tbuckley/cabot-search huggingface dataset:
Equity in Causation Judgments
Authors: NANCY N. DUBLER
Journal: Annals of Internal Medicine (1987)

Editorials1 November 1987Equity in Causation JudgmentsNANCY N. DUBLER, LL.B.NANCY N. DUBLER, LL.B.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-107-5-766 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptBrennan's absorbing article in this issue (1) on hazardous substance litigation is an erudite and lucid analysis of conflicting understandings of causation in medicine and law. His suggestions to physicians for carefully monitoring their behavior when testifying in hazardous substance litigation provide practical guidelines for expert witnesses committed to informing, rather than manipulating or swaying, a judge or jury. One might ask, however, whether this sort of scholarly, evenhanded advice addresses the real problem. Certainly, the public perceives that expert testimony is cut to satisfy the fashion of the highest bidder and that we live in an era of scientific...References1. BRENNAN T. Untangling causation issues in law and medicine: hazardous substance litigation. Ann Intern Med. 1987; 107:741-7. LinkGoogle Scholar2. Expert witnesses: booming business for the specialist, The New York Times. 1987, July 5:1, 13. Google Scholar3. . Causation and Financial Compensation; 1986:26. Cited in: WEINSTEIN, JACK B. Improving expert testimony. U Rich L Rev. 1986;20:473, 491 n. 71. Google Scholar4. . Recommendation no. 2: Base causation findings on credible scientific and medical evidence and opinions. In: The Report of the Tort Policy Working Group on The Causes, Extent and Policy Implications of the Current Crisis in Insurance Availability and Affordability. Cited in WEINSTEIN, JACK B. Improving expert testimony. U Rich L Rev. 1986;20:473, 491 n. 71. Google Scholar5. . An analysis of proposed changes in substantive and procedural law in response to perceived difficulties in establishing whether or not causation exists in mass toxic tort litigation. Rec. A.B. City N. Y. 1986;41:905-11. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: NANCY N. DUBLER, LL.B.Affiliations: Montefiore Medical Center PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 November 1987Volume 107, Issue 5Page: 766-768KeywordsBehavior ePublished: 1 December 2008 Issue Published: 1 November 1987 PDF downloadLoading ...
Boolean Algebra and Clinical Taxonomy
Authors: Alvan R. Feinstein
Journal: New England Journal of Medicine (1963)

PHYSICIANS may be startled to discover that they think in mathematical sets and with symbolic logic. The thinking occurs with every act of diagnosis, prognostic estimation, therapeutic decision and clinical correlation with laboratory data. These acts are really exercises in deductive and inductive reasoning, and can be described in appropriate mathematical symbols and diagrams.The branches of mathematics (or philosophy) used for these functions are called set theory and symbolic logic; they are about a century old. As relatively new mathematical developments, they were not included in the premedical training of most contemporary physicians. Courses in these disciplines, however, have . . .
Failure of PTFE-covered stents to lower restenosis rate in aorto-ostial lesions
Authors: Konstantinos Toutouzas, Goran Stankovic, Takuro Tagaki, Vassilis Spanos, Carlo Di Mario, Remo Albiero, Nicola Corvaja, Ginevra Sivieri, Damiana Milici, Antonio Colombo
Journal: Journal of the American College of Cardiology (2002)
Midline Catheterization in Hospitalized Patients
Authors: John P. Manzella
Journal: Annals of Internal Medicine (1996)

Letters15 October 1996Midline Catheterization in Hospitalized PatientsJohn P. Manzella, MD, Geraldine A. Stott, MD, and Deborah Maust, RNJohn P. Manzella, MDYork Hospital, York, PA 17405Search for more papers by this author, Geraldine A. Stott, MDYork Hospital, York, PA 17405Search for more papers by this author, and Deborah Maust, RNYork Hospital, York, PA 17405Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-8-199610150-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Mermel and colleagues [1] describe their experience with a polyurethane-elastomeric hydrogel composite catheter (Landmark, Menlo Care, Inc., Menlo Park, California) in hospitalized patients. At our institution, the intravenous team (which is responsible for placing and maintaining peripheral intravenous access) found increased mechanical problems associated with the Landmark midline catheter compared with other types of peripheral venous access. We therefore evaluated noninfectious risk associated with the Landmark midline catheter. From 1 January 1994 to 31 December 1995, we prospectively evaluated 206 Landmark catheters placed in 206 patients (1826 patient-days). All catheters were used for administration of parenteral antibiotics. ...REFERENCE1. Mermel LA, Parenteau S, Tow SM. The risk of midline catheterization in hospitalized patients. A prospective study. Ann Intern Med. 1995; 123:841-4. Google Scholar Author, Article, and Disclosure InformationAffiliations: York Hospital, York, PA 17405 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByRe‐evaluating expanding intravenous catheters in medical practice 15 October 1996Volume 125, Issue 8Page: 695KeywordsAllergy and immunologyAntibioticsAntimicrobialsCatheterizationCatheters Issue Published: 15 October 1996 CopyrightCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Chlorpromazine Dermatitis
Authors: Norman E. Levan
Journal: New England Journal of Medicine (1957)

CHLORPROMAZINE contact dermatitis has become an important occupational hazard of nursing. This drug, particularly in the form of its injectable solution, is a potent cutaneous sensitizer, and nursing personnel with exposure ordinarily occurring in the course of administering such injections, in cleaning syringes or indeed merely from the fumes of opened vials are frequently afflicted with severe and at times prolongedly disabling eruptions. Furthermore, immunochemical relations existing between chlorpromazine and certain other commonly used drugs, most notably other phenothiazine derivatives, may result in cross-sensitizations clinically important in causing cryptic recurrences.Case ReportH.M., a 44-year-old nurse, was first seen on . . .
803-4 Analysis of anti-apoptotic intracellular viral serpins as anti-atherosclerotic agents
Authors: Liyung Liu, Kasinath Viswanathan, Erbin Dai, Peter C Turner, Jide Togonu-Bickersteth, Ben Pang, Yue Li, Richard W Moyer, Grant McFadden, Alexandra Lucas
Journal: Journal of the American College of Cardiology (2004)
Aerobic Actinomyces Septicemia
Authors: Paul M. Kohn, Morris Tager, Mortimer L. Siegel, Rosemary Ashe
Journal: New England Journal of Medicine (1951)

ALTHOUGH actinomycotic infection can no L longer be considered a rare disease, positive blood cultures with this group of organisms during life have been distinctly unusual. This is true despite the fact that blood-stream dissemination of the infecting organism is not uncommon, as shown by the relatively numerous cases of actinomycosis with widespread metastatic lesions reported in the literature. In his monograph Cope1 makes no reference to the isolation of the organism from blood cultures. In several reported cases of generalized actinomycosis blood cultures were taken, but with the exception of the five cases noted below, no growth occurred.The . . .
Synergistic Sedation with Low-Dose Midazolam and Propofol for Colonoscopies
Authors: F. M. Reimann, U. Samson, I. Derad, M. Fuchs, B. Schiefer, E. F. Stange
Journal: Endoscopy (2000)

Background and Study Aims: Patients undergoing colonoscopy are often sedated with benzodiazepines and long-acting opiates. Since low-dose midazolam also acts synergistically with short-acting propofol, we compared this synergistic sedation with a standard combination of midazolam and the opioid nalbuphine for colonoscopies.
The Missing Waveform Information in the Orthogonal Electrocardiogram (Frank Leads)
Authors: F. KORNREICH, P. BLOCK, D. BRISMEE
Journal: Circulation (1974)

A new lead system recording nine surface ECGs was found capable of resynthesizing in each patient all the QRS waveforms recorded on the thoracic surface. Observations were made in 416 patients: 150 normal (N) individuals, 95 patients with left ventricular hypertrophy (LVH), 97 patients with right ventricular hypertrophy (RVH), and 74 patients with biventricular hypertrophy (BVH). After time-normalization and division of the nine waveforms into eight equal parts, 72 variables were determined for each patient. Recordings from Frank XYZ leads were also available for each subject. After time-normalization and division in eight equal parts, 24 variables were obtained from Frank lead recordings in each individual. The 72 variables from the new system and 24 variables from the Frank leads were then submitted to multivariate statistical procedures in order to differentiate BVH from N, LVH, and RVH. Four parameters were finally retained — for both the 9-lead system and the Frank leads — as the best discriminators for the separation of BVH from normal, BVH from LVH, and BVH from RVH. The diagnostic performances, defined as ½ (specificity + sensitivity), were 93.5%, 85%, and 81%, respectively, for the 9-lead system and 88.5%, 69%, and 75% for the Frank leads. The repeatability of the results was tested on independent control samples and found reasonable. The limited clinical use of independent pairwise comparisons is discussed and the alternative of stepwise pairwise comparisons following a decision tree is proposed. Some deterioration in the final classification is noticed; the recognition rates are 90% for normal, 79% for LVH, 75% for RVH and 73% for BVH (average 79%) with the 9-lead system, and 90% for N, 55% for LVH, 46% for RVH and 59% for BVH (average 62%) with the Frank leads.
Human Exposure to Endocrine-Disrupting Chemicals and Prenatal Risk Factors for Cryptorchidism and Hypospadias: A Nested Case–Control Study
Authors: Mariana F. Fernandez, Begoña Olmos, Alicia Granada, Maria José López-Espinosa, José-Manuel Molina-Molina, Juan Manuel Fernandez, Milagros Cruz, Fátima Olea-Serrano, Nicolás Olea
Journal: Environmental Health Perspectives (2007)

BackgroundExposure to xenoestrogens during pregnancy may disturb the development and function of male sexual organs.ObjectiveIn this study we aimed to determine whether the combined effect of environmental estrogens measured as total effective xenoestrogen burden (TEXB) is a risk factor for male urogenital malformations.MethodsIn a case–control study, nested in a mother–child cohort (n = 702) established at Granada University Hospital, we compared 50 newborns with diagnosis of cryptorchidism and/or hypospadias with 114 boys without malformations matched by gestational age, date of birth, and parity. Controls did not differ from the total cohort in confounding variables. TEXB and levels of 16 organochlorine pesticides were measured in placenta tissues. Characteristics of parents, pregnancy, and birth were gathered by questionnaire. We used conditional and unconditional regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs).ResultsTEXB from organohalogenated compounds was detectable in 72% and 54% of case and control placentas, respectively. Compared with controls, cases had an OR for detectable versus non-detectable TEXB of 2.82 (95% CI, 1.10–7.24). More pesticides were detected in cases than in controls (9.34 ± 3.19 vs. 6.97 ± 3.93). ORs for cases with detectable levels of pesticides, after adjusting for potential confounders in the conditional regression analysis, were o,p′-DDT (OR = 2.25; 95% CI, 1.03–4.89), p,p′-DDT (OR = 2.63; 95% CI, 1.21–5.72), lindane (OR = 3.38; 95% CI, 1.36–8.38), mirex (OR = 2.85; 95% CI, 1.22–6.66), and endosulfan alpha (OR = 2.19; 95% CI, 0.99–4.82). Engagement of mothers in agriculture (OR = 3.47; 95% CI, 1.33–9.03), fathers’ occupational exposure to xenoestrogens (OR = 2.98; 95% CI, 1.11–8.01), and history of previous stillbirths (OR = 4.20; 95% CI, 1.11–16.66) were also associated with risk of malformations.ConclusionsWe found an increased risk for male urogenital malformations related to the combined effect of environmental estrogens in placenta.
CUTIS GYRATUM, ACANTHOSIS NIGRICANS AND OTHER CONGENITAL ANOMALIES A NEW SYNDROME
Authors: J. M. BEARE, J. A. DODGE, N. C. NEVIN
Journal: British Journal of Dermatology (1969)

SUMMARY. A boy with a complex combination of physical features is reported. These include an unusual fades with hypertelorism, cutis gyratum, acanthosis nigricans, abnormal genitalia, cleft of the soft palate, bifid uvula, premature eruption of teeth, partial anodontia, retardation of bone growth and functional pyloric obstruction. These features are compared with those of leprechaunism, Seip's syndrome, and a case of "leprechaunism" in a male described by Patterson and Watkins (1962). The aetiology is unknown.
Lymphocyte subpopulations in adult coeliac disease.
Authors: A W Bullen, M S Losowsky
Journal: Gut (1978)

Rosetting techniques were used to estimate T and B cell subpopulations in the peripheral blood in patients with treated and untreated adult coeliac disease and in control subjects. In patients with untreated coeliac disease, T cell numbers were significantly lower than in controls or treated patients, although there was no difference in total lymphocyte counts. There was no significant difference in B cell numbers between treated and untreated patients, and the subpopulation which increased to replace the T cells in untreated patients comprised cells not identified by B or T cell markers. Total lymphocyte counts and lymphocyte subpopulations were affected by splenic atrophy. It is suggested that these effects might be caused by the loss of lymphocytes from the gastrointestinal tract in untreated coeliac disease.
Therapies for Benign Prostatic Hyperplasia
Authors: John Concato
Journal: JAMA (1993)

To the Editor.  —We are responding to the letter by Roos et al. 1 Roos et al 2 previously reported that men with benign prostatic hyperplasia had higher mortality after transurethral resection of the prostate (TURP) than after open prostatectomy. Investigating the survival of patients with benign prostatic hyperplasia at Yale-New Haven Hospital, we found that the increased mortality after TURP was attributable to patients' being older and sicker at the time of surgery. 3 In their subsequent letter in JAMA , Roos et al made four main comments.  First, the authors referred to a trial in which 5-year mortality was higher after TURP (9/43 patients) than after open prostatectomy (2/32 patients). 4 Roos et al report that the difference in proportions was statistically significant using a one-tail Student's t test, although the trial investigators did not conclude that TURP was responsible for the higher mortality. The authors did not discuss
Dr Foster's correlation oversimplifies complicated and multifactorial problem
Authors: C. M. A. Wasson
Journal: BMJ (2012)

Like many trusts across the country, we were worried by Dr Foster’s report of increased mortality at weekends and the correlation with reduced levels of medical staffing.1 I routinely review the case notes of all patients who die, looking for learning points or systematic errors that could be rectified. Recently, I reviewed 53 consecutive deaths, specifically comparing weekday …
TCT-183 ENERGY 1,000 Patient Registry with a Thin Strut Bare Metal Stent with Passive Coating presenting Two Year Data
Authors: Ariel Roguin, Ton Slagboom, Erwin Schroeder, Sebastian Philipp, Thomas Heitzer, Harald Schwacke, Oded Ayzenberg, Antonio Serra, Nicolas Delarche, Raimund Erbel
Journal: Journal of the American College of Cardiology (2013)
Gagging on it?
Authors: F. W Arnold
Journal: BMJ (2010)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following Gagging on it? Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Step-Down Therapy in Hypertension
Authors: Frank A. Finnerty
Journal: JAMA (1981)

To determine the minimum amount of therapy needed to control arterial pressure, the amount of one drug was reduced, then use of one or more drugs was discontinued after the diastolic pressure had been lower than 90 mm Hg for six months in 51 hypertensive patients. By six months, one drug had been eliminated in 38 patients, and the dose of another had been decreased in 49 patients. By 12 months, stepping up therapy was necessary in 13 patients; thus, one drug therapy had been eliminated in only 27 patients, and the dose was decreased in another 43 patients. No further therapeutic changes were necessary during the next six months. Originally, 161 complaints of side effects were noted. After step-down therapy, 18% of the side effects were reported unchanged, 26% were significantly decreased, and 56% were completely absent.
Colorectal Liver Metastases: 18F-Fluorodeoxyglucose-Positron Emission Tomography
Authors: Stéphanie Truant, Damien Huglo, François-René Pruvot
Journal: Liver Cancer (2009)

During the last years, 18F-fluorodeoxyglucosepositron emission tomography (FDG-PET) has been advocated as a useful tool in the management of recurrent colorectal cancer, mainly in liver and pelvic recurrences, whereas regarding the primary tumor, FDG-PET has proven to show very poor yield in comparison with conventional diagnostic methods. In the first meta-analysis of the literature for whole-body FDG-PET detection of recurrent colorectal cancer, FDG-PET had a positive impact on surgical decision-making in 29% of patients (Huebner et al., 2000). On the other hand, in the beginning of FDG-PET, most studies on colorectal liver metastases have shown limitations. Survey of previous reports shows indeed heterogeneous study designs that were mostly retrospective and simultaneously included various subsets of circumstances, e.g., preopera-tive staging of liver metastases together with locoregional recurrence, unexplained elevated serum carcinoembryonic antigen (CEA) levels and/or symptoms with negative imaging. The methodology to define the true lesion status of the FDG-PET findings was also variable from one study to another, including histopathologic analy-sis (performed at surgery, biopsy, and autopsy), intraoperative observation (e.g., manual palpation or ultrasonogra-phy) and/or 6-months or 1-year follow-up. The rate of histological confirmation that is the gold standard particularly in the evaluation of false-positive and false-negative readings varied from < 10% to 95% (Truant et al., 2005). A non-standard method of image analysis, as well as some degree of inequivalence in FDG-PET and computed tomography (CT) performance, may have led to a misjudgement of their relative diagnostic performance, as reflected by high rates of FDG-PET/CT discordances (range, 10–31%). FDG-PET was performed prospectively and the interpretation of the FDG-PET images was generally made with a priori knowledge of results of conventional diagnostic procedures. In contrast, CT was reviewed retrospectively and performed at various institutions, resulting in its sensitivity and specificity rates being among the worst, which were reported in general literature regarding colorectal liver metastases. In the two meta-analyses performed in the beginning of the use of FDG-PET, only few studies fulfilled the inclusion criteria and the guidelines established by the authors, reflecting the limitations of published reports (Huebner et al., 2000; Kinkel et al., 2002). Over time, however, studies on FDG-PET have focused on more definite settings and have included more systematically histological verifications of FDG-PET findings, resulting in a better assessment of FDG-PET accuracy and impact. In this chapter, the yield of FDG-PET in colorectal liver metastases will be preferentially analyzed through these latter studies.
Increased propensity of atopic dermatitis (AD) patients to viral infections may be due to Th2 cytokines which down-regulate cathelicidins with anti-viral activity*1
Authors: M.D. Howell, J.E. Streib, K.O. Kisich, J.F. Jones, R.L. Gallo, D.Y.M. Leung
Journal: Journal of Allergy and Clinical Immunology (2004)
Caesarean delivery in the second stage of labour: Consider the value of a functionally intact perineum
Authors: Michelle J Thornton
Journal: BMJ (2006)

EDITOR—Spencer et al say that instrumental delivery may reduce the caesarean section rate in the second stage of labour.1 Although this may be important for the 2006 NHS budget—saving anaesthetic, operating theatre, and hospital costs in the short term—the longer term health outcomes and …
Hospitals without appropriate expertise should not offer trauma care
Authors: Zosia Kmietowicz
Journal: BMJ (2007)

Less than half of people who sustain serious injuries receive good care before they arrive in an emergency department, a new report says. And it says that such failings in care continue once the patients have arrived at hospital.

A team approach is needed to deliver effective care for trauma patients in the same way that cancer services teams have worked across healthcare disciplines to improve outcomes, said Simon Carter, one of the report's authors.

“We need to see significant improvements made now to pre-hospital and hospital trauma care in order to prevent the unnecessary death of young patients, with its tragic consequences for families, …
Avoiding Mental Hospital Admission: A Follow-Up Study
Authors: DONALD G. LANGSLEY, PAVEL MACHOTKA, KALMAN FLOMENHAFT
Journal: American Journal of Psychiatry (1971)

Three hundred patients requiring immediate hospitalization were randomly assigned to outpatient family crisis therapy (FCT) or were admitted to a university psychiatric hospital. Post-treatment follow-up showed that patients treated without admission were less likey to be hospitalized after treatment and that their hospitalization was significantly shorter. At both six and 18 months, FCT patients were doing as well as the hospitalized patients on two measures of social adaptation and were managing crises more efficiently.
Immune surveillance of tumors
Authors: Jeremy B. Swann, Mark J. Smyth
Journal: Journal of Clinical Investigation (2007)

The ability of the immune system to identify and destroy nascent tumors, and to thereby function as a primary defense against cancer, has been debated for many decades. Recent findings by a number of investigators in both mouse models of cancer and humans with cancer now offer compelling evidence that particular immune cell types, effector molecules, and pathways can sometimes collectively function as extrinsic tumor suppressor mechanisms. This work provides the basis for further study of natural immunity to cancer and for rational use of this information in the design of immunotherapies in combination with other conventional cancer treatments.