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The requirement from several health authorities to demonstrate cardiovascular (CV) safety of new antidiabetes drugs represents both an opportunity and a challenge. In a few years, this requirement may avail [...]

Lingering questions related to cardiovascular (CV) safety of type 2 diabetes treatments resulted in new U.S. Food and Drug Administration (FDA) regulations requiring careful assessment of CV risk. These new [...]

OBJECTIVE--The aim of this study was to describe the National Institutes of Health's experience initiating an islet isolation and transplantation center, including descriptions of our first six recipients, and lessons [...]

We've established a nonhuman primate islet allotransplant model to address questions such as whether transplanting islets into the gut's arterial system would more safely and as effectively support long-term islet allograft survival compared with the traditional portal vein approach. We reasoned that islets make up, Type 1 diabetes results from the immune-mediated destruction of the insulin-producing pancreatic β-cells, located in cell clusters called the islets of Langerhans (1,2). The field of islet transplantation recently emerged [...]

OBJECTIVE: To determine clinical characteristics of elderly patients presenting with the syndrome of inappropriate antidiuretic hormone secretion (SIADH), their outcome, and the extent of evaluation that is warranted. DESIGN: A retrospective study. SETTING: An 800-bed primary and tertiary care center in Jerusalem, Israel. PATIENTS: Fifty elderly patients, hospitalized with serum sodium levels below 130 mmol/L consistent with a diagnosis of SIADH. MEASUREMENTS: Data collection of the medical history, functional status, physical examination, laboratory evaluation, length of hospital stay, treatment, and outcome. RESULTS: The neurological clinical presentation on admission ranged widely: 48% were fully alert, 42% were stuporotic, and 10% had seizures. Sensorial impairment was significantly associated only with sodium values of less than 110 mmol/L. The majority of patients underwent a comprehensive work-up including chest x-ray, computerized tomography (CT) scans, and thyroid and adrenal function tests. The cause of SIADH in most of the patients remained obscure (60% of cases were idiopathic). The 2 main causes identified were pneumonia in 9 cases (18%) and medication in 6 cases (12%). Most of the patients survived the event; only two patients died, both because of sepsis and not due to hyponatremia. The average hospital stay was 12.8 [+ or -] 9 days. CONCLUSIONS: Elderly patients with SIADH usually have an idiopathic form of this condition and a benign course. Extensive routine diagnostic procedures are not warranted. Simple measures like medical history taking with special emphasis on medications, physical examination, and chest x-rays can lead to a treatable diagnosis in most patients who do not have the idiopathic form of SIADH. Am J. Med 1997;103:270-273. [C] 1997 by Excerpta Medica, Inc.

Objectives: Hemoptysis, an important and alarming symptom, often indicates serious disease. This study was designed to assess the different causes of hemoptysis, the relative importance of the different diagnostic modalities [...]

One-Year Follow-up Background: Blast injury to the lung is one of the devastating threats facing victims of an explosion. Although the pathogenesis of blast injury has been studied, little is [...]

We thank Drs. Charles and Selam for their thoughtful comments (1) regarding our study describing the National Institutes of Health (NIH) islet transplantation experience (2). We agree that the question [...]

Islet transplantation can now result in markedly improved metabolic control for a subset of individuals with 'brittle' type 1 diabetes. Yet, the immunosuppression required to prevent allograft rejection may come [...]

Background: The rates of morbidity and mortality associated with lung abscess are still significant despite the introduction of antibiotic treatments. The aim of this work was to identify the factors [...]