tbuckley/cabot-search huggingface dataset:
Endoscope disinfection and its pitfalls - requirement for retrograde surveillance cultures
Authors: A. Buss, M. Been, R. Borgers, I. Stokroos, W. Melchers, F. Peters, A. Limburg, J. Degener
Journal: Endoscopy (2008)

Several endoscopy-related outbreaks of infection have been reported in recent years. For early recognition of inadequate disinfection of endoscopes we designed a microbiological surveillance system to evaluate the efficacy of the cleaning and disinfection procedure, and to trace disinfection problems to individual endoscopes or washer-disinfectors.Our surveillance protocol included anterograde and retrograde sampling, a decision algorithm, genetic fingerprinting, and scanning electron microscopy.Over a period of 29 months we found an increasing number of patient-ready endoscopes testing positive for Candida species other than albicans, especially C. parapsilosis. These yeasts were also isolated from the washer-disinfectors. The number of positive tests for Candida species varied from 1 out of 21 to 14 out of 27 samples from nine frequently used endoscopes. The number of colony-forming units per milliliter ranged from 1 - 10 to 3000 for endoscopes and 0.002 to 0.06 for the washer disinfectors. DNA fingerprinting was not able to discriminate different strains within C. parapsilosis.Our protocol was able to detect a structural problem in the endoscope disinfection process. Retrograde sampling was crucial for this purpose, because it has much higher sensitivity than anterograde sampling. Endoscopes with damaged working channels are probably the source of the contamination problem with Candida species.
Standardizing Slide-Based Assays in Breast Cancer: Hormone Receptors, HER2, and Sentinel Lymph Nodes
Authors: Jeffrey S. Ross, W. Fraser Symmans, Lajos Pusztai, Gabriel N. Hortobagyi
Journal: Clinical Cancer Research (2007)

Despite the rapid expansion of novel diagnostics designed to personalize breast cancer care, there remain several significant unmet needs for improving the accuracy and reliability of tests that are already in common daily clinical practice. For example, although immunohistochemistry has been the predominant method for measuring estrogen receptor and progesterone receptor status for over 15 years, this assay remains unstandardized and there is a widespread concern that inaccuracy in immunohistochemistry technique and interpretation is leading to an unacceptably high error rate in determining the true hormone receptor status. Similarly, there is considerable concern that both false-negative and false-positive result rates for testing for HER2 status are unacceptably high in current clinical practice. This commentary considers a variety of factors, including preanalytic conditions and slide-scoring procedures, and other variables that may be contributing to current testing error rates and why there is a great need for the standardization of these biomarker assay procedures to further enable the highest possible quality of care for newly diagnosed breast cancer patients.
Evaluation of elite British cyclists: the role of the squad medical.
Authors: M J Callaghan, C Jarvis
Journal: British Journal of Sports Medicine (1996)

To describe and report results from the procedures and protocols used by the British Cycling Federation during the squad medicals of its elite cyclists.Screening of over 500 elite riders has been done by doctors, dentists, physiotherapists, opticians, and dietitians since 1990. A questionnaire provided additional information on musculoskeletal problems.523 riders have been examined and 92 (17.5%) have been referred for further assessment or treatment. Most of these riders were sent either to their own general practitioner or to the British Olympic Medical Centre. The questionnaire was completed by 81% of riders. Low back pain was the most common problem that riders encountered (60%), and knee pain the second most common (33%). Four riders failed the eye examination, and a further 11 were classed as borderline. Twenty one per cent of riders undergoing dental examination needed further dental treatment.The squad medical is an important and useful strategy for evaluating elite British cyclists. It shows that a structured system can help early diagnosis and treatment to provide injury-free cyclists at the start of a competitive season. The results from the questionnaire confirm previously unsubstantiated opinions about the incidence of musculoskeletal injuries in cyclists.
Survival Outcomes 1 Year After Reperfusion Therapy With Either Alteplase or Reteplase for Acute Myocardial Infarction
Authors: Eric J. Topol, E. Magnus Ohman, Paul W. Armstrong, Robert Wilcox, Alan M. Skene, Philip Aylward, John Simes, Anthony Dalby, Amadeo Betriu, Christoph Bode, Harvey D. White, Judith S. Hochman, Hakan Emanuelson, Alec Vahanian, Shelly Sapp, Amanda Stebbins, David J. Moliterno, Robert M. Califf
Journal: Circulation (2000)

Background —New recombinant plasminogen activators have been developed to simulate the fibrinolytic action of the physiological serine protease tissue plasminogen activator (alteplase, t-PA), and have prolonged half-life features permitting bolus administration. One such activator, reteplase (r-PA), was compared with t-PA in the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO)-III Trial. Methods and Results —At 1-year follow-up, survival status was ascertained in 97.4% of the 15 059 patients enrolled in the GUSTO-III trial. At 1 year, the mortality rate for the t-PA–assigned group was 11.06%, and for r-PA it was 11.20% ( P =0.77). The absolute mortality difference of 0.14% has 95% CIs of −1.21% to 0.93%. There were no significant differences in outcome by intention-to-treat for the 2 different plasminogen activators in the prespecified groups (age, infarct location, time-to-treatment). The absolute difference in mortality rates between t-PA and r-PA progressively narrowed over the predetermined observation times after random assignment; it was 0.31% at 24 hours, 0.26% at 7 days, 0.23% at 30 days, and 0.14% at 1 year. Of note, mortality rate in the trial between 30 days and 1 year in 13 883 patients was 4.02% and did not differ between the treatment groups. However, this mortality rate was substantially greater than in GUSTO-I, in which mortality rate for t-PA versus streptokinase between 30 days and 1-year was 2.97% (heart rate 1.36, 95% CI 1.23, 1.50, P &lt;0.001). Conclusions —The r-PA and t-PA strategies yielded similar survival outcomes after 30 days in this trial. The increase in mortality rate during extended follow-up compared with previous trials may reflect higher-risk patients and highlights the need for improved secondary prevention strategies.
Whose Death Is It, Anyway
Authors: Edward Ringel
Journal: Annals of Internal Medicine (1997)

Letters1 April 1997Whose Death Is It, AnywayEdward Ringel, MDEdward Ringel, MDOakland, ME 04963Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-7-199704010-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The essay by Hansot [1] and the article by Gilligan and Raffin [2] address, at a most visceral level, the emotional issues of death in an intensive care unit and the pain and sense of helplessness that physicians, patients, and families experience when communication fails. I empathize with the frustration of everyone involved. However, might Dr. Hansot have been too quick to invoke her mother's advance directive?The decision that a patient's condition is terminal is often an evolutionary process. Ms. Hansot's physician, to meet his obligation to provide optimum care, needed to give a patient with ...References1. Hansot E. A letter from a patient's daughter. Ann Intern Med. 1996; 125:149-51. Google Scholar2. Gilligan T, Raffin TA. Whose death is it anyway? Ann Intern Med. 1996; 125:137-41. Google Scholar Author, Article, and Disclosure InformationAffiliations: Oakland, ME 04963 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1997Volume 126, Issue 7Page: 585KeywordsEmotionsExtubationIntensive care unitsPatientsStroke Issue Published: 1 April 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Institutional variation of coronary artery bypass graft surgery: emphasis on myocardial protection.
Authors: G C Kaiser
Journal: Circulation (1982)

There are institutional variations in the operative mortality of coronary artery bypass graft surgery (CABG). Patient selection, based on clinical and angiographic criteria, is a significant factor. Even after adjustment for patient selection, institutional differences remain. Operative experience and volume of cases are also related to institutional variations. Recent attention to the technique of myocardial preservation has highlighted its significance in reducing the incidence of perioperative myocardial infarction and operative mortality. Institutional heterogeneity also exists in the nonoperative management of ischemic heart disease. However, undetected factors probably significantly affect the outcome. These institutional variations emphasize a major advantage of randomized clinical trials--that they should equalize these unknown factors.
Clinical course and risk factors of hepatitis C virus related liver disease in the general population: report from the Dionysos study
Authors: S Bellentani, G Pozzato, G Saccoccio, M Crovatto, L S Crocè, L Mazzoran, F Masutti, G Cristianini, C Tiribelli
Journal: Gut (1999)

BACKGROUND The severity, clinical course, and risk of hepatitis C virus (HCV) related chronic liver disease are still rather poorly defined. AIMS To investigate the prevalence, risk factors, and severity of HCV related liver disease in the general population, and investigate whether infection with a specific genotype is associated with an increased risk of cirrhosis or hepatocellular carcinoma. METHODS HCV RNA determination by polymerase chain reaction (PCR) and HCV genotyping were performed in all anti-HCV positive subjects belonging to the Dionysos study (6917 subjects). Diagnosis of cirrhosis and hepatocellular carcinoma was established by liver biopsy in all cases. All the data were analysed by univariate and multivariate statistics in all the cohort. To investigate the natural history of HCV infection, anti-HCV positive subjects were followed up every six months for three years with liver function tests and ultrasonograms. RESULTS The overall prevalence of HCV RNA positivity was 2.3%. Positivity increased progressively with age, and was higher in women (ratio of men to women = 0.7). Genotypes 1b and 2a were the most frequent (42 and 24% of HCV RNA positive patients), with a prevalence of 1 and 0.6% respectively. Intravenous drug use, blood transfusions received before 1990, history of previous hepatitis among the cohabiting, and history of animal (mainly dogs) bites were significantly (p&lt;0.05) associated with HCV infection, independently of age and sex. Multivariate analysis showed that, independently of age, sex, and alcohol intake, genotype 1b infection, with or without coinfection with other genotypes, is the major risk factor associated with the presence of cirrhosis and/or hepatocellular carcinoma. During the three years of follow up, 57 (35%) of the HCV RNA positive subjects had consistently normal alanine aminotransferase and γ-glutamyltransferase values. Two of the 22 HCV RNA positive cirrhotic patients, all drinking more than 90 g of alcohol a day, developed hepatocellular carcinoma (incidence rate = 3.0% per year). CONCLUSIONS In the general population of Northern Italy, HCV infection is widespread, but only less than 50% of the anti-HCV positive subjects, particularly those infected with genotype 1b, are associated with a more severe liver disease. Alcohol consumption greater that 30 g a day significantly aggravates the natural course of the disease.
Registering clinical trials
Authors: A Tonks
Journal: BMJ (1999)

Randomised trials of medical interventions are the foundation of evidence based health care, but most are effectively conducted in secret. Few people—usually an elite network of investigators, funding agencies, and government regulatory bodies—know about a trial from its inception Most trials become public knowledge only when the investigators publish their completed project in a journal—if they ever do.1 In the meantime, others may be duplicating the effort or, worse, ignoring early warning signs that an intervention is dangerous. One trial of the class I antiarrhythmic drug lorcainide, for example, went unreported for over a decade even though the data suggested that the drug increased mortality in patients with myocardial infarction During that time, use of such drugs continued and shortened the lives of up to 70 000 people each year in the United States alone.2 A register of clinical trials is one way of opening up the process and avoiding these problems.

The idea was first mentioned 13 years ago3 and has been refined since then by an international group of trialists, academics, and enthusiasts campaigning for a comprehensive, up to date, and searchable archive of ongoing and recently completed randomised trials, including trials done by the pharmaceutical industry. This article reports a recent conference on trial registration hosted in London by the BMJ , the Lancet , and the Association of the British Pharmaceutical Industry. The article was prepared from conference presentations and subsequent debate, discussion with selected speakers and delegates, reviews by those speakers who are running their own registers, and a bibliography of studies prepared by Iain Chalmers, director of the UK Cochrane Centre.

#### Summary points

Clinical trials should be registered so that essential details are made public from a trial's inception, rather than from publication many years later

Openness about trials in progress reduces the …
Nanoparticle based delivery of hypoxia-regulated VEGF transgene system combined with myoblast engraftment for myocardial repair
Authors: Lei Ye, Wei Zhang, Li-Ping Su, Husnain K. Haider, Kian-Keong Poh, Mary J. Galupo, Geronica Songco, Ruo-Wen Ge, Huay-Cheem Tan, Eugene K.W. Sim
Journal: Biomaterials (2011)
Abstract 2383: A new approach to isolate label-free and viable circulating tumor cells for monitoring cancer patient treatment response
Authors: Sanger Hung-Chih Lin, Min-Hsien Wu, Hung-Chih Hsu, Chia-Hsun Hsieh, Ju-Chien Cheng, Ching-Ping Tseng
Journal: Cancer Research (2012)

Abstract The number of circulating tumor cells (CTCs) has been demonstrated as a good indicator for cancer progression and for monitoring treatment response of cancer patients. Most of the current methods for detecting CTCs were based on positive selection using the antibody specific to epithelial cell surface marker. In this study, we established a novel PowerMag system for negative selection and enrichment of CTCs by depletion of CD45+ cells. The efficacy of PowerMag system in CTCs isolation was first analyzed by spiking prostatic PC3 cancer cells into the peripheral blood from healthy volunteers. Our data revealed that, when compared with the methods that have been reported, the PowerMag system had high sensitivity (6-7 log10 enrichment), comparable recovery rate (50-60%), broad detection range (more than 3 log10), and stable and reproducible experimental results (r2=0.999). Notably, the cancer cells obtained from PowerMag system were label-free and viable with the capability for proliferation. To validate the feasibility of PowerMag system in clinical application, the numbers and characteristics of CTCs from 38 metastatic cancer patients with a total of 175 blood samples were determined. At least two populations of CTCs with the surface markers of EpCAM+CD45−CD146− and EpCAM−CD45−CD146− were identified. The detection rate reached 100% for the patients in the baseline level before treatment. The change in CTCs numbers for both cell populations appears to correlate with patient clinical outcomes after chemotherapy. As a whole, the PowerMag system is proven to be capable of isolating CTCs from whole blood effectively and economically, by which time- consuming sample pretreatment and costly equipments are not required. PowerMag has paved an alternation rout to monitor the progression and treatment response of cancer patients. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2383. doi:1538-7445.AM2012-2383
Overexpression of Tissue Inhibitor of Matrix Metalloproteinase-1 Inhibits Vascular Smooth Muscle Cell Functions In Vitro and In Vivo
Authors: Reza Forough, Noriyuki Koyama, David Hasenstab, Holly Lea, Monika Clowes, Seppo T. Nikkari, Alexander W. Clowes
Journal: Circulation Research (1996)

Arterial smooth muscle cells (SMCs) are in a quiescent growth state under normal physiological conditions, but they can be stimulated to proliferate and migrate from one tissue compartment to another if the vessel is injured. This response might require a selective and focal increase in tissue degradation, which might be mediated through the increased production of matrix metalloproteinases (MMPs). Blockade of MMP activity might therefore inhibit the SMC response to injury. To test this hypothesis, we developed clones of rat SMCs that overexpress baboon tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), using retrovirally mediated gene transfer, and characterized the functional capacity of these cells in vitro and in vivo. SMCs transduced with the TIMP-1 vector (LTSN) grew more slowly and also migrated through a gel matrix in a Boyden chamber assay more slowly than the vector alone (LXSN) cells. The conditioned medium from LTSN cells completely inhibited the platelet-derived growth factor-BB–induced migration of normal SMCs across a matrix-coated filter, while the LXSN cell conditioned medium had no effect. The inhibitory activity in the LTSN conditioned medium could be neutralized with an antibody to TIMP-1. In vivo, local overexpression of TIMP-1 using LTSN cells implanted onto balloon-injured rat carotid artery inhibited intimal hyperplasia. Neutralizing antibodies against TIMP-1 suppressed the effect of LTSN cell seeding on intimal thickening. These data support the conclusion that the process of SMC activation leading to a thickened intima is dependent on MMP activity and that TIMP-1 could be utilized to inhibit this process.
592. A Multifunctional Envelope-Type Nano Device for the Novel Gene Delivery of siRNA Plasmids: Optimization of Condensing Polycations
Authors: Rumiko Moriguchi, Kentaro Kogure, Hidetaka Akita, Siroh Futaki, Makoto Miyagishi, Kazunari Taira, Hideyoshi Harashima
Journal: Molecular Therapy (2005)

RNA interference (RNAi), an efficient strategy of gene-silencing induced by short interfering RNA (siRNA) has become a widely used tool mainly for analysis of gene functions and has the potential for the gene therapy of various diseases such as cancer and viral infections. For the development of RNAi-based therapeutics, however, an efficient gene delivery system is required. We recently succeeded in the development of an original non-viral vector, multifunctional envelope-type nano device (MEND), which consists of plasmid DNA condensed by poly-L-lysine (PLL) and lipid envelope [Kogure K et.al. J Control. Release 98 (2004) 317]. The transfection activity of MEND modified with octaarginine (R8) was as high as adenovirus, and no toxicity was observed. Therefore, the R8-modified MEND (R8-MEND) could be a suitable gene delivery system of siRNA expression plasmid into the nucleus.
PERSONAL EXPERIENCES IN AN ATTACK OF YELLOW FEVER
Authors: HENRY HANSON
Journal: JAMA (1926)

In July, 1919, I was asked by the Peruvian health department to investigate and report on an epidemic of fever prevailing in Piura, the capital of the department of Piura in the northern section of Peru. I undertook the task with some degree of apprehension owing to the fact that I was not immune to yellow fever, and that, to a certain extent, I shared the popular fear of this much dreaded disease.  Both my knowledge of and experience with yellow fever were limited at that time, but I had had the good fortune to be associated with Surg. S. B. Grubbs of the United States Public Health Service, who was on the Panama Canal in the capacity of chief quarantine officer during the time that I was there as assistant chief health officer. Our discussions of yellow fever began when an engineer from the old Steamship Jamaica arrived at
Medical equipment for expeditions
Authors: R. W Davis
Journal: BMJ (1981)

moon.Had we included admissions for self-injury and accidental poisoning, including smoke injury, the figures would have been 390 and 336.The mean number of selfpoisoning admissions, with standard deviation, on full moon days was 5 9 2 3 (range 2-10) but on new moon days only 5-1 2 6 (0-12).We made comparisons for each full moon and new moon pair, and found t= 1 8487, df= 61.If we merely ask whether there might be a significant difference among the pairs then p = 007, which does not reach standards for significance.However, the report from India specified a direction of difference and allowed a prediction, and if we consequently adopt a one-tailed test then p =0035.The likelihood that the higher rate of admissions for poisoning on full moon days than on new moon days in Edinburgh, as in Patna, could be a matter of chance alone would thus be only about 1 in 28.
Arsenic Exposure and Diabetes Mellitus in the United States
Authors: Chin-Hsiao Tseng
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
PERNICIOUS ANEMIA—THE STATISTICS OF A SERIES OF FORTY CASES.
Authors: THOMAS McCRAE
Journal: JAMA (1902)

interfered with by the effects of the depression of the vasomotor center.That the center extends for some distance in the bulb is rendered probable by the fact that a marked rise of temperature may still be observed when * The Discussion on papers on "Blood Count," was printed August 4, page 503.
Medical library innovates on the Internet
Authors: C. Hukins, M. Pitcher
Journal: BMJ (1995)

EDITOR,--Andrew Millman and colleagues' article about the Internet is a useful introduction for doctors who want to know more.1 However, the Internet changes quickly, and it is perhaps worth mentioning that there are now several British resources that index web sites for medical practitioners--for example the south and west health care libraries initiative (url:http://cochrane.epi.bris.ac.uk/rd/links) and the OMNI (organising medical networked information) project (url:http://www.nimr.mrc.ac.uk/OMNI), which is looking at providing access to high quality networked information resources.

In …