tbuckley/cabot-search huggingface dataset:
Malpractice Litigation
Authors: Don Harper Mills
Journal: JAMA (1975)

PHYSICIANS in most large metropolitan areas are aware that an immediate crisis in malpractice insurance exists. The rest of the medical community will be exposed rather quickly, because the nonavailability of insurance and the skyrocketing of premiums, even when insurance is available, will spread rapidly throughout the country this year. The causes for this rapid deterioration in the insurance market are legion. Well known to most of us, the frequency of claims against the medical profession has been building year after year, accompanied by spiraling costs. It has been reported that the average cost per claim in California was slightly more than $5,000 in 1969, rising to approximately $7,500 in 1973. Since then it has jumped to $12,000, and over the next five years the estimated individual claim cost will be $25,000. These are staggering figures; yet they are borne by a relatively small contributing population— the medical profession and
Protective effects of N-acetylcysteine treatment after phosgene exposure in rabbits.
Authors: A M Sciuto, P T Strickland, T P Kennedy, G H Gurtner
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

We examined the effects of treatment with N-acetylcysteine (NAC) on pulmonary edema formation in isolated perfused rabbit lungs following in vivo phosgene exposure. This study focused on posttreatment intratracheal administration of NAC after exposure. Rabbits, 2 to 3 kg, were exposed to a cumulative dose of phosgene to attain a concentration x time exposure effect of 1,500 ppm/min. Lungs were perfused with Krebs-Henseleit buffer at 40 ml/min from 70 to 150 min after exposure. Pulmonary artery pressure (Ppa), tracheal pressure (Pt), and the rate of lung weight gain (LWG) were measured continuously. Perfusate concentration of peptide leukotrienes LTC4, D4, and E4 were measured every 20 min during perfusion. At the conclusion of the experiment, lung tissue was analyzed for reduced and oxidized glutathione (GSH and GSSG) and lipid peroxidation (thiobarbituric acid-reactive substances, TBARS). Exposure to phosgene significantly increased Pt, LWG, LTC4, D4, and E4, TBARS, and GSSG over time compared with controls. Compared with phosgene, intratracheal NAC lowered Ppa, LWG, LTC4, D4, and E4, TBARS, and GSSG. We conclude that NAC protected against phosgene-induced lung injury by acting as an antioxidant by maintaining protective levels of glutathione, reducing both lipid peroxidation and production of arachidonic acid metabolites.
Autoreactive B Cell Receptors Mimic Autonomous Pre-B Cell Receptor Signaling and Induce Proliferation of Early B Cells
Authors: Fabian Köhler, Eva Hug, Cathrin Eschbach, Sonja Meixlsperger, Elias Hobeika, Juliane Kofer, Hedda Wardemann, Hassan Jumaa
Journal: Immunity (2008)
Abstract 5005: The histone demethylase JMJD1A induces cell migration and invasion by up-regulating the expression of the long noncoding RNA MALAT1
Authors: ANDREW E. TEE, BELAMY CHEUNG, GLENN M. MARSHALL, TAO LIU
Journal: Cancer Research (2014)

Abstract Patients with neuroblastoma due to N-Myc oncogene-amplification die of tumor metastasis. However, it is not clear how N-Myc induces cell migration, invasion and metastasis. The histone demethylase JMJD1A activates target gene transcription by demethylating the lysine 9 residue of histone H3 (H3K9) at target gene promoters, and the long noncoding RNA MALAT1 induces lung cancer cell migration and plays a pivotal role in lung cancer metastasis. Here we demonstrated that N-Myc up-regulated the expression of JMJD1A in N-Myc oncogene-amplified human neuroblastoma cells by directly binding to JMJD1A gene promoter. Affymetrix gene array studies revealed that the gene second most significantly up-regulated by JMJD1A was MALAT1. Consistent with this finding, RT-PCR, chromatin immunoprecipitation and luciferase assays showed that JMJD1A bound to MALAT1 gene promoter, demethylates histone H3K9 at MALAT1 gene promoter and activates MALAT1 promoter activity. Moreover, JMJD1A and MALAT1 induce, while the small molecule JMJD1A inhibitor DMOG suppresses, neuroblastoma cell migration and invasion. Taken together, our data identify a novel pathway through which N-Myc causes neuroblastoma cell migration, invasion and potentially metastasis, and provide important evidence for further development of more potent JMJD1A/MALAT1 inhibitors for the prevention of tumor metastasis. Note: This abstract was not presented at the meeting. Citation Format: ANDREW E. TEE, BELAMY CHEUNG, GLENN M. MARSHALL, TAO LIU. The histone demethylase JMJD1A induces cell migration and invasion by up-regulating the expression of the long noncoding RNA MALAT1. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 5005. doi:10.1158/1538-7445.AM2014-5005
What is per protocol analysis?
Authors: P. Sedgwick
Journal: BMJ (2013)

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 What is per protocol analysis? Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Deficiency of plasma platelet-activating factor acetylhydrolase: Roles of blood cells
Authors: Hidemi Yoshida, Kei Satoh, Masayuki Koyama, Makoto Hiramoto, Shigeru Takamatsu
Journal: American Journal of Hematology (1996)

Platelet-activating factor (PAF), a potent mediator of inflammation and circulatory shock, is inactivated by the enzyme PAF acetylhydrolase. Plasma PAF acetylhydrolase deficiency occurs even in healthy subjects. We hypothesized that erythrocyte PAF acetylhydrolase could play a supplementary role in this plasma acetylhydrolase deficiency. We examined 1,030 subjects who participated in mass checkups, and assayed plasma and erythrocyte PAF acetylhydrolase. We also investigated the degradation of exogenous PAF by erythrocytes or other blood cells obtained from subjects who exhibited the plasma enzyme deficiency. The incidence of the plasma enzyme deficiency in this general Japanese population was 4.7% (48/1,030). None of the subjects with the deficiency had a history of allergy, circulatory shock, or chronic inflammatory diseases. The mean values for erythrocyte cytosolic PAF acetylhydrolase activity in the normal and deficient subjects were 0.51 ± 0.15 (SD) and 0.71 ± 0.28 nkat (nmol/s)/g protein, respectively, and the difference was significant (P < 0.001, Mann-Whitney U-test). The half-life of 10 nmol/l [3H]PAF in plasma from normal subjects was about 5 min, and the half-life in whole blood or erythrocyte suspension in autologous plasma was almost the same as that in plasma. In plasma from deficient subjects, unchanged PAF virtually remained and the degradation in whole blood or erythrocyte suspension was a little faster than in plasma. We conclude that erythrocytes contribute only little to PAF metabolism in normal blood but they account for almost all of the slow PAF degradation in blood from subjects deficient in plasma PAF acetylhydrolase. © 1996 Wiley-Liss, Inc.
Neonatology: Diseases of the Fetus and Infant
Authors: C. Joan Richardson
Journal: JAMA (1974)

Neonatology is a vigorous young specialty that is rapidly developing its own body of knowledge. In this book, Dr. Behrman has undertaken to provide in a single volume a detailed description of the diseases that affect infants in the early weeks of life. It is aimed at the needs of physicians, nurses, and special nursery assistants involved in caring for the neonate. The rapid accumulation of knowledge in this field and its great diversity provide a real challenge for a textbook, and the authors of this work have been successful in meeting it. There are 29 contributors to the book. Most chapters are organized by body systems in the traditional medical textbook fashion. They include an introductory section on anatomy and physiology, which is followed by a discussion of the diseases common or uncommon to the neonate. The diseases are described in terms of cause, pathology, symptoms, signs, complications, diagnosis,
Chaparral ingestion. The broadening spectrum of liver injury caused by herbal medications
Authors: D. W. Gordon
Journal: JAMA (1995)

Unconventional medical practices, including the use of herbal remedies, are prevalent in the United States. Chaparral is an herbal preparation made from a desert shrub and used for its antioxidant properties. We report the case of a 60-year-old woman who took chaparral for 10 months and developed severe hepatitis for which no other cause could be found. Despite aggressive supportive therapy, the patient deteriorated and required orthotopic liver transplantation. She is now well, more than 1 year after her transplant. This case suggests that chaparral can cause serious liver injury and fulminant hepatic failure. Herbal medications should be considered as potential causes of liver toxicity. (<i>JAMA</i>. 1995;273:489-490)
SUDDEN DEATH FROM ECHINOCOCCUS CYST OF LIVER FOLLOWING TRIVIAL INJURY
Authors: Denis S. O'Connor
Journal: JAMA (1924)

This case is of interest, not because of the presence of an echinococcus cyst, but because the cyst was the cause of the sudden death of a young man, apparently in good health, following a minor injury. <h3>REPORT OF CASE</h3> A well developed and well nourished Italian, aged 23, employed in a large factory as a driver on an electric truck, failed to stop it while traveling at a speed of about 5 miles an hour, and it crashed into some boxes piled against an iron post. There were two tiers of the boxes, the top tier projecting out over the lower for about 2 feet. No part of the truck came into contact with the boxes, but the driver, to avoid hitting the upper row with his face, was obliged to hyperextend his body, and it is assumed that the lower edge of the upper projecting box struck him
Sleep Deprivation and Performance of Residents
Authors: Karen Ritchie
Journal: JAMA (1989)

To the Editor.—  Deaconson et al 1 show only that chronically sleep-deprived residents do no worse on cognitive tests when they are also acutely sleep-deprived. One must question what this proves. The study does not discover whether sleep deprivation impairs performance—to investigate this possibility, those who are sleep deprived should be compared with those who are not. But the authors admit that they did not use [prolonged-rest] controls, as these are inappropriate to the realities of the clinical on-call schedules of residents. In other words, they did not address whether a reduction in call would be beneficial to patients. If they had wanted to ask this question, they would have had to compare the performance of residents working every other night with those working less often.  They also discount previous studies that showed impairment because those studies did not offer incentives to their subjects, even as they admit that their
Risks of acupuncture range from stray needles to pneumothorax, finds study
Authors: Z. Kmietowicz
Journal: BMJ (2012)

About 100 patients a year in England and Wales experience adverse events after acupuncture delivered by the NHS, ranging from having needles left on their body to pneumothorax, a study has found.1

Although most incidents aren’t harmful, it is likely that the total figure is an underestimate because of under-reporting, say the researchers. They recommend a number of practices that can improve the safety of acupuncture.

The researchers searched the database of the national reporting and learning system run …
Number Needed To Treat and Relative Risk Reduction
Authors: Henry McQuay
Journal: Annals of Internal Medicine (1998)

Letters1 January 1998Number Needed To Treat and Relative Risk ReductionHenry McQuay, DM and Andrew Moore, DSHenry McQuay, DMUniversity of Oxford; Oxford OX3 7LJ, United KingdomSearch for more papers by this author and Andrew Moore, DSUniversity of Oxford; Oxford OX3 7LJ, United KingdomSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-1-199801010-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Physicians make different choices about treatments according to how the information is presented [1]. They make more conservative choices with NNT than with relative risk reduction. The actual numbers, of course, remain the same, but they are framed. Any danger of interpretation lies in us, not in the numbers. A 50% reduction or increase sounds wonderful, but there is a huge difference between a 50% reduction or increase in a common event, and a 50% reduction or increase in a rare event. The NNTs make the point about how rare or common an event is because the absolute ...References1. Naylor CD, Chen E, Strauss B. Measuring enthusiasm: does the method of reporting trial results alter perceptions of therapeutic effectiveness? Ann Intern Med. 1992; 117:916-21. Google Scholar2. Guillebaud J. Advising women on which pill to take: the informed user should be the chooser. BMJ. 1995; 311:1112. Google Scholar3. Pill scare linked to rise in abortions. BMJ. 1996; 312:993. Google Scholar4. McQuay H, Moore A, Justins D. Treating acute pain in hospital. BMJ. 1997; 314:1531-5. Google Scholar Author, Article, and Disclosure InformationAffiliations: University of Oxford; Oxford OX3 7LJ, United Kingdom PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByKetamine and postoperative pain – a quantitative systematic review of randomised trials 1 January 1998Volume 128, Issue 1Page: 72-73KeywordsAbsolute risk reductionAnalgesicsNumber needed to treatOral contraceptive therapyPatientsPregnancyRelative riskSystematic reviewsThromboembolism Issue Published: 1 January 1998 CopyrightCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Comparison of Trends for Adolescent Smoking and Smoking in Movies, 1990-2007
Authors: James D. Sargent
Journal: JAMA (2009)

To the Editor: The National Cancer Institute reported that “the total weight of evidence from cross-sectional, longitudinal, and experimental studies indicates a causal relationship between exposure to depictions of smoking in movies and youth smoking initiation.”1 Attributable risk estimates suggest that movie smoking accounts for one-third to one-half of adolescent smoking onset,2,3 raising the possibility that trends in movie smoking could influence trends in adolescent smoking. We compared current (past 30-day) smoking among US eighth-grade adolescents with smoking in popular movies.
Should genetic information be disclosed to insurers? Yes
Authors: Søren Holm
Journal: BMJ (2007)

UK insurers have said that they may seek approval to use the results of genetic tests for cancer from next year. <b>Søren Holm </b>believes there is no reason not to pass the results on to insurance companies, but <b>Richard Ashcroft </b>argues that the risks of disclosure justify privacy in most cases
Regulation of gene expression in pancreatic adaptation to nutritional substrates or hormones.
Authors: H F Kern, U Rausch, G A Scheele
Journal: Gut (1987)

Beginning with the work of J Pavlov, published in 1897, it has been known that levels of proteases and glycosidases in pancreatic juice were regulated in direct proportion to levels of protein and starch, respectively, in the diet.Pancreatic adaptation to nutritional substrates has been extensively studied at the level of tissue content' and at the level of biosynthesis of specific enzymes.2-5From a study of normal, diabetic, and insulin-treated rats, Desnuelle first suggested that insulin is involved in the adaptation of amylase biosynthesis in response to changes in carbohydrates in the diet.Despite numerous studies however, which have documented the predominant role of secretin and cholecystokinin (CCK) in stimu- lating fluid, bicarbonate and enzyme secretion in the exocrine pancreas, the role of these peptide hormones in the regulation of protein synthesis and pancreatic adaptation was, until recently, largely unappreciated.Because of rapid dedifferentiation of pancreatic acinar cells placed in tissue culture, it has not been possible to study under in vitro conditions, adaptive changes on normal isolated cells.By use ofcontinuous intravenous infusion of synthetic caerulein and secretin in optimal concentrations in the conscious rat we have been able to determine the limits of biochemical response to these hormones.68After removal of the pancreas and incorporation of radio- labelled amino acids in the pancreatic lobules under in vitro conditions, separation of proteins by two dimensional IEF/SDS-gel electrophoresis has allowed a study of individual rates of synthesis for each of the exocrine products synthesised in the differentiated gland.An initial study' varying the content of protein and carbohydrate in the diet between 0 and 82%, respectively, keeping lipid constant, indicated that amylase and the majority of protease zymogens were synthesised in direct proportions to the nutritional substrates (Fig. 1).Caerulein infusion in the conscious rat resulted in both coordinate and anticoordinate regulation of
EMA policy on transparency is "strikingly" similar to deal struck with drug company, say experts
Authors: P. Doshi
Journal: BMJ (2014)

In the light of our experience and that of others (Oldham <i>et al.</i>, 1969; Iben, Pupello, Stinson, and Shumway, 1969), early surgical closure of acquired ventricular septal defect is advocated. Two successful cases are presented, one after myocardial infarction and one after penetrating trauma to the heart. Description of the present method of repair is presented. Two prosthetic patches are interposed in the closure of the defect. The advantages of this technique are (<i>a</i>) the key sutures are placed through healthy tissue and are anchored by the two patches, and (<i>b</i>) an additional suture line along the free edge of the right ventricular patch ensures a complete closure.
PAINFUL PERIARTICULAR CALCIFICATIONS AT WRIST AND ELBOW: DIAGNOSIS AND TREATMENT
Authors: Irving I. Cowan
Journal: JAMA (1952)

Painful periarticular calcifications about the wrist and elbow joints produce a disability commensurate with the shoulder syndrome due to calcific tendinitis or bursitis. Clinical and roentgenologic recognition of calcareous deposits about the wrist and elbow are also important, because these conditions are so disabling, yet so amenable to treatment. The so-called subacromial calcific bursitis or tendinitis has been frequently reported in the literature in recent years, and its various methods of treatment are so well known as not to merit further discussion in this communication. Similarly, there have been numerous reports in the literature of calcific deposits in the soft tissues about the hip joint; however, there have been few references to calcific periarticular tendinitis involving the wrist and elbow joints.<sup>1</sup>We are reporting a series of 11 cases that illustrate the types of involvement of the soft tissues about the wrist and elbow, with special emphasis on the early
Association of Incident Dementia With Hospitalizations
Authors: Elizabeth A. Phelan, Soo Borson, Louis Grothaus, Steven Balch, Eric B. Larson
Journal: JAMA (2012)

Dementia is associated with increased rates and often poorer outcomes of hospitalization, including worsening cognitive status. New evidence is needed to determine whether some admissions of persons with dementia might be potentially preventable.To determine whether dementia onset is associated with higher rates of or different reasons for hospitalization, particularly for ambulatory care-sensitive conditions (ACSCs), for which proactive outpatient care might prevent the need for a hospital stay.Retrospective analysis of hospitalizations among 3019 participants in Adult Changes in Thought (ACT), a longitudinal cohort study of adults aged 65 years or older enrolled in an integrated health care system. All participants had no dementia at baseline and those who had a dementia diagnosis during biennial screening contributed nondementia hospitalizations until diagnosis. Automated data were used to identify all hospitalizations of all participants from time of enrollment in ACT until death, disenrollment from the health plan, or end of follow-up, whichever came first. The study period spanned February 1, 1994, to December 31, 2007.Hospital admission rates for patients with and without dementia, for all causes, by type of admission, and for ACSCs.Four hundred ninety-four individuals eventually developed dementia and 427 (86%) of these persons were admitted at least once; 2525 remained free of dementia and 1478 (59%) of those were admitted at least once. The unadjusted all-cause admission rate in the dementia group was 419 admissions per 1000 person-years vs 200 admissions per 1000 person-years in the dementia-free group. After adjustment for age, sex, and other potential confounders, the ratio of admission rates for all-cause admissions was 1.41 (95% confidence interval [CI], 1.23-1.61; P < .001), while for ACSCs, the adjusted ratio of admission rates was 1.78 (95% CI, 1.38-2.31; P < .001). Adjusted admission rates classified by body system were significantly higher in the dementia group for most categories. Adjusted admission rates for all types of ACSCs, including bacterial pneumonia, congestive heart failure, dehydration, duodenal ulcer, and urinary tract infection, were significantly higher among those with dementia.Among our cohort aged 65 years or older, incident dementia was significantly associated with increased risk of hospitalization, including hospitalization for ACSCs.
Effects of oxygen inhalation on intramyocardial oxygen tension
Authors: A. J. Moss, J. Johnson
Journal: Cardiovascular Research (1970)

Quantitative intramyocardial oxygen tension measurements were made in seven anaesthetized dogs using a polarographic technique. One hundred per cent oxygen inhalation produced only a modest 7 mm Hg increase in intramyocardial oxygen tension (16 to 23 mm Hg pO2) despite a five-fold increase in arterial blood oxygen tension. These experimental findings are in agreement with basic theoretical considerations and raise certain fundamental questions about the value of oxygen therapy in acute myocardial infarction.