tbuckley/cabot-search huggingface dataset:
Germany has two tier health service, study shows
Authors: Annette Tuffs
Journal: BMJ (2008)

A study has provoked controversy in Germany because it shows that the country’s healthcare system has two tiers ( International Journal of Equity in Health 2008;7:1; doi: 10.1186/1475-9276-7-1).

The study, by the Institute of Health Economics and Clinical Epidemiology of Cologne University, has shown that patients who have statutory health insurance have to wait about three times longer for an appointment with a specialist than members of private health insurance schemes.

The German health minister Ulla Schmidt said that this is illegal, but the president of the German Medical Association, Jorg Hoppe, admitted that there are differences in the …
Aspiration of Food by Psychiatric Patients
Authors: Martin H. Wendkos
Journal: JAMA (1982)

<h3>To the Editor.—</h3> As Mittleman and Wetli indicated in their article entitled "The Fatal Cafe Coronary: Foreign-Body Airway Obstruction" inThe Journal(1982;247:1285), their purpose was to isolate the factors predisposing a person to this cause of sudden death and, in this connection, found that their data showed a meaningful number of such fatalities in institutionalized persons with evidence of mental retardation or senility. However, they did not refer to accidental deaths of this sort in chronic schizophrenic patients, and, for this reason, I wonder whether they had not encountered this particular fatal syndrome in patients afflicted with this particular type of mental illness. For many years, both before and after the introduction of phenothiazines or other neuroleptic drugs, such a case of sudden death has been reported. In my discussion of this syndrome in my book, under the rubrics of alimentary strangulation,<sup>1</sup>I have emphasized that the important
Urine analysis: current performance and strategies for improvement.
Authors: C G Fraser
Journal: BMJ (1985)

Carefully performed selective biochemical testing of urine may be useful and cost effective.' 2 Nevertheless, in addition to ensuring that tests are performed to answer specific clinical questions, it must be ensured that the analysis is carried out correctly.This paper reviews current analytical performance achieved, describes real and potential sources of analytical difficulties, and expands on the details of simple strategies2 to overcome these problems.
Arsenic Exposure in Pregnancy Increases the Risk of Lower Respiratory Tract Infection and Diarrhea during Infancy in Bangladesh
Authors: Anisur Rahman, Marie Vahter, Eva-Charlotte Ekström, Lars-Åke Persson
Journal: Environmental Health Perspectives (2010)

Previous studies have reported associations between prenatal arsenic exposure and increased risk of infant mortality. An increase in infectious diseases has been proposed as the underlying cause of these associations, but there is no epidemiologic research to support the hypothesis.We evaluated the association between arsenic exposure in pregnancy and morbidity during infancy.This prospective population-based cohort study included 1,552 live-born infants of women enrolled during 2002-2004 in Matlab, Bangladesh. Arsenic exposure was assessed by the concentrations of metabolites of inorganic arsenic in maternal urine samples collected at gestational weeks 8 and 30. Information on symptoms of lower respiratory tract infection (LRTI) and diarrhea in infants was collected by 7-day recalls at monthly home visits.In total, 115,850 person-days of observation were contributed by the infants during a 12-month follow-up period. The estimated risk of LRTI and severe LRTI increased by 69% [adjusted relative risk (RR) = 1.69; 95% confidence interval (CI), 1.36-2.09)] and 54% (RR = 1.54; 95% CI, 1.21-1.97), respectively, for infants of mothers with urinary arsenic concentrations in the highest quintile (average of arsenic concentrations measured in early and late gestation, 262-977 µg/L) relative to those with exposure in the lowest quintile (< 39 µg/L). The corresponding figure for diarrhea was 20% (RR = 1.20; 95% CI, 1.01-1.43).Arsenic exposure during pregnancy was associated with increased morbidity in infectious diseases during infancy. Taken together with the previous evidence of adverse effects on health, the findings strongly emphasize the need to reduce arsenic exposure via drinking water.
Neurohormonal antagonism in heart failure; beneficial effects of vasopressin V1a and V2 receptor blockade and ACE inhibition
Authors: M Naitoh
Journal: Cardiovascular Research (2002)

Objective: To assess the long-term efficacy of vasopressin (AVP) V1a and V2 receptor blockade with conivaptan, alone and in combination with angiotensin converting enzyme (ACE) inhibition on blood pressure, metabolic and neurohormonal parameters, and cardiovascular structure in a rat model of congestive heart failure (CHF). Methods: CHF was induced by left coronary artery ligation. CHF rats received conivaptan (1 mg/kg/day), ACE inhibition (captopril, 50 mg/kg/day), conivaptan and captopril (Combination) or vehicle for 4 weeks. Blood pressure was measured weekly, metabolic caging studies performed at 25 days, and rats killed and blood and tissue collected after 4 weeks treatment. Results: Combination treatment lowered blood pressure (P<0.01), and conivaptan and Combination caused an aquaresis (P<0.01). Combination decreased plasma natriuretic peptide (P<0.05), reduced left and right ventricular mass (P<0.01) and lung mass (P<0.05). Conclusions: In CHF, blockade of vasopressin V1a and V2 receptors was associated with increased water excretion, and the combination of conivaptan with ACE inhibition was the only treatment to reduce blood pressure, natriuretic peptide and pulmonary congestion. These results suggest conivaptan may be a useful addition to ACE inhibitors in the management of vasoconstriction and fluid retention that characterizes CHF.
Canadian Medical Association tightens control over its journal
Authors: D. Spurgeon
Journal: BMJ (2003)

The Canadian Medical Association has appointed an oversight committee to review the content of the association's journal ( CMAJ ) and the work of its editor and to help in maintaining harmonious relations between the journal and the association.

The association set up the committee after the journal published an editorial accusing Quebec physicians of having broken trust with the public when they failed to staff an emergency department at night, and a 51 year old heart attack victim who arrived six minutes after it closed died shortly afterwards ( CMAJ 2002;167:617).

The editorial provoked a letter to the journal from the association's president, Dana Hanson, calling it an “unwarranted attack on the whole profession” and its conclusion “repugnant” ( CMAJ 2002;167:986).

In the current issue of CMAJ , John Hoey, its editor, and Anne Marie …
<i>Cronobacter sakazakii</i>: stress survival and virulence potential in an opportunistic foodborne pathogen
Authors: Audrey Feeney, Kai A Kropp, Roxana O’Connor, Roy D Sleator
Journal: Gut Microbes (2014)

A characteristic feature of the opportunistic foodborne pathogen Cronobacter sakazakii is its ability to survive in extremely arid environments, such as powdered infant formula, making it a dangerous opportunistic pathogen of individuals of all age groups, especially infants and neonates. Herein, we provide a brief overview of the pathogen; clinical manifestations, environmental reservoirs and our current understanding of stress response mechanisms and virulence factors which allow it to cause disease.
Evidence for Preconditioning by Isoflurane in Coronary Artery Bypass Graft Surgery
Authors: D. Belhomme, J. Peynet, M. Louzy, J.-M. Launay, M. Kitakaze, P. Menasche
Journal: Circulation (1999)

Experimentally, isoflurane, a commonly used volatile anesthetic agent, mimics the cardioprotective effects of ischemic preconditioning via a mechanism that could involve the activation of protein kinase C. The present study was designed to assess the clinical relevance of this observation in patients undergoing elective CABG.Twenty patients were included in the study. In 10 of them, preconditioning was elicited after the onset of cardiopulmonary bypass via a 5-minute exposure to isoflurane (2.5 minimum alveolar concentration), followed by a 10-minute washout before aortic cross-clamping and cardioplegic arrest. Ten case-matched control patients underwent an equivalent period (15 minutes) of prearrest isoflurane-free bypass. Outcome measurements included troponin I and creatine kinase-MB isoenzyme (until the third postoperative day) levels and the activity of ecto-5'-nucleotidase, which contributes to adenosine production and is considered to be a reporter of protein kinase C activation, as assessed in right atrial biopsy samples taken before bypass and at the end of the preconditioning protocol (or after 15 minutes of bypass in control patients). Aortic cross-clamping times did not differ between the 2 groups: 52+/-14 and 48+/-14 minutes (mean+/-SD) in control and isoflurane-preconditioned patients, respectively. Likewise, prebypass values of ecto-5'-nucleotidase were similar in control (3.54+/-0.86 nmol x mg protein(-1) x min(-1)) and isoflurane-treated (2.98+/-1.08 nmol x mg protein(-1) x min(-1)) patients. The values subsequently remained unchanged in control patients (3.62+/-0.94 nmol x mg protein(-1) x min(-1)), whereas they significantly increased after isoflurane preconditioning (4.74+/-0. 50 nmol x mg protein(-1) x min(-1); P<0.002 versus baseline values, P<0.004 versus time-matched values in control patients). This was paralleled by a consistently smaller release of troponin I, which yielded an area under the curve and a peak value of 204+/-147 ng x mL(-1) x min(-1) and 3.98+/-2.83 ng/mL, respectively, versus 284+/-136 ng x mL(-1) x min(-1) and 5.88+/-3.64 ng/mL, respectively, in control patients. The release of creatine kinase-MB featured a similar pattern. There were no adverse effects related to isoflurane.These data support a cardioprotective effect of isoflurane and, more generally, demonstrate the feasibility of pharmacologically preconditioning the human heart during cardiac surgery.
Role of ischemia in causing apoptosis, atrophy, and nodular hyperplasia in human liver
Authors: K Shimamatsu, I R Wanless
Journal: Hepatology (1997)

Ischemia is known to be a cause of hepatocellular apoptosis and atrophy in experimental animals, but the effect of vascular obstruction on such lesions in the normal or cirrhotic human liver has not been studied. The purpose of this study was to investigate the role of ischemia in the development of apoptosis, atrophy, and nodular hyperplasia in cirrhotic and noncirrhotic human livers. Apoptosis, focal atrophy, and nodular hyperplasia were semiquantitated in 203 liver specimens obtained at transplantation, segmental resection, or autopsy. These parameters were correlated with etiology, stage, activity, and acute and healed portal vein thrombosis (PVT). Large numbers of apoptotic cells were found in livers with acute PVT (17.2/medium-power field [MPF]) and in infarcts of Zahn caused by obstruction of portal veins (PVs) by tumor (16.4/MPF). Smaller numbers of apoptotic cells were found in cirrhosis of various etiologies (3.8-10.0/MPF) and rarely in normal livers (0.16/MPF). Evidence of healed PVT was found in 47% of cirrhotic livers and was associated with nodular hyperplasia (58% vs. 32%, P < .01) and focal atrophy (79% vs. 49%, P < .002). Apoptotic cells were found equally in those with and without healed PVT (40% vs. 38%, not significant). These observations suggest that apoptosis is a transient response to acute ischemia and that atrophy and nodular hyperplasia are chronic responses to ischemia. Vascular obstruction may be an important cause of the apoptosis and atrophy, which are found in nodular regenerative hyperplasia (NRH), infarct of Zahn, chronic hepatitis, and cirrhosis.
THE THERAPEUTICS OF CROUPOUS PNEUMONIA.Read in the Section on Diseases of Children at the Forty-fourth Annual Meeting of the American Medical Association.
Authors: JOHN A. LARRABEE
Journal: JAMA (1893)

In an attempt to present to you for discussion, the subject which, by your too partial choice has been assigned to me, I shall endeavor to keep as nearly as possible within its limits, and with a due regard for the value of your time, I shall be as concise as possible. It will, of course, be understood that pneumonia known as catarrhal or bronchial, which prevails to so much greater extent in infancy and childhood, but differs so widely in both etiology and treatment, shall form no part of this discussion beyond mention. The attempt to draw an age limit around croupous pneumonia by many of the older writers has been responsible for many failures in diagnosis. While few physicians at the present time fail to diagnosticate croupous pneumonia in the adult at some time during its progress, I must record my conviction, based upon experience, that many infants
Warning About Unsafe Electrode Lead Wires and Patient Cables Used With Medical Devices
Authors: Stuart L. Nightingale
Journal: JAMA (1994)

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
A Renewable Tissue Resource of Phenotypically Stable, Biologically and Ethnically Diverse, Patient-Derived Human Breast Cancer Xenograft Models
Authors: Xiaomei Zhang, Sofie Claerhout, Aleix Prat, Lacey E. Dobrolecki, Ivana Petrovic, Qing Lai, Melissa D. Landis, Lisa Wiechmann, Rachel Schiff, Mario Giuliano, Helen Wong, Suzanne W. Fuqua, Alejandro Contreras, Carolina Gutierrez, Jian Huang, Sufeng Mao, Anne C. Pavlick, Amber M. Froehlich, Meng-Fen Wu, Anna Tsimelzon, Susan G. Hilsenbeck, Edward S. Chen, Pavel Zuloaga, Chad A. Shaw, Mothaffar F. Rimawi, Charles M. Perou, Gordon B. Mills, Jenny C. Chang, Michael T. Lewis
Journal: Cancer Research (2013)

Abstract Breast cancer research is hampered by difficulties in obtaining and studying primary human breast tissue, and by the lack of in vivo preclinical models that reflect patient tumor biology accurately. To overcome these limitations, we propagated a cohort of human breast tumors grown in the epithelium-free mammary fat pad of severe combined immunodeficient (SCID)/Beige and nonobese diabetic (NOD)/SCID/IL-2γ-receptor null (NSG) mice under a series of transplant conditions. Both models yielded stably transplantable xenografts at comparably high rates (∼21% and ∼19%, respectively). Of the conditions tested, xenograft take rate was highest in the presence of a low-dose estradiol pellet. Overall, 32 stably transplantable xenograft lines were established, representing 25 unique patients. Most tumors yielding xenografts were “triple-negative” [estrogen receptor (ER)−progesterone receptor (PR)−HER2+; n = 19]. However, we established lines from 3 ER−PR−HER2+ tumors, one ER+PR−HER2−, one ER+PR+HER2−, and one “triple-positive” (ER+PR+HER2+) tumor. Serially passaged xenografts show biologic consistency with the tumor of origin, are phenotypically stable across multiple transplant generations at the histologic, transcriptomic, proteomic, and genomic levels, and show comparable treatment responses as those observed clinically. Xenografts representing 12 patients, including 2 ER+ lines, showed metastasis to the mouse lung. These models thus serve as a renewable, quality-controlled tissue resource for preclinical studies investigating treatment response and metastasis. Cancer Res; 73(15); 4885–97. ©2013 AACR.
Inhibition of cholangiocarcinoma growth by Tannic acid
Authors: Carla Marienfeld, Laura Tadlock, Yoko Yamagiwa, Tushar Patel
Journal: Hepatology (2003)

Cholangiocarcinoma is an aggressive malignancy of the biliary tract for which effective treatment is lacking. Tannic acid (TA) is a naturally occurring polyphenolic compound with antioxidant and radical scavenging properties as well as anticarcinogenic effects. TA inhibited proliferation of malignant human cholangiocytes in vitro . Furthermore, the growth rate of Mz–ChA–1 cholangiocarcinoma xenografts in balb/c athymic mice was reduced from 10.9 ± 1.8 mm 3 /d in mice fed with normal water to 5.5 ± 1.2 mm 3 /d in mice fed with water containing 0.05% TA. Pretreatment with 50 μg/mL TA for 24 hours before xenograft implantation increased tumor latency by 2.5–fold compared with untreated controls, and decreased subsequent growth rates compared with controls in the absence of TA feeding. TA was not cytotoxic to Mz–ChA–1 cells in vitro , but enhanced sensitivity to camptothecin cytotoxicity. TA potently inhibited cell cycle progression, and increased expression of the cyclin–dependent kinase inhibitor p27 KIP1 . In addition, TA (0–50 μg/mL) inhibited proteasomal activity in cholangiocyte cell extracts in a concentration–dependent manner. In conclusion, the growth inhibitory effects of TA may result from dysregulation of cell cycle progression due to altered proteasomal degradation of these cell cycle regulatory proteins. TA warrants evaluation as a candidate for the treatment of human cholangiocarcinoma either by itself or in combination with other chemotherapeutic agents.
Epidemiologic basis for photochemical oxidant standard.
Authors: D V Bates
Journal: Environmental Health Perspectives (1983)

The problem of photochemical oxidant pollution, 98% of which is ozone, is addressed. Ozone itself is not the cause of all adverse effects (e.g., peroxyacetyl nitrites cause eye irritation). The typical sequence in the development of oxidant pollution is an initial increase in nitrous oxide, followed by nitrogen dioxide, followed by ozone. These pollutants can be carried long distances and may have long range effects. Ozone is considered by far the most irritant gas to humans, with effects seen even at extremely low concentrations. Dr. Bates reviewed the initial results of a study of hospitalization in the Niagara Peninsula of Ontario as it related to hourly pollution measurement, noting a relationship between elevated ozone and SO2 levels and respiratory admissions within 24 hr during the summer months. This is an important preliminary finding, as EPA data indicate that nitrogen oxides are increasing while other pollutants are decreasing.
Increased activity of the sarcoplasmic reticular calcium pump in porcine stunned myocardium
Authors: J. M J Lamers, D. J Duncker, K. Bezstarosti, E. O McFalls, L. M A Sassen, P. D Verdouw
Journal: Cardiovascular Research (1993)

Objective: The aim was to determine whether changes in sarcoplasmic reticular Ca2+ transport activity and the degree of phosphorylation of phospholamban of "stunned" myocardium are involved in the reversible depression of contractile function. Methods: In anaesthetised open chest swine, stunning was induced by subjecting the myocardium perfused by the left anterior descending coronary artery to two cycles of 10 min of occlusion and 30 min of reperfusion. Before and after stunning, systemic haemodynamic variables and regional myocardial function and perfusion were determined, while biopsies were taken for determination of the content of high energy phosphate compounds. Sarcoplasmic reticular function (ATP dependent Ca2+ transport and phosphorylation of phospholamban) of the stunned and control myocardium was determined at the end of the stunning protocol. Results: In the stunned myocardium the segment length shortening decreased from 17.4(SD 4.0)% to 3.5(4.4)%, while perfusion was 38% less than at baseline. ATP and total adenine nucleotide levels of the stunned myocardium were about 35% lower than in the control myocardium, but the energy charge was normal as creatine phosphate levels had increased by 66% over the content determined at baseline. Ca2+ uptake by the sarcoplasmic reticulum isolated from the stunned region was 17% (p<0.05) higher than Ca2+ uptake from the control region [1240(303) and 1450(280) nmol·min−1·mg−1 protein, respectively]. In the presence of exogenous cyclic AMP dependent protein kinase the amount of 32P incorporated into phospholamban was similar for both myocardial regions. Conclusions: In this model of stunned porcine myocardium, the phosphorylation state of phospholamban was unchanged, but Ca2+ uptake by the sarcoplasmic reticulum was slightly increased. The results indicate that a change in active Ca2+ transport by the sarcoplasmic reticulum is most likely not to be the principal cause of contractile dysfunction of stunned myocardium. Cardiovascular Research 1993;27:520-524
Estimating the cost of compensating victims of medical negligence
Authors: P Fenn, D Hermans, R Dingwall
Journal: BMJ (1994)

The current system in Britain for compensating victims of medical injury depends on an assessment of negligence.Despite the sporadic pressure on the government to adopt a "no fault" approach, such as exists in Sweden, the negligence system will probably remain for the immediate future.The cost of this system was estimated to be £52-3m for England 1990-1.The problem for the future, how- ever, is one of forecasting accuracy at provider level: too high a guess and current patient care will suffer; too low a guess and future patient care will suffer.The introduction of a mutual insurance scheme may not resolve these difficulties, as someone will have to set the rates.Moreover, the figures indicate that if a no fault scheme was introduced the cost might be four times that of the current system, depending on the type ofscheme adopted.