tbuckley/cabot-search huggingface dataset:
Switching Phlebotomy Needles
Authors: William J. Elliott
Journal: Annals of Internal Medicine (1991)

Letters1 January 1991Switching Phlebotomy NeedlesWilliam J. Elliott, MD, PhDWilliam J. Elliott, MD, PhDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-114-1-94 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors: Krumholz and colleagues (1) recently reported no differences between "false-positive" blood cultures injected into the culture medium, using either the original phlebotomy needle or a new, sterile needle. Unfortunately, the rates of such "false-positive" cultures were so low that their recommendations not to "switch" needles may not be based on a sufficient number of patients to support their conclusions. The group with "switched" needles incurred only a 1.3% rate of false-positive cultures, whereas the group using the original needles had a 1.55% false-positive rate.Because of the very low occurrence rates of false-positive cultures, the well-known nomograms...References1. KrumholzCummingsYork HSM. Blood culture phlebotomy: switching needles does not prevent contamination. Ann Intern Med. 1990;113:290-2. LinkGoogle Scholar2. YoungBresnitzStrom MEB. Sample size nomograms for interpreting negative clinical studies. Ann Intern Med. 1983;99:248-51. LinkGoogle Scholar3. BrownKelenAshtonWerman CGJH. The beta error and sample size determination in clinical trials in emergency medicine. Ann Emerg Med. 1987;16:183-7. CrossrefMedlineGoogle Scholar4. FreimanChalmersSmith JTH. The importance of beta, the type II error and sample size in the design and interpretation of the randomized control trial. N Engl J Med. 1978;299:690-4. CrossrefMedlineGoogle Scholar5. Feinstein A. Clinical Biostatistics. St. Louis: CV Mosby; 1977. CrossrefGoogle Scholar1. KrumholzCummingsYork HSM. Blood culture phlebotomy: switching needles does not prevent contamination. Ann Intern Med. 1990;113:290-2. LinkGoogle Scholar2. StrandShulman CJ New approaches to detection of bacteremia. In: . Bloodstream Infections: Laboratory Detection and Clinical Considerations. Chicago: ASCP Press; 1988:45-64. Google Scholar1. Significance questing [Editorial]. Ann Intern Med. 1986;105:445-7. LinkGoogle Scholar2. Confidence intervals extract clinically useful information from data [Editorial]. Ann Intern Med. 1988;108:296-8. LinkGoogle Scholar3. ArplGahrn-HansenRosdahl MBV. Contaminating coagulase-negative staphylococci isolated in the lysis-centrifugation (Isolator) blood culture system. Application of different epidemiological markers for deduction of mode of contamination. Apmis. 1988;96:611-7. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: The University of Chicago Chicago, IL 60637 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 January 1991Volume 114, Issue 1Page: 94-95KeywordsBloodPhlebotomy Issue Published: 1 January 1991 PDF downloadLoading ...
New Marijuana Laws in 2 States Prompt Caution
Authors: Rebecca Voelker
Journal: JAMA (1996)

TWO DAYS after the November elections, Anaheim, Calif, family physician S. Clarke Smith, MD, came face to face with his state's new Proposition 215. "A young man with the requisite ponytail came in to my office complaining of back pain," Smith says. "He said he had muscle spasms and had had a laminectomy. He wanted marijuana." Under the newly passed Proposition 215, the state of California now would allow Smith to write or merely tell the young man that he could smoke marijuana to relieve his back pain, without physician or patient having to fear state criminal reprisals. Smith's response? "I told him that just because we had passed a proposition in California, it didn't mean the federal law didn't apply." But the patient still pushed him to put it in writing. "I told him no way," Smith says. "I said, 'I can't and I won't.' " <h3>Wait Till the Dust</h3>
Challenges Facing Family Practice and Primary Care
Authors: Richard G. Fried
Journal: JAMA (2003)

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
Oral and dental disease in terminally ill cancer patients.
Authors: J. Jobbins, J. Bagg, I. G. Finlay, M. Addy, R. G. Newcombe
Journal: BMJ (1992)

stasis are thought to be of primary importance pre- disposing to octreotide induced gall stones,3 and this is supported by a report of impaired postprandial contractility' and our observation of a substantially increased fasting gall bladder volume.In conclusion, our findings show recovery of gall bladder function and asymptomatic resolution of gall stones when octreotide is withdrawn.
Dynamics of BCR-ABL mRNA expression in first-line therapy of chronic myelogenous leukemia patients with imatinib or interferon α/ara-C
Authors: M C Müller, N Gattermann, T Lahaye, M W N Deininger, A Berndt, S Fruehauf, A Neubauer, T Fischer, D K Hossfeld, F Schneller, S W Krause, C Nerl, H G Sayer, O G Ottmann, C Waller, W Aulitzky, P le Coutre, M Freund, K Merx, P Paschka, H König, S Kreil, U Berger, H Gschaidmeier, R Hehlmann, A Hochhaus
Journal: Leukemia (2003)
Salicylates as Hypoglycemic Agents
Authors: Steven H Baron
Journal: Diabetes Care (1982)

Salicylates lower blood sugar and enhance glucose-stimulated insulin secretion in normal and diabetic man. Although the hypoglycemic effect appears to be mediated by enhanced insulin secretion, extrapancreatic mechanisms cannot be excluded. The mechanism of the enhanced insulin secretion appears to be mediated by prostaglandin synthesis inhibition. The effect of salicylates on insulin secretion mediated by other secretagogues is imprecisely known. In addition to their glucose lowering action, salicylates have been reported to lower free fatty acids, triglycerides, and cholesterol. Salicylates have been imprecisely evaluated as hypoglycemic and hypolipidemic agents. Knowledge of their mechanism of action may provide further insight into the pathogenesis of diabetes mellitus and hyperlipidemic states.
Facial naevus and unsuspected visual loss from glaucoma.
Authors: A O'Connell, R Pitts Crick
Journal: BMJ (1978)

CommentSince argyria was reviewed by Hill and Pilsbury in 19392 it has become rare with the diminished use of silver compounds.A recent case was ascribed to silver iodide nose drops.3In argyria silver, probably bound to proteins, is deposited widely in the body tissues.Pigmentation results partly from stimulation of melanin deposition but mainly from photoactivated reduction to metallic silver in the dermis-hence the distribution over areas exposed to light.It may be mistaken for cyanosis.No non-cutaneous systemic effects have been described.Deposition of insoluble silver salts in the mouth is the therapeutic basis of several preparations used to discourage smoking, but argyria resulting from this has not been described.It has been suggested that no silver will be absorbed from Respaton,4 but our retention figures suggest that this is unlikely.The dosage was high in our case, our measurements indicating about 32 lozenges daily for six months.Nevertheless, argyria has been described after lower doses of silver.Respaton has been available from retail chemists since 1974.Inquiries in the Glasgow area suggest that it is not widely used, but it may be important to establish whether argyria has been associated with silver-containing anti-smoking preparations (Respaton, Tabmint) in other patients.No specific treatment has been attempted.The patient, unfortunately, will remain discoloured for life.She now smokes two or three cigarettes daily.
FOUR CASES OF EXOPHTHALMIC GOITRE TREATED WITH INSULIN: A Preliminary Report to the Medical Research Council
Authors: R. D. Lawrence
Journal: BMJ (1924)

THE idea of treating hylerthyroidism with founded on the hypothesis of an antagonism between hormones of the thyroid and the panereas.hypothesis admits of no definite proof, but the pathological anid experimental evidence in its favour the hope that.insuliniiiight prove useful of hyperthyroidism and exoplithalmic Since work was begun, Goffin' has published four cases of Graves's disease treated witlh insulin, which were greatly ameliorated.His work may be riiticized on the grounds that no estimations of miietabolism made and thei eforc lhyper-thyr oidism ws as definitely established, nor is there a record of the hlis experiment being carefullv conltrolled.here reported two were successful, and, early to genelalize on these few cases, they indication of the type of case most likely insulin.As each case requir es very longed investigation to be of real experimental valuie few can be adequately undertaken at a time, four cases are recorded niow in detail in the hope that may be tempted to investigate the question.Evidentce of an Antagonism betueei the Thyroid the P'an creas.The clinical picture of hyperthyroidism and exophithalmic goitre is well known.The conditioni is due ani production and perhaps a qualitative change hormone thyroxin, an iodine compound.When present in excess, as in exophthahlmic goitre,thee metabolismn as judged by the minimal heat production-the bas,al metabolic rate as it is called--is miarkedly increased, katabolisii exceeds anaboismn, the tissues broken down and nitrogenous excretion is increased, weighlt is lost, the pulse and, respir ation lare rapid, perature often elevated.In brief, tlyroxin aii excessive draught to the fires of the body.In the sympathetic system is over-active, and to of nervousniess, tremors, and exoplhtalmos miinly ascribed.
Claudin-1 Is a Metastasis Suppressor and Correlates with Clinical Outcome in Lung Adenocarcinoma
Authors: Yu-Chih Chao, Szu-Hua Pan, Shuenn-Chen Yang, Sung-Liang Yu, Ting-Fang Che, Chung-Wu Lin, Mu-Shiun Tsai, Gee-Chen Chang, Che-Hsiang Wu, Yi-Ying Wu, Yung-Chie Lee, Tse-Ming Hong, Pan-Chyr Yang
Journal: American Journal of Respiratory and Critical Care Medicine (2008)

Claudin (CLDN)-1, a key component of tight junction complexes, was down-regulated in human lung adenocarcinomas.To investigate the clinical significance of CLDN1 expression in patients with lung adenocarcinoma and its role in cancer invasion and metastasis.We examined the CLDN1 mRNA expression in tumor specimens from 64 patients with lung adenocarcinoma and protein expression by immunohistochemistry in an independent cohort of 67 patients with lung adenocarcinoma. CLDN1 functions in cancer cell migration, invasion, and metastatic colonization were studied by overexpression and knockdown of CLDN1. Affymetrix microarrays were performed to identify gene expression changes associated with CLDN1 overexpression.We found that low-CLDN1 mRNA expression had shorter overall survival (P = 0.027, log-rank test) in 64 patients with lung adenocarcinoma, and we confirmed by immunohistochemistry that low CLDN1 expression had shorter overall survival (P = 0.024, log-rank test) in an independent cohort of 67 patients with lung adenocarcinoma. Overexpression of CLDN1 inhibited cancer cell dissociation in time-lapse imaging of wound healing, and suppressed cancer cell migration, invasion, and metastasis. Knockdown CLDN1 expression increased cancer cell invasive and metastatic abilities. Affymetrix microarrays identified a panel of genes altered by CLDN1 overexpression. CLDN1 increased expressions of cancer invasion/metastasis suppressors (e.g., connective tissue growth factor [CTGF], thrombospondin 1 [THBS1], deleted in liver cancer 1 [DLC1], occludin [OCLN], zona occludens 1 [ZO-1]) and suppressed expressions of invasion/metastasis enhancers (e.g., secreted phosphoprotein 1 [SPP1], cut-like homeobox 1 [CUTL1], transforming growth factor alpha [TGF-alpha], solute carrier family 2 [faciliated glucose transporter] member 3 [SLC2A3], placental growth factor [PGF]), supporting a role for CLDN1 as an invasion and metastasis suppressor.CLDN1 is a cancer invasion/metastasis suppressor. CLDN1 is also a useful prognostic predictor and potential drug treatment target for patients with lung adenocarcinoma.
Effects of donor T-cell trafficking and priming site on graft-versus-host disease induction by naive and memory phenotype CD4 T cells
Authors: Britt E. Anderson, Patricia A. Taylor, Jennifer M. McNiff, Dhanpat Jain, Anthony J. Demetris, Angela Panoskaltsis-Mortari, Ann Ager, Bruce R. Blazar, Warren D. Shlomchik, Mark J. Shlomchik
Journal: Blood (2008)
Successful treatment of malignant testicular teratoma with brain metastases.
Authors: S B Kaye, R H Begent, E S Newlands, K D Bagshawe
Journal: BMJ (1979)

suggests a direct action on bone, as has been shown in tissue culture.5The previous thyroidectomy and parathyroid removal, with the lack of response to calcitonin, indicate that the reduction in bone resorption could not have been mediated by a reduction in parathyroid hormone secretion or rise in endogenous calcitonin.It is unlikely that developing hypothyroidism played any major part in the action of hydrocortisone on bone resorption in this patient, since the response to hydrocortisone was rapid and the plasma half life of T4 is of the order of 6-7 days.Indeed, after the initial withdrawal of the thyroid supplements there was a steady increase in bone resorption until the administration of hydrocortisone.
Bacterial Antigen in the Kidney
Authors: Edward H. Kass
Journal: New England Journal of Medicine (1969)

The role of bacterial infection in the pathogenesis of chronic pyelonephritis has been one of the fruitful areas of controversy in recent years. The classic observations of Weiss and Parker,1 and of many others, had traced a morphologic continuum from acute to chronic pyelonephritis and had related the latter lesion to hypertension and to renal failure as well as to other diseases.On the basis of their finding that most cases of chronic pyelonephritis were undetected during life, and in the belief that there were asymptomatic infections of the urinary tract that would be related to later chronic disease, methods . . .
Alcohol Use and Mortality from Coronary Heart Disease: The Role of High-Density Lipoprotein Cholesterol
Authors: Il Suh, B. Jessica Shaten, Jeffrey A. Cutler, Lewis H. Kuller
Journal: Annals of Internal Medicine (1992)

To study the association between alcohol consumption and death from coronary heart disease and to determine the extent to which the association can be explained by the high-density lipoprotein (HDL) cholesterol level.A cohort study involving men enrolled in the Multiple Risk Factor Intervention Trial (MRFIT).Community-based study.Men (n = 11,688) at high risk for developing coronary heart disease but without clinical evidence of it. More than 90% of the men were white, and the average age was 46 years. Five percent of the men abstained from alcohol during the trial, 81% consumed fewer than 21 alcoholic drinks per week, and 14% consumed more than 21 alcoholic drinks per week.Average alcohol intake over 7 years was calculated for MRFIT participants who were alive at the end of the trial and who had at least three follow-up records of alcohol consumption. Post-trial mortality during a 3.8-year period was assessed.The adjusted relative risk for death from coronary heart disease for each increase of 7 drinks per week was 0.89 (95% CI, 0.80 to 1.00), with an apparent dose-response relationship. The average HDL level was associated with the average alcohol intake in a least-squares regression model (beta = -0.0074; P less than 0.01). When the average HDL level was included in the proportional hazards model for mortality from coronary heart disease, the absolute value of the coefficient for average drinks per week declined 45%, yielding an adjusted relative risk for each additional 7 drinks per week of 0.94 (CI, 0.84 to 1.05).In middle-aged men who are light to moderate drinkers, the inverse association between alcohol consumption and death from coronary heart disease can be explained, in large part, by the HDL cholesterol level, which increases with alcohol consumption. However, alcohol consumption cannot be recommended because of the known adverse effects of excess alcohol use.
Lung Cancer in US Women
Authors: Jyoti D. Patel, Peter B. Bach, Mark G. Kris
Journal: JAMA (2004)

Lung cancer is the leading cause of cancer death in US women and is responsible for as many deaths as breast cancer and all gynecological cancers combined. Most lung cancer is caused by cigarette smoke. Despite all that is known about the devastating effects of cigarettes, one quarter of women in the United States continue to smoke. Women are targeted in tobacco advertising, and teenage girls are often drawn to cigarette smoking under a variety of social pressures. Following the increase in smoking, the death rate from lung cancer in US women rose 600% from 1930 to 1997. Women may be more susceptible than men to the carcinogenic properties of cigarette smoke. In addition, differences in the biology of lung cancer exist between the 2 sexes with higher levels of DNA adduct formation, increased CYP1A1 expression, decreased DNA repair capacity, and increased incidence of K-ras gene mutations in women. The novel estrogen receptor beta has also been detected in lung tumors and suggests that estrogen signaling may have a biological role in tumorigenesis. Given these differences and given the enormous toll this disease has on US women, undertaking sex-specific research in lung cancer is crucial. Finally, disseminating information about this epidemic may prevent a similar epidemic in other parts of the world where women are just now becoming addicted to tobacco.
Reflectance spectrophotometry in the objective assessment of dye laser-treated port-wine stains
Authors: A. TROILIUS, B. LJUNGGREN
Journal: British Journal of Dermatology (2006)

At present, the treatment of choice for congenital capillary malformations of the port-wine stain type (PWS) is the flashlamp pulsed dye laser. Good results can be obtained in the majority of patients with this technique, but there is a group of poor responders. In the search for predictive tools to determine the therapeutic outcome, we have used a new photoelectric reflectance instrument. Sixty-six patients with PWS, mainly on the face, were treated with a pulsed dye laser during a 21-month period. Using a hand-held reflectance photometer, erythema indices were obtained for the PWS and normal skin. Based on these indices, a relative blanching effect could be calculated. The therapeutic result was judged to be excellent in 19, good in 20, fair in 14 and poor in 13 patients. There was a good correlation (r=0·844) between the degree of blanching and the therapeutic result. In the ‘excellent’ category, an average blanching effect of 47% was present after the first treatment, and this increased to between 75 and 100% after successive treatments. In the ‘poor’ category, the blanching effect after one treatment averaged 14%, increasing to only 40% after up to six treatments. It thus seems to be possible to predict the outcome of therapy, which is of considerable help in treatment planning. Reflectance measurements, an objective estimate of blanching, correlate well with the clinical results, and are helpful in monitoring and predicting the therapeutic outcome in dye laser-treated PWS.
MRP1 at apical (maternal-facing) pole of human trophoblasts accounts for the placental transfer of unconjugated bilirubin (UCB) from the fetal to the maternal circulation
Authors: L. Pascolo, C. Fernetti, E. Crivellato, V.M.Garcia Mediavilla, D.J. Ostrow, C. Tiribelli
Journal: Journal of Hepatology (2001)
Falsifying data is main problem in US research fraud review
Authors: M. Pownall
Journal: BMJ (1999)

Half of the US biomedical researchers accused of scientific fraud and subjected to formal investigations in recent years have been found guilty of misconduct, a new review has found.

In the biggest review of scientific fraud ever published, the US Office of Research Integrity, has released data on nearly a thousand allegations investigated over the five years from 1993 to 1997. The review covered inquiries into allegations of misconduct …
Correlation of hepatocyte HBsAg expression with virus replication and liver pathology
Authors: Hey-Chi Hsu, Ming-Yang Lai, Ih-Jen Su, Ding-Shinn Chen, Mei-Hwei Chang, Pei-Ming Yang, Chieng-Yen Wu, Hong-Chung Hsieh
Journal: Hepatology (1988)

To elucidate the biologic significance of hepatocyte HBsAg, its expression patterns were correlated with virus replication and liver pathology in 578 liver biopsies taken from chronic HBsAg carriers aged 1 to 80 years. Five major patterns of hepatocyte HBsAg were identified: homogeneous [intense and discrete, (Pattern A), faint and discrete, (Pattern B) and faint and grouped (Pattern C)]; globular or spotty (Pattern D), and marginal (Pattern E). Pattern A was always associated with viremia and also very frequently with membrane HBsAg expression, but rarely with active liver disease. It occurred most commonly in HBeAg-positive carrier children and young adults, reflecting an early immune tolerance phase with active virus replication. Pattern B was also usually associated with viremia, but very commonly associated with active disease (70%), reflecting active virus replication with enhanced immune response. Pattern E (marginal HBsAg), which was always in group distribution resembling a clonal expansion, predominated the HBeAg-negative phase and was associated with absence of viremia and occurred mostly in older adults with inactive bipolar disease spectrum (normal liver/mild disease or cirrhosis/hepatocellular carcinoma); this reflects a late phase of inactive virus replication or integration. Patterns C and D did not correlate well with viremia, but also tended to have inactive diseases as did Pattern E. These findings suggest that hepatocyte HBsAg expression is closely related to the natural course of chronic hepatitis B virus infection.