tbuckley/cabot-search huggingface dataset:
Study: Vast Majority of &lt;emph type="ital"&gt;C difficile&lt;/emph&gt; Infections Occur in Medical Settings
Authors: Rebecca Voelker
Journal: JAMA (2012)

MOST CLOSTRIDIUM DIFFICILE INfections, often assumed to be communityacquired,actually occurinmedicalsettings,accordingtorecent data from the Centers for Disease Control and Prevention (CDC). In fact, 94% of thepotentiallyfatal infections are in people who recentlyreceivedcare in facilities suchas hospitals, nursing homes,physicians’ offices, and outpatient surgical centers. To stem the rising tide of C difficile infections, CDC officials say hospitals and other health care settings needgreater adherence to infectioncontrolpracticesandimprovedcommunication to notify each other whenever they transfer an infected patient. “These infections are now a patient safety concern everywhere medical care is given,” said Clifford McDonald, MD, a CDC medical epidemiologist and lead author of the study in the Morbidity and Mortality Weekly Report (http://tinyurl .com/7dh83hh). “About 25% of C difficile infectionsfirstshowsymptomsamong patientsinhospitals;75%firstshowsymptoms among patients in nursing homes or in patients recently cared for in doctors’ offices or clinics.” The report, which analyzed data from 2 CDC data sets and state-led infection control programs in 71 hospitals in Illinois, Massachusetts, and New York, also showed that 50% of hospital-diagnosed C difficile infections are in patients who were transferred or recently discharged from other facilities. “The other half of infections diagnosed in hospitals are a result of care in that particular facility,” McDonald said during a press briefing. Deaths and excess health care costs from C difficile infections are at historic highs,accordingtotheCDC.Deathshave increased from 3000 per year in 1999-2000 to 14 000 annually in 2006-2007; more than 90% of deaths are in patients aged 65 years or older. Excess health care costs of hospital-onsetinfections in 2003 were an estimated $5042 to $7179 per case and up to $1.3 billion nationally. The CDC recommends the following preventive practices: • Prescribe antibiotics properly; about 50% of all antibiotic use is unnecessary and raises the risk of C difficile infections. • When patients transfer between facilities, notify the new facility of patients with C difficile infections. • Test patients for C difficile if they have diarrhea while taking antibiotics or within several months of taking them. • Immediately isolate patients with C difficile infection. • WearglovesandgownswhentreatingpatientswithCdifficile infection;hand sanitizerdoesn’tkill thebacteriaandhand washing may not be sufficient. • Clean room surfaces with bleach or another Environmental Protection Agency–approved disinfectant where patients with C difficile infection have been treated. news@JAMA From JAMA’s Daily News Site
Hereditary Elliptocytosis in a Peruvian Family
Authors: Gmo. Garrido-Lecca, Cesar Merino, Gustavo Luna
Journal: New England Journal of Medicine (1957)

THE presence of oval or elliptical erythrocytes in the peripheral blood of man was first described in the medical literature in the United States by Dresbach1 fifty-two years ago. Since then more than 400 reports2 have appeared from different parts of the world describing elliptocytosis in various human races, mainly from Europe,3 but the present study represents the first case found among a native Peruvian family. Since this abnormality in the shape of the erythrocytes has been demonstrated to be hereditary,4 the 11 members of the family were studied.Case ReportsCase 1. E. I. A., a 20-year-old married native . . .
Exposure to Fireworks and Eye Injuries—Reply
Authors: Vanessa D. Alphonse, Andrew R. Kemper, Stefan M. Duma
Journal: JAMA (2012)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Hospital Performance and Acute Coronary Syndrome Outcomes
Authors: Henry H. Ting, Kirsten Hall Long
Journal: JAMA (2006)

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 2022 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
Disrupting functional interactions between platelet chemokines inhibits atherosclerosis in hyperlipidemic mice
Authors: Rory R Koenen, Philipp von Hundelshausen, Irina V Nesmelova, Alma Zernecke, Elisa A Liehn, Alisina Sarabi, Birgit K Kramp, Anna M Piccinini, Søren R Paludan, M Anna Kowalska, Andreas J Kungl, Tilman M Hackeng, Kevin H Mayo, Christian Weber
Journal: Nature Medicine (2009)
Disruption of cytoskeletal structures mediates shear stress-induced endothelin-1 gene expression in cultured porcine aortic endothelial cells.
Authors: T Morita, H Kurihara, K Maemura, M Yoshizumi, Y Yazaki
Journal: Journal of Clinical Investigation (1993)

Hemodynamic shear stress alters the architecture and functions of vascular endothelial cells. We have previously shown that the synthesis of endothelin-1 (ET-1) in endothelial cells is increased by exposure to shear stress. Here we examined whether shear stress-induced alterations in cytoskeletal structures are responsible for increases in ET-1 synthesis in cultured porcine aortic endothelial cells. Exposure of endothelial cells to 5 dyn/cm2 of low shear stress rapidly increased monomeric G-actin contents within 5 min without changing total actin contents. The ratio of G- to total actin, 54 +/- 0.8% in quiescent endothelial cells, increased to 87 +/- 4.2% at 6 h and then decreased. Following the disruption of filamentous (F)-actin into G-actin, ET-1 mRNA levels in endothelial cells also increased within 30 min and reached a peak at 6 h. The F-actin stabilizer, phalloidin, abolished shear stress-induced increases in ET-1 mRNA; however, it failed to inhibit increases in ET-1 mRNA secondary to other stimulants. This indicates that shear stress-induced increases in ET-1 mRNA levels may be mediated by the disruption of actin fibers. Furthermore, increases in ET-1 gene expression can be induced by actin-disrupting agents, cytochalasin B and D. Another cytoskeleton-disrupting agent, colchicine, which inhibits dimerization of tubulin, did not affect the basal level of ET-1 mRNA. However, colchicine completely inhibited shear stress- and cytochalasin B-induced increases in ET-1 mRNA levels. These results suggest that shear stress-induced ET-1 gene expression in endothelial cells is mediated by the disruption of actin cytoskeleton and this induction is dependent on the integrity of microtubules.
"Fade" of hyperpolarizing responses to vagal stimulation at the sinoatrial and atrioventricular nodes of the rabbit heart.
Authors: J J Salata, J Jalife
Journal: Circulation Research (1985)

Previous studies have suggested that maintained vagal stimulation or acetylcholine infusion results in a fade of responses in the sinoatrial node but not in the atrioventricular node, implying different muscarinic receptor subtypes in the two regions. We investigated this hypothesis in 23 isolated rabbit atrial preparations made quiescent by continuous superfusion with verapamil (1 microgram/ml). Transmembrane potentials were recorded simultaneously from cells in the sinoatrial pacemaker region and from the "N" region of the atrioventricular node. Postganglionic vagal stimulation was achieved by the application of trains of pulses (50-150 microseconds; 10-20 V; 200 Hz). Simultaneous application of long-lasting (1-10 sec) vagal trains produced hyperpolarizations which were nearly identical for both nodal regions. Maximal hyperpolarizations (approximately or equal to 24 mV for sinoatrial node; 26 mV for atrioventricular node) were reached about 500 msec after initiation of the vagal train. Thereafter, hyperpolarizations faded, following a biphasic time course, and thus displaying two different time constants, one fast (tau fast = 580 msec for sinoatrial node; 550 msec for atrioventricular node), and one slow (tau slow = 9.2 sec for both sinoatrial and atrioventricular nodes). Hyperpolarizations during brief (200-msec) but repetitive vagal trains also faded biphasically, but approached a steady state much more rapidly than responses to long-lasting trains. Recovery from hyperpolarization decay occurred rather slowly and was linear. Our results demonstrate that the membrane potential responses to vagal stimulation in the atrioventricular node are indistinguishable from those in the sinoatrial node, and suggest that similar muscarinic receptors are operative in both regions. These phenomena may play an important role in the response of the cardiac conducting system to direct or reflexly mediated vagal input.
Amyloidosis and female protein in the Syrian hamster. Concurrent regulation by sex hormones.
Authors: J E Coe, M J Ross
Journal: The Journal of Experimental Medicine (1990)

Previous results have shown that when compared to male Syrian hamsters, female Syrian hamsters have a distinct predisposition to acquire amyloidosis either normally with aging or experimentally with sodium caseinate or diethylstilbestrol (DES) treatments. In the present study, we tested the influence of testosterone on expression of amyloid to determine if this hormone was solely responsible for the sex-limited amyloidosis of the Syrian hamster. Males deprived of testosterone by castration acquired amyloid at an unusually young age, an age of onset similar to that in female hamsters. Also, the amyloidogenic effect of DES in male Syrian hamsters was inhibited by concomitant injections of testosterone, indicating that estrogens induce amyloid in male hamsters by inhibiting testosterone synthesis. When administered to female hamsters, testosterone inhibited expression of amyloid in aging female Syrian hamsters and extended the life span of this gender. Of the two components of amyloid, the major component Amyloid A-derived fibril or the minor constituent, Amyloid P component, only the P component is under sex hormone control in the Syrian hamster; testosterone inhibits the hepatic synthesis of the P component homologue (called female protein), which is normally expressed 100-200-fold greater in female vs. male Syrian hamster. In general, the serum level of female protein under various experimental conditions correlated with the presence of amyloid and indicated that in the Syrian hamster the P component homologue is of primary importance in the deposition of amyloid.
Circumcision: The Painful Dilemma
Authors: Hugh C. Thompson
Journal: JAMA (1986)

This book is a highly emotional, thoroughly biased presentation of the horrors and disadvantages of circumcision, especially neonatal. Chapters are also devoted to the procedure in children after the neonatal period, females, and adult males. The author starts by describing her conversion from acceptance of circumcision for her three boys to violent opposition. Fifty-two pages are devoted to circumcision and Judaism. This chapter contains a section (pp 67-73) in which there is the only interview in the book with someone in favor of circumcision—a rabbi, not a physician. The chapter on complications is extensively referenced (pp 231-234)— mostly with case reports. The fact that nearly all significant complications can be prevented by proper techniques is not clearly stated and only indirectly referenced (p 203). Much of the text is devoted to quotations from persons interviewed by the author, either in person or by letter—parents, older circumcised individuals, nurses, physicians, and
microRNA-135b promotes cancer progression acting as a downstream effector of oncogenic pathways in colon cancer
Authors: Nicola Valeri, Chiara Braconi, Pierluigi Gasparini, Jonathan Hart, Sergei Grivennikov, Francesca Lovat, Giovanni Lanza, Roberta Gafa, Gerard Nuovo, Wendy Frankel, Joanna Groden, Peter K Vogt, Michael Karin, Carlo M Croce
Journal: The Lancet (2013)
Pilot sites in England to test the impact of integrating health and social care
Authors: H. Mooney
Journal: BMJ (2009)

NHS and social services organisations in 16 pilot sites throughout England are set to work together in a government backed scheme which will explore how services for patients and service users can be improved by integration.

The £4m (€4.4m; $5.8m) scheme led by the Department of Health will assess the benefits of different models of care and identify where best practice could be rolled out. 

The scheme has been designed to “look beyond traditional health and social care boundaries to explore how services for patients and service users can be improved.”

Each of the selected sites has already developed new methods to help respond to particular local health needs including dementia, care for the elderly, substance misuse, …
Interaction of TFAP2C with the Estrogen Receptor-α Promoter Is Controlled by Chromatin Structure
Authors: George W. Woodfield, Michael J. Hitchler, Yizhen Chen, Frederick E. Domann, Ronald J. Weigel
Journal: Clinical Cancer Research (2009)

Transcriptional regulation of estrogen receptor-alpha (ERalpha) involves both epigenetic mechanisms and trans-active factors, such as TFAP2C, which induces ERalpha transcription through an AP-2 regulatory region in the ERalpha promoter. Attempts to induce endogenous ERalpha expression in ERalpha-negative breast carcinomas by forced overexpression of TFAP2C have not been successful. We hypothesize that epigenetic chromatin structure alters the activity of TFAP2C at the ERalpha promoter.DNA methylation, histone acetylation, and chromatin accessibility were examined at the ERalpha promoter in a panel of breast carcinoma cell lines. TFAP2C and polymerase II binding were analyzed by chromatin immunoprecipitation. Epigenetic chromatin structure was altered using drug treatment with 5-aza-2'-deoxycytidine (AZA) and trichostatin A (TSA).The ERalpha promoter in the ERalpha-negative lines MDA-MB-231, MCF10A, and MCF7-5C show CpG island methylation, histone 3 lysine 9 deacetylation, and decreased chromatin accessibility compared with ERalpha-positive cell lines MCF7 and T47-D. Treatment with AZA/TSA increased chromatin accessibility at the ERalpha promoter and allowed TFAP2C to induce ERalpha expression in ERalpha-negative cells. Chromatin immunoprecipitation analysis showed that binding of TFAP2C to the ERalpha promoter is blocked in ERalpha-negative cells but that treatment with AZA/TSA enabled TFAP2C and polymerase II binding.We conclude that the activity of TFAP2C at specific target genes depends upon epigenetic chromatin structure. Furthermore, the combination of increasing chromatin accessibility and inducing TFAP2C provides a more robust activation of the ERalpha gene in ERalpha-negative breast cancer cells.
Relationship of Insulin Autoantibodies to Presentation and Early Course of IDDM in Children
Authors: Etienne Sochett, Denis Daneman
Journal: Diabetes Care (1989)

Insulin antibodies have been documented before (insulin autoantibodies [IAAs]) and after (insulin antibodies) insulin administration in children with new-onset insulin-dependent diabetes mellitus (IDDM). Whereas the relationship of IAA to various factors at presentation has been studied in some detail, little is known about their relationship to events during the 1st yr after diagnosis. Furthermore, the course and factors affecting insulin-antibody response to human insulin administration in children with newly diagnosed IDDM remain poorly defined. To study these questions, we measured serum glucose, pH, bicarbonate, C-peptide, and IAA at diagnosis in 84 children between 0.5 and 18 yr of age. Basal and peak C-peptide responses to Sustacal ingestion, glycosylated hemoglobin (HbA1c), and IAA were then measured in 33 of these patients at 10 days and 1,3,6, and 12 mo after diagnosis. At presentation, lAAs were absent (binding below the mean + 3SD of the binding of control serums) in 51 patients (61%) and present (binding above the mean + 3SD) in 33 patients (39%). Multiple regression analysis showed a significant nonlinear relationship between lAAs and both age (P &amp;lt; .005) and blood glucose (P &amp;lt; .05) at onset. There was a stepwise increase in median insulin-antibody binding throughout the 1st yr. This increase was most marked during the 1st mo of insulin therapy and showed a statistically significant difference between successive measurements only during this period. Analysis of variance showed no effect of the factors measured at diagnosis (age, blood glucose, C-peptide, pH, bicarbonate, IAA) or those measured during the 1st yr (blood glucose, insulin dose, C-peptide, HbA1c) on the antibody response to insulin. Furthermore, IAA did not correlate with either insulin antibodies or C-peptide at any time during the 1st yr. Because lAAs do not appear to be related to residual insulin secretion and do not predict the insulin-antibody response to human insulin administration, the data failed to define a role for these antibodies in the pathogenesis of this disorder. This suggests that lAAs may be markers of the immune confrontation with the β-cell rather than active participants in its destruction. Furthermore, insulinantibody response after human insulin administration appears to have no effect on residual insulin secretion, insulin requirement, or metabolic control during the 1st yr after diagnosis.
Failure to deliver hepatitis B vaccine
Authors: R Patel, G R Kinghorn, G Kudesia
Journal: BMJ (1991)

vaccination.This is particularly important for those drug users who fail to make contact with drug services.General practitioners and prison medical officers could also have a valuable role in extending vaccination to drug users who are not in contact with drug services.The effect of hepatitis B vaccination on injecting behaviour and sexual risk taking behaviour has not been evaluated, but it probably helps reduce risk taking behaviour.Perhaps, by auditing the delivery of hepatitis B vaccination to drug users, we can lay the ground for future HIV vaccination programmes.Lessons learnt now may save valuable time later.
A Systematic Approach to Diabetes Management in the Post-DCCT Era
Authors: David K McCulloch, Russell E Glasgow, Sarah E Hampson, Ed Wagner
Journal: Diabetes Care (1994)

As with the discovery of a new wonder drug, the reporting of a major newclinical trial is usually followed by a three-step adjustment period in the collective attitudes of the health-care profession and the general public. There is initial euphoria that this is the answer, the panacea, i.e., the treatment for everyone. These feelings are followed by a rebound response of despondency that the side effects and problems with the new treatment are too serious and that the treatment is too costly and complex to make it useful at all. Finally, a rational place for the new discovery is found in medical practice.
The bone marrow-expressed antimicrobial cationic peptide LL-37 enhances the responsiveness of hematopoietic stem progenitor cells to an SDF-1 gradient and accelerates their engraftment after transplantation
Authors: W Wu, C H Kim, R Liu, M Kucia, W Marlicz, N Greco, J Ratajczak, M J Laughlin, M Z Ratajczak
Journal: Leukemia (2011)
FDA guidance on patient reported outcomes
Authors: J. Speight, S. M. Barendse
Journal: BMJ (2010)

A prompt for the industry to raise scientific standards 

The value gained from understanding health outcomes from the patient’s perspective has been acknowledged increasingly in recent years.1 2 National surveys of patient experience are now a feature of NHS regulation,3 and the drugs industry now recognises the use of such outcomes in labelling (efficacy) claims to promote market access.4 5 Release of the long awaited definitive guidance from the US Food and Drug Administration (FDA) on the use of patient reported outcome (PRO) measures to support labelling claims6 marks a coming of age for PRO measurement.

After publication of the draft guidance in 2006,5 there was much speculation about the meaning and implications of the FDA’s stance on the development and use of PRO measures. The draft offered guiding principles to those conducting and supporting industry sponsored clinical trials, and it was largely welcomed as encouraging the adoption of scientific standards. However, several aspects of the draft guidance were seen as contestable (for example, the use of ”minimally important differences”) or lacking in detail (for example, recommendations for use of ”conceptual frameworks” and “endpoint models”). Consequently, the draft guidance generated more questions than answers about the nature of PRO research and the level of evidence needed to demonstrate good scientific practice. Indeed, …
THROMBUS ASPIRATION IN ACUTE MYOCARDIAL INFARCTION: IS IT ALWAYS NECESSARY?
Authors: Anouska Moynagh, Darach O. h-Ici, Jhonathan Uribe, Jérôme Garot, Marie-Claude Morice, Thierry Lefèvre, Yves Louvard, Thierry Unterseeh, Thomas Hovasse, Philippe Garot
Journal: Journal of the American College of Cardiology (2011)
Delayed Perforation of a Strangulated Hernia
Authors: James L. Berk, James Weaver, Edward Siegler
Journal: JAMA (1978)

STRANGULATED hernia of the intestine, if untreated, normally runs a progressively downhill course. <h3>Report of a Case</h3> A 68-year-old obese woman was admitted to a hospital with a one-week history of abdominal pain, vomiting, and oliguria. At the time of admission, her blood pressure (BP) was 60/40 mm Hg, pulse rate was 120 beats per minute, and temperature was 38.3 °C. The abdomen was distended, and there was a tender mass in an old lower abdominal incision, consistent with an incarcerated hernia. Chest roentgenogram showed prominent hilar vessels but no pneumonia. Blood studies demonstrated a hypokalemic, hypochloremic alkalosis, and cultured<i>Klebsiella pneumoniae</i>and<i>Escherichia coli</i>. The WBC count was 18,000/cu mm. Urinalysis showed many WBCs. Past history showed that the patient had hypertensive arteriosclerotic heart disease with congestive failure, treated with diuretics and digitalis, and moderately advanced chronic obstructive pulmonary disease. Four years before admission, she had a sigmoid resection