tbuckley/cabot-search huggingface dataset:
Why error reporting systems should be voluntary
Authors: M. R Cohen
Journal: BMJ (2000)

Doctors, nurses, and pharmacists share a common goal of identifying medical error, understanding its causes, and making system wide changes to reduce medical risks. Error reporting is a primary component of that goal. Recent public policy discussions in the United States have explored the risks and benefits of mandatory and voluntary reporting systems to identify the most effective ways to promote candid disclosure of medical error. 1 2 The Institute for Safe Medication Practices has been a strong and vocal proponent of non-punitive, voluntary error reporting programmes.3

National models exist in the US for both mandatory and voluntary error reporting programmes. The Medication Errors Reporting Program, operated by the United States Pharmacopoeia in cooperation with the Institute for Safe Medication Practices, is a confidential, voluntary medication error reporting programme. About 1000 completed error reports are received each year from clinicians and state boards, but more important than the number of reports is their quality. Each report provides a great deal of information which has allowed us to identify the wide scope of medication safety problems and explore their system based causes. Practical recommendations to prevent reoccurrence are made through a widely distributed newsletter and other educational efforts.

The information derived …
Host And Viral Risk Factors Associated With Human Rhinovirus Infant Respiratory Illness Severity
Authors: E.K. Miller, J.V. Williams, T. Gebretsadik, K. Carroll, W. Dupont, Y. Mohamed, L. Morin, L. Heil, P.A. Minton, K. Woodward, Z. Liu, T.V. Hartert
Journal: Journal of Allergy and Clinical Immunology (2010)
Monitoring of disease activity by measurement of inflammatory markers in atopic dermatitis in childhood
Authors: G. Halmerbauer, T. Frischer, D.Y. Roller
Journal: Allergy (1997)

Serum levels of soluble interleukin-2 receptor (sIL-2R), intercellular adhesion molecule-1 (ICAM-1), endothelial leukocyte adhesion molecule (ELAM-1), and eosinophil cationic protein (ECP) were measured in 20 patients with atopic dermatitis before and after 4 days' treatment with prednisolone p.o. as well as in 16 healthy, nonatopic controls. Before steroid treatment, patients with atopic dermatitis demonstrated significantly higher serum levels of sIL-2R, ICAM-1, and ECP than healthy controls (P < 0.001), whereas ELAM-1 levels were not different between the groups. After 4 days of steroid treatment, clinical improvement was associated with a decrease of sIL-2R (P < 0.003), ICAM-1 (P < 0.004), and ECP serum levels (P < 0.003), but ELAM-1 levels remained unchanged. Both serum ECP and sIL-2R levels were significantly correlated with disease severity before as well as after steroid treatment. Changes of sIL-2R concentrations were strongly related to the changes of ECP levels. In addition, changes of serum sIL-2R and ECP levels in percentage were correlated with clinical improvement. These results indicate that the determination of sIL-2R and ECP serum levels may be useful in monitoring disease activity in atopic dermatitis in childhood, especially in treatment trials.
Effect of a Pharmacy Care Program on Medication Adherence and Persistence, Blood Pressure, and Low-Density Lipoprotein Cholesterol
Authors: Jeannie K. Lee, Karen A. Grace, Allen J. Taylor
Journal: JAMA (2006)

Poor medication adherence diminishes the health benefits of pharmacotherapies. Elderly patients with coronary risk factors frequently require treatment with multiple medications, placing them at increased risk for nonadherence.To test the efficacy of a comprehensive pharmacy care program to improve medication adherence and its associated effects on blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C).A multiphase, prospective study with an observational phase and a randomized controlled trial conducted at the Walter Reed Army Medical Center of 200 community-based patients aged 65 years or older taking at least 4 chronic medications. The study was conducted from June 2004 to August 2006.After a 2-month run-in phase (measurement of baseline adherence, BP, and LDL-C), patients entered a 6-month intervention phase (standardized medication education, regular follow-up by pharmacists, and medications dispensed in time-specific packs). Following the intervention phase, patients were randomized to continued pharmacy care vs usual care for an additional 6 months.Primary end point of the observation phase was change in the proportion of pills taken vs baseline; secondary end points were the associated changes in BP and LDL-C. Primary end point of the randomization phase was the between-group comparison of medication persistence.A total of 200 elderly patients (77.1% men; mean [SD] age, 78 [8.3] years), taking a mean (SD) of 9 (3) chronic medications were enrolled. Coronary risk factors included drug-treated hypertension in 184 patients (91.5%) and drug-treated hyperlipidemia in 162 (80.6%). Mean (SD) baseline medication adherence was 61.2% (13.5%). After 6 months of intervention, medication adherence increased to 96.9% (5.2%; P<.001) and was associated with significant improvements in systolic BP (133.2 [14.9] to 129.9 [16.0] mm Hg; P = .02) and LDL-C (91.7 [26.1] to 86.8 [23.4] mg/dL; P = .001). Six months after randomization, the persistence of medication adherence decreased to 69.1% (16.4%) among those patients assigned to usual care, whereas it was sustained at 95.5% (7.7%) in pharmacy care (P<.001). This was associated with significant reductions in systolic BP in the pharmacy care group (-6.9 mm Hg; 95% CI, -10.7 to -3.1 mm Hg) vs the usual care group (-1.0 mm Hg; 95% CI, -5.9 to 3.9 mm Hg; P = .04), but no significant between-group differences in LDL-C levels or reductions.A pharmacy care program led to increases in medication adherence, medication persistence, and clinically meaningful reductions in BP, whereas discontinuation of the program was associated with decreased medication adherence and persistence.clinicaltrials.gov Identifier: NCT00393419
De Novo Large B-Cell Lymphoma in a Parenchymal Brain Lesion: Evidence of Clonal Evolution From Splenic Marginal Zone Lymphoma
Authors: Olajumoke Fadugba, TuDung T. Nguyen, John McGill, Nina Wagner-Johnston
Journal: Journal of Clinical Oncology (2011)

A 61-year-old man presented with a 6-month history of personality change involving frequent bouts of anger, expressive aphasia, and tangential speech.Neurologic examination was notable for inappropriate behavior, although his Mini Mental State Examination score was 30 of 30, and no focal deficits were observed.The remainder of his physical examination was pertinent for a palpable spleen and absence of peripheral lymphadenopathy.CBC and differential were remarkable for lymphocytosis and anemia (leukocytes, 49.6 K/cumm with 21% neutrophils, 78% lymphocytes, and 1% monocytes; hemoglobin, 10.6 g/dL; hematocrit, 33.3% with mean corpuscular volume of 74.6 fL; platelets, 170 K/cumm).A majority of circulating lymphocytes on the peripheral blood smear were small and had a plasmacytoid or monocytoid ap-pearance without cytoplasmic villous projections.Flow cytometric analysis of peripheral blood showed monoclonal B cells with selective expression of lambda surface light chain (bright) and coexpression of CD19 and CD20, with no significant expression of CD5, CD11c, CD25, or CD103.Two restricted peaks in the gamma region were noted on serum protein electrophoresis, measuring 0.5 g/dL and 1.0 g/dL, respectively, which were identified as immunoglobulin M lambda on immunofixation.Serum albumin was normal at 4.0 g/dL.Lactate dehydrogenase was normal at 153 U/L.A noncontrast computed tomography (CT) scan of the brain revealed a 4-cm mass in the left frontal lobe.Subsequent brain magnetic resonance imaging (MRI) confirmed the presence of a mass in the medial aspect of the left frontal lobe measuring 5 cm, with satellite lesions in the inferior anterior aspect of the frontal lobe.The mass extended to the genu of the corpus callosum, medial right frontal lobe, and left temporal lobe, resulting in a midline shift to the right and large amount of associated edema (Fig 1A).CT scans of the chest, abdomen, and pelvis revealed a markedly enlarged spleen measuring 21 cm, 14-mm right hilar lymph node, A B C D Fig 1.
Utility of Gallium-Technetium Subtraction Imaging in Evaluation of Pulmonary Involvement by Lymphoma
Authors: R BOUDREAU, R P du CRET, P JUENEMANN, M LOKEN
Journal: Clinical Nuclear Medicine (1987)

Pulmonary spread of lymphoma was suspected during Ga-67 citrate imaging of a patient with Hodgkin's disease. Computer subtracted Ga-67-Tc-99m imaging revealed only unusual cephalad migration of the liver during supine positioning.
Is CD133 a marker of metastatic colon cancer stem cells?
Authors: Mark A. LaBarge, Mina J. Bissell
Journal: Journal of Clinical Investigation (2008)

The concept of the so-called cancer stem cell (CSC) holds that only a minority of cells within a tumor have the ability to generate a new tumor. Over the last decade, a large body of literature has implicated the protein CD133 as a marker of organ-specific adult stem cells and in some cancers as a bona fide CSC marker. In this issue of the JCI, Shmelkov et al. challenge the view that CD133 is a marker of CSCs in colon cancer (see the related article beginning on page 2111). CD133 was thought previously to have a very restricted distribution within tissues; the authors have used genetic knock-in models to demonstrate that CD133 in fact is expressed on a wide range of differentiated epithelial cells in adult mouse tissues and on spontaneous primary colon tumors in mice. In primary human colon tumors, all of the epithelial cells also expressed CD133, whereas metastatic colon cancers isolated from liver had distinct CD133+ and CD133- epithelial populations. Intriguingly, the authors demonstrate that the CD133+ and CD133- populations were equally capable of tumor initiation in xenografts. In light of these new findings, the popular notion that CD133 is a marker of colon CSCs may need to be revised.
Efficacy of 24-Week Monotnerapy With Acarbose, Glibenclamide, or Placebo in NIDDM Patients: The Essen Study
Authors: Juergen Hoffmann, Manfred Spengler
Journal: Diabetes Care (1994)

To compare the different therapeutic principles of alpha-glucosidase inhibitors and sulphonylureas as first-line treatment in non-insulin-dependent diabetes mellitus (NIDDM) patients with dietary failure.Ninety-six NIDDM patients (35-70 years of age, body mass index [BMI] < or = 35), insufficiently treated with diet alone (HbA1c 7-9%) were randomized into three groups and treated for 24 weeks with acarbose, glibenclamide, or placebo. Efficacy, based on fasting blood glucose (BG), BG 1 h after ingestion of standard breakfast (postprandial), serum insulin, postprandial insulin increase, and HbA1c; and tolerability, based on subjective symptoms and laboratory values, were investigated every 6 weeks. Efficacy evaluation was valid for 85 patients.The test drugs were dosed as follows: 100 mg acarbose (A) three times a day, 1 placebo tablet three times a day, 3.5 mg glibenclamide tablets dosed 1-0-0 or 1-0-1, mean dose 4.3 mg/day. Compared with the placebo, both drugs showed the same mean efficacy on fasting BG (-1.4 mM with acarbose, -1.6 mM with glibenclamide), 1-h postprandial BG (-2.2 mM with acarbose, -1.9 mM with glibenclamide), and HbA1c (-1.1% with acarbose, -0.9% with glibenclamide); but they showed a marked difference in 1-h postprandial insulin values (-80.7 pM with acarbose, 96.7 pM with glibenclamide). The mean relative insulin increase (1-h postprandial) was 1.5 in the placebo group, 1.1 in the acarbose group, and 2.5 in the glibenclamide group. No changes in body weight could be observed. No adverse events were seen under placebo. Acarbose led to mild or moderate intestinal symptoms in 38% of patients. Glibenclamide led to hypoglycemia, which could be solved by dose reduction, in 6% of patients. No dropouts occurred in any of the treatment groups.Acarbose and glibenclamide are effective drugs for the monotherapy of NIDDM patients when diet alone fails. Because postprandial insulin increase has been shown to be associated with increased risk for cardiovascular disease, acarbose, which lowers pp increase, may be superior to glibenclamide, which elevates postprandial insulin increase.
Abstract P5-01-05: Personalized peptide vaccines in combination with conventional chemo- or endocrine therapy for metastatic breast cancer: A single-arm phase II study
Authors: U Toh, N Iwakuma, M Mishima, M Takenaka, R Takahashi, K Koura, T Fujii, S Nakagawa, E Ogo, M Tanaka, T Sasada, K Itoh, K Shirouzu
Journal: Cancer Research (2013)

Abstract Background: Immunotherapy using multiple personalized peptide vaccines (PPV) has been reported to be effective for boosting anticancer immunity in patients (pts) with advanced prostate cancer and glioblastoma. The PPVs binding HLA-A2, A24, A3 family and A26 molecules were selected from 31 candidate peptides derived from various tumor associated antigens. Currently, we performed a phase II trial to evaluate the benefit of the PPVs in combination with conventional chemo-or endocrine therapy for pretreated metastatic breast cancer (MBC). Methods: Seventy-one pretreated pts had histologically confirmed measurable MBC and their HLA A molecules matched each of HLA-A2, A24, A26 and A3 family. Pre-vaccination plasma was measured for their IgG levels reactive to each of 31 peptides followed by administration subcutaneously of the four peptides at maximum showing higher levels of IgG in order with schedule of every 1-2 week. The concurrent conventional chemotherapy or endocrine therapy was available for the combination of PPVs. The primary endpoint was anti-tumor immunologic effect and safety, and the secondary endpoints were clinical responses and survival. Levels of IgG reactive to each of the 31 peptides in the pre- and post-treatment plasma at every 6 times of vaccination were measured using LUMNEX system. The CTL responses were simultaneously evaluated using ELISPOT method. Clinical response was evaluated by RECIST criteria. Results: Between May 2009 and December 2012, a total of 71 pts (Luminal-Her2- cases: 39; Her2+cases: 18; Triple negative(TN) cases:14) were enrolled in this study. The median duration of follow-up was 20.7 months. Concurrent chemotherapies (capecitabine, gemcitabine, eribulin, vinorelbine etc.) and endocrine therapies (aromatase inhibitor, toremifen or fulvestrant) were administered to 36 and 24 pts, respectively. Trastuzumab, Laptinib or Bevacizumab was simultaneously used for 13 pts. After 6th vaccination, the IgG reaction and CTL response were identified in 53 of 71 (74.6%) pts and 33 of 63 (52.3%) pts. There were no significant differences between TN cases and the other cases of MBC with regard to immunological humoral and/or cellular responses. No vaccine-related severe adverse events were observed. Clinical response rate of assessable 61 pts was 14.8% (CR 3, PR 6, SD 24, PD 28). The median PFS and OS were 7.6 m and 20.7 m, respectively. In contrast, the PFS and OS of luminal type, Her2 type or TN type were 12, 4.6 or 8.3 m and 24, 15 or 12 m. Conclusions: The phase II PPVs study for MBC demonstrated the promising response and safety, and further studies are essential to identify the clinical benefits of this novel therapy. Clinical trial information: UMIN000001482. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P5-01-05.
Lung deposition of colomycin depends on the nebuliser used
Authors: D Simcock
Journal: Thorax (2003)

▴ Byrne NM, Keavey PM, Perry JD, et al . Comparison of lung deposition of colomycin using the HaloLite and the Pari LC Plus nebulisers in patients with cystic fibrosis. Arch Dis Child2003;88:715–8 [OpenUrl][1][Abstract/FREE Full Text][2] Inhalation of antibiotics against Pseudomonas aeruginosa slows the decline in lung function and increases survival in patients with cystic fibrosis. The Pari LC Plus is the breath enhanced nebuliser most commonly used for administering aerosolised antibiotics. Drug delivery can be lengthy and unpredictable. The HaloLite analyses the patient’s respiratory cycle, … [1]: {openurl}?query=rft.jtitle%253DArchives%2Bof%2BDisease%2Bin%2BChildhood%26rft.stitle%253DArch.%2BDis.%2BChild.%26rft.issn%253D0003-9888%26rft.aulast%253DByrne%26rft.auinit1%253DN%2BM%26rft.volume%253D88%26rft.issue%253D8%26rft.spage%253D715%26rft.epage%253D718%26rft.atitle%253DComparison%2Bof%2Blung%2Bdeposition%2Bof%2Bcolomycin%2Busing%2Bthe%2BHaloLite%2Band%2Bthe%2BPari%2BLC%2BPlus%2Bnebulisers%2Bin%2Bpatients%2Bwith%2Bcystic%2Bfibrosis%26rft_id%253Dinfo%253Adoi%252F10.1136%252Fadc.88.8.715%26rft_id%253Dinfo%253Apmid%252F12876172%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=archdischild&resid=88/8/715&atom=%2Fthoraxjnl%2F58%2F11%2F982.atom
Preoperative Posterior Leaflet Angle Accurately Predicts Outcome After Restrictive Mitral Valve Annuloplasty for Ischemic Mitral Regurgitation
Authors: Julien Magne, Philippe Pibarot, François Dagenais, Zeineb Hachicha, Jean G. Dumesnil, Mario Sénéchal
Journal: Circulation (2007)

Ischemic mitral regurgitation (MR) often persists after restrictive mitral valve annuloplasty, in which case it is associated with worse clinical outcomes. The goal of the present study was to determine whether persistence of MR and/or clinical outcome could be predicted from preoperative analysis of mitral valve configuration.In 51 consecutive patients undergoing restrictive annuloplasty for ischemic MR, posterior leaflet (PL) angle, anterior leaflet angle, coaptation distance, and tenting area were quantified by echocardiography before surgery (6+/-3 days), and MR severity was assessed before and early after surgery (9+/-4 days). Postoperatively, persistence of mild to moderate MR (vena contracta > 3 mm) was observed in 11 (22%) of the patients. The best predictor of postoperative persistence of MR was a PL angle > or = 45 degrees (sensitivity 100%, specificity 97%, positive predictive value 92%, negative predictive value 100%). Patients with persistent MR had markedly lower 3-year event-free survival (26+/-20%) compared with those with nonpersistent MR (75+/-12%, P=0.01). Preoperative presence of a PL angle > or = 45 degrees also was associated with a markedly lower 3-year event-free survival (22+/-17% versus 76+/-12%; P<0.001).In patients undergoing restrictive annuloplasty for ischemic MR, persistence of MR and 3-year event-free survival can accurately be predicted by preoperative analysis of mitral valve configuration. Patients with a PL angle > or = 45 degrees (ie, with high PL restriction) should thus be considered poor candidates for this procedure, and concomitant or alternative procedures should be contemplated.
Randomized controlled trial comparing endoscopic clips and over-the-scope clips for closure of natural orifice transluminal endoscopic surgery gastrotomies
Authors: D. von Renteln, M. Vassiliou, R. Rothstein
Journal: Endoscopy (2009)

See also: Commentaire de travail de D. von Renteln et al., pp. 1056Endoscopy 2009; 41(12): 1105-1105DOI: 10.1055/s-0032-1306762
p21-Activated Kinase 1 Is Required for Efficient Tumor Formation and Progression in a Ras-Mediated Skin Cancer Model
Authors: Hoi Yee Chow, Adrian M. Jubb, Jennifer N. Koch, Zahara M. Jaffer, Dina Stepanova, David A. Campbell, Sergio G. Duron, Marie O'Farrell, Kathy Q. Cai, Andres J.P. Klein-Szanto, J. Silvio Gutkind, Klaus P. Hoeflich, Jonathan Chernoff
Journal: Cancer Research (2012)

The RAS genes are the most commonly mutated oncogenes in human cancer and present a particular therapeutic dilemma, as direct targeting of Ras proteins by small molecules has proved difficult. Signaling pathways downstream of Ras, in particular Raf/Mek/Erk and PI3K/Akt/mTOR, are dominated by lipid and protein kinases that provide attractive alternate targets in Ras-driven tumors. As p21-activated kinase 1 (Pak1) has been shown to regulate both these signaling pathways and is itself upregulated in many human cancers, we assessed the role of Pak1 in Ras-driven skin cancer. In human squamous cell carcinoma (SCC), we found a strong positive correlation between advanced stage and grade and PAK1 expression. Using a mouse model of Kras-driven SCC, we showed that deletion of the mouse Pak1 gene led to markedly decreased tumorigenesis and progression, accompanied by near total loss of Erk and Akt activity. Treatment of Kras(G12D) mice with either of two distinct small molecule Pak inhibitors (PF3758309 and FRAX597) caused tumor regression and loss of Erk and Akt activity. Tumor regression was also seen in mice treated with a specific Mek inhibitor, but not with an Akt inhibitor. These findings establish Pak1 as a new target in KRAS-driven tumors and suggest a mechanism of action through the Erk, but not the Akt, signaling pathway.
Involvement of the mannose receptor in the uptake of der p 1, a major mite allergen, by human dendritic cells
Authors: Gaë tan Deslée, Anne-Sophie Charbonnier, Hamida Hammad, Gerhild Angyalosi, Isabelle Tillie-Leblond, Alberto Mantovani, Andr é-Bernard Tonnel, Joël Pestel
Journal: Journal of Allergy and Clinical Immunology (2002)
Diphenylhydantoin Effects in Hypocalcemia
Authors: JOSHUA TRABULUS
Journal: Annals of Internal Medicine (1976)

Letters1 June 1976Diphenylhydantoin Effects in HypocalcemiaJOSHUA TRABULUS, B.A., PAUL O. GULSRUD, M.D., INDER J. CHOPRA, M.D., F.A.C.P.JOSHUA TRABULUS, B.A.Search for more papers by this author, PAUL O. GULSRUD, M.D.Search for more papers by this author, INDER J. CHOPRA, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-84-6-709 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe constellation of paresthesias, weakness, muscle fasciculations, and carpopedal spasm associated with hypocalcemic tetany is well known. We recently observed a severely hypocalcemic patient who did not show any signs of tetany while receiving anticonvulsant doses of diphenylhydantoin. Trousseau's sign was elicited only after several days of withdrawal of diphenylhydantoin. We discuss here the clinical and electromyographic studies of this patient.A 59-year-old white woman was admitted to UCLA hospital in September 1975 in an obtunded, delirious, and semicomatose state. She had undergone total thyroidectomy in 1967 for a goiter that was diagnosed at histology to be Hashimoto's thyroiditis. She...References1. MORRELLBRADLEYPTASHNE FWM: Effect of diphenylhydantoin on peripheral nerve. Neurology 8:140-144, 1958 CrossrefMedlineGoogle Scholar2. SCHAAFPAYNE MC: Effect of diphenylhydantoin and phenobarbital on overt and latent tetany. N Engl J Med 214:1228-1233, 1966 CrossrefGoogle Scholar3. FONSECACALVERLEY OJ: Neurological manifestations of hypoparathyroidism. Arch Intern Med 120:202-206, 1967 CrossrefMedlineGoogle Scholar4. GREENESWANSON JL: Psychosis in hypoparathyroidism; with a report of five cases. Ann Intern Med 14:1233-1236, 1941 LinkGoogle Scholar5. FRAME B: Hypocalcemia and osteomalacia associated with anticonvulsant therapy. Ann Intern Med 74:294-295, 1971 LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Department of Medicine UCLA Center for the Health Sciences Los Angeles, CA 90024 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByB 1 June 1976Volume 84, Issue 6Page: 709-710KeywordsAnticonvulsantsElectromyographyFasciculationsHistologyHypocalcemiaThyroidectomy Issue Published: 1 June 1976 PDF DownloadLoading ...