tbuckley/cabot-search huggingface dataset:
Colitis Associated with Variant <i>Clostridium difficile</i>
Authors: Quentin B. Deming, Edward S. Hyman
Journal: Annals of Internal Medicine (2002)

Letters20 August 2002Colitis Associated with Variant Clostridium difficileQuentin B. Deming, MD and Edward S. Hyman, MDQuentin B. Deming, MDHanover, NH 03755-6600New Orleans, LA 70125Search for more papers by this author and Edward S. Hyman, MDHanover, NH 03755-6600New Orleans, LA 70125Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-4-200208200-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their report of a case of fatal pseudomembranous colitis associated with a variant Clostridium difficile strain, Johnson and colleagues (1) did an impressive job of characterizing the toxin B–producing variant and emphasizing that “clinical laboratories and clinicians who rely solely on toxin A immunoassay to diagnose C. difficile disease should recognize the possibility of C. difficile diarrhea in patients with negative test results.” The laboratory studies performed on the isolate were informative, and the telephone survey revealing that half of the hospitals in the Chicago, Illinois, area rely exclusively on the assay for toxin A provided ...Reference1. Johnson S, Kent SA, O'Leary KJ, Merrigan MM, Sambol SP, Peterson LR, et al . Fatal pseudomembranous colitis associated with a variant clostridium difficile strain not detected by toxin A immunoassay. Ann Intern Med. 2001;135:434-8. [PMID: 11560456] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Quentin B. Deming, MD; Edward S. Hyman, MDAffiliations: Hanover, NH 03755-6600New Orleans, LA 70125 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoFatal Pseudomembranous Colitis Associated with a Variant Clostridium difficile Strain Not Detected by Toxin A Immunoassay Stuart Johnson , Sara A. Kent , Kevin J. O'Leary , Michelle M. Merrigan , Susan P. Sambol , Lance R. Peterson , and Dale N. Gerding Colitis Associated with Variant Clostridium difficile Stuart Johnson , Dale N. Gerding , and Lance R. Peterson Metrics 20 August 2002Volume 137, Issue 4Page: 297-298KeywordsAntibioticsC difficile colitisClinical laboratoriesClostridium difficileDiarrheaOsteomyelitisPatientsResearch laboratoriesToxinsVancomycin ePublished: 20 August 2002 Issue Published: 20 August 2002 Copyright & PermissionsCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Factitious Disorders in a Teaching Hospital
Authors: PETER REICH
Journal: Annals of Internal Medicine (1983)

To obtain an overview of factitious disorders in hospitalized patients we surveyed the cases found in our hospital during a 10-year period. Forty-one disorders were identified including one that was fatal and others that were chronic, severe, and life-threatening. The disorders fell into four subgroups: self-induced infections, simulated illnesses, chronic wounds, and surreptitious selfmedication. These subgroups had implications for prognosis and management. The patients included 39 women and 2 men, average age 33 years, 28 working in medical jobs. With three possible exceptions, none of the patients had Munchausen's syndrome and were not malingerers or sociopaths. Most of these patients
Abortion and the Sanctity of Human Life: A Philosophical View
Authors: Glen W. Davidson
Journal: JAMA (1976)

Probably no ethical issue generates more simplistic dogmatism today than abortion. Few dogmatists seem to take the time or even show the concern about identifying "the what" about which they are dogmatic. Baruch Brody's analysis of the subject is anything but simplistic. Formerly a faculty member at Massachusetts Institute of Technology, Professor Brody is presently Chairman of the Department of Philosophy at Rice University. In the best tradition of philosophical distinction-making, he attempts to show how his own position on abortion issues has changed from assuming that "opposition to abortion is based solely upon dubious theological claims" to the judgment that "abortion has never been morally justifiable." Few readers can fail to appreciate Professor Brody's rational clarity, but many clinicians will fault that presumption of philosophical method which disregards the phenomena of propriety, propinquity, and prejudice, which so often turn rational principle into its dogmatic opposite in the clinical context.
Assessment of Sinus Node Function in Patients with the Sick Sinus Syndrome
Authors: WILLIAM J. MANDEL, HIROKAZU HAYAKAWA, HOWARD N. ALLEN, RONALD DANZIG, ALAN I. KERMAIER
Journal: Circulation (1972)

Thirty-one patients with symptomatic sinus node dysfunction were evaluated with electrocardiograms, Holter monitor recordings, exercise, isoproterenol infusions, atropine administration, Valsalva maneuvers, carotid sinus massage, and overdrive pacing. Four basic clinical subsets were recognized: (1) carotid sinus hypersensitivity (2) bradycardia-tachycardia syndrome, (3) episodic sinus arrest, and (4) persistent symptomatic sinus bradycardia. The study group demonstrated a normal heart rate response to exercise and isoproterenol infusion (%Δ = +95 exercise, +144 isoproterenol) in the face of diminished responsiveness to atropine administration (%Δ = +23). Marked carotid sinus hypersensitivity was demonstrated in eight patients, and four patients demonstrated slight abnormalities during performance of Valsalva maneuvers. Significant suppression of sinus node dysfunction was observed following atrial overdrive in the study group (postpacing pause = 3087 ± 464 msec) as compared to patients without significant sinus node function (postpacing pause = 1073 ± 63 msec) ( P &lt; 0.001). In patients with intact V-A conduction, ventricular overdrive also resulted in sinus node suppression (postpacing pause = 1901 ± 357 msec). There was a marked decrease in the degree of sinus node depression following atropine administration. Ten of 31 patients demonstrated various degrees of A-V block following atrial pacing at rates less than 100 beats/min. It is concluded that the present methods of evaluation of sinus function, especially sinus node recovery time following overdrive pacing, may prove of value in the investigation of patients with syncope of unknown etiology.
Informed consent: edging forwards (and backwards)
Authors: R. Smith
Journal: BMJ (1998)

News p 955 Education and debate pp 1000–1011 Letters p 1022 Personal views pp 1026-1027 

The issue of informed consent within medical practice, research, and publication is coming increasingly to the fore as the balance of power in the doctor-patient relationship tips towards patients. Last week Britain's General Medical Council heard a case in which a paediatric cardiologist was accused of going beyond the consent that he was given to treat a child. The child died, and he was found guilty of serious professional misconduct and erased from the medical register for six months (p 955).1 When, last year, we published a cluster of articles asking whether we should decline to publish studies where patients had not given fully informed consent we prompted a flood of correspondence. We received over 50 letters, most of them argued with unusual care and clarity. Authors split down the middle between those who argued that we should always insist on informed consent (except in very limited circumstances) and those who thought that there were occasions when we need not. Today we try to advance the debate by publishing further responses to last year's debate, including some from patients' representatives. Within the broad context of informed consent we also explore the particular issue of consent for publication of material that emerges from the doctor-patient relationship.

In our first cluster Len Doyal made the case for insisting on informed consent with only a few narrow exceptions,2 while Jeff Tobias argued that the BMJ should sometimes publish papers that did not include fully informed consent.3 Both reflect on the subsequent debate, but neither has changed his position (pp 1000,1001).4



Previous articles and comment on informed consent are available on our website (see Collections)



Mary Warnock, a philosopher who chaired …
1033. Tightly Controlled and Reversible Knockdown of Gene Expression Using Lentiviral Vectors Encoding Tetracycline-Dependent Repressors or Transactivators
Authors: Krzysztof Pluta, William Diehl, Robert H. Kutner, Xian-Yang Zhang, Jakob Reiser
Journal: Molecular Therapy (2006)

RNAi accomplished in mammalian cells by the introduction of small interfering RNAs (siRNAs) is a powerful emerging tool for reverse genetic studies. To control siRNA-mediated gene knockdown both spatially and temporally, we undertook the development of HIV-1-based lentiviral vector systems for the conditional, doxycycline (Dox) dependent production of short hairpin RNAs (shRNAs) in mammalian cells from modified human RNA polymerase III (Pol III) promoters. Our results showed that expression of shRNAs from engineered human U6 (hU6) promoters containing a single tetracycline operator (TO) sequence between the proximal sequence element (PSE) and the TATA box, or a second- generation Tet-responsive promoter element (TRE) upstream ofthe promoter was tight and reversible in the presence of a modified Tet-repressor (TetR). Reversible repression of shRNA production was mediated by doxycycline (Dox) addition. We also established a novel hU6 promoter system in which the distal sequence element (DSE) of the hU6 promoter was replaced with a second-generation TRE element. In this system, positive regulation of shRNA production is mediated by a novel Tet-dependent transactivator bearing the transactivator domain of the human Sp1 transcription factor. The results obtained using EGFP and human CXCR4 chemokine receptor mRNAs as targets suggest that these vectors systems are useful for tight and controlled gene knockdown in mammalian cells in vitro. They may ultimately find applications in vivo including transgenic mouse models of human disease.
Surgical Treatment of Degenerative Arthritis of the Knee Joint
Authors: G. E. Haggart
Journal: New England Journal of Medicine (1947)

SINCE the conservative treatment of degenerative or hypertrophic arthritis of the knee joint had been disappointing at the Lahey Clinic, particularly in vigorous patients with unilateral involvement, a plan of surgical management was decided on, and in 1940 the results obtained in knee joints that had been operated on in 20 cases were reported.1 Since then sufficient time has elapsed to evaluate the results in an additional 10 cases. The object of this paper is to discuss criteria for selection of patients for surgery, to present details of the operative technic and finally to report the results obtained. Selection of . . .
Virtual White Coat
Authors: Adam Possner
Journal: JAMA (2013)

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
The Development of Emphysema in Cigarette Smoke-exposed Mice Is Strain Dependent
Authors: Alexei Guerassimov, Yuma Hoshino, Yasutaka Takubo, Antony Turcotte, Midori Yamamoto, Heberto Ghezzo, Alexandra Triantafillopoulos, Kevin Whittaker, John R. Hoidal, Manuel G. Cosio
Journal: American Journal of Respiratory and Critical Care Medicine (2004)

Only 20% of smokers develop chronic obstructive pulmonary disease. An important determinant of susceptibility is genomic variation. We undertook this study to define strains of mice with different susceptibilities for the development of smoking-induced emphysema because they could help identify genetic factors of susceptibility. NZWLac/J, C57BL6/J, A/J, SJ/L, and AKR/J strains were exposed to cigarette smoke for 6 months. Elastance (Htis), the extent of emphysema (mean linear intercept [Lm]), and the inflammatory cell and cytokine response were measured. NZWLac/J had no change in Lm or Htis (resistant). C57BL6/J, A/J, and SJ/L increased Lm, but not Htis (mildly susceptible). AKR/J increased Lm and Htis (super-susceptible). Only AKR/J had significant inflammation comprising macrophages, neutrophils, and T cells. The AKR/J showed an upregulation of Th1 cytokines whereas in the C57BL/6/J and NZWlac/J, cytokines did not change or were downregulated. We conclude that Lm, elastance, and inflammation are features that are needed to phenotype emphysema in mice. The inflammatory cell and cytokine profile may be an important determinant of the phenotype in response to cigarette smoke exposure. The identification of resistant and susceptible strains for the development of emphysema could be useful for genomic studies of emphysema susceptibility in mice and eventually in humans.
Vasoflux, a New Anticoagulant With a Novel Mechanism of Action
Authors: Jeffrey I. Weitz, Edward Young, Marilyn Johnston, Alan R. Stafford, James C. Fredenburgh, Jack Hirsh
Journal: Circulation (1999)

Background —Heparin and direct thrombin inhibitors, such as hirudin, have limitations in the treatment of acute coronary syndromes. Heparin does not inactivate fibrin-bound thrombin, whereas hirudin fails to block thrombin generation. In contrast, Vasoflux is a novel anticoagulant that inactivates fibrin-bound thrombin and attenuates factor Xa generation. Methods and Results —Vasoflux is prepared by depolymerization of heparin, restricting molecular size to between 3000 and 8000 Da, and reducing antithrombin affinity by periodate oxidation. Vasoflux catalyzes fibrin-bound thrombin inactivation by heparin cofactor II (HCII) and inhibits factor IXa activation of factor X independently of antithrombin and HCII. Compared with other anticoagulants in a thrombogenic extracorporeal circuit, Vasoflux maintains filter patency at concentrations that produce an activated clotting time (ACT) of 220 seconds. In contrast, to maintain filter patency, heparin, low-molecular-weight heparin (LMWH), and hirudin require concentrations that produced an ACT of 720, 415, and &gt;1500 seconds, respectively, whereas dermatan sulfate was ineffective at concentrations that produced an ACT of 360 seconds. Conclusions —Vasoflux is more effective than heparin and LMWH because it inactivates fibrin-bound thrombin and is superior to hirudin and dermatan sulfate because it also blocks factor Xa generation.
ANDROGENS STIMULATE HUMAN ENDOTHELIAL PROGENITOR CELL FUNCTION AND HUMAN CORONARY COLLATERALIZATION
Authors: Chi-Jen Hsu, Renee Chow, Pip Simpson, Louise Dunn, Kim Chan, Andy Yong, Daniel Sieveking, Matthew Guillou, David Celermajer, Martin Ng
Journal: Journal of the American College of Cardiology (2011)
Linear order and its place in grammar
Authors: Richard Wiese
Journal: Behavioral and Brain Sciences (2003)

This commentary discusses the division of labor between syntax and phonology, starting with the parallel model of grammar developed by Jackendoff. It is proposed that linear, left-to-right order of linguistic items is not represented in syntax, but in phonology. Syntax concerns the abstract relations of categories alone. All components of grammar contribute to linear order, by means of the interface rules.
Neonatal ward in Bremen is closed down again after two more deaths of babies
Authors: A. Tuffs
Journal: BMJ (2012)

The neonatal ward and maternity unit at the Central Bremen Hospital closed on 29 February after the recurrence of extended spectrum β lactamase (ESBL) Klebsiella pneumoniae infection and the deaths of two more babies. 

The ward closed for two months in November 2011 after three premature babies died from infections with multiresistant bacteria ( BMJ 2011;343:d7396, doi:10.1136/bmj.d7396 …
"CURRENT CRITICISMS OF MEDICAL EDUCATION"
Authors: Frank M. Wood
Journal: JAMA (1924)

<h3>To the Editor:</h3> —Your recent editorial on this subject, and Dr. Pusey's comment, together with his masterly address as President-Elect of the Association, reveal facts which every physician needs to digest and ponder; because every day he faces social movements and notes their successful action to the hurt of our profession. The public health propaganda in every community is now bringing into medical practice such an army of untrained, hairbrained cultists and faddists, working in and through the public schools and free clinics, that it is up to us to meet this movement by some definite plan of action. On the other hand, the increasing difficulty of completing the present day medical requirements, and of passing the state examination for medical licensure, is forcing many worthy young men and women out of the regular medical field, into the more attractive field of easy practice and easy money, among the irregulars
Improving Quality Improvement Using Achievable Benchmarks For Physician Feedback
Authors: Catarina I. Kiefe, Jeroan J. Allison, O. Dale Williams, Sharina D. Person, Michael T. Weaver, Norman W. Weissman
Journal: JAMA (2001)

Performance feedback and benchmarking, common tools for health care improvement, are rarely studied in randomized trials. Achievable Benchmarks of Care (ABCs) are standards of excellence attained by top performers in a peer group and are easily and reproducibly calculated from existing performance data.To evaluate the effectiveness of using achievable benchmarks to enhance typical physician performance feedback and improve care.Group-randomized controlled trial conducted in December 1996, with follow-up through 1998.Seventy community physicians and 2978 fee-for-service Medicare patients with diabetes mellitus who were part of the Ambulatory Care Quality Improvement Project in Alabama.Physicians were randomly assigned to receive a multimodal improvement intervention, including chart review and physician-specific feedback (comparison group; n = 35) or an identical intervention plus achievable benchmark feedback (experimental group; n = 35).Preintervention (1994-1995) to postintervention (1997-1998) changes in the proportion of patients receiving influenza vaccination; foot examination; and each of 3 blood tests measuring glucose control, cholesterol level, and triglyceride level, compared between the 2 groups.The proportion of patients who received influenza vaccine improved from 40% to 58% in the experimental group (P<.001) vs from 40% to 46% in the comparison group (P =.02). Odds ratios (ORs) for patients of achievable benchmark physicians vs comparison physicians who received appropriate care after the intervention, adjusted for preintervention care and nesting of patients within physicians, were 1.57 (95% confidence interval [CI], 1.26-1.96) for influenza vaccination, 1.33 (95% CI, 1.05-1.69) for foot examination, and 1.33 (95% CI, 1.04-1.69) for long-term glucose control measurement. For serum cholesterol and triglycerides, the achievable benchmark effect was statistically significant only after additional adjustment for physician characteristics (OR, 1.40 [95% CI, 1.08-1.82] and OR, 1.40 [95% CI, 1.09-1.79], respectively).Use of achievable benchmarks significantly enhances the effectiveness of physician performance feedback in the setting of a multimodal quality improvement intervention.
Experiment with the Medical-School Curriculum at Boston University
Authors: Chester S. Keefer
Journal: New England Journal of Medicine (1964)

MEDICAL education in the United States has been undergoing change and reform for the past two centuries. Each reform has had as its objectives improvement and extension — improvement in the methods of teaching and extension of the subjects and of the time required to acquire a basic education. Changes have also been introduced to meet the future needs of specialized training in clinical medicine, and the medical sciences.The first requisite for any medical educational reform is the faculty, stimulating one another and working together as a unit, with vision, imagination and well defined objectives. The second requisite is . . .
TCT-736 Markedly Reduced Platelet Inhibition with Clopidogrel Given To Patients Undergoing Therapeutic Hypothermia Post Cardiac Arrest
Authors: Rohit Moudgil, Haytham Al-Turbak, Michel Le May, George Wells, Derek So, Alexander Dick, Michael Froeschl, Christopher Glover, Jean-Francois Marquis, Marino Labinaz
Journal: Journal of the American College of Cardiology (2012)
Keratinocyte conditioned medium stimulates type IV collagenase synthesis in cultured human keratinocytes and fibroblasts
Authors: G. KRATZ, K. JANSSON, M. GIDLUND, A. HAEGERSTR
Journal: British Journal of Dermatology (1995)

We have previously shown that conditioned medium from cultured human keratinocytes stimulates proliferation of a variety of cell types involved in wound healing. as well as re-epithelization of wounds in human skin in vitro. We now present evidence for an autocrine/paracrine control of the synthesis of type IV collagenases in human keratinocytes and fibroblasts. During wound healing, keratinocytes migrate over the wound bed, an activity coupled with lysis of basement membranes, and hence requiring the presence of collagenases. Collagenases are also needed for the production and remodelling of the granulation tissue. In order to study the autocrine/paracrine control of collagenase production in keratinocytes and fibroblasts, we stimulated these cells in culture with conditioned medium from cultured keratinocytes. Protease synthesis was determined by affinity labelling with 3H-diisopropylfluorophosphoridate (DFP) and by zymography. Keratinocyte-conditioned medium was found to increase the expression of 72 and 92 kDa type IV collagenase in human keratinocytes, and the 72 kDa collagenase in human fibroblasts. indicating that an autocrine/paracrine control mechanism is involved in collagenase production in these cell types during wound healing. This increased expression of collagenases could he partly responsible for the stimulated healing seen in wounds treated with sheets of cultured keratinocytes.