tbuckley/cabot-search huggingface dataset:
Chemotherapy Patients' Perceptions of Drug Administration Safety
Authors: David L.B. Schwappach, Martin Wernli
Journal: Journal of Clinical Oncology (2010)

To explore chemotherapy patients' experiences of drug administration safety and to investigate the relationship between perceptions of risk and harm from error, staff safety practices, and patients' engagement in error prevention strategies.Four hundred seventy-nine chemotherapy patients treated at the oncology/hematology department of a large regional hospital in Switzerland completed a self-administered survey (53% response rate).Sixteen percent of patients reported having experienced an error in their care, and 11% were currently very concerned about errors. Patients perceived the risk of four detailed errors as rather low, whereas the mean rating of potential harm from error was substantial. Relative to other errors, patients seem to underestimate the harm associated with drug overdosing. Seventy-seven percent of responders agreed that patients can help to prevent errors. Although patients perceived staff as being committed to providing safe care, ratings related to patient involvement in safety were considerably lower. More than one quarter of patients disagreed that staff instructed them to watch for and report errors. Patients engaged in safety behaviors, particularly in those behaviors that are compatible with traditional patient-provider relations. Risk of error perceptions, affirmative attitudes toward patient preventability, and error experience were positively linked to safety-related behaviors, whereas higher levels of global trust in staff safety practices were inconsistently associated with lower frequency of engagement in safety strategies.Chemotherapy safety is a considerable concern for patients. Many patients are prepared to be involved in error prevention. The results highlight areas for improvement in communication and cooperation for safety between patients and providers.
Valproate-Induced Hepatic Injury: Analyses of 23 Fatal Cases
Authors: Hyman J. Zimmerman, Kamal G. Ishak
Journal: Hepatology (1982)

Analyses of 23 fatal instances of hepatic injury in patients taking valproic acid reveals that all but three were less than 20 years old, and all but four had been taking the drugs for more than 1 month. Convulsions, facial edema, lassitude, and vomiting were prominent clinical features. Hypoglycemia was recorded in six patients. Rash and eosinophilia were not seen. Values for transaminases were modestly elevated in most patients. Most levels of SGOT were below 500 IU, and SGPT levels were below 200 IU. Livers showed microvesicular steatosis in most patients, usually accompanies by necrosis. Four patients had cirrhosis. Overt valproic acid-induced hepatic injury appears to be rare and hence, by definition, idiosyncratic. That it may be an idiosyncratic exaggeration of a much more frequent phenomenon is suggested by the higher incidence of seemingly trivial injury. The idiosyncrasy appears to be metabolic rather than immunologic, and the available information leads to the plausible hypothesis that a metabolite is responsible for the microvesicular steatosis seen in most fatal cases. The steatosis resembles that of Reye's syndrome and Jamaican vomiting sickness, and there is reason to believe that the metabolite responsible for the steatosis resembles the agent responsible for Jamaican vomiting sickness. A different metabolite is presumably responsible for the necrosis seen in many of the cases.
A MEMORABLE PATIENT
Authors: A P Joseph
Journal: BMJ (1996)

Some 40 years have elapsed since the death of my landlord at university but the event is still clearly etched in my memory. I was a late acceptance for the Cambridge medical course that year and my college had difficulty in finding accommodation. Finally it succeeded in persuading one of its former landladies to reverse her decision that she would no longer take students. Accordingly, I was billeted with an elderly couple of whom the husband was by now increasingly handicapped from injuries that he suffered in the first world war. His wife considered herself to be burdened enough looking after him, but she was a good landlady. Everything changed dramatically on 1 March 1956 …
Osteocalcin: a marker of disease activity in ankylosing spondylitis?
Authors: A Falkenbach
Journal: Annals of the Rheumatic Diseases (2002)

In rheumatic diseases the synovial concentration of osteocalcin, which represents osteoblast activity, is inversely correlated with the extent of joint inflammation.1 Synovial and serum osteocalcin correlate positively.1 In ankylosing spondylitis (AS) the serum concentration of osteocalcin has been reported to be low2,3 or normal.4–7 Cross sectional studies have shown no significant correlation between osteocalcin serum concentration and erythrocyte sedimentation rate (ESR) or C reactive protein.5,7

To answer the question whether serum osteocalcin is a useful marker …
Metoclopramide and Tremor
Authors: JUDITH C. AHRONHEIM
Journal: Annals of Internal Medicine (1982)

Letters and Corrections1 October 1982Metoclopramide and TremorJUDITH C. AHRONHEIM, M.D.JUDITH C. AHRONHEIM, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-97-4-621_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Metoclopramide, a central dopamine receptor antagonist, has potent cholinergic stimulatory effects on the gastrointestinal tract and is used for a variety of motility related symptoms. Reported extrapyramidal side effects of the drug include acute dystonic reactions, parkinsonism, and tardive dyskinesias (1-5), the last two occurring predominantly in the elderly. I report an elderly woman in whom short-term metoclopramide induced an acute extrapyramidal reaction in which essential-type tremor was the predominant feature.An 86-year-old woman with postprandial belching and abdominal bloating was treated with oral metoclopramide, 10 mg three times a day. Her gastrointestinal symptoms were relieved, but...References1. GRIMES J, HASSAN M, and PRESTON D Adverse neurologic effects of metoclopramide. Can Med Assoc J. 1982;120:23-5. Google Scholar2. CASTEELS-VAN DAELE M, JAEKEN J, and VAN DER SCHUEREN P. Dystonic reactions in children caused by metoclopramide. Arch Dis Child. 1970;45:130. CrossrefMedlineGoogle Scholar3. MELMED S and BANK H. Metoclopramide and facial dyskinesia. Br Med J. 1975;1:331. CrossrefMedlineGoogle Scholar4. KATARIA M, TRAVIS M, and MARSDEN C. Extrapyramidal side-effects of metoclopramide. Lancet. 1978;2:1254-5. CrossrefMedlineGoogle Scholar5. LAW S, MELAMED E, and PENCHAS S. Tardive dyskinesia associated with metoclopramide. Br Med J. 1978;1:77-8. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JUDITH C. AHRONHEIM, M.D.Affiliations: Bellevue Hospital Center New York, NY 10016 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDrug-induced movement disordersDrug-induced tremorsDrug- and Toxin-Induced Tremor 1 October 1982Volume 97, Issue 4 Page: 621-621 Keywords Adverse reactions Cholinergics Dopamine Elderly Gastrointestinal tract ePublished: 1 December 2008 Issue Published: 1 October 1982 PDF downloadLoading ...
Sex differences in case fatality before and after admission to hospital after acute cardiac events: analysis of community based coronary heart disease register
Authors: G. S Sonke, R. Beaglehole, A. W Stewart, R. Jackson, F. M Stewart
Journal: BMJ (1996)

<h3>Abstract</h3> <b>Objective</b>: To determine whether the reported higher case fatality in hospital after an acute cardiac event in women can be explained by sex differences in mortality before admission and in baseline risk factors. <b>Design</b>: Analyses of data from a community based coronary heart disease register. <b>Setting</b>: Auckland region, New Zealand. <b>Subjects</b>: 5106 patients aged 25–64 years with an acute cardiac event leading to coronary death or definite myocardial infarction within 28 days of onset, occurring between 1986 and 1992. <b>Main outcome measures</b>: Case fatality before admission, 28 day case fatality for patients in hospital, and total case fatality after an acute cardiac event <b>Results</b>: Despite a more unfavourable risk profile women tended to have lower case fatality before admission than men (crude odds ratio 0.88; 95% confidence interval 0.77 to 1.02). Adjustment for age, living arrangements, smoking, medical history, and treatment increased the effect of sex (0.72; 0.60 to 0.86). After admission to hospital, women had a higher case fatality than men (1.76; 1.43 to 2.17), but after adjustment for confounders this was reduced to 1.18 (0.89 to 1.58). Total case fatality 28 days after an acute cardiac event showed no significant difference between men and women (0.85; 0.70 to 1.02). <b>Conclusions</b>: The higher case fatality after an acute cardiac event in women admitted to hospital is largely explained by differences in living status, history, and medical treatment and is balanced by a lower case fatality before admission. <h3>Key messages</h3> Data from a community based coronary heart disease register were used to examine sex differences in case fatality before and after admission Women had a higher case fatality after admission but a lower case fatality before admission Total case fatality 28 days after an acute cardiac event showed no significant difference between men and women The higher case fatality after an acute cardiac event in women admitted to hospital is largely explained by confounding
Abstract 4530: The anti-tumor effect of MDM2 antagonist nutlin-3 in gastric cancer cell <i>in vitro</i> and <i>in vivo</i>
Authors: Shinji Endo, Hideo Suzuki, Sachiko Hirai, Ichinosuke Hyodo, Kenji Yamato
Journal: Cancer Research (2010)

Abstract Purpose: The mortality of gastric cancer is still high accounting for an estimated 50,000 deaths in Japan. The chemotherapies based on fluoropyrimidine and platinum complexes are widely used for unresectable advanced gastric cancer, however, development of new strategies including molecular targeting therapies are urgently required to obtain further effectiveness. Recent studies demonstrate that 70% of gastric cancers has wild-type p53 gene and its function thought to be inhibited by over-expression of murine double minute 2 (MDM2), a regulator of p53 turnover by binding p53 and acting as a ubiquitin E3 ligase. Nutlin-3 is a small-molecule MDM2 antagonist that efficiently activates p53 and its tumor suppresser function has been shown in retinoblastoma and hematological malignancy but not in gastrointestinal carcinoma. In this study, we investigated the antitumor effects of nutlin-3 in gastric cancer cells in combination with 5-fluorouracil or cisplatin in vitro and in vivo. Experimental Design: Human gastric cancer cell lines carrying wild-type (4 cell lines) or mutated p53 gene (3 cell lines) were incubated with nutlin-3 alone or combination with 5-fluorouracil or cisplatin in time dependent manner. Cell viability was calculated by WST assay. Western blot analysis for MDM2 and p53 are also performed to investigate protein expression. In vivo study, mice xenografted gastric cancer cells were treated with nutlin-3 alone or combination with 5-fluorouracil intraperitoneally. The tumor size was measured and histochemistry was done after 3 weeks administration. Results: Nutlin-3 showed strong cytotoxicity in gastric cancer cells carrying wild-type p53 gene not mutated p53 gene, regardless of expression level of MDM2 protein. Anti-tumor effect of Nutlin-3 was also observed in xenografted mice model. Histochemical analysis indicated nutlin-3 induced apoptotic cell death in tumor tissue. Furthermore, combined treatment with nutlin-3 and 5-fluorouracil or cisplatin revealed enhanced cytotoxicity in gastric cancer cells with wild-type p53 gene. Conclusions: Our results present new option in exploiting reactivation of p53 as what we believe to be a novel and highly selective treatment for gastric cancer patients with wild-type p53 gene. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4530.
Signs of illness preceding sudden unexpected death in infants.
Authors: R E Gilbert, P J Fleming, Y Azaz, P T Rudd
Journal: BMJ (1990)

OBJECTIVE--To determine whether signs of illness reported by parents can be used to identify babies at risk from the sudden infant death syndrome. DESIGN--A two year prospective case-controlled study based in a geographically defined area. SETTING--Four health districts in Avon and north Somerset. SUBJECTS--Babies who had died suddenly and unexpectedly aged between 1 week and 2 years (index babies) and two control babies for each index baby selected from the same health visitor9s list and matched for age, time of year of the interview, and area of residence. MAIN OUTCOME MEASURES--Major and minor signs of illness during two weeks before the index babies9 death, or before the interview for control babies, and consultations with the general practitioner during the same period. RESULTS--Parents reported major and minor signs of illness in the previous week in 66 of the 95 index babies compared with 77 of the 190 controls. No significant difference was found in the incidence of major signs reported (34 out of 95 index babies and 44 out of 190 controls), but a higher proportion of the index babies had been seen by their general practitioner during the previous week (17/95 v 11/190). CONCLUSION--Major and minor signs of illness are neither a sensitive nor a specific indicator of sudden unexpected death of infants and have no predictive value. Better understanding of the reasons why a higher proportion of parents of babies who died took them to their general practitioners may help to identify babies at risk before death.
Biologically Based Epidemiological Studies of Electric Power and Cancer
Authors: Richard G. Stevens
Journal: Environmental Health Perspectives (1993)

As societies industrialize, the health profile of the population changes; in general, acute infectious disease declines and chronic disease increases. Use of electricity is a hallmark of the industrialization process, but there has been no suspicion that electricity could increase the risk of cancer. Recently, however, a number of epidemiologic studies have suggested that electromagnetic fields (EMF) may do just that. Although few cancer experiments have been done yet, there are a number of biological effects of EMF reported in the literature that might provide bases for designing cancer experiments and epidemiologic studies. These include effects of EMF on: a) DNA transcription and translation, b) calcium balance in cells, and c) pineal production of melatonin. Alterations in DNA transcription and translation could have pleiotropic effects. Disruption of calcium homeostasis has many implications including oncogene activation, promotional activity via protein kinases and ornithine decarboxylase (ODC), and increasing oxidative stress. Reduction of melatonin suggests a possible increased risk of cancers of hormone-dependent tissues such as breast and prostate. The idea that a cancer-causing agent must either be an initiator or a promoter should be discarded; indeed, the phenomenologic meaning of these two terms has become confused with imputed mechanistic necessity in recent years. Agents that affect division of normal cells or of fully transformed cells can play an important role in clinical cancer development quite apart from initiation or promotion.(ABSTRACT TRUNCATED AT 250 WORDS)
Prenatal Whole-Genome Sequencing — Is the Quest to Know a Fetus's Future Ethical?
Authors: Ilana R. Yurkiewicz, Bruce R. Korf, Lisa Soleymani Lehmann
Journal: New England Journal of Medicine (2014)

Researchers have reported sequencing a fetal genome from cell-free fetal DNA in a pregnant woman's blood, heralding the possibility of performing whole-genome sequencing as early as the first trimester of pregnancy. This innovation raises ethical and policy questions.
Chronic Diabetic Complications and Tissue Glycosylation: Relevant Concern for Diabetes-Prone Black Population
Authors: Helen Vlassara
Journal: Diabetes Care (1990)

A significant segment of the Black population is affected by chronic diabetes, and most of them are subjected to severe cardiovascular, renal, and neurological complications that shorten survival and diminish quality of life. One of the important pathogenetic mechanisms under intensive investigation is advanced tissue glycosylation. Tissue and cell surface proteins modified nonenzymatically by glucose are shown to be highly active in protein cross-linking and have been implicated in tissue damage. Such protein-glucose interactions, called advanced glycosylation end products (AGEs), are processed by macrophages through a high-affinity receptor. Coupling of AGE proteins to their AGE receptors results in their degradation and removal and, simultaneously, in synthesis and secretion of pluripotential cytokines such as tumor necrosis factor and interleukin 1. This suggests that AGE may act normally as a signal for growth-promoting factor secretion in a coordinated replacement process during tissue remodeling. In chronic diabetes, however, where accelerated accumulation of tissue AGE occurs, a disturbance of this balance may lead to several pathological, lytic, and/or proliferative responses like those in the vasculopathy of diabetes. Progress has been made with the discovery of aminoguanidine HCI, an AGE inhibitor, which has prevented significant pathology in short-term diabetic animal studies.
Leg ulcers in Klinefelter's syndrome - further evidence for an involvement of plasminogen activator inhibitor-1
Authors: T.M. ZOLLNER, J.C.J.M. VERAART, M. WOLTER, S. HESSE, B. VILLEMUR, A. WENKE, R.J. WERNER, W.-H. BOEHNCKE, S.S. JOST, I. SCHARRER, R. KAUFMANN
Journal: British Journal of Dermatology (1997)

An abnormality in platelet aggregability or fibrinolysis, namely elevated activity of plasminogen activator inhibitor‐1 (PAI‐1), has been recently documented in patients suffering from Klinefelter's syndrome associated with leg ulceration without underlying venous insufficiency. To determine whether increased PAI‐1 activity is a general feature of Klinefelter's syndrome, or more specifically associated with leg ulceration, we investigated PAI‐1 influencing parameters and PAI‐1 activity in two groups of patients: (i) Klinefelter patients suffering from leg ulceration (n=7); and (ii) Klinefelter patients without leg ulceration (n=6). On analysing PAI‐1 influencing parameters such as age, body mass index, triglycerides, C‐reactive protein, testosterone, smoking behaviour, the presence of diabetes mellitus, and artierial hypertension, respectively, we found no statistically significant differences between the two groups. However, PAI‐1 activity in group 1 was highly significantly elevated compared with that in group two patients (P<0.005). We conclude that (i) PAI‐1 activity is not elevated in Klinefelter's syndrome in general; (ii) elevation of PAI‐1 activity in patients suffering from Klinefelter's syndrome does not appear to be secondary to PAI‐1 influencing parameters; and (iii) elevation of PAI‐1 activity may play a crucial role in the pathogenesis of leg ulceration in Klinefelter's syndrome. Therefore, a therapy for leg ulceration in Klinefelter's syndrome that aims to return the elevated PAI‐1 activity to normal should be explored.
MicroRNA-182 promotes clonal expansion of activated T helper cells
Authors: A-B Stittrich, C Haftmann, A Hegazy, M Floessdorf, J Dong, F Fuhrmann, G Heinz, N Li, Z Fang, A Jahn, R Baumgrass, J Grun, W Chen, T Hofer, M Lohning, H-D Chang, N Rajewsky, A Radbruch, M-F Mashreghi
Journal: Annals of the Rheumatic Diseases (2010)

Upon activation by antigen, T lymphocytes switch from a resting state to clonal expansion.This switch requires inactivation of the forkhead transcription factor Foxo1, which suppresses proliferation in resting T helper lymphocytes.In the initial antigen-dependent phase of clonal expansion, Foxo1 is inactivated by antigen receptor-dependent post-translational modifi cations.However, the late antigen-independent phase of clonal expansion is controlled by interleukin 2 (IL2), and it has not been clear how Foxo1 is inactivated in this phase.Here the authors show that in the IL2-dependent late phase of clonal expansion, expression of Foxo1 is downregulated by microRNA-182.Expression of microRNA-182 in activated T lymphocytes is induced by IL2.MicroRNA-182 is expressed between 2 and 4 days after onset of T cell activation.In this time, Foxo1 mRNA expression is reduced by 90%.Specifi c inhibition of microRNA-182 by locked nucleic acids inhibits clonal expansion of activated T lymphocytes in vitro.Ectopic constitutive expression of microRNA-182 results in a ninefold enhanced clonal expansion in vivo.Our results identify IL2-induced expression of microRNA-182 as a critical step regulating the late phase of clonal expansion of activated T helper lymphocytes, and presumably also the transition from expansion to contraction, as future research may show.The central role of a microRNA, here microRNA-182, in the regulation of T cell expansion provides entirely new options for therapeutic interference, namely the use of specifi c antagomiRs to limit T cell expansion in vivo.This may be of relevance in immune-mediated diseases.
Anti-vaccinationists past and present
Authors: R. M Wolfe
Journal: BMJ (2002)

<i>The British Vaccination Act of 1840 was the first incursion of the state, in the name of public health, into traditional civil liberties. The activities of today9s propagandists against immunisations are directly descended from, indeed little changed from, those of the anti-vaccinationists of the late nineteenth century, say Robert Wolfe and Lisa Sharp</i>
On So-Called Hysterical Pain
Authors: T. Inman
Journal: BMJ (1858)

TIIERE is scarcely any mnedical dictum upon which practitioners miiore securely repose, than that superficial tenderness, and tolerance of firm pressure, are a proof that any unusual pain complained of by females is " hvsterical" in its character.The pbysician, wlhen his patient complains of pain-say in the abdoimnen-ordinarily places hiis hand upon the part; and, find- ing that the individlual shrinks from contact, begins to talk of things in genieral, but mlaking all the time his lhanid weigh heavier; atil if no muore suffering is evinced, he concludes that the pain is only hyjsterical.Whein this conclusion is arrivedl at, one of two ideas may be adopted: 1, that the pain is real, but of no consequence;2, that it is unireal-tle result of a morbid propensity to enjoy miserable sensations.This style of reasoning reeminds us of the Pickwick Club, in wlich anl insult ceased to be so, when it was stated that the words were used in a " Pickwickian" sense ; for in medicine, pain is nio pain, an(d suiffering no suffering, in an hystericalsense.An hy 4terical pain is one wlich a patient feels, but has not; which lhasino existence; but wbhicl, by being thouglht upon, mlay growv, unltil it is unbearable !It is like the weapon
The general practitioners' work load.
Authors: M Hall
Journal: BMJ (1979)

Falciparum malaria despite chemoprophylaxis SIR,-Mr P Moody rightly points out the great current difficulty involved in the selection of optimal malaria prophylactics for some parts of the world (9 June, p 1565) and shows the disadvantages of almost all the options available.His view that advice may be difficult to obtain is, however, fortunately less correct.The Ross