tbuckley/cabot-search huggingface dataset:
Multicentre trial to introduce the Ottawa ankle rules for use of radiography in acute ankle injuries
Authors: I. Stiell, G. Wells, A. Laupacis, R. Brison, R. Verbeek, K. Vandemheen, C D. Naylor
Journal: BMJ (1995)

<h3>Abstract</h3> <b>Objective</b>: To assess the feasibility and impact of introducing the Ottawa ankle rules to a large number of physicians in a wide variety of hospital and community settings over a prolonged period of time. <b>Design</b>: Multicentre before and after controlled clinical trial. <b>Setting</b>: Emergency departments of eight teaching and community hospitals in Canadian communities (population 10000 to 3000000). <b>Subjects</b>: All 12777 adults (6288 control, 6489 intervention) seen with acute ankle injuries during two 12 month periods before and after the intervention. <b>Intervention</b>: More than 200 physicians of varying experience were taught to order radiography according to the Ottawa ankle rules. <b>Main outcome measures</b>: Referral for ankle and foot radiography. <b>Results</b>: There were significant reductions in use of ankle radiography at all eight hospitals and within a priori subgroups: for all hospitals combined 82.8% control v 60.9% intervention (P&lt;0.001); for community hospitals 86.7% v 61.7%; (P&lt;0.001); for teaching hospitals 77.9% v 59.9%; (P&lt;0.001); for emergency physicians 82.1% v 61.6%; (P&lt;0.001); for family physicians 84.3% v 60.1%; (P&lt;0.001); and for housestaff 82.3% v 60.1%; (P&lt;0.001). Compared with patients without fracture who had radiography during the intervention period those who had no radiography spent less time in the emergency department (54.0 v 86.9 minutes; P&lt;0.001) and had lower medical charges ($70.20 v $161.60; P&lt;0.001). There was no difference in the rate of fractures diagnosed after discharge from the emergency department (0.5 v 0.4%). <b>Conclusions</b>: Introduction of the Ottawa ankle rules proved to be feasible in a large variety of hospital and community settings. Use of the rules over a prolonged period of time by many physicians of varying experience led to a decrease in ankle radiography, waiting times, and costs without an increased rate of missed fractures. The multiphase methodological approach used to develop and implement these rules may be applied to other clinical problems.
Hospital preparedness and management of patients affected by viral haemorrhagic fever or smallpox at the Lazzaro Spallanzani Institute, Italy
Authors: G Ippolito, E Nicastri, M R Capobianchi, A Di Caro, N Petrosillo, V Puro
Journal: Eurosurveillance (2005)

The US cases of anthrax in 2001 and the recent severe acute respiratory syndrome outbreak have heightened the need for preparedness and response to naturally emerging and re-emerging infections or deliberately released biological agents. This report describes the response model of the Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani (INMI), Rome, Italy for managing patients suspected of or affected by smallpox or viral haemorrhagic fever (VHF) either in the context of an intentional release or natural occurrence. The INMI is Italy’s leading hospital in its preparedness and response plan to bioterrorism-related infectious agents. All single and double rooms of INMI are equipped with negative air pressure, sealed doors, high efficiency particulate air (HEPA) filters and a fully-equipped anteroom; moreover, a dedicated high isolation unit with a laboratory next door for the initial diagnostic assays is available for admission of sporadic patients requiring high isolation. For patient transportation, two fully equipped ambulances and two stretcher isolators with a negative pressure section are available. Biomolecular and traditional diagnostic assays are currently performed in the biosafety level 3/4 (BSL 3/4) laboratories. Continuing education and training of hospital staff, consistent application of infection control practices, and availability of adequate personnel protective equipment are additional resources implemented for the care of highly infectious patients and to maintain the readiness of an appropriately trained workforce to handle large scale outbreaks.
Abstract 10860: Skap2 Directs Integrin-Stimulated Cytoskeletal Rearrangement, Modulates Macrophage Effector Functions, and Regulates Atherogenesis
Authors: Francis J Alenghat, Nooreen T Rubin, David E Golan, Kenneth D Swanson
Journal: Circulation (2011)

Background:  Integrins mediate macrophage functions, such as migration and phagocytosis, that are critical for atherogenesis. We have previously shown that the myeloid-specific adaptor protein Skap2 controls integrin-induced macrophage migration and actin remodeling, and we hypothesized that, through this role in macrophage function, Skap2 could modulate atherogenesis.   Methods & Results:  On a standard diet, 24-week old Skap2 -/- ;apoE -/-  C57BL/6 mice develop increased atherosclerotic plaque in their aortic roots compared to their Skap2 +/- ;apoE -/-  counterparts (plaque area by Oil Red O stain: 135±20 vs. 44±10 x10 3  μ m 2 , n=8 per genotype) with no detectable difference in weight, lipid profile, development, or other organ pathology. Moreover, the Skap2 -/-  mice have specific increased circulating cytokine levels (IL-1α 14.9±8.6, IL-6 6.4±2.4, IL-8 12.0±4.1 pg/ml, n=8) compared to Skap2 +/-  mice (IL-1α 2.0±0.8, IL-6 2.1±0.8, IL-8 4.4±2.5 pg/ml, n=8), supporting a macrophage-centric inflammatory process. Consistent with our previous finding that Skap2 binds Sirpα, bone marrow derived macrophages (BMMs) lacking either Skap2 or Sirpα exhibit similarly impaired local actin polymerization upon ligating αV integrins with antibody-coated microbeads. Furthermore, BMMs containing Skap2 mutants reveal that this cytoskeletal response requires the lipid binding activity of the Skap2 PH domain, likely by disrupting an auto-inhibitory interaction with the dimerization domain. Downstream of Skap2 and Sirpα, activation of the RacGEF Vav1 followed by PAK and LimK phosphorylation comprise the events leading to cofilin-mediated actin polymerization. While Skap2 does not impact baseline nonspecific macropinocytosis, Skap2 -/-  BMMs demonstrate impaired acetylated LDL uptake, a process mediated by the scavenger receptor and requiring actin reorganization.   Conclusion:  We find that Skap2 deficiency increases atheromatous burden in apoE -/-  mice, and we detail a pathway by which Skap2, in conjunction with Sirpα, directs integrin-mediated actin reorganization with functional consequences in macrophages. These findings provide new insight into the role of integrin-mediated intracellular signaling in the inflammatory component of atherosclerosis.
Abstract 3131: Axial Flow LVADs are Associated with Fewer Device-Related Infections than Pulsatile LVADs
Authors: Timothy P Martens, Mark J Russo, Isaac George, Faisal H Cheema, Tariq M Naseem, J Aidan Boswick, Veli K Topkara, Allan S Stewart, Mehmet C Oz, Yoshifumi Naka
Journal: Circulation (2006)
Abstract 1352: In-Hospital Assessment of Hemoglobin A1c in Patients With Diabetes Treated for Myocardial Infarction: Variability Between Hospitals and Relationship With Established Quality Indicators
Authors: Joshua M Stolker, Darren K McGuire, John A Spertus, Silvio E Inzucchi, Saif S Rathore, Thomas M Maddox, Frederick A Masoudi, Fengming Tang, Philip G Jones, Mikhail Kosiborod
Journal: Circulation (2009)

BACKGROUND It is unknown whether hospitals that provide higher quality care for acute MI are also more likely to focus on management of coexisting conditions, such as diabetes (DM). While the Ameri...
Risk-benefit ratio must be taken into account
Authors: S. Dollow
Journal: BMJ (1996)

Table 1-Comparison of results of study by Barrett and colleagues and study by Phillips and Kass.2Figures are numbers (percentages) of subjects except where stated otherwise Barrett and Phillips colleagues and Kass Total taking mefloquine 1214 285 Women taking mefloquine 698 (57) 171 (60) Median duration of use (weeks) 7 6 Adverse effects (all grades) occurred 503 (41) 108 (38) Events interfered with daily activities 143 (12) 32 (11) Stopped taking drug owing to adverse effects 63 (5) 18 (6)were admitted to hospital; the third had a seizure.Our study also found that basic travel, as opposed to group travel itself, was a major posi- tive effect modifying variable for adverse events associated with mefloquine.If this useful drug is not to be abandoned pre- maturely, prescribers must be given guidance about the pharmacology of mefloquine in women and possible interactions with recrea- tional drugs.We fully inform potential meflo- quine users about these issues and, when possible, give people two or three doses as a trial before they leave Australia.Initial poor tolerance of mefloquine can be greatly improved by altering the regimen to half a tablet twice weekly, although this has yet to be verified scientifically.
Age Range Widens for Pertussis Vaccine
Authors: Mike Mitka
Journal: JAMA (2006)

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
Effectiveness of planned short hospital stays for mental health care
Authors: S. Eth, P. Johnstone, G. Zolese
Journal: BMJ (1999)

Editor—Johnstone and Zolese report their systematic review of the effectiveness of planned short hospital stays for mental health care.1 Their findings may leave casual readers believing that new evidence has been marshalled to show that brief admissions to a psychiatric hospital “do not encourage a ‘revolving door’ pattern of care for people with serious mental illness and may be more effective than standard care.”1 Such a conclusion would be erroneous and, in an era of aggressive cost containment, dangerous.

In fact, this article merely presents a meta-analysis of four old and very different studies, each comparing “long” with “short” hospital stays. All the studies were performed more than 20 years ago, before the adoption of current diagnostic criteria (Diagnostic and Statistical Manual of Mental Disorders, fourth edition, and International Classification of Diseases, ninth revision) and modern treatment methods, such as use of selective serotonin reuptake inhibitors and atypical antipsychotic drugs. Further, the prominent decrease in psychiatric facilities (notably the American state hospital system) has meant that many of the patients with chronic mental illness who were institutionalised two decades ago are now subject to repeated acute care admissions to general hospitals.2

In the two studies by Glick et al that the authors cited, a short admission was defined as 21-28 days and a long admission as 90-120 days. Clearly, the adjectives short and long have since come to have very different meanings: a four week hospital stay today would generally be considered to be long. The other two studies were of a mixed sample of patients with either exclusively schizophrenic or “functional psychiatric” disorders that conceivably could encompass all personality, mood, and psychotic conditions. Can one draw an informed conclusion from pooling such outdated and heterogeneous data?3

At best this meta-analysis presents a historical snapshot of distant relevance to today’s world of inpatient psychiatry. Nevertheless, profit driven managed care companies may interpret this paper as justifying a solution to mental health cost control through the imposition of inappropriate limits on inpatient care.
Abstract B17: Tumor-associated stellate cells promote an invasive phenotype of pancreatic cancer cells
Authors: Emelie Karnevi, Ann H. Rosendahl, Moin A. Saleem, Roland Andersson
Journal: Cancer Research (2015)

Abstract At the time of diagnosis, almost 80% of pancreatic cancer patients present with either new-onset type 2 diabetes or impaired glucose tolerance. Pancreatic cancer is associated with a highly abundant stroma, which is believed to influence the pathogenesis of the disease. In the local tumor microenvironment, both elevated glucose levels and the presence of tumor-associated stellate cells are hypothesized to promote the tumor progression and invasion by tumor cells. In this study, the influence by the microenvironment on pancreatic cancer cell invasion was investigated in vitro. Epithelial-to-mesenchymal transition (EMT) of human pancreatic cancer cells co-cultured in normal (5mM) or high (25 mM) glucose conditions with tumor-associated pancreatic stellate cells (TPSCs) was monitored by Western immunoblotting. In addition, a three-dimensional organotypic model was established to study and visualize the pancreatic cancer cell invasion. After co-culture, the expression of several EMT-markers was altered. The levels of E-cadherin were reduced by more than 95% (P&amp;lt;0.001) while vimentin was increased by 45% (P&amp;lt;0.05). In addition, high glucose conditions reduced the levels of ZO-1 and β-catenin compared to normal glucose. TGF-β stimulation, a known inducer of EMT, resulted in a similar modulation of EMT markers. The organotypic model showed differences in the extent of invasion between the cell lines investigated, of which PANC-1 human pancreatic cells were shown to be the most invasive and also formed a highly proliferative epithelium. In high glucose conditions, the invasion of PANC-1 cells appeared to increase both in number and distance covered by the cells. Immunofluorescent staining of EMT-markers in organotypic sections displayed a lack of E-cadherin and extensive expression of vimentin in the tumor epithelium. In conclusion, this study show TPSCs to induce changes in pancreatic cancer cells associated with enhanced invasiveness. In addition, a three-dimensional model visualized the invasive potential of the pancreatic cancer cells, which was further enhanced by high glucose conditions. This study contributes to further elucidate the interplay between, and influence of, the cell types present in the local tumor microenvironment, which promotes the tumor cell invasion as an important step in the pancreatic tumor progression. Citation Format: Emelie Karnevi, Ann H. Rosendahl, Moin A. Saleem, Roland Andersson. Tumor-associated stellate cells promote an invasive phenotype of pancreatic cancer cells. [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer: Innovations in Research and Treatment; May 18-21, 2014; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2015;75(13 Suppl):Abstract nr B17.
Abstract 9361: Ivabradine in Inappropriate Sinus Tachycardia: an Appropriate Alternative.
Authors: Juan Benezet-Mazuecos, Jose Manuel Rubio, Jeronimo Farre, Ester Macia, Silvia del Castillo, Jose Antonio Iglesias, Juan Jose de la Vieja, Pedro Pablo Perez
Journal: Circulation (2010)

Introduction: Inappropriate sinus tachycardia (IST) is a challenging clinical syndrome characterized by elevation of heart rate (HR) disproportional to the physiologic demand. The incomplete unders...
Abstract 2085: Tissue Engineered Vascular Graft Remodelling in a Growing Lamb Model: Expression of Matrix Metalloproteinases (MMPS) and Collagen Content in vitro and in vivo
Authors: Ian Cummings, Sarah George, Jens Kelm, Doerthe Schmidt, Simon Hoerstrup
Journal: Circulation (2009)

Objectives: MMPs are a key family of proteases that contribute to matrix remodelling. In this study we aimed to assess whether expression and activity of MMP-2 and MMP-9 and collagen content are re...
Bone Resorption in Multiple Myeloma and in Monoclonal Gammopathy of Undetermined Significance: Quantification by Urinary Pyridinium Cross-Links of Collagen
Authors: Martin Pecherstorfer, Markus J. Seibel, Henning W. Woitge, Eva Horn, Judith Schuster, Jane Neuda, Peter Sagaster, Horst Köhn, Peter Bayer, Daniel Thiébaud, Heinz Ludwig
Journal: Blood (1997)
The effect of a cancer diagnosis on disability status
Authors: E. B. Habermann, B. A. Virnig, P. M. McGovern, A. M. McBean, B. H. Alexander, N. N. Baxter
Journal: Journal of Clinical Oncology (2009)

6531 Background: Although cancer and cancer treatments may lead to an inability to work, working-age adults eligible for Medicare benefits on the basis of disability face a 29-month waiting period between initial application due to disability and enrollment in the program. In this study we evaluated patterns of Medicare enrollment for working-age adults with cancer and determined factors predicting enrollment. Methods: The Surveillance, Epidemiology, and End Results (SEER) and SEER-Medicare data were used for this retrospective cohort analysis. We included patients age 21 to 59 diagnosed with lung, prostate, colorectal, and breast cancer (female) cases from 1992 through 2002. Patients were followed until 2005 or death. We constructed line plots of time from cancer diagnosis to enrollment in Medicare due to disability, anticipating a spike in enrollment around 29 months post-diagnosis. We compared demographic and tumor characteristics in the disabled to the all similarly aged patients included in SEER. We used logistic regression to determine factors associated with enrollment in Medicare due to disability 29 to 35 months post-diagnosis including demographic characteristics, stage at diagnosis, and type of surgical treatment. Results: We identified 359,049 working-age adults who were diagnosed with prostate, lung, colorectal, or female breast cancer. Within 5 years of diagnosis, 4.4% had enrolled in Medicare due to disability, most between 29 and 31 months post-diagnosis (the earliest time period of eligibility on the basis of cancer diagnosis). Later stage at diagnosis, lack of surgical treatment, aggressive surgical treatment, unmarried marital status, Hispanic or African American race/ethnicity, older age, and male gender were associated with statistically significantly higher odds of enrollment in Medicare due to disability. Conclusions: A significant number of working-age cancer patients become eligible for enrollment in Medicare due to disability. Most become eligible between 29 and 31 months after diagnosis indicating that cancer and/or treatment had a substantial permanent impact on ability to work from the time of diagnosis. Federal policy offering Medicare benefits only 29 months after application should be reevaluated. No significant financial relationships to disclose.
The selective peroxisomal proliferator-activated receptor-gamma agonist has an additive effect on plaque regression in combination with simvastatin in experimental atherosclerosis
Authors: Roberto Corti, Julio I Osende, John T Fallon, Valentin Fuster, Gabor Mizsei, Hani Jneid, Samuel D Wright, William F Chaplin, Juan J Badimon
Journal: Journal of the American College of Cardiology (2004)
Abstract 13222: Transgenic Mice with Cardiac-Directed Expression of a Catalytically Inactive AC6 have Increased LV Contractile Function Despite Marked Diminution of cAMP Production
Authors: Meihua Gao, Byeong Jo Chun, N. Chin Lai, Tong Tang, H. Kirk Hammond
Journal: Circulation (2010)

Background:  Cardiac-directed expression of adenylyl cyclase type 6 (AC6) has favorable effects on the failing heart, which is paradoxical since other agents that increase cAMP are deleterious in heart failure. One possibility is that AC69s beneficial effects on left ventricular (LV) function are independent of cAMP production.   Methods & Results:  To test this hypothesis, we made a catalytically inactive AC6 mutant (AC6mut). To preserve structural similarity to normal AC6, we changed only a single amino acid, replacing aspartic acid with alanine at position 426 in the C1 loop. Gene transfer of AC6mut in cultured cardiac myocytes showed markedly impaired cAMP generation in response to isoproterenol (Iso) and forskolin (Fsk). We then generated transgenic (TG) mice with cardiac-directed AC6mut expression. Line 2 was a low expresser (2-fold increase in AC6 protein), but Lines 1 and 3 showed high level expression (6- and 7-fold), had similar results in LV cAMP generation and physiological studies, and were therefore combined in a single group. LV samples showed marked impairment of Iso- (74% reduction; p Figure, left ). Isolated hearts from these animals (vs TG negative sibling mice) showed increased LV dP/dt response to isoproterenol infusion ( Figure, right ), despite impaired cAMP generation. In contrast, we previously showed that AC6 deleted TG mice have similarly impaired cAMP production, and have  impaired  LV contractile function.   Conclusion:  Increased LV function despite marked impairment of cAMP generating capacity indicates that AC6mut beneficially affects LV function through cAMP-independent effects.
Observations on the Effect of Thymectomy on Spontaneous Leukemias in Mice of the High-Leukemic Strains, RIL and C58
Authors: L. W. Law, J. H. Miller
Journal: JNCI Journal of the National Cancer Institute (1950)

Journal Article Observations on the Effect of Thymectomy on Spontaneous Leukemias in Mice of the High-Leukemic Strains, RIL and C58 Get access L. W. Law, L. W. Law Search for other works by this author on: Oxford Academic PubMed Google Scholar J. H. Miller J. H. Miller National Cancer Institute, National Institutes of Health, U. S. Public Health Service, Bethesda, Md. Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 11, Issue 2, October 1950, Pages 253–262, https://doi.org/10.1093/jnci/11.2.253 Published: 01 October 1950 Article history Received: 14 April 1950 Published: 01 October 1950