tbuckley/cabot-search huggingface dataset:
University College London issues new research standards but says it won't investigate Wakefield
Authors: Z. Kmietowicz
Journal: BMJ (2012)

University College London has updated its mechanisms for safeguarding research participants and ensuring the quality and ethical standards of its research. In doing so it has taken account of lessons learnt from the case of Andrew Wakefield, whose research into a possible link between the measles, mumps, and rubella (MMR) vaccine and autism led to him being struck off the UK medical register. But it says it will not investigate the Wakefield case further, despite calls from the BMJ to do so.

John Tooke, UCL’s vice provost (health), described the university’s updated research governance framework as “robust and fit for purpose.”

However, the college stopped short of commissioning an independent investigation into the case, which articles in the BMJ suggested amounted to research fraud that warranted further scrutiny. 

In a paper on the development of its new framework, UCL said that after taking advice from the UK Research Integrity Office and “a senior legal figure” it concluded that “the net result [from …
Infants of Diabetic Mothers
Authors: Rosita S. Pildes
Journal: New England Journal of Medicine (1973)

INCREASED understanding of the various problems of infants of diabetic mothers has led to improved clinical management and a corresponding reduction in neonatal mortality.1 , 2 Still, complications in the neonatal period occur in approximately 50 per cent of insulin-dependent and 10 to 20 per cent of infants of gestational diabetic women. Furthermore, intrauterine deaths are more frequent than in infants of normal mothers. Infants of prediabetic women encounter similar problems, but to a lesser degree.Clinical ManifestationsDespite their size, generally "large for date," infants of diabetic mothers are physiologically "immature for date." They need not, in fact, be large; diabetic . . .
THE SPECIALTY OF GYNECOLOGY AND OBSTETRICS
Authors: FRANK W. LYNCH
Journal: JAMA (1924)

We are meeting this week as a body of physicians who are keenly interested in the problems of general medicine, but whose chief interest lies in gynecology. For this reason, it seems appropriate at this time to review briefly the present status of our specialty, to prognosticate somewhat as to our future, and, as a logical sequence, to outline a proper training for those who will follow later in our field.  Gynecology, as it exists today, is the offshoot of a confused beginning some seventy years ago. It is a far cry from the gynecologist of the present day to the one of the early eighties, whose horizon was limited largely to the speculum, the sound and the curet. During these forty years, the world has seen the most tremendous advance in medicine in the history of time, completely outweighing all the medical discoveries and inventions that had been made
Complete regression of a suprasellar secondary mass in a patient with low-grade non-Hodgkin's Lymphoma (NHL) Treated With 2-Chlorodeoxyadenosine (CDA)
Authors: F. deCataldo, F. Baudo, C. Ottonelli, C. Italia, R. Valdagni
Journal: American Journal of Hematology (1998)

lymph node involvement with rt ureter compression that required a stent insertion.Brain CT showed a suprasellar lesion involving the diencephalic and chiasmatic regions (Fig. 1a).The patient was treated with CdA (2 hr-infusion of 0.14 mg/kg die × 7 days) and Dexamethasone (0.3 mg/kg die × 4 days).Therapy was well tolerated without significant hematologic toxicity (WHO G4 leukopenia duration, 3 days; no thrombocytopenia).Partial regression of the liver, kidney, and lymph node involvement and complete regression of the brain lesions (Fig. 1b) were documented 1 month later by CT.The patient was discharged on May 24 with complete regression of the neurological symptoms.On June 13 she died from an acute cerebral vascular accident (CVA) of ischemic origin (brain CT not shown).In this patient, a single cycle of CdA induced complete regression of the brain lesion.CVA as a complication of therapy with CdA has not been reported; a relationship between treatment and the final event is unlikely.
Dispelling the myths surrounding traditional birth attendants
Authors: C. J. Gill, D. H. Hamer, A. B. Knapp
Journal: BMJ (2011)

<h3>Background</h3> To date, there have not been any studies to evaluate the extent of blood loss and its significance in the hospital course of acute ischemic stroke (AIS) patients undergoing endovascular revascularization. <h3>Objective</h3> The aim of this study was to evaluate the extent of peri-procedural blood loss measured by hemoglobin (Hb) and hematocrit (HCT), in AIS patients undergoing endovascular revascularization. <h3>Design/methods</h3> Consecutive AIS patients in Grady Memorial Hospital were retrospectively analyzed. The AIS transfers from outside hospitals were excluded from this study given lack of available data about pre-procedure Hb/HCT levels. The HCT and Hb right before (PRE-HCT and PRE-Hb) and within 24 h after the endovascular procedure (POST-HCT and POST Hb) were recorded. Patients9 demographic information, baseline NIHSS, site of occlusion, revascularization modalities, and the need for transfusion early after the procedure were documented. Descriptive statistics are provided. <h3>Results</h3> Forty-one patients (age 68±14; 46% male) with large vessel occlusions were included (26 patients with M1 occlusion, nine patients with M2/3 occlusion, seven patients with ICA occlusion and two patients with basilar/PCA occlusions). The mean NIHSS was 18. Patients had PRE and POST HCT/Hb of 39.3±5.3/ 13.1±1.8 and 34.5±5.3/ 11.5±1.8, respectively. The extent of drop from PRE to POST HCT/Hb (4.7±3.6/1.5±1.2) was statistically significant (paired t-test, p&lt;0.0001). Six patients (14.6%) had HCT/Hb drop &gt;9.0/3.0. The type of device (Merci vs Penumbra) and use of IV or IA-tPA was not associated with any differences in HCT/Hb drop. Only one patient (PRE HCT/Hb:34.9/11.9; POST HCT/Hb:24.6/8.3) required blood transfusion. <h3>Conclusions</h3> Our results suggest some extent of blood loss in endovascular management of acute stroke. However, clinically significant blood loss and blood transfusion requirement are uncommon. Future studies with higher number of patients are needed to further delineate this potential complication. <h3>Competing interests</h3> A Noorian: None. S Rangaraju: None. K Owada: None. B Glenn: None. S Belagaje: None. A Anderson: None. M Frankel: None. R Gupta: Concentric Medical, Codman Neurovascular, CoAxia, and Rapid Medical. R Nogueira: Concentric Medical, ev3 Neurovascular, CoAxia, and Rapid Me.
Increasing Adiposity
Authors: David S. Ludwig, Mark I. Friedman
Journal: JAMA (2014)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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) 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
Microvolt T-Wave Alternans Identifies Patients With Ischemic Cardiomyopathy Who Benefit From Implantable Cardioverter-Defibrillator Therapy
Authors: Theodore Chow, Dean J. Kereiakes, Cheryl Bartone, Terri Booth, Edward J. Schloss, Theodore Waller, Eugene Chung, Santosh Menon, Brahmajee K. Nallamothu, Paul S. Chan
Journal: Journal of the American College of Cardiology (2006)
Cholesterol Levels and the Breast-feeding Mom
Authors: Robert G. Jensen
Journal: JAMA (1989)

To the Editor.—  Additional data are available to help answer a question asked recently in JAMA  1 : Are serum cholesterol levels elevated in lactating women? Mellies et al 2 found mean ± SD levels of plasma cholesterol of 5.6 ± 0.42 mmol/L in 11 women who were breast-feeding 1 month post partum. The quantity had decreased to 4.8 ± 0.27 mmol/L in 6 women who were still breast-feeding after 7 months. There was no correlation between blood and milk cholesterol contents.  We obtained the following data in a study on the composition of milks from insulin-dependent diabetic and control mothers in which serum cholesterol levels at 3, 14, and 42 days post partum were measured. 3 At day 3 post partum, the least-squares mean ± SEM serum cholesterol content of the control women was 5.25 ± 0.12 mmol/L (n = 72); day 14, 5.71 ± 0.13 mmol/L (n = 65); and day
Occupational asthma in a grain worker due to <i>Lepidoglyphus destructor</i>, assessed by bronchial provocation test and induced sputum
Authors: Mj Alvarez, R Castillo, N Ortega, C Blanco, T Carrillo, A Rey
Journal: Allergy (1999)

Background: Occupational asthma (OA) can be a debilitating disease even when removal from the workplace is achieved. Today, the “gold standard” in the assessment of OA is the bronchial provocation test (BPT). Induced sputum is a noninvasive method of exploring airway inflammation which can provide additional information about such challenges and thus could be applied in OA diagnosis and monitoring. Methods: We report the study carried out in a grain worker sensitized to Lepidoglyphus destructor (Ld), who suffered from mild asthma at the workplace. Skin prick test and specific serum IgE were measured. Ld‐BPT was performed, and the changes in eosinophil rates, and ECP and tryptase levels in induced sputum were studied 30 min and 18 h after Ld‐BPT. We also determined the changes in nonspecific bronchial hyperresponsiveness (NSBH), given as PD 20 values. To assess the specificity of the changes, we also carried out sputum induction and methacholine challenge after barley‐BPT. Results: An isolated immediate response was obtained with Ld‐BPT, while barley‐BPT was negative. Induced sputum showed higher tryptase levels 30 min after Ld‐BPT, and higher eosinophil and epithelial cell percentages and ECP levels 18 h after Ld‐BPT. There was also a decrease in methacholine PD 20 values after Ld‐BPT. Those changes were not observed after barley‐BPT. Conclusions: The study of eosinophilic and mast‐cell markers in induced sputum provides additional knowledge about the inflammatory process occurring in the airways, suggesting that the study of induced sputum should be considered in the assessment of OA.
Intra-articular Hyaluronic Acid in Treatment of Knee Osteoarthritis
Authors: Grace H. Lo, Michael LaValley, Timothy McAlindon, David T. Felson
Journal: JAMA (2003)

ContextIntra-articular hyaluronic acid is a US Food and Drug Administration–approved treatment for knee osteoarthritis (OA); however, its efficacy is controversial.ObjectiveTo evaluate whether intra-articular hyaluronic acid is efficacious in treating knee OA.Data SourcesWe searched for human clinical trials in MEDLINE (1966 through February 2003) and the Cochrane Controlled Trials Register, using the search terms (osteoarthritis, osteoarthrosis, or degenerative arthritis) and (hyaluronic acid, Hyalgan, Synvisc, Artzal, Suplasyn, BioHy, or Orthovisc). We also hand searched manuscript bibliographies that met inclusion criteria, selected rheumatic disease journals, and abstracts from scientific meetings.Study SelectionIncluded were published or unpublished, English and non-English, single- or double-blinded, randomized controlled trials comparing intra-articular hyaluronic acid with intra-articular placebo injection for the treatment of knee OA. Trials also were required to have extractable data on pain reported by 1 of the outcome measures recommended by the Osteoarthritis Research Society.Data ExtractionTwo reviewers independently performed data extraction using standardized data forms. For each trial, we calculated an effect size (small-effect sizes, 0.2-0.5; large-effect sizes, 1.0-1.8, equivalent to a total knee replacement). We used a random-effects model to pool study results, the Cochrane Q test to evaluate heterogeneity, and a funnel plot and the Egger test to evaluate publication bias.Data SynthesisThe overall dropout rate in the 22 selected trials was 12.4%. The pooled effect size for hyaluronic acid was 0.32 (95% confidence interval [CI], 0.17-0.47). There was significant heterogeneity among studies (P<.001). Two outlier trials, both evaluating the highest-molecular-weight hyaluronic acid, had effect sizes in excess of 1.5. However, the third trial of the same compound showed a nearly null effect. When the 3 trials of this compound were removed, heterogeneity was no longer significant (P = .58), and the pooled effect size for intra-articular hyaluronic acid decreased to 0.19 (95% CI, 0.10-0.27). There was evidence of publication bias with an asymmetric funnel plot, a positive Egger test, and identification of 2 unpublished trials whose pooled effect size was 0.07 (95% CI, − 0.15 to 0.28).ConclusionIntra-articular hyaluronic acid has a small effect when compared with an intra-articular placebo. The presence of publication bias suggests even this effect may be overestimated. Compared with lower-molecular-weight hyaluronic acid, the highest-molecular-weight hyaluronic acid may be more efficacious in treating knee OA, but heterogeneity of these studies limits definitive conclusions.
Effect of public education aimed at early diagnosis of malignant melanoma: cohort comparison study
Authors: R. M MacKie
Journal: BMJ (2003)

Excision of primary melanomas < 1.5 mm thick improves patients' chances of survival, giving 10 year disease free survival rates of 90% in men and 95% in women. 1 Once a melanoma has metastasised, however, non-surgical therapy does not prolong survival.Early recognition of malignant melanoma is therefore important.In 1986, we reported that only 20 out of 125 patients with melanoma consulted their general practitioner within three months of observing a worrying pigmented skin lesion and that only 38% had melanomas < 1.5 mm thick. 2 This survey gave rise to a public education campaign about melanoma in Scotland, 3 which was subsequently extended throughout the United Kingdom. 4 We have reported early results 5 and now report a study conducted in 2001 to measure changes in diagnostic delays attributable to patients, primary care, and secondary care over 15 years.We also investigated whether reductions in treatment delay were accompanied by reductions in the thickness of primary melanomas, the most important prognostic factor.
P04.17 * DIAGNOSTIC VALUE OF PLASMA AND URINARY 2-HYDROXYGLUTARATE TO IDENTIFY PATIENTS WITH IDH-MUTATED GLIOMA
Authors: G. Lombardi, G. Corona, P. Farina, A. D. Puppa, R. Bertorelle, M. Gardiman, G. Toffoli, L. Denaro, D. D'Avella, V. Zagonel
Journal: Neuro-Oncology (2014)

BACKGROUND: Mutation of IDH1 gene is a prognostic factor and a diagnostic hallmark of gliomas. Mutant IDH1 enzyme can convert α-KG into 2-Hydroxyglutarate(2HG); mutated gliomas have elevated amounts of intracellular 2HG. We analyzed 2HG concentration in plasma and urine in glioma patients(PTS) to identify a biomarker of IDH1 gene mutation METHODS: All PTS had a prior histological confirmation of glioma, a recent brain MRI (within 2 weeks) showing the neoplastic lesions. The exclusion criteria were any chemotherapy performed within 28 days prior, other neoplastic and metabolic diseases. Plasma and urine samples were taken from all PTS and 2HG concentrations determined by liquid chromatography tandem mass spectrometry; Mann-Whitney test was used to test for differences in metabolite concentrations. ROC curve was used to evaluate the cut off value of 2HG biomarker. RESULTS: 84 PTS were enrolled: 38 with IDH1 mutated and 46 IDH1 wild-type. Among PTS with mutant IDH1 we had 21 high-grade gliomas (HGG) and 17 low-grade gliomas (LGG); among PTS with IDH1 wild-type we had 35 HGG and 11 LGG. In all PTS we analyzed the mean 2HG concentration in plasma (P_2HG), in urine (U_2HG) and the ratio between P_2HG and U_2HG (R_2HG). We found an important significant difference in R_2HG between PTS with and without IDH1 mutation: 24.9 versus 15.3, respectively. The optimal cut-off value of R_2HG to identify glioma PTS with and without IDH1 mutation was 19 with sensitivity (S) 63%, specificity (SP) 76% and accuracy (A) 70%.; in only PTS with HGG the optimal cut-off value was 20 (S 76%, SP 89%, A 84%, PPV 80%, NPV 86%). No association between the grade or size of tumor and R_2HG were found. In 7 out of 7 HGG PTS, we found a correlation between R_2HG value and response to treatment. CONCLUSIONS: By analyzing the R_2HG derived from individual plasma and urine 2HG levels is possible discriminate glioma PTS with and without IDH1 mutation. A larger samples need to be analyzed to investigate this method to monitor treatment efficacy.
Chronic headache: the role of deformity of the nasal septum
Authors: J M S Pearce
Journal: BMJ (1984)

The NK-lymphocyte has more recently been identified as a peroxidase containing leukocyte, and this cell has been implicated in auto- immune disease.Again we have noted that K562 cell induced chemiluminescence is inhibited by methimazole and propylthiouracil.Cytolysis of these specific target cells was also suppressed indicating that NK-lymphocyte function can be appreciably influenced by the antithyroid drugs.The remaining lymphocyte populations do not possess peroxidase, but phytohaemagglutinin induced transformation is modulated suggesting yet a further regu- latory role.Finally, the role of thiocarbamides on prostaglandin, thromboxane, and prostacyclin synthesis cannot be ignored.The conversion of prostaglandin G2 to prostaglandin H2 is accomplished by a prostaglandin peroxidase, and we have noted that methimazole and propylthiouracil are co-oxygenated in this reaction, stimulating the uptake of oxygen by cyclo-oxygenase.It is apparent that thiocarbamide drugs have considerable immunoregulatory potential, but the extent of this role still requires elucidation.
Sudden Death in Young Competitive Athletes
Authors: Barry J. Maron
Journal: JAMA (1996)

To develop clinical, demographic, and pathological profiles of young competitive athletes who died suddenly.Systematic evaluation of clinical information and circumstances associated with sudden deaths; interviews with family members, witnesses, and coaches; and analyses of postmortem anatomic, microscopic, and toxicologic data.A total of 158 sudden deaths that occurred in trained athletes throughout the United States from 1985 through 1995 were analyzed. MAIN OUTCOME MEASURES--Characteristics and probable cause of death.Of 158 sudden deaths among athletes, 24 (15%) were explained by noncardiovascular causes. Among the 134 athletes who had cardiovascular causes of sudden death, the median age was 17 years (range, 12-40 years), 120 (90%) were male, 70 (52%) were white, and 59 (44%) were black. The most common competitive sports involved were basketball (47 cases) and football (45 cases), together accounting for 68% of sudden deaths. A total of 121 athletes (90%) collapsed during or immediately after a training session (78 cases) or a formal athletic contest (43 cases), with 80 deaths (63%) occurring between 3 PM and 9 PM. The most common structural cardiovascular diseases identified at autopsy as the primary cause of death were hypertrophic cardiomyopathy (48 athletes [36%]), which was disproportionately prevalent in black athletes compared with white athletes (48% vs 26% of deaths; P = .01), and malformations involving anomalous coronary artery origin (17 athletes [13%]). Of 115 athletes who had a standard preparticipation medical evaluation, only 4 (3%) were suspected of having cardiovascular disease, and the cardiovascular abnormality responsible for sudden death was correctly identified in only 1 athlete (0.9%).Sudden death in young competitive athletes usually is precipitated by physical activity and may be due to a heterogeneous spectrum of cardiovascular disease, most commonly hypertrophic cardiomyopathy. Preparticipation screening appeared to be of limited value in identification of underlying cardiovascular abnormalities.
Aphasia, Apraxia and Agnosia: Clinical and Theoretical Aspects
Authors: Emre Kokmen
Journal: JAMA (1972)

In the preface of this book the author promises to develop a new theory that will interpret aphasic disturbances as "interruptions in successive planes in the process of language formation." The rest of the monograph is then divided into sections, chapters and subchapters bearing the titles of conventional concepts of disturbances of higher cortical function, from anomia to alexia. In each chapter or section, the author gives a historical survey and a clinical description of each of these concepts. A total of 14 cases evaluated by the author are described in some detail. Many clinical neurologists will find some of the tests used in evaluating these patients somewhat unfamiliar. However, on many occasions the author has given some effort to describing the tests and his interpretations of them. Observing signs and symptoms demonstrated by a patient, then subjecting these to an interpretation, then choosing a test procedure appropriate to this
Arsenic Exposure <i>In utero</i> Exacerbates Skin Cancer Response in Adulthood with Contemporaneous Distortion of Tumor Stem Cell Dynamics
Authors: Michael P. Waalkes, Jie Liu, Dori R. Germolec, Carol S. Trempus, Ronald E. Cannon, Erik J. Tokar, Raymond W. Tennant, Jerrold M. Ward, Bhalchandra A. Diwan
Journal: Cancer Research (2008)

Abstract Arsenic is a carcinogen with transplacental activity that can affect human skin stem cell population dynamics in vitro by blocking exit into differentiation pathways. Keratinocyte stem cells (KSC) are probably a key target in skin carcinogenesis. Thus, we tested the effects of fetal arsenic exposure in Tg.AC mice, a strain sensitive to skin carcinogenesis via activation of the v-Ha-ras transgene likely in KSCs. After fetal arsenic treatment, offspring received topical 12-O-tetradecanoyl phorbol-13-acetate (TPA) through adulthood. Arsenic alone had no effect, whereas TPA alone induced papillomas and squamous cell carcinomas (SCC). However, fetal arsenic treatment before TPA increased SCC multiplicity 3-fold more than TPA alone, and these SCCs were much more aggressive (invasive, etc.). Tumor v-Ha-ras levels were 3-fold higher with arsenic plus TPA than TPA alone, and v-Ha-ras was overexpressed early on in arsenic-treated fetal skin. CD34, considered a marker for both KSCs and skin cancer stem cells, and Rac1, a key gene stimulating KSC self-renewal, were greatly increased in tumors produced by arsenic plus TPA exposure versus TPA alone, and both were elevated in arsenic-treated fetal skin. Greatly increased numbers of CD34-positive probable cancer stem cells and marked overexpression of RAC1 protein occurred in tumors induced by arsenic plus TPA compared with TPA alone. Thus, fetal arsenic exposure, although by itself oncogenically inactive in skin, facilitated cancer response in association with distorted skin tumor stem cell signaling and population dynamics, implicating stem cells as a target of arsenic in the fetal basis of skin cancer in adulthood. [Cancer Res 2008;68(20):8278–85]