tbuckley/cabot-search huggingface dataset:
The Medical Review Officer's Guide to Drug Testing
Authors: Craig Zwerling
Journal: JAMA (1994)

Over the last decade, workplace drug testing has become increasingly common in the United States. In 1980, only the military and the nuclear industry tested routinely. Today, most large corporations require preemployment drug screens. Federal drug testing requirements apply to some 7 million Americans. While the manufacture of equipment and chemicals used in drug testing cost $300 million in 1990, more recent estimates suggest that drug testing is now a billion-dollar-a-year industry. The rapid growth of drug testing has given rise to a new role for physicians: medical review officer (MRO). First defined in the 1988 guidelines for drug testing in the federal workplace, an MRO is a physician who reviews the results of drug tests. The MRO offers the employee the chance to provide an explanation for a positive result, such as a prescription for a controlled substance. In addition, MROs have come to serve an important quality control
Clinics in neurology and neurosurgery of sport: peripheral nerve injury
Authors: G Davis, D G Kline, R J Spinner, E l Zager, M J Garberina, G R Williams, P McCrory
Journal: British Journal of Sports Medicine (2008)

Peripheral nerve injuries are not uncommon in sports. Typically, these are associated with orthopaedic injury (eg, axillary nerve injury with glenohumeral joint dislocation) rather than the transection or gunshot-type injuries often seen in emergency departments.

The classification of nerve injuries is complex,1 2 but the underlying principle is that the simplest of nerve injuries is a physiological loss only (neurapraxia) and the most severe form is complete anatomical transection of the nerve and its coverings (neurotmesis). Between these two extremes are varying degrees of injury to the axon and its covering sheath.

With all degrees of nerve injury, the greater the degree of preservation of anatomical structures, the greater the chance of neurological recovery. Thus a neurapraxic injury will recover spontaneously, whereas a neurotmetic injury will not recover without surgical intervention. Between these two ends of the spectrum is a large group of nerve injuries in which the capacity for spontaneous recovery cannot be accurately assessed clinically and may require surgical exploration with or without nerve repair.

On the sports field, the most common mechanism of nerve injury is a stretch or traction type of injury. In the first few weeks following a stretch injury, clinical observation is required. and after sufficient time has elapsed for Wallerian degeneration to occur (at least 2 weeks), then nerve conduction studies (NCS) and electromyography (EMG) can be performed. Over the following 6–8 weeks, a nerve injury is then followed by clinical examination and repeat NCS/EMG, with the objective being to determine whether spontaneous recovery will occur. If there is failure of neurological recovery at 3 months after the injury, then surgical intervention is required to facilitate recovery before irreversible fibrosis in the denervated muscle results.

The principles used by the peripheral nerve surgeon include neurolysis, intraoperative nerve action potentials (NAP), primary repair, …
Elevated serum IgE and IgG4 in patients with atopic dermatitis
Authors: F. SHAKIB, P. McLAUGHLAN, D. R. STANWORTH, E. SMITH, E. FAIRBURN
Journal: British Journal of Dermatology (1977)

The quantitative measurement of the IgE and IgG subclass levels in the sera of 29 patients with atopic dermatitis has revealed significantly elevated levels of IgE and IgG4 in a relatively high proportion of patients with this condition compared to non‐atopic patients with warts and to a group of normal volunteers studied previously. The possible significance of these observations is discussed in relation to current evidence suggesting the involvement of IgG4 in certain immediate‐type hypersensitivity disorders.
Increase in mortality in Russia in the 1990s: Authors' reply
Authors: S L Plavinski
Journal: BMJ (2003)

Editor—The hypothesis that alcohol is a major determinant of the recent mortality fluctuations in Russia is based on circumstantial evidence.1 Changes in binge drinking patterns are not compatible with changes in mortality.2 High death rates from cardiovascular disease cannot be explained by misclassification of deaths attributable to acute alcohol poisoning.3 Our study also failed to support an “alcohol only” hypothesis.

Firstly, the mortality structure did not change in two cohorts: non-natural death was responsible for 11% of all cases in the first cohort and 7% in the second cohort. The proportion of deaths due to cancer remained the same (26.3% and 26%), which argues against sudden increase in alcohol related deaths even misclassified as deaths from cardiovascular disease.

Secondly, “weekend deaths” are believed to be an indicator of alcohol related mortality. In the first cohort among people with the lowest education there was slight excess of mortality on Saturdays, but in the second cohort the excess was on Tuesday and Friday. No weekend excess was evident. The same pattern was observed for participants with a university education who showed no increase in overall mortality.

Thirdly, alcohol is not a major risk factor for mortality in Russian middle aged men,4 and an increase in mortality was seen in only 5% of frequent heavy drinkers.5​5



Figure 1



Fourthly, another study performed in St Petersburg showed that people with a poor education receive poor hypertension treatment—only 12.5% received adequate drug treatment in contrast to 50% of people with a university education (S L Plavinski and E V Frolova, 12th lipid meeting, Leipzig, 2002). We sincerely believe that other factors should be discussed as the reason for the mortality increase in Russia.
Relationship between insulin sensitivity, insulin secretion and glucose tolerance in cirrhosis
Authors: Yolanta T. Kruszynska, Philip D. Home, Neil McIntyre
Journal: Hepatology (1991)

Hepatic insulin extraction is difficult to measure in humans; as a result, the interrelationship between defective insulin secretion and insulin insensitivity in the pathogenesis of glucose intolerance in cirrhosis remains unclear. To reassess this we used recombinant human C-peptide to measure C-peptide clearance in cirrhotic patients and controls and thus derive C-peptide and insulin secretion rates after a 75-gm oral glucose load and during a 10 mmol/L hyperglycemic clamp. Cirrhotic patients were confirmed as insulin-insensitive during a euglycemic clamp (glucose requirement: 4.1 +/- 0.1 mg/kg/min vs. 8.1 +/- 0.5 mg/kg/min; p less than 0.001), which also demonstrated a low insulin metabolic clearance rate (p less than 0.001). Although intolerant after oral glucose, the cirrhotic patients had glucose requirements identical to those of controls during the hyperglycemic clamp (cirrhotic patients: 6.1 +/- 1.0 mg/kg/min; controls: 6.3 +/- 0.7 mg/kg/min), suggesting normal intravenous glucose tolerance. C-peptide MCR was identical in cirrhotic patients (2.93 +/- 0.16 ml/min/kg) and controls (2.96 +/- 0.24 ml/min/kg). Insulin secretion was higher in cirrhotic patients, both fasting (2.13 +/- 0.26 U/hr vs. 1.09 +/- 0.10 U/hr; p less than 0.001) and from min 30 to 90 of the hyperglycemic clamp (5.22 +/- 0.70 U/hr vs. 2.85 +/- 0.22 U/hr; p less than 0.001). However, with oral glucose the rise in serum C-peptide concentration was relatively delayed, and the insulin secretion index (secretion/area under 3-hr glucose curve) was not elevated. Hepatic insulin extraction was reduced both in fasting and during the hyperglycemic clamp (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
Erythroderma resembling sezary syndrome after treatment with Fansidar and chloroquine.
Authors: J A Langtry, J I Harper, R C Staughton, P Barrington
Journal: BMJ (1986)

Contamination ofparaphernalia usedfor injection-Four addicts submitted their injection paraphernalia for culture.C albcans was isolated from one set and C parapsilosis from another.The remaining two sets yielded negative results.Recovery offungi from street heroin-It is illegal to obtain heroin sold in the streets.Legal restrictions on the availability of confiscated drugs precluded analysis, despite our attempts to arrange this.Effect of diacetylmorphine hrydrochloride on growth of C albicans-Previous studies failed to isolate Candida spp from heroin sold in the street.23Cultures of C albicans in the exponentially growing and resting phases were found to be inhibited by diacetylmorphine in agar diffusion susceptibility tests.Excision-of the inhibition zones and further incubation in drug free medium did notenhance growth of the organisms.This indicates a fungicidal potential for the drug.The minimum inhibitory concentration using agar and broth dilution methods was 25-30 g/l.
Fearful Symmetry: Subversion of Asymmetric Division in Cancer Development and Progression
Authors: Jeevisha Bajaj, Bryan Zimdahl, Tannishtha Reya
Journal: Cancer Research (2015)

Asymmetric division is an evolutionarily conserved process that generates daughter cells with different fates through the unequal partitioning of fate determinants. While asymmetric division is critically important in generating diversity during development, its dysregulation can also promote oncogenesis. In particular, signals that shift the normal balance of symmetric and asymmetric division can lead to a differentiation arrest and trigger cancer progression. Here, we discuss the studies that have provided increasing support for this idea. Beginning with original work carried out in Drosophila, we trace more recent work in mammalian systems that suggest that the subversion of asymmetric division can contribute significantly to the development and progression of both hematologic malignancies and solid cancers.
Fat, Fruits, Vegetables, and Breast Cancer Survivorship
Authors: Susan M. Gapstur, Seema Khan
Journal: JAMA (2007)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Cerebral microdialysis in patients with fulminant hepatic failure
Authors: F Tofteng
Journal: Hepatology (2002)

Fulminant hepatic failure (FHF) is often complicated by high intracranial pressure (ICP) and fatal brain damage. In this study, we determined if a rise in [glutamate]ec and [lactate]ec preceded surges of high ICP in patients with FHF (median age, 42; range, 20-55 years; 7 women; 3 men) by inserting a microdialysis catheter into the brain-cortex together with an ICP catheter. The microdialysis catheter was perfused with artificial cerebrospinal-fluid at a rate of 0.3 microL/min. Dialysate was collected approximately every 30 minutes or when ICP increased. A total of 352 microdialysis samples were collected during a median of 3 days and allowed for approximately 1,760 bedside analyses of the collected dialysate. In 5 patients that later developed surges of high ICP, the initial values of [glutamate]ec and [lactate]ec were 2 to 5 times higher compared with patients with normal ICP. [Glutamate]ec then tended to vanish with time in both groups of patients. An increase in [glutamate]ec did not precede high ICP in any of the cases. In contrast, [lactate]ec was high throughout the study in the high ICP group and increased further before surges of high ICP. We conclude that in patients with FHF, cerebral [glutamate]ec and [lactate]ec are elevated. However, the elevated [glutamate]ec is not correlated to high ICP. In contrast, elevations in [lactate]ec preceded surges of high ICP. In conclusion, accelerated glycolysis with lactate accumulation is implicated in vasodilatation and high ICP in patients with FHF. The data suggest that bedside cerebral microdialysis is a valuable tool in monitoring patients with FHF and severe hyperammonemia.
Drotrecogin alfa (activated) did not reduce mortality at 28 or 90 days in patients with septic shock
Authors: Christian Brun-Buisson
Journal: Annals of Internal Medicine (2012)

ACP Journal Club21 August 2012Drotrecogin alfa (activated) did not reduce mortality at 28 or 90 days in patients with septic shockChristian Brun-Buisson, MDChristian Brun-Buisson, MDCHU Henri Mondor, AP-HP, Créteil, France (C.B.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-4-201208210-02011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationRanieri VM, Thompson BT, Barie PS, et al; PROWESS-SHOCK Study Group. Drotrecogin alfa (activated) in adults with septic shock. N Engl J Med. 2012;366:2055-64. https://pubmed.ncbi.nlm.nih.gov/22616830Clinical Impact RatingsHospitalists: Infectious Disease: Critical Care: References1 Bernard GR, Vincent JL, Laterre PF, et al; Recombinant human protein C Worldwide Evaluation in Severe Sepsis (PROWESS) study group. Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med. 2001;344:699-709. [PMID: 11236773] Google Scholar2 Nadel S, Goldstein B, Williams MD, et al; REsearching severe Sepsis and Organ dysfunction in children: a gLobal perspective (RESOLVE) study group. Drotrecogin alfa (activated) in children with severe sepsis: a multicentre phase III randomised controlled trial. Lancet. 2007;369:836-43. [PMID: 17350452] Google Scholar3 Abraham E, Laterre PF, Garg R, et al; Administration of Drotrecogin Alfa (Activated) in Early Stage Severe Sepsis (ADDRESS) Study Group. Drotrecogin alfa (activated) for adults with severe sepsis and a low risk of death. N Engl J Med. 2005;353:1332-41. [PMID: 16192478] Google Scholar Author, Article, and Disclosure InformationAuthors: Christian Brun-Buisson, MDAffiliations: CHU Henri Mondor, AP-HP, Créteil, France (C.B.)This article was published at Annals.org on 7 August 2012. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 21 August 2012Volume 157, Issue 4Page: JC2-11KeywordsDrugsHemorrhageMortalityResuscitationSaline solutionsSepsisSerious adverse eventsShockVasopressorsWeaning ePublished: 21 August 2012 Issue Published: 21 August 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Vincent van Gogh: Chemicals, Crises, and Creativity
Authors: Marie Fernicola Pennanen
Journal: JAMA (1993)

The popularity of Vincent van Gogh a century after his death attests to his unique artistic genius. The tragic details of his life, his self-mutilation, and his suicide have prompted speculation about the underlying illness that drove a gifted artist to self-destruction and raised the question of whether his vision of the world was colored by it, literally. Was van Gogh a great artist despite, or because of, his infirmity? Wilfred N. Arnold, a biochemist who has published six books on Vincent van Gogh's medical history, has written in<i>Vincent van Gogh: Chemicals, Crises, and Creativity</i>a thorough account of van Gogh's health, the likely etiology of his symptoms, and alternate hypotheses. He introduces information gradually, until the proposed diagnosis, acute intermittent porphyria, is revealed. The work is a synthesis of medical history, art history, biography, and science. Each chapter begins with a lavish reproduction of a painting by or
Factors Related to Errors in Medication Prescribing
Authors: Timothy S. Lesar
Journal: JAMA (1997)

To quantify the type and frequency of identifiable factors associated with medication prescribing errors.Systematic evaluation of every third prescribing error detected and averted by pharmacists in a 631-bed tertiary care teaching hospital between July 1, 1994, and June 30, 1995. Each error was concurrently evaluated for the potential to result in adverse patient consequences. Each error was retrospectively evaluated by a physician and 2 pharmacists and a factor likely related to the error was identified.All physicians prescribing medications during the study period and all staff pharmacists involved in the routine review of medication orders.Frequency of association of factors likely related to medication errors in general and specific to medication classes and prescribing services (needed for medical, pediatric, obstetric-gynecologic, surgical, or emergency department patients); and potential consequences of errors for negative patient outcomes.A total of 2103 errors thought to have potential clinical importance were detected during the 1-year study period. The overall rate of errors was 3.99 errors per 1000 medication orders, and the error rate varied among medication classes and prescribing services. A total of 696 errors met study criteria (ie, errors with the potential for adverse patient effects) and were evaluated for a likely related factor. The most common specific factors associated with errors were decline in renal or hepatic function requiring alteration of drug therapy (97 errors, 13.9%), patient history of allergy to the same medication class (84 errors, 12.1%), using the wrong drug name, dosage form, or abbreviation (total of 79 errors, 11.4%, for both brand name and generic name orders), incorrect dosage calculations (77 errors, 11.1%), and atypical or unusual and critical dosage frequency considerations (75 errors, 10.8%). The most common groups of factors associated with errors were those related to knowledge and the application of knowledge regarding drug therapy (209 errors, 30%); knowledge and use of knowledge regarding patient factors that affect drug therapy (203 errors, 29.2%); use of calculations, decimal points, or unit and rate expression factors (122 errors, 17.5%); and nomenclature factors (incorrect drug name, dosage form, or abbreviation) (93 errors, 13.4%).Several easily identified factors are associated with a large proportion of medication prescribing errors. By improving the focus of organizational, technological, and risk management educational and training efforts using the factors commonly associated with prescribing errors, risk to patients from adverse drug events should be reduced.
Antisense oligonucleotides against collagen-binding stress protein HSP47 suppress peritoneal fibrosis in rats
Authors: Tomoya Nishino, Masanobu Miyazaki, Katsushige Abe, Akira Furusu, Yoko Mishima, Takashi Harada, Yoshiyuki Ozono, Takehiko Koji, Shigeru Kohno
Journal: Kidney International (2003)
Cytosolic Hsp60 orchestrates the survival and inflammatory responses of vascular smooth muscle cells in injured aortic vessels
Authors: Boae Choi, Mina Choi, Charny Park, Eun Kyung Lee, Dong Hoon Kang, Doo Jae Lee, Jae Yoon Yeom, Yeonjoo Jung, Jaesang Kim, Sanghyuk Lee, Sang Won Kang
Journal: Cardiovascular Research (2015)

Pro-inflammatory response of vascular smooth muscle cells (VSMCs) is triggered by endothelial damage and a causative step for thrombosis and neointimal thickening in the injured arterial vessels. Therefore, we investigate a role of cytosolic Hsp60 as a novel pro-inflammatory mediator in VSMCs. Hsp60 was detected in the cytosol of VSMCs. The selective depletion of cytosolic Hsp60 in VSMCs reduced the IκB kinase activation, repressed the induction of nuclear factor (NF)-κB-dependent survival genes (MnSOD and Bfl-1/A1), and enhanced apoptotic death in response to TNF-α. Moreover, a quantitative RNA sequencing revealed that the expression of 75 genes among the 774 TNF-α-inducible genes was significantly reduced by the depletion of cytosolic Hsp60. In particular, the expression of pro-inflammatory cytokines/chemokines, such as CCL2, CCL20, and IL-6, was regulated by the cytosolic Hsp60 in VSMCs. Finally, the depletion of cytosolic Hsp60 markedly inhibited the neointimal thickening in the balloon-injured arterial vessels by inducing apoptotic cell death and inhibiting chemokine production. This study provides the first evidence that cytosolic Hsp60 could be a therapeutic target for preventing VSMC hyperplasia and inflammatory response in the injured vessels.
STUDIES ON PEROXIDATIVE DETOXIFICATION OF PURIFIED DIPHTHERIA TOXIN
Authors: Kjell Agner
Journal: The Journal of Experimental Medicine (1950)

The mechanism of the peroxidative oxidation of diphtheria toxin has been investigated. It has been found that this reaction requires the presence of an oxidizable, dialyzable cofactor in addition to hydrogen peroxide and peroxidase. Cofactors are present in a variety of materials and have been partially purified from urine. The flocculation titer of toxin modified by peroxidation remains unchanged even after 99 per cent or more of the toxicity has been destroyed. The change thus appears analogous to the conversion of toxin to toxoid in the presence of formalin. It is suggested that the well known conversion of crude diphtheria toxin to toxoid which occurs on storage or aging may be due to a slow peroxidative process.
Drug industry to fight New Zealand's move to ban direct to consumer advertising
Authors: Bob Burton
Journal: BMJ (2004)

Moves by New Zealand's health minister, Annette King, to end advertising directly to consumers later this year by “harmonising” with Australian government standards has drawn opposition from the drug industry.

In December 2003 New Zealand and Australia signed a treaty to establish a single bi-national agency to regulate medicines, medical devices, and complementary health products on 1 July 2005 (2004;328:68). The text of the treaty was tabled in both parliaments in late March and is subject to review by parliamentary committees. Supporting documentation identified direct to consumer advertising as one of the differences where efficiencies could be made. …