tbuckley/cabot-search huggingface dataset:
Nurse-administered propofol sedation: Differences in perspective
Authors: David Frank Dies
Journal: Hepatology (2009)

I read the position paper supporting nurse-administered propofol sedation (NAPS) which was coissued by the American Association for the Study of Liver Diseases (AASLD) and other societies.1 Currently, the package insert states "the drug should be administered only by persons trained in the administration of general anesthesia". By this definition, registered nurses would not qualify. In fact, NAPS is illegal in more than a dozen states, including my own. Most endoscopy centers use a nurse to administer moderate sedation with midazolam. The problem with propofol is that it was designed for use beyond moderate sedation, specifically, deep sedation and general anesthesia. In fact, the U.S. Food and Drug Adminstration (FDA) has reports of hundreds of patients who have died as a result of propofol administration. This is likely an underestimation and also does not include those who encountered peril but survived. The American Society of Anesthesiologists (ASA) practice guidelines state: "Even if moderate sedation is intended, patients receiving propofol should receive care consistent with that required for deep sedation".2 In a position statement, the ASA feels that because of the significant risk that patients who receive deep sedation may enter a state of general anesthesia, privileges to administer deep sedation should be granted only to practitioners who are qualified to administer general anesthesia.3 The American Association for Accreditation of Ambulatory Surgical Facilities specifically prohibits NAPS.4 The Joint Commission on Accreditation of Healthcare Organizations standards regarding sedation require that the person administering the medication and monitoring the patient must be able to manage the patient at whatever level of anesthesia is achieved, even if that level was unintended.5, 6 This may pose a problem for hospitals if their "standard" for the operating room (where endoscopy is sometimes performed) is that propofol be administered exclusively by certified registered nurse anesthestists, yet allows NAPS in the endoscopy area. Most of the studies referenced in this position paper involve retrospective data. In the prospective study by Rex et al., ASA class III patients were excluded.7 The AASLD position paper discusses NAPS in low-risk patients. Endoscopy related to liver disease mainly centers around patients with cirrhosis and varices. Are these patients low risk? Should there be prospective trials with our patient population prior to the AASLD endorsing this position? The wording of the package insert warning approved by the FDA, the ASA's position against NAPS, and roughly 25% of states with laws against NAPS pose a formidable legal hurdle if an adverse event were encountered. What if the ASA collects data on the safety of anesthesiologists supervising registered nurses performing endoscopy? Will our society be as quick to accept their perspective? David Frank Dies M.D.*, * GastroIntestinal Specialists, The Liver Center, Shreveport, LA.
Treatment With Interferon Beta for Multiple Sclerosis
Authors: Douglas S. Goodin, Anthony T. Reder, Gary Cutter
Journal: JAMA (2012)

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
Therapy in Genetic Disease
Authors: Richard W. Erbe
Journal: New England Journal of Medicine (1974)

Present efforts at therapy in the major groups of genetic diseases have met with varying degrees of success. In the common multifactorial disorders, in which the genetic predisposition frequently depends heavily on precipitating environmental factors for its expression, treatment is often effective, as in the therapy of diabetes mellitus with insulin or drugs. The chromosome disorders include both those involving the sex chromosomes, such as the Klinefelter and Turner syndromes, in which the administration of the deficient sex hormones is often helpful, and those involving the autosomal chromosomes, such as Down's syndrome, in which specific therapy is at present lacking. . . .
Tim-3 is an inducible human natural killer cell receptor that enhances interferon gamma production in response to galectin-9
Authors: Michelle K. Gleason, Todd R. Lenvik, Valarie McCullar, Martin Felices, M. Shea O'Brien, Sarah A. Cooley, Michael R. Verneris, Frank Cichocki, Carol J. Holman, Angela Panoskaltsis-Mortari, Toshiro Niki, Mitsuomi Hirashima, Bruce R. Blazar, Jeffrey S. Miller
Journal: Blood (2012)
Thrombotic Thrombocytopenic Purpura
Authors: J. HERMAN
Journal: Annals of Internal Medicine (1982)

Letters and Corrections1 June 1982Thrombotic Thrombocytopenic PurpuraJ. HERMAN, M.D.J. HERMAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-96-6-791_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The report by Rosove and colleagues (1) on the ineffectiveness of aspirin and dipyridamole in the treatment of thrombotic thrombocytopenic purpura underscores the difficulty in determining a therapeutic rationale for a condition of unknown cause, uncertain pathogenesis, and disputed definition (2, 3). The situation is further complicated by the widely differing degrees of severity manifested by this syndrome, which may follow a fulminant and rapidly fatal course, may be subacute and relatively mild (4), or even chronic and relapsing (5). Finally, reporting of treatment has not been standardized and it is often difficult, when perusing a case...References1. ROSOVE M, HO W, and GOLDFINGER D. Ineffectiveness of aspirin and dipyridamole in the treatment of thrombotic thrombocytopenic purpura. Ann Intern Med. 1982;96:27-33. LinkGoogle Scholar2. ANSELL J, BEASER R, and PECHET L. Thrombotic thrombocytopenic purpura fails to respond to fresh plasma infusion. Ann Intern Med. 1979; 89:647-8. LinkGoogle Scholar3. LERNER R, RAPAPORT S, and MELTZER J. Thrombotic thrombocytopenic purpura. Serial clotting studies, relation to the generalized Schwartzman reaction and remission after adrenal steroid and dextran therapy. Ann Intern Med. 1967;66:1180-90. LinkGoogle Scholar4. KOHN D, HERMAN J, FLATAU E, DAHER O, LEV A, and DUBNOV B. Thrombotic thrombocytopenic purpura with a sub-acute course: remission after steroids and high-dose plasma exchange. Isr J Med Sci. 1981;17:283-5. MedlineGoogle Scholar5. CAHALANE S and HORN R. Thrombotic thrombocytopenic purpura of long duration. Am J Med. 1959;27:333-41. CrossrefMedlineGoogle Scholar1. ROSOVE M, HO W, and GOLDFINGER D. Ineffectiveness of aspirin and dipyridamole in the treatment of thrombotic thrombocytopenic purpura. Ann Intern Med. 1982;96:27-33. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: J. HERMAN, M.D.Affiliations: Family Medicine Clinic Beisan Israel PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1982Volume 96, Issue 6_Part_1Page: 791-792KeywordsAspirinPathogenesisThrombotic thrombocytopenic purpura ePublished: 1 December 2008 Issue Published: 1 June 1982 PDF downloadLoading ...
Cancer: Etiology, Diagnosis, and Treatment
Authors: Al B. Benson
Journal: Annals of Internal Medicine (1998)

Medical Writings15 June 1998Cancer: Etiology, Diagnosis, and TreatmentAl B. BensonAl B. BensonNorthwestern Medical School, Chicago, IllinoisSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-12_Part_1-199806150-00036 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Cancer: Etiology, Diagnosis, and Treatment; Burdette WJ. 287 pages. New York: McGraw-Hill; 1998. $39.00. ISBN 0070089922. Order phone 800-262-4729.Field of medicine: Hematology and oncology.Format: Softcover book.Audience: Persons other than oncologists, including nurses, medical students, physicians in training, and generalist physicians, who are involved in the diagnosis and care of patients with cancer.Purpose: To provide a “comprehensive but succinct account of the professional services available” for patients with cancer and to give the reader information on how to combine these resources from multiple disciplines to optimize patient care.Content: The first 13 chapters of the book briefly ... Author, Article, and Disclosure InformationAffiliations: Northwestern Medical School, Chicago, Illinois PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 June 1998Volume 128, Issue 12_Part_1Page: 1051KeywordsCancer treatmentChemotherapyEtiologyHematologic malignanciesHematology and oncologyInternetMolecular biologyPatients ePublished: 15 August 2000 Issue Published: 15 June 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Quantitative Differences in Treg Cells in Allergic Asthma: Impact of Site of Inflammation, Disease State and Medication Use
Authors: P.E. Dahlberg, A.M. Singh, K.A. Burmeister, M.D. Evans, K.A. Roberg, J.E. Gern, C.M. Seroogy
Journal: Journal of Allergy and Clinical Immunology (2010)
Hepatic effects of phthalate esters.
Authors: P K Seth
Journal: Environmental Health Perspectives (1982)

Di(2-ethylhexyl) phthalate (DEHP), a commonly used plasticizer and microchemical environmental pollutant, produces subtle changes in hepatic function as judged by increase in liver weight and morphological and biochemical alterations. It can modify the biological response of drugs and other xenobiotics. Such interactions appear to occur at the pharmacokinetic phase, as DEHP was found to alter the activity of microsomal drug-metabolizing enzymes and ethanol metabolism. DEHP produced a time- and route-dependent effect on the hepatic cytochrome P-450 contents and activity of aminopyrine N-demethylase, aniline hydroxylase, alcohol dehydrogenase and high and low Km aldehyde dehydrogenases when given orally or intraperitoneally. Under in vitro conditions, DEHP produced no effect on the activity of aminopyrine N-demethylase or aniline hydroxylase, while mono(2-ethylhexyl) phthalate (MEHP) and 2-ethylhexanol (2-EH) significantly inhibited their activity at concentrations ranging from 2.5 to 15.0 mM. Activity of aminopyrine N-demethylase and aniline hydroxylase was also inhibited by dimethyl phthalate (DMP) and dibutyl phthalate (DBP) after a single oral administration. In view of the possibility of the human exposure to phthalates and other xenobiotics simultaneously, these observations are of great significance.
NHS contribution to the Ebola epidemic
Authors: C. Houlihan, R. Behrens, D. Moore
Journal: BMJ (2014)

To control the current Ebola epidemic—the largest recorded, with more than 1500 deaths to date—a global response is needed in terms of finance, equipment, and skilled personnel.1 2 The UK government has shown commitment to the global response through the Department for International Development (DFID), which is convening experts from a variety of fields. Furthermore, WHO, Medecins Sans Frontieres, …
Spending in the U.S. on Advertising for Fast Foods, Sodas, and Automobiles
Authors: Garry Welch
Journal: Diabetes Care (2003)

Type 2 diabetes is approaching epidemic proportions, mostly because of a sharp increase in the prevalence of obesity and the associated insulin resistance (1). Important risk factors in the pathogenesis of type 2 diabetes (sedentary lifestyle, poor diet, and changes in body composition) are essentially modifiable risks related to profound social and cultural changes that have taken place recently in our society. Several reports suggest that our more hectic pace of life, longer working hours, and changes in family roles all reward convenience in eating habits and limit time available for recreation and outside activities (2–10). Greater use of labor-saving devices, including the automobile, further …
The B7 family member B7-H6 is a tumor cell ligand for the activating natural killer cell receptor NKp30 in humans
Authors: Cameron S. Brandt, Myriam Baratin, Eugene C. Yi, Jacob Kennedy, Zeren Gao, Brian Fox, Betty Haldeman, Craig D. Ostrander, Tomonori Kaifu, Christian Chabannon, Alessandro Moretta, Robert West, WenFeng Xu, Eric Vivier, Steven D. Levin
Journal: The Journal of Experimental Medicine (2009)

Cancer development is often associated with the lack of specific and efficient recognition of tumor cells by the immune system. Natural killer (NK) cells are lymphocytes of the innate immune system that participate in the elimination of tumors. We report the identification of a tumor cell surface molecule that binds NKp30, a human receptor which triggers antitumor NK cell cytotoxicity and cytokine secretion. This previously unannotated gene belongs to the B7 family and, hence, was designated B7-H6. B7-H6 triggers NKp30-mediated activation of human NK cells. B7-H6 was not detected in normal human tissues but was expressed on human tumor cells, emphasizing that the expression of stress-induced self-molecules associated with cell transformation serves as a mode of cell recognition in innate immunity.
Contribution of endothelin-1 to warm ischemia/reperfusion injury of the rat lung.
Authors: M Okada, C Yamashita, M Okada, K Okada
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

The purpose of the present study was to clarify the role of endothelin-1 (ET-1) in the pathogenesis of ischemia/reperfusion lung injury and to determine whether pretreatment with an ET receptor antagonist prevents such injury. The left lung of Sprague-Dawley rats was subjected to 60 min of no-flow warm ischemia followed by 90 min of reperfusion. The plasma ET-1 concentration increased significantly after reperfusion compared with before and after ischemia (p < 0.05). Arterial oxygen tension was reduced, and the lung tissue wet/dry weight ratio increased in post-reperfusion lungs compared with both pre-ischemia and post-ischemia lungs. Histologic study showed pulmonary edema, hemorrhage, hyaline membrane formation, and a significant increase in lung tissue neutrophils after reperfusion. In addition, the expression of ET-1 mRNA was determined by Northern blot analysis. Although ischemia did not significantly alter ET-1 expression, reperfusion increased expression in the left lung markedly and in the right lung moderately. Pre-infusion of FR139317, an ETA receptor antagonist, prevented post-reperfusion damage to the lung. These results suggest that ET-1 contributes to the ischemia/reperfusion injury of the rat lung, mediated by an ETA receptor, and that an ETA receptor antagonist may inhibit ischemia/reperfusion lung injury.
Early Revascularization After Coronary Occlusion
Authors: JOHN ROSS
Journal: Circulation (1974)

MYO-CARDIAL INFARCTION can be reduced by diminishing cardiac oxygen requirements to marginal tissues surrounding an area of ischemia.'A possible alternative approach is to increase the supply of oxygen to the ischemic myocardium by reperfusion of the coronary arterial bed.The time beyond which myocardial damage becomes permanent after temporary coronary occlusion has been of interest to investigators for many years.In 1940, Blumgart2 described myocardial infarction resulting from 25 minutes of coronary occlusion, and later investigators reported that infarction usually occurred after 40 to 60 minutes of coronary occlusion in dogs.3 4 However, these studies were not focused on the question of whether or not the size of the zone of damage could be modified by resupplying oxygenated blood after relatively long periods of coronary occlusion.In recent experimental studies, the amount of myocardial tissue that could be salvaged by coronary artery reperfusion after temporary coronary occlusion was determined in dogs.5When coronary artery reperfusion was performed after three hours of occlusion, we found an average salvage of 60% of the region of myocardium destined for necrosis.Infarct size was estimated during the acute occlusion by ST-segment mapping"15 and the actual infarct size was assessed one week later by gross examination, histologic studies, and myocardial creatine phosphokinase (CPK) depletion.'It also appeared that paradoxical motion present in the ischemic zone during the cor- onary occlusion was lost immediately after coronary reperfusion.'In later experiments, it was shown that
Marketing and public policy
Authors: H. Marcovitch
Journal: BMJ (1994)

ITV (Granada) World in Action: “Shot in the Dark” 28 November

Critics of the current measles and rubella immunisation campaign say that it was conceived in haste and executed carelessly. World in Action's attempt at highlighting this suffered from exactly the same faults.

The Infertility Maze at the Science Museum is the first exhibition in the United Kingdom to explore the medical and moral issues surrounding infertility treatment. Exhibits include a pinball machine which illustrates the difficulties of conception by getting the player to aim at elusive targets. Frustrated by this game, visitors to the exhibition can follow a computer generated couple as they are referred to a specialist for investigation of their infertility. The couple become increasingly medicalised as they pass through a maze of tests and results in their efforts to …
Viruses Causing Common Respiratory Infections in Man.
Authors: George Gee Jackson, Robert Lee Muldoon
Journal: Annals of Internal Medicine (1976)

Within the past two decades, many new viruses have been isolated and temporally associated with respiratory illness in humans. Initially, the taxonomic position of these viruses could not be assigned, and it was useful to assemble the known characteristics of each of them into a uniform format. With the acquisition of additional data, a more stable taxonomy of the viruses has been created. Nevertheless, the outline used in this manual was helpful for accumulating known and new data about these viruses and has served as a useful reference for
PREVALENCE OF MYOCARDIAL SCAR IN WOMEN WITH SIGNS AND SYMPTOMS OF ISCHEMIA BUT NO OBSTRUCTIVE CORONARY ARTERY DISEASE: A REPORT FROM THE WOMEN’S ISCHEMIA SYNDROME EVALUATION
Authors: May Bakir, Janet Wei, Louise Thomson, John Petersen, Quanlin Li, Erika Jones, Puja Mehta, Chrisandra Shufelt, Daniel Berman, Eileen Handberg, Sheryl Kelsey, George Sopko, Carl Pepine, C. Noel Bairey Merz
Journal: Journal of the American College of Cardiology (2015)
A false alarm
Authors: P. Timms
Journal: BMJ (2009)

John had an undiagnosed hypomanic state for several years. His undoubted intelligence had helped to mask his pressure of speech, grandiose ideas, and thought disorder. However, he could not hold a job down and, in the end, became homeless. While hypomanic, he was arrested by the police for a rather public misdemeanour. He escaped the criminal justice system but was admitted to a locked psychiatric ward, an experience he found humiliating and disturbing.

His symptoms were subsequently controlled with a combination of lithium …
PRESENT-DAY CANCER PROBLEMS
Authors: FRANK L. RECTOR
Journal: JAMA (1933)

The cancer problem today is one of the greatest challenges facing the medical profession. With an insidious and usually painless onset, an increasing death rate, many unknown factors in etiology and the lack of opportunity for seeing many cases in the early and curable stages of the disease, the profession is faced with a monumental task in developing an effective program of prevention and control. Whether or not cancer is actually increasing is beside the point as far as this discussion is concerned. Statistically one knows that the death rate is increasing steadily, and since 1900 has been stepped up nearly 65 per cent. Cancer is being found in the younger age groups more frequently than formerly, authentic cases of carcinoma having been reported in the new-born and in children under 2 years of age. In 1930 more than 115,000 deaths from this disease were reported from the registration area
Plasma R Binder Deficiency and Neurologic Disease
Authors: S H Sigal, C A Hall, J P Antel
Journal: New England Journal of Medicine (1987)

THE extracellular transport of vitamin B12 (cobalamin) is complicated and incompletely understood. Transport in plasma is associated with two carriers: transcobalamin II and R binder protein (R denotes "rapid" and refers to electrophoretic mobility).1 Transcobalamin II is required for efficient cellular uptake of cobalamin; in the rare cases of newborns with congenital deficiency of the protein, intractable megaloblastic anemia develops and is responsive only to pharmacologic doses of the vitamin.2 R binder proteins are a class of immunologically identical but electrophoretically distinct glycoproteins with molecular weights of 56,000 to 62,000. They are found in many secretions and differ only . . .
Abstract 398: Interleukin 6 may predict chemoresistant ovarian cancer
Authors: Elizabeth H. Kerr, Denise K. Oelschlager, Lacey R. McNally, William E. Grizzle
Journal: Cancer Research (2011)

Abstract Interleukin 6 (IL-6) has been hypothesized to facilitate the growth and progression of some malignancies by increasing angiogenesis. The aim of this study was to evaluate ovarian ascites from chemotherapy-naïve ovarian cancer patients and determine whether cytokines including IL-6 could predict resistance. After IRB approval, patient ascites and metastatic implants were collected. The metastatic implants were evaluated for platinum sensitivity by treatment with 50 uM carboplatin for 48 hours and then cell viability was analyzed. The cells were removed by centrifugation from the ascites fluid and expression of IL-6, IL-1a, IL-1ra, IL-8, VEGF, and RANTES was evaluated in the fluid and lysed cells separately using a Millipore Custom Magnetic Bead Kit (Millipore, Billerica, MA) on a Bio-Plex Cytokine Assay (Bio-Rad Laboratories, Hercules, CA). Twelve patients with advanced stage ovarian papillary serous carcinoma undergoing primary cytoreductive surgery had ascites samples which were adequate for analysis. Six patients were platinum sensitive and 6 patients were platinum resistant. IL-6 levels in the acellular fluid correlated with chemoresistance (P = 0.05). IL-1a and IL-1ra levels tended to be associated with chemoresistance (P = 0.22; P = 0.1) while IL-8 and VEGF levels tended to be associated with chemosensitivity (P = 0.23; P = 0.16). RANTES showed no association with either chemoresistance or chemosensitivity. Levels of cytokines extracted from the cells were low and did not impact the results of analysis of the cytokines. We conclude that levels of IL-6 in ascites may indicate platinum resistance. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 398. doi:10.1158/1538-7445.AM2011-398