tbuckley/cabot-search huggingface dataset:
Woman makes legal history in right to die case
Authors: C. Dyer
Journal: BMJ (2002)

A tetraplegic woman on a ventilator made legal history last week when she became the first patient in the United Kingdom to go to court in a bid to have the ventilator switched off.

The case made headlines when the High Court convened at the woman's bedside in an intensive care unit, with the scene relayed by video to family, friends, and reporters in the courtroom.

In another first, the rest of the two and a half day hearing, which took place at the royal courts of justice in central London, was watched by the woman on a video screen in her room. Propped up on pillows and attended to by her carers, she could be seen on three large screens in the courtroom, following the case intently.

The hearing ended last Friday (8 March), with judgment not likely to be given until after Easter. A court order bans identification of the …
Genetics testing firm is accused of "hiding vital breast cancer data"
Authors: N. Hawkes
Journal: BMJ (2012)

A private company that leads the market in genetic testing for breast cancer genetic mutations has refused to share information that could help patients, experts have charged.

Myriad Genetics, based in Salt Lake City, Utah, owns patents that make it the monopoly provider in the United States of tests for BRCA1 and BRCA2, two genetic variants that predispose women to breast cancer. It has conducted nearly a million tests and built up databases that give it unrivalled power to analyse the results, especially when they show mutations whose significance is uncertain.

When Myriad finds such a mutation, it offers free testing to family members, building up the database and enhancing its ability to assess the importance of “variants of unknown significance” (VUS).

In a paper in the European Journal of Human Genetics a team led by Robert Cook-Deegan of Duke University …
How NICE may be outflanked
Authors: R E Ferner, Sarah E McDowell
Journal: BMJ (2006)

We argued a decade ago that the NHS should not have to pay for new drugs unless they are at least as good as older ones, nor for expensive drugs whose benefits are uncertain.1 Since then, the National Institute for Health and Clinical Excellence (NICE) has been created. NICE appraises technologies that are available to the NHS and recommends whether they should be used unreservedly, with restrictions, or not at all.2 Part of its remit is to ensure equity, but equity is not in everyone's interests. Here, we consider how individuals or groups with specific interests may seek to outflank NICE.

When many people share common resources, it is rational for each individual to increase personal use of the resources. But if all individuals do this, the resources are overexploited and eventually everyone will be ruined. This is termed the tragedy of commons.3 The NHS is a common resource. A patient acts rationally in seeking an expensive treatment that produces a benefit (even if small), because the cost falls almost entirely on others. But the NHS cannot support overexploitation indefinitely. It already spends £10.3bn (€15bn; $19bn) a year on drugs, and costs are rising rapidly.w1 One way to avoid overexploitation is to appoint a guardian to administer the commons. NICE plays this role but faces many challenges.

NICE examines the value of drugs only when it is invited to do so by the Department of Health and Welsh Assembly, so it may never review some important aspects of therapeutics. The process is complex, involves many interested parties (stakeholders), and takes around two years to complete.w2 The delays between the initial suggestion and the final determination can allow patterns of treatment of uncertain cost effectiveness to become established. The longer the patterns persist, the harder they …
Prevention of Mast-Cell Degranulation by Ketotifen in Patients with Physical Urticarias
Authors: David P. Huston, Robert B. Bressler, Michael Kaliner, Laura K. Sowell, Marjorie W. Baylor
Journal: Annals of Internal Medicine (1986)

The capacity for ketotifen to prevent mast-cell degranulation in vivo was studied in patients with physical urticarias. Patients were exposed to the appropriate stimulus to elicit their physical urticaria before and during ketotifen therapy. Histamine concentrations in plasma samples, obtained before and serially after the physical provocation, were determined by radioenzymatic thin-layer chromatography. Ketotifen therapy was associated with marked reductions in plasma histamine levels after stimulation and in clinical evidence of urticaria in each patient. A direct correlation of ketotifen therapy and a reduction in histamine release was confirmed in a patient with a cold-induced urticaria who was studied again after discontinuation and again after reinstitution of therapy. Although the mechanism of action is unknown, this report shows that ketotifen is capable of inhibiting cutaneous mast-cell degranulation and its accompanying symptoms. These findings suggest important therapeutic alternatives for patients with mast-cell-mediated diseases.
Doctors must challenge political decisions that will cause medical harm
Authors: S. E. Roche
Journal: BMJ (2012)

Traditionally, British doctors have not been a very political bunch. They might contest decisions about service delivery or resource allocation within their organisations in local micropolitical disputes. New models of health provision or changes in health legislation might galvanise them, as happened in response to the Health and Social Care Act.1 They may even support industrial action, including striking, over revisions to retirement and pension schemes. But while this shows their political engagement may be growing, it is still a far cry from, for example, Greek doctors, who took to the streets of Athens last year to demonstrate against austerity measures and the effect of these measures on healthcare.2

Why are British doctors (in line with doctors in many other developed countries) not given to overt political activism? Reasons are complex, but perhaps part of the problem is the pervasive depoliticisation that has spread through Western capitalist countries. The belief that the fall of the Berlin Wall heralded a new era of unopposed global capitalism was announced by the US political scientist and author …
A bit of a doctor
Authors: Theodore Dalrymple
Journal: BMJ (2007)

<h3>SUMMARY:</h3> We present the imaging findings in an 8-week-old infant with LPL deficiency. Due to markedly increased lipoproteins in the serum, abnormal hypodensity and abnormal T1-weighted hyperintensity were identified in the dural venous sinuses and medullary veins.
Proliferative Retinopathy in Type 1 Diabetes Is Associated With Cerebral Microbleeds, Which Is Part of Generalized Microangiopathy
Authors: Jorn Woerdeman, Eelco van Duinkerken, Mike P. Wattjes, Frederik Barkhof, Frank J. Snoek, Annette C. Moll, Martin Klein, Michiel P. de Boer, Richard G. IJzerman, Erik H. Serné, Michaela Diamant
Journal: Diabetes Care (2013)

OBJECTIVE We investigated whether proliferative diabetic retinopathy in type 1 diabetic patients can be generalized to cerebral small vessel disease and whether it is associated with impaired peripheral microvascular function. RESEARCH DESIGN AND METHODS Thirty-three patients with proliferative diabetic retinopathy (PDR+), 34 patients without proliferative diabetic retinopathy, and 33 controls underwent magnetic resonance imaging to assess cerebral microangiopathy (cerebral microbleeds) and ischemic damage (white matter hyperintensities and lacunes). Peripheral microvascular function, i.e., skin capillary density and capillary recruitment, was assessed by capillary microscopy. RESULTS Cerebral microbleeds, but not ischemic damage, were more prevalent in PDR+ patients versus the other groups (P < 0.05). A trend was found across groups for the lowest baseline capillary density in PDR+ patients (P for trend = 0.05). In individuals with microbleeds, capillary recruitment was impaired compared with those without microbleeds (P = 0.04). CONCLUSIONS In PDR+ patients, cerebral microbleed prevalence was higher and seems part of generalized microangiopathy that may affect the skin and the brain.
Evidence for Microtubule Target Engagement in Tumors of Patients Receiving Ixabepilone
Authors: Sen H. Zhuang, Y. Elizabeth Hung, Laura Hung, Robert W. Robey, Dan L. Sackett, W. Marston Linehan, Susan E. Bates, Tito Fojo, Marianne S. Poruchynsky
Journal: Clinical Cancer Research (2007)

Abstract Purpose: Microtubule-stabilizing agents, such as taxanes, have been shown to be effective anticancer drugs. α-Tubulin, a basic unit of microtubules, can undergo several posttranslational modifications after assembly into stabilized microtubules, including acetylation and detyrosination. These modifications have been observed in cell cultures after exposure to microtubule stabilizers. Our objective was to develop a straightforward and dependable assay to show tubulin target engagement in tumor tissue after treatment of patients with ixabepilone(BMS-247550; Ixempra). Experimental Design: Levels of posttranslationally modified α-tubulin were assessed in lysates of cultured malignant cell lines, as well as in both tumor tissue and peripheral blood mononuclear cells derived from patients before and after treatment with ixabepilone. Modification-specific antibodies permitted quantitative Western blot analysis. Results: In cultured cell lines, the levels of detyrosinated (glu-terminated) and acetylated α-tubulin increased after microtubule stabilization induced by ixabepilone. ixabepilone treatment also induced a 2-fold to 25-fold increase in detyrosinated α-tubulin levels in 11 of 13 serial biopsies and a 2-fold to 100-fold increase in acetylated α-tubulin in 11 of 12 serial biopsies obtained from patients receiving ixabepilone. Overall, little or no difference in tubulin modifications were observed between the before and after ixabepilone treatment in lysates from their peripheral blood mononuclear cells at the time point examined. Conclusion: Assessing the levels of detyrosinated and/or acetylated α-tubulin seems to provide a simple and reliable assay to show target engagement by the microtubule-stabilizing agent ixabepilone. Such analyses may provide further understanding of therapeutic success or failure of microtubule-stabilizing agents in cancer therapy.
" The Great Patent Regulator," the Code of Ethics (No Pun).
Authors: Thos. F. Rumbold
Journal: JAMA (1893)

To the Editor of the Journal of the American Medical Association:  Dear Sir:  —I have just finished reading the correspondence by Dr. A. C. Simonton of San Jose, Cal., and most thoroughly agree with all he has said in regard to the revision of the Code of Ethics. But I am a little surprised that his logical mind did not mention the illogical position taken by the Code on the subject of patent rights and copyrights.  Every one knows that there is but small difference between a patent right and a copyright; morally there is no difference, one protecting the holder in the shape of an instrument, and the other in the contents of a book, consequently it should be equally derogatory to professional character for a physician to hold either. If an individual may, without committing an unprofessional act, protect his writings by a copyright, what law of morals
Industry-Sponsored Clinical Research
Authors: Marcia Angell
Journal: JAMA (2008)

controversial character rather quickly. The faculty moves on—and this should encourage other AMCs to appoint their own task forces to design and implement change. As change becomes embedded in medical centers, it will be vital to analyze outcomes both qualitatively and quantitatively. There are many important questions to be answered: Do attitudes and practices change over time? Do house staff and medical students experience the change in terms of an intensified commitment to professionalism? Do disclosure requirements affect appointments to formulary committees or teaching assignments? As visits from pharmaceutical representatives decline, do physicians’ prescriptions for generics increase? What effect on research funding might occur? Does the pharmaceutical industry devise new strategies that undercut the policies, and if so, how do the AMCs respond? Last, but certainly not least, will AMCs make sufficient progress to obviate the need for government intervention?
Medical Negligence Litigation: A Practitioner's Guide
Authors: J. Murphy
Journal: BMJ (1995)

Stephen Irwin, Claire Fazan, Richard Allfrey Legal Action Group, pounds sterling35, pp 400 ISBN 0 905099 55 9

Few who are concerned with medical negligence litigation, either as practitioners or as academics, can fail to be struck by the comparative dearth of lawyers specialising in the subject, especially as medical negligence has become “big business” in recent years. Something that goes a long way to explaining this phenomenon is the fact that the language of medical litigation is often perceived as prohibitively esoteric: medical terms are not something with which most lawyers are ordinarily familiar. This linguistic hurdle dissuades many from specialising in medical malpractice. To all …
FIBROMA OF STOMACH
Authors: J. R. Cooper
Journal: JAMA (1923)

On account of the rare occurrence of fibroid tumors in the stomach, I thought it would be interesting to report this case. In fact, I have been unable to find any reference to it in the literature I have at hand. <h3>History.</h3> —A business man, aged 45, married, was referred to me in September, 1921, by Dr. F. F. Urey for a roentgenray examination to determine, if possible, the cause of hemorrhages he was having from the stomach and bowels. About two years before, the patient at times became dizzy, and his stools after these spells were dark and of a tarry consistency. He consulted a number of physicians, but none of them were able to discover the real cause of his trouble. In 1920 his dizzy spells became more pronounced, and he occasionally vomited blood in considerable quantities. His condition then was thought to be ulcer of the stomach
Effects of Anion-Transport Inhibitors on NaCl Reabsorption in the Rat Superficial Proximal Convoluted Tubule
Authors: Marjory S. Lucci, David G. Warnock
Journal: Journal of Clinical Investigation (1979)

The effects of anion-transport inhibitors on volume reabsorption, and total CO2 concentrations were examined by in vivo microperfusion of superficial proximal convoluted tubules of rats. The luminal perfusion solution was a high-chloride, low-bicarbonate solution like that in the in vivo late proximal tubule. The anion-transport inhibitors were only added to the luminal perfusion solutions.
Dangers of Distracted Driving
Authors: David D. Teater
Journal: JAMA (2013)

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
Herpes Simplex Virus Lung Infection in Patients Undergoing Prolonged Mechanical Ventilation
Authors: Charles-Edouard Luyt, Alain Combes, Claire Deback, Marie-Hélène Aubriot-Lorton, Ania Nieszkowska, Jean-Louis Trouillet, Frédérique Capron, Henri Agut, Claude Gibert, Jean Chastre
Journal: American Journal of Respiratory and Critical Care Medicine (2007)

It is not known whether the isolation of herpes simplex virus (HSV) from lower respiratory tract samples of nonimmunocompromised ventilated patients corresponds to bronchial contamination from the mouth and/or throat, local tracheobronchial excretion of HSV, or true HSV lung involvement (bronchopneumonitis) with its own morbidity/mortality.This prospective, single-center, observational study was conducted to define the frequency, risk factors, and relevance of HSV bronchopneumonitis.All consecutive nonimmunocompromised patients receiving mechanical ventilation for 5 days or more were evaluated. Bronchoalveolar lavage, oropharyngeal swabs, and bronchial biopsies (presence of macroscopic bronchial lesions) were obtained for all who deteriorated clinically with suspected lung infection. HSV bronchopneumonitis was defined as this deterioration, associated with HSV in bronchoalveolar lavage and HSV-specific nuclear inclusions in cells recovered during lavage or bronchial biopsies.HSV bronchopneumonitis was diagnosed in 42 (21%) of the 201 patients who deteriorated clinically, with a mean mechanical ventilation duration before diagnosis of 14 +/- 6 days. Risk factors associated with HSV bronchopneumonitis were oral-labial lesions, HSV in the throat, and macroscopic bronchial lesions seen during bronchoscopy. Patients with HSV bronchopneumonitis were comparable to those without at admission, but their courses were more complicated, with longer duration of mechanical ventilation and intensive care unit stays.HSV bronchopneumonitis is common in nonimmunocompromised patients with prolonged mechanical ventilation, is associated with HSV reactivation or infection of the mouth and/or throat, and seems to be associated with poorer outcome.
Mathematical constraints on a theory of human memory - Response
Authors: S. Dennis, M. S. Humphreys, J. Wiles
Journal: Behavioral and Brain Sciences (1996)

Colonius suggests that, in using standard set theory as the language in which to express our computational-level theory of human memory, we would need to violate the axiom of foundation in order to express meaningful memory bindings in which a context is identical to an item in the list. We circumvent Colonius's objection by allowing that a list item may serve as a label for a context without being identical to that context. This debate serves to highlight the value of specifying memory operations in set theoretic notation, as it would have been difficult if not impossible to formulate such an objection at the algorithmic level.
Research and the Ulcer Problem
Authors: Lester R. Dragstedt
Journal: JAMA (1960)

This paperbacked monograph contains a readable account of the present status of peptic ulcer and chronic ulcerative colitis in the United States. It is written for the intelligent layman and the physician. The discussion of the scientific aspects of these diseases and their etiology and pathogenesis is necessarily brief and incomplete; the statistical data indicates that their enormous economic importance will probably prove startling to workers in the field. A conservative estimate is made that the total economic loss due to these ulcerative disorders is over one-half billion dollars per year. In sharp contrast to this figure, the author estimates that in 1955 a total of 5 million dollars was spent in the United States in the investigation of all diseases of the digestive system combined. It is pointed out that there has been no fund-raising, disease-oriented, organization exclusively devoted to the problems of patients with peptic ulcer and chronic
Amrinone stimulation test: Ability to predict improvement in left ventricular ejection fraction after coronary bypass surgery in patients with poor baseline left ventricular function
Authors: Nestor A. Perez-Baliño, Osvaldo H. Masoli, Alejandro H. Meretta, Alfredo Rodriguez, Daniel E. Cragnolino, Sergio Perrone, Fernando Boullon, Eduardo Mele, Igor Palacios, Kenneth A. Brown
Journal: Journal of the American College of Cardiology (1996)
An Electrocardiogram-Based Algorithm To Detect Loss of Left Ventricular Capture during Cardiac Resynchronization Therapy
Authors: Peter Ammann, Christian Sticherling, Dietrich Kalusche, Jens Eckstein, Alain Bernheim, Beat Schaer, Stefan Osswald
Journal: Annals of Internal Medicine (2005)

Loss of left ventricular capture in patients with cardiac resynchronization devices may account for worsening heart failure and can be difficult to diagnose without a programmer.To determine whether distinct morphologic changes on the surface electrocardiogram indicate loss of left ventricular capture.After analysis of the R-S spike ratio in the 12-lead electrocardiogram during right ventricular and biventricular pacing in 10 patients, an algorithm to detect loss of left ventricular capture was developed.University hospital.54 patients with a cardiac resynchronization device and underlying left bundle-branch block.Leads V1 and I of a 12-lead electrocardiogram were assessed after biventricular pacing was confirmed and after the device was programmed to right ventricular pacing only (simulating loss of left ventricular capture).The sensitivity of the algorithm to correctly identify loss of left ventricular capture was 94% (95% CI, 88.2% to 97.7%), and the specificity was 93% (CI, 86.3% to 95.8%). The likelihood ratio of a positive test result was 12.8 (CI, 6.443 to 23.310), and the likelihood ratio of a negative test result was 0.06 (CI, 0.024 to 0.137).The algorithm was tested in patients in whom the right ventricular electrode was placed in the apex of the right ventricle only.Presence of biventricular capture--the prerequisite for successful cardiac resynchronization therapy--and loss of left ventricular capture can be accurately detected by an algorithm based on analysis of the R-S ratio on leads V1 and I of the surface electrocardiogram.
Cutaneous Transfection and Immune Responses to Intradermal Nucleic Acid Vaccination Are Significantly Enhanced by in Vivo Electropermeabilization
Authors: Joseph J. Drabick, Jill Glasspool-Malone, Stella Somiari, Alan King, Robert W. Malone
Journal: Molecular Therapy (2001)

Naked DNA injection with electropermeabilization (EP) is a promising method for nucleic acid vaccination (NAV) and in vivo gene therapy. Skin is an ideal target for NAV due to ease of administration and the accessibility of large numbers of antigen-presenting cells within the tissue. This study demonstrates that in vivo skin EP may be used to increase transgene expression up to an average of 83-fold relative to naked DNA injection (50 μg DNA per dose, P < 0.005). Transfected cells were principally located in dermis and included adipocytes, fibroblasts, endothelial cells, and numerous mononuclear cells with dendritic processes in a porcine model. Transfected cells were also observed in lymph nodes draining electropermeabilized sites. A HBV sAg-coding plasmid was used to test skin EP-mediated NAV in a murine model. Analysis of humoral immune responses including immunoglobulin subclass profiles revealed strong enhancement of EP-mediated NAV relative to naked DNA injection, with a Th1-dominant, mixed-response pattern compared to immunization with HBV sAg protein that was exclusively Th2 (P = 0.02). Applications for these findings include NAV-based modulation of immune responses to pathogens, allergens, and tumor-associated antigens and the modification of tolerance.