tbuckley/cabot-search huggingface dataset:
Medication errors that have led to manslaughter charges
Authors: R E Ferner
Journal: BMJ (2000)

Doctors, like other professional people, are expected to exercise proper care in their work. If they neglect to do so and their patients are harmed they can expect to be criticised. Over the past decade, this criticism has increasingly taken the form of civil action against the doctor by patients or their families who seek financial recompense. More rarely, a patient dies as a result of alleged negligence and the Crown Prosecution Service considers that a criminal charge of manslaughter is justified. Up to 1990 these cases were very rare. In 1970, Leahy Taylor wrote that it was “unlikely in the extreme” that any doctor would face a charge of criminal negligence.1 He was aware of only two cases, those of Dr Percy Bateman, who had been convicted of manslaughter after an obstetric patient died, but was later pardoned on appeal,2 and a Dr Wight, who had been sentenced to 3 months' imprisonment for performing a forceps delivery while he was under the influence of chloral hydrate, as a result of which the mother died. In 1867 a Dr Spencer was acquitted of manslaughter after a medication error in which strychnine was dispensed to a patient instead of bismuth.3 This article focuses on errors in administering anaesthetics and in prescribing and giving medicines since these are the most common mistakes described in published reports.

#### Summary points

If a doctor is grossly negligent and the patient dies as a result, the doctor can be charged with manslaughter

The numbers of doctors charged with and convicted of manslaughter have increased appreciably in the past decade

Blaming one or a few people for an error that may be the result of difficulties at many stages in a complex process is dangerous

This action encourages secrecy and inhibits system changes that would reduce …
End-of-Life Communication in the ICU: A Global Perspective
Authors: Elaine C. Meyer
Journal: JAMA (2008)

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
Minorities get preferential admission to US medical schools
Authors: F. Charatan
Journal: BMJ (2001)

The Center for Equal Opportunity, a private non-profit making think-tank based in Washington, DC, has found that black and Hispanic students are being admitted to American medical schools with substantially lower college grades and test scores than white or Asian students.

The centre commissioned the independent consultants Drs Robert Lerner and Althea Nagai to conduct an analysis of six medical schools, representing every geographic region of the country. They found that a black, or to a lesser degree, Hispanic applicant, had a far …
Optimism and consent to treatment
Authors: F. Godlee
Journal: BMJ (2014)

We know that patients and doctors tend to overestimate the benefits of treatment and underestimate the harms. We also know that people’s natural optimism is often boosted by the systematic optimism bias of the medical literature ( Br J Psych 2010;197:441-7, doi:10.1192/bjp.bp.110.078006; PLoS One 2014;9(5):e98246, doi:10.1371/journal.pone.0098246). But in the case of percutaneous coronary intervention there is no such excuse. Experts and guidelines are clear: it improves symptoms but not survival. Nor does it reduce the risk of myocardial infarction. It should be offered to patients with stable coronary artery disease only if medical treatment is failing to manage their angina.

Despite this clarity, …
Polymers to treat brain tumours
Authors: Henry Brem
Journal: Biomaterials (1990)

Brain tumours are difficult to treat by conventional methods. A biodegradable polymer, poly-[bis(p-carboxyphenoxy) propane sebacic acid] with a nitrosourea, carmustine, has been demonstrated to be biocompatible in the brains of experimental animals and to release drugs in a predictable sustained manner. Carmustine impregnated in polymers appears to be more effective than when delivered by standard methods. A Phase I clinical study has demonstrated the safety of this approach in treating brain tumours and a Phase III placebo-controlled study is currently underway. Other applications of the polymer in the treatment of brain diseases are discussed.
Nucleoside Diphosphate Kinase, a Source of GTP, Is Required for Dynamin-Dependent Synaptic Vesicle Recycling
Authors: K.S Krishnan, Richa Rikhy, Sujata Rao, Madhuri Shivalkar, Michael Mosko, Radhakrishnan Narayanan, Paul Etter, Patricia S Estes, Mani Ramaswami
Journal: Neuron (2001)
Virchow's Pathological Reports on Frederick III's Cancer
Authors: Jain I. Lin
Journal: New England Journal of Medicine (1984)

The illness of a famous person, especially of a political leader, always fascinates the medical profession and lay public. The laryngeal cancer of Frederick III aroused enormous interest and discussion.1 Frederick was a beloved German emperor with a liberal mind; his wife, Empress Frederick (Vicky), was the eldest daughter of Queen Victoria. With this marriage, Germany and England expected to maintain a cordial relationship. After reigning over the empire for only three months, Frederick unfortunately succumbed to aspiration pneumonia following tracheostomy. Many-believed his untimely death changed the course of history in Europe as well as Germany.1 Shortly after Frederick's death, . . .
Contamination of heparin by histamine: measurement and characterization by high‐performance liquid chromatography and radioimmunoassay
Authors: K. Hermann, G. Frank, J. Ring
Journal: Allergy (1994)

Plasma samples which were collected in the presence of heparin contained 12.83 ± 0.34 ng/ml histamine‐immunoreactive material ( n = 10). In contrast, histamine‐immunoreactive material in plasma samples which were collected in the presence of EDTA/phenanthroline contained 0.32 ± 0.01 ng/ml ( n = 10). Histamine‐immunoreactive material was found as a contaminant in three different heparin formulations with unrelated batch numbers. The concentrations of the histamine‐like material were 32.82, 81.93, and 280.23 ng/ml, respectively. Octadecasilyl‐silica (ODS) cartridges were used to purify histamine from other constituents in the heparin preparations. The histamine‐immunoreactive material in the three preparations could be characterized as histamine with cation‐exchange high‐performance liquid chromatography (HPLC) on a TSK SP‐5 PW column with NaH 2 PO 4 , pH5.0, as a mobile phase and gradient elution. For the accurate measurement of histamine in plasma samples with heparin as an anticoagulant, one should be aware of a possible contamination of heparin formulations by histamine.
Community general practitioners.
Authors: J T Hart
Journal: BMJ (1984)

Commemorating a giant figure whose memory is still fresh to many is a heavy responsibility. Pat Byrne was a plebeian and rejoiced in the plebs' victory represented by the introduction of the National Health Service in 1948. In 30 years of practice in Milnethorpe, a market town and former seaport of Westmore? land, Pat developed the ideal of personal, continuing primary care of the highest clinical quality then possible. He was able to look after his patients as he would have wished himself, or his own family, to be looked after. In 1970 he became the first professor of general practice in England, in the utterly different circumstances of central Manchester. He did as much as any general practitioner, and more than most, to apply his Milnethorpe ideal to the reality of an industrial city. Though he went on to solve other problems successfully, in this particular task he was probably no more and no less successful than all the others who have broken their hearts trying to get enough clinical enthusiasm into urban industrial practice for it to achieve active, independent, un subsidised growth. He did not, and could not, transfer Milne? thorpe to Darbishire House health centre. If giants have failed to apply the rural and market town model of good general practice to urban industrial settings ordinary men and women are unlikely ever to do so. For too long we seem to have assumed that bad work in bad places can, by mighty acts of will, be changed into the good work of good places without any accompanying changes of structure or circumstance. We have attributed perfunctory care to perfunctory men instead of recognising that both are the consequence of intolerable circumstances that can and should be changed.
1157 EARLY HCVRNA DYNAMICS AND FACTORS ASSOCIATED WITH HIGH EARLY HCVRNA LEVEL DURING ACUTE HCV INFECTION
Authors: B. Hajarizadeh, K. Page, A.Y. Kim, B.H. McGovern, A.L. Cox, T.M. Rice, R. Sacks-Davis, J. Bruneau, M. Morris, J. Amin, B. Grady, J. Schinkel, L. Maher, M. Hellard, A.R. Lloyd, M. Prins, J. Grebely, G.J. Dore
Journal: Journal of Hepatology (2013)
Erythromycin Administration Before Sleep is Effective in Decreasing Fasting Hyperglycemia in Type 2 Diabetic Patients
Authors: Naohiko Ueno, Akio Inui, Akihiro Asakawa, Fumiaki Takao, Akira Ichibangase, Yoshio Komatsu, Masato Kasuga
Journal: Diabetes Care (2001)

Diabetic Ketoacidosis Associated With Orlistat Treatment Orlistat is a drug frequently prescribed as an adjuvant in weight control therapy (1-2).Orlistat inhibits gastric and pancreatic lipases in the lumen of the gastrointestinal tract to decrease the systemic absorption of dietary fat (1,2).In clinical trials, steatorrhoea and other gastrointestinal disorders are the most frequently reported side effects (3).Other reported adverse effects include hypertension (4) and depression (5).No cases of severe hyperglycemia or diabetic ketoacidosis (DKA) have been previously reported with this drug.We report an 18-year-old Caucasian woman with type 1 diabetes for the past 3 years who had a progressive increase in weight, reaching 89 kg, and a height of 164 cm (BMI 33 kg/m 2 ).She was administered several weight-reducing regimens, but to no avail.One month before her hospitalization, she began taking, on her own, orlistat (120 mg three times per day) in addition to a low-calorie diet.This was accompanied by one to three watery bowel movements per day.She was progressively lethargic, and her insulin dose requirement increased from 86 to 98 U/day, in three preprandial injections of regular insulin with one evening dose of long-acting insulin.She had no other underlying illnesses and was not on any other medication.Her home blood glucose monitoring revealed progressive worsening of her diabetes control.On the day of presentation in the emergency room, she was complaining of severe lethargy, abdominal discomfort, nausea, and two episodes of vomiting.Laboratory data showed severe hyperglycemia (blood glucose 550 mg/dl), acidosis (pH 7.0), hyperosmolar state (Na 153 mEq/l, K 3.0 mEq/l, BUN 60 mg/dl, creatinine 1.8 mg/ dl), severe ketosis (ketone bodies 40 mg/ dl), and positive urinary ketones.She was afebrile (37.2°C), weighed 85 kg, had an HbA 1c 12%, and was dehydrated (ϳ10% of her body weight).Orlistat was stopped, and the patient was started on intravenous hydration and insulin.The patient showed significant improvement over a period of 5 days.On discharge, she was back on her baseline insulin dosage of 82 U/day, and she was hemodynamically stable.In this patient, orlistat, probably secondary to the watery stools, seemed to have progressively caused dehydration and a decrease in intravascular volume.Initially, this lead to insulin resistance and increased insulin requirements, followed by DKA.This is the first report of DKA precipitated by orlistat in a type 1 diabetic patient.We advise caution and close monitoring of patients with type 1 diabetes who are given orlistat for obesity management.
Teratogenesis from Lithium Carbonate
Authors: HARRY C. SHIRKEY
Journal: Annals of Internal Medicine (1970)

Editorial Notes1 August 1970Teratogenesis from Lithium CarbonateHARRY C. SHIRKEY, M.D.HARRY C. SHIRKEY, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-73-2-336 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTeratogenesis (the production of biological malformations) from therapeutic agents represents an extension of the potential of drugs for adverse reactions but limited to a particular stage of the living organism—specifically, the fetus (1,2). Whenever new drugs are used or older ones used for new purposes, adverse reactions should be expected (3), and teratogenesis is among them. The introduction of lithium salts and their availability now for prescription use in the treatment of affective psychoses (4-6) can be expected to bring, as with any other new drug, some unwanted as well as desired effects.Drug treatment of women in the first...References1. WILSONWARKANY JJ: Teratology Principles and Techniques, Chicago, The University of Chicago Press, 1965 Google Scholar2. SHIRKEY H (editor): Adverse Reactions to Drugs—Their Relation to Growth and Development. Pediatric Therapy, 3rd ed., St. Louis, The C. V. Mosby Co., 1968 Google Scholar3. MOSER R (editor): Diseases of Medical Progress: A Study of Iatrogenic Disease 3rd ed., Springfield, Ill., Charles C Thomas, Publisher, 1969 Google Scholar4. GERSHORN S: Lithium in mania. Clin Pharmacol Ther 11:168-187, 1970 CrossrefMedlineGoogle Scholar5. WHARTON R: Lithium carbonate for depression and mania (letter). JAMA 211:1379, 1970 CrossrefMedlineGoogle Scholar6. : Lithium carbonate. Ann Intern Med 73:291-293, 1970 LinkGoogle Scholar7. MELLINKATZENSTEIN GM: The saga of thalidomide. Neuropathy to embryopathy, with case reports of congenital anomalies. New Eng J Med 267:1184-1193, 1238-1244, 1962 CrossrefMedlineGoogle Scholar8. SZABO K: Teratogenic effects of lithium carbonate in the foetal mouse. Nature (London) 225:73-75, 1970 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Kauikeolani Children's Hospital Honolulu, Hawaii PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByToxic effects of lithium in newborn infants: A commentaryHuman Experiences Related to Adverse Drug Reactions to the Fetus or Neonate from Some Maternally Administered DrugsThe Use of Lithium in Psychiatry 1 August 1970Volume 73, Issue 2Page: 336-337KeywordsAdverse reactionsCarbonatesDrugsFetusesPsychosesSalts Issue Published: 1 August 1970 PDF DownloadLoading ...
Descriptors of breathlessness in cardiorespiratory diseases.
Authors: D A Mahler, A Harver, T Lentine, J A Scott, K Beck, R M Schwartzstein
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

The purposes of this study were: to examine the decriptors of breathlessness chosen by a large sample of patients with cardiorespiratory disease; to determine test-retest reliability of a patient's selection of the descriptors; and to assess whether a patient's recall of the experience of breathlessness is the same as that provoked by physical activity. Questionnaire data were collected at an initial visit for patients who complained of breathlessness and at a second visit in a subgroup of patients. A total of 218 patients who sought medical care for difficulty breathing due to one of seven different conditions were recruited from an outpatient pulmonary disease clinic at a university medical center. Patients selected statements that described qualities of breathlessness from a 15-item questionnaire and completed pulmonary function tests. At a subsequent visit (4 to 15 d later) a subgroup of 16 patients with chronic obstructive pulmonary disease (COPD) repeated the questionnaire at rest (to assess reliability) and after walking in a hallway to provoke a moderate intensity of breathlessness (to compare recall with direct experiences). The relationship among descriptors was evaluated by cluster analysis. The "work/effort" cluster was common for all diagnoses. Each condition was characterized by more than one cluster except COPD. Each diagnosis was associated with a unique set of dusters (e.g., asthma with "work/effort" and "tight," interstitial lung disease with "work/effort" and "rapid" breathing). Percent agreement for all descriptors selected at Visits 1 and 2 (recall) was 79% (r = 0.82; p = 0.001). Percent agreement at Visit 2 between descriptors for recall and for breathlessness provoked by walking was 68% (r = 0.69; p = 0.004). We conclude that patients with different cardiorespiratory conditions experience distinct qualities of breathlessness. Patients' recall of their sensations of breathlessness is reliable and comparable to dyspnea with walking. Employing a questionnaire containing descriptors of breathlessness may help to establish a specific diagnosis and to identify mechanisms whereby a specific intervention relieves dyspnea.
Decreased renal α-Klotho expression in early diabetic nephropathy in humans and mice and its possible role in urinary calcium excretion
Authors: Osamu Asai, Kimihiko Nakatani, Tomohiro Tanaka, Hirokazu Sakan, Akihiro Imura, Shuhei Yoshimoto, Ken-ichi Samejima, Yukinari Yamaguchi, Masaru Matsui, Yasuhiro Akai, Noboru Konishi, Masayuki Iwano, Yoichi Nabeshima, Yoshihiko Saito
Journal: Kidney International (2012)
Antitumor Activity of Pyridocarbazole and Benzopyridoindole Derivatives that Inhibit Protein Kinase CK2
Authors: Renaud Prudent, Virginie Moucadel, Chi-Hung Nguyen, Caroline Barette, Frédéric Schmidt, Jean-Claude Florent, Laurence Lafanechère, Céline F Sautel, Eve Duchemin-Pelletier, Elodie Spreux, Odile Filhol, Jean-Baptiste Reiser, Claude Cochet
Journal: Cancer Research (2010)

Abstract The alkyloid compound ellipticine derived from the berrywood tree is a topoisomerase II poison that is used in ovarian and breast cancer treatment. In this study, we report the identification of ellipticine derivatives and their tetracyclic angular benzopyridoindole analogues as novel ATP-competitive inhibitors of the protein kinase CK2. In vitro and in vivo assays showed that these compounds have a good pharmacologic profile, causing a marked inhibition of CK2 activity associated with cell cycle arrest and apoptosis in human cancer cells. Further, in vivo assays demonstrate antitumor activity in a mouse xenograft model of human glioblastoma. Finally, crystal structures of CK2–inhibitor complex provide structural insights on the molecular basis of CK2 inhibition. Our work lays the foundation for development of clinically useful CK2 inhibitors derived from a well-studied scaffold with suitable pharmacokinetics parameters. Cancer Res; 70(23); 9865–74. ©2010 AACR.
Promotion of sleep by targeting the orexin system in rats, dogs and humans
Authors: Catherine Brisbare-Roch, Jasper Dingemanse, Ralf Koberstein, Petra Hoever, Hamed Aissaoui, Susan Flores, Celia Mueller, Oliver Nayler, Joop van Gerven, Sanne L de Haas, Patrick Hess, Changbin Qiu, Stephan Buchmann, Michael Scherz, Thomas Weller, Walter Fischli, Martine Clozel, François Jenck
Journal: Nature Medicine (2007)
Abstract S5-6: Activating HER2 mutations in HER2 gene amplification negative breast cancers.
Authors: R Bose, SM Kavuri, AC Searleman, W Shen, D Shen, DC Koboldt, J Monsey, S Li, L Ding, ER Mardis, MJ Ellis
Journal: Cancer Research (2012)

Abstract Background: Breast cancer genome sequencing projects, performed by the genome sequencing centers in the U.S., Canada, and the U.K., are elucidating the somatic mutations and other genomic alterations that occur in human breast cancer. These studies recently identified somatic HER2 mutations in breast cancers lacking HER2 gene amplification. Results: Compilation of data from seven sequencing studies documented 22 patients with somatic HER2 mutations. These mutations clustered in three regions. The first cluster was at amino acid (aa) 309–310 (exon 8), located in the extracellular domain. These aa residues form part of the HER2 dimerization interface. The second cluster was at aa 755–781, located in the kinase domain (exons 19–20). This was the most common location for HER2 mutations, with 17 out of 22 patients having somatic mutations here. The third region was at aa 835–896, also in the kinase domain (exons 21–22). Using multiple experimental approaches (cell line experiments, in vitro kinase assays, protein structure modeling, and xenograft experiments), we tested seven of these HER2 mutations and showed that 4 of them are activating mutations that are sensitive to lapatinib and trastuzumab. Another 2 mutations were found to be lapatinib resistant and we determined their sensitivity to neratinib, canertinib, and gefitinib. Conclusions: These findings biologically validate somatic HER2 mutations as good targets for breast cancer treatment, but the appropriate choice of targeted drug is dependent on the precise mutation present. This study is among the first to functionally characterize mutations identified by breast cancer genome sequencing. A prospective, multi-institutional clinical trial has been launched to screen for HER2 mutation positive patients and determine the clinical outcome of treatment with HER2 targeted drugs. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr S5-6.
Platelet GP IIIa Pl <sup>A</sup> Polymorphisms Display Different Sensitivities to Agonists
Authors: Alan D. Michelson, Mark I. Furman, Pascal Goldschmidt-Clermont, Mary Ann Mascelli, Craig Hendrix, Lindsay Coleman, Jeanette Hamlington, Marc R. Barnard, Thomas Kickler, Douglas J. Christie, Sourav Kundu, Paul F. Bray
Journal: Circulation (2000)

Both inherited predisposition and platelet hyperreactivity have been associated with ischemic coronary events, but mechanisms that support genetic differences among platelets from different subjects are generally lacking. Associations between the platelet Pl(A2) polymorphism of GP IIIa and coronary syndromes raise the question as to whether this inherited variation may contribute to platelet hyperreactivity.In this study, we characterized functional parameters in platelets from healthy donors with the Pl(A) (HPA-1) polymorphism, a Leu (Pl(A1)) to Pro (Pl(A2)) substitution at position 33 of the GP IIIa subunit of the platelet GP IIb/IIIa receptor (integrin alpha(IIb)beta(3)). We studied 56 normal donors (20 Pl(A1,A1), 20 Pl(A1,A2), and 16 Pl(A2,A2)). Compared with Pl(A1,A1) platelets, Pl(A2)-positive platelets showed a gene dosage effect for significantly greater surface-expressed P-selectin, GP IIb/IIIa-bound fibrinogen, and activated GP IIb/IIIa in response to low-dose ADP. Surface expression of GP IIb/IIIa was similar in resting platelets of all 3 genotypes but was significantly greater on Pl(A2,A2) platelets after ADP stimulation (P=0.003 versus Pl(A1,A1); P=0.03 versus Pl(A1,A2)). Pl(A1,A2) platelets were more sensitive to inhibition of aggregation by pharmacologically relevant concentrations of aspirin and abciximab.Pl(A2)-positive platelets displayed a lower threshold for activation, and platelets heterozygous for Pl(A) alleles showed increased sensitivity to 2 antiplatelet drugs. These in vitro platelet studies may have relevance for in vivo thrombotic conditions.