mao, Vasant Jadhav, Joseph P Davide, Paul A Burke, Alan B Sachs, Steven M Stirdivant, Laura Sepp-Lorenzino
Journal: Molecular Therapy (2009)

Despite recent progress, systemic delivery remains the major hurdle for development of safe and effective small inhibitory RNA (siRNA)-based therapeutics. Encapsulation of siRNA into liposomes is a promising option to overcome obstacles such as low stability in serum and inefficient internalization by target cells. However, a major liability of liposomes is the potential to induce an acute inflammatory response, thereby increasing the risk of numerous adverse effects. In this study, we characterized a liposomal siRNA delivery vehicle, LNP201, which is capable of silencing an mRNA target in mouse liver by over 80%. The biodistribution profile, efficacy after single and multiple doses, mechanism of action, and inflammatory toxicity are characterized for LNP201. Furthermore, we demonstrate that the glucocorticoid receptor (GR) agonist dexamethasone (Dex) inhibits LNP201-induced cytokine release, inflammatory gene induction, and mitogen-activated protein kinase (MAPK) phosphorylation in multiple tissues. These data present a possible clinical strategy for increasing the safety profile of siRNA-based drugs while maintaining the potency of gene silencing.
Editorial policies on financial disclosure
Authors: Michael F Jacobson, Virginia A Sharpe, Marcia Angell, Nicholas A Ashford, Alan Blum, Lin Kaatz Chary, Mildred Cho, Bruce C Coull, Devra Davis, Russell F Doolittle, David Egilman, Samuel S Epstein, Morris Greenberg, Kim Hooper, James Huff, Tushar K Joshi, Sheldon Krimsky, Joseph LaDou, Charles Levenstein, Steven Miles, Herbert Needleman, Edmund D Pellegrino, Bill Ravanesi, Jennifer Sass, Arnold Schecter, Jill S Schneiderman, David Schubert, Morando Soffritti, David Suzuki, Tim K Takaro, Norman J Temple, Benedetto Terracini, Andrew Thompson, David Wallinga, Steven Wing
Journal: Nature Neuroscience (2003)
COMMON DISEASES OF CHILDREN.
Authors: R. L. MOORE
Journal: JAMA (1883)

Viewing the disease from my standpoint, I begin the treatment for the disease proper with nervines, and as a normal temperature (or a somewhat elevated temperature, is a favorable condition for micro-organ¬ isms and inflammation), I use cold compresses to the bowels and ice water injections, and for the second¬ ary symptoms I use pepsine, sub.nit. of bismuth, and carbolic acid.discussion on dr.good's paper.
The chromosomal order of genes controlling the major histocompatibility complex, properdin factor B, and deficiency of the second component of complement.
Authors: D Raum, D Glass, C B Carpenter, C A Alper, P H Schur
Journal: Journal of Clinical Investigation (1976)

The relationship of the genes coding for HLA to those coding for properdin Factor B allotypes and for deficiency of the second component of complement (C2) was studied in families of patients with connective tissue disorders. Patients were selected because they were heterozygous or homozygous for C2 deficiency. 12 families with 15 matings informative for C2 deficiency were found. Of 57 informative meioses, two crossovers were noted between the C2 deficiency gene and the HLA-B gene, with a recombinant fraction of 0.035. A lod score of 13 was calculated for linkage between C2 deficiency and HLA-B at a maximum likelihood value of the recombinant fraction of 0.04. 18 families with 21 informative matings for both properdin Factor B allotype and HLA-B were found. Of 72 informative meioses, three recombinants were found, giving a recombinant fraction of 0.042. A lod score of 16 between HLA-B and Factor B allotypes was calculated at a maximum likelihood value of the recombinant fraction of 0.04. A crossover was shown to have occurred between genes for Factor B and HLA-D, in which HLA-D segregared with HLA-A and B. These studies suggest that the genes for Factor B and C2 deficiency are located outside those for HLA, that the order of genese is HLA-A, -B, -D, Factor B allotype, C2 deficiency, that the genes coding for C2 deficiency and Factor B allotypes are approximately 3--5 centimorgans from the HLA-A and HLA-B loci, and that the apparent lack of recombinants between the Factor B gene and C2 deficiency gene suggests that these two genes lie in close proximity to one another.
Evidence Favoring the Use of Anticoagulants in the Hospital Phase of Acute Myocardial Infarction
Authors: Thomas C. Chalmers, Raymond J. Matta, Harry Smith, Anne-Marie Kunzler
Journal: New England Journal of Medicine (1977)

Abstract Since the last comprehensive review of anticoagulation in acute myocardial infarction four additional randomized control trials have been reported. The overwhelming majority of all trials favored anticoagulation. Rates of thromboembolism were higher in the control, and hemorrhagic complications in the anticoagulated group. Pooling of all randomized control trials gives mean case fatality rates of 19.6 per cent for the control and 15.4 per cent for the anticoagulated group, a relative reduction of 21 per cent (P<0.05 or <0.001, depending on the analytic method). Five of six randomized control trials reported "no effect" because the difference favoring anticoagulation was not statistically significant. However, sample sizes in these "negative" papers were too small to protect against missing a 21 per cent reduction in true case fatality rate due to anticoagulation (β<0.10). All patients who present no specific contraindication should receive anticoagulants during hospitalization for infarction. (N Engl J Med 297:1091–1096, 1977)
Additional reverse transcription-polymerase chain reaction of peripheral slices is not superior to analysis of the central slice in sentinel lymph nodes from melanoma patients
Authors: H-J. Blaheta, S. Roeger, K. Sotlar, B. Schittek, H. Breuninger, B. Bueltmann, C. Garbe
Journal: British Journal of Dermatology (2004)

The status of the sentinel lymph node (SLN) is an important prognostic factor in patients with cutaneous melanoma. Reverse transcription-polymerase chain reaction (RT-PCR) has been used as a sensitive means of detecting tumour cells in SLNs.To determine whether RT-PCR analysis of the SLN using both the central and the peripheral slices is more sensitive than molecular analysis of the central slice only.Eighty-three SLNs from 59 patients with primary cutaneous melanoma were identified by SLN mapping. All SLNs were bisected along their longitudinal axis to produce two equal halves. One half was used for histology and immunohistochemistry, and the other was analysed by RT-PCR for tyrosinase and MelanA. Parallel to the longitudinal axis, one central slice (approximately 2 mm in thickness) was cut manually. This central slice was used for our standard RT-PCR protocol. In the current study, up to eight additional peripheral slices (each approximately 2 mm in thickness) were cut parallel to the existing cut surface. These peripheral slices were analysed by additional RT-PCR.Standard RT-PCR of the central slice yielded positive results in 34 of 59 patients (57%). Additional RT-PCR of peripheral slices demonstrated positive findings in six additional patients (10%) who were initially negative by standard RT-PCR of the central slice. In detail, seven of those 34 patients positive by standard RT-PCR of the central slice had positive histological findings. In each of these seven patients, RT-PCR was positive both in the central slice as well as in the peripheral slices. The remaining 27 patients with positive RT-PCR results of the central slice showed negative histological findings. Only nine (33%) of these 27 patients had a positive RT-PCR also in the peripheral slices. Finally, all 25 patients with negative RT-PCR results in the central slice showed negative histological findings. Six of these patients (24%) revealed positive RT-PCR results on the analysis of peripheral slices. However, three of these patients expressed only MelanA but not tyrosinase. Thirty lymph nodes from 24 nonmelanoma patients served as negative controls for RT-PCR. In three of these 24 patients (13%) expression of MelanA but not tyrosinase was detected by RT-PCR.Molecular analysis of peripheral slices yielded six additional patients (10%) positive by RT-PCR who were initially negative by standard RT-PCR of the central slice. However, three of these six patients were found to express only MelanA but not tyrosinase. As MelanA expression was also found in 13% of control lymph nodes, positive MelanA expression alone in SLNs of melanoma patients requires cautious interpretation in order to avoid false-positive findings. Thus, additional molecular processing of peripheral slices did not significantly increase the number of patients with RT-PCR-positive SLNs.