tbuckley/cabot-search huggingface dataset:
Number of Nodes Examined and Staging Accuracy in Colorectal Carcinoma
Authors: Jan H. Wong, Richard Severino, M. Barbera Honnebier, Paul Tom, Thomas S. Namiki
Journal: Journal of Clinical Oncology (1999)

PURPOSE: The objective of this study was to determine the number of nodes that need to be examined to accurately reflect the histology of the regional lymphatics in colorectal carcinoma. PATIENTS AND METHODS: Patients undergoing curative resection for T2 and T3 colorectal cancer between 1992 and 1996 were reviewed. Pathologic data from these patients were entered into a computerized database for storage, retrieval, and analysis. The major outcome measured was the number of nodes that need to be examined to achieve a node-positive rate consistent with that reported in the National Cancer Data Base (NCDB) report. RESULTS: The number of nodes examined ranged from 0 to 78 (mean, 17 nodes). Node-negative patients had fewer nodes examined (mean, 14 nodes) than node-positive patients (mean, 20 nodes; P = .003). The entire sample had a node-positive rate of 38.8% (95% confidence interval [CI], 32% to 45.5%), not statistically different from that in the NCDB report. When at least 14 nodes were examined, the percent of patients with at least one positive node was 33.3% (95% CI, 24.6% to 42.3%), not statistically different from the NCDB report. CONCLUSION: In a sample of patients statistically similar to the sample in the NCDB report, the examination of at least 14 nodes after resection of T2 or T3 carcinoma of the colon and rectum will accurately stage the lymphatic basin.
Immunity and Immunopathology to Respiratory Syncytial Virus
Authors: Peter J. M. Openshaw
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Infection with respiratory syncytial virus (RSV) is a major unsolved challenge for vaccine development. RSV is worldwide in distribution and infects almost all children during the first 2 yr of life. The mouse model of RSV lung disease has been very successful in reproducing many aspects of the human disease. In particular, the role of antiviral T cells in both eliminating virus and causing enhanced disease has been shown dramatically. This immunopathologic paradox is now more clearly understood than for any other common human infection, largely due to insights gained from the mouse model. This review focuses on the unique ability of different RSV proteins to prime for specific functional subsets in the mouse, and the association between sensitization to the major surface glycoprotein G, the induction of T helper 2 cells, and the subsequent appearance of lung eosinophilia during RSV infection. Openshaw PJM. Immunity and immunopathology to respiratory syncytial virus: the mouse model.
Review: In RA, standard- and high-dose biologic drugs increase serious infection compared with traditional DMARDs
Authors: Ami Schattner
Journal: Annals of Internal Medicine (2015)

Source Citation Singh JA, Cameron C, Noorbaloochi S, et al.Risk of serious infection in biological treatment of patients with rheumatoid arthritis: a systematic review and meta-analysis. Lancet. 2015;386:258-65. 25975452
Specificity and Degeneracy in Antigen Recognition: Yin and Yang in the Immune System
Authors: Herman N. Eisen
Journal: Annual Review of Immunology (2001)

One of the hallmarks of the immune system is specificity, a concept based on innumerable observations that antibodies react with the substance that elicited their production and only a few other structurally similar substances. The study of T cells has begun to suggest, however, that in responses mediated by their antibody-like receptors (T cell receptor or TCR) an individual T cell, expressing a singular TCR, can discriminate as exquisitely among antigens as the most specific antibodies but also exhibit “degeneracy”: i.e., it can react with many disparate antigens (peptide-MHC complexes). An explanation for this duality (specificity and degeneracy) can be found in (i) the powerful amplifying signal transduction cascades that allow a T cell to respond to the stable engagement of very few TCR molecules, initially perhaps only one or two out of around 100,000 per cell, by their natural ligands (peptide-MHC complexes or epitopes on antigen-presenting cells—or APC) and (ii) the inverse relationship between TCR affinity for epitopes and epitope density (the number of copies of an epitope per APC). Older observations on the excess of total globulin production over specific antibody production in response to conventional immunization procedures suggest that B cells also exhibit degeneracy, as well as specificity. These views are developed against a backdrop describing how the author became interested in the immune system and has pursued that interest. “…a concept of science drawn from … [textbooks] … is no more likely to fit the enterprise that produced them than an image of a national culture drawn from a tourist brochure.” Thomas Kuhn, Structure Of Scientific Revolutions
Immunogenetics of human haptoglobins
Authors: Jamshid Javid, Wendy Yingling
Journal: Journal of Clinical Investigation (1968)

The various antigenic determinants of serum haptoglobins (Hp) may be studied semiquantitatively in a radioimmunoassay system. Using three antisera of overlapping specificities, we constructed an antigenic model of the various Hp phenotypes comprising four distinct determinants. This adds a new determinant, situated near the hemoglobin binding site, to the three determinants reported in the literature. The assay system is sensitive to 0.2 mug or less of serum Hp. Furthermore, it can detect determinants that are not recognized by double diffusion studies.
A single-blind comparison of intravenous ondansetron, a selective serotonin antagonist, with intravenous metoclopramide in the prevention of nausea and vomiting associated with high-dose cisplatin chemotherapy.
Authors: J Hainsworth, W Harvey, K Pendergrass, B Kasimis, D Oblon, G Monaghan, D Gandara, P Hesketh, A Khojasteh, G Harker
Journal: Journal of Clinical Oncology (1991)

Ondansetron (GR 38032F), a selective antagonist of serotonin subtype 3 receptors, is effective in the prevention of emesis associated with cisplatin as well as other chemotherapeutic agents. In this randomized, single-blind, multicenter, parallel group study, we compared the efficacy and safety of intravenous (IV) ondansetron with IV metoclopramide in the prevention of nausea and vomiting associated with high-dose (greater than or equal to 100 mg/m2) cisplatin chemotherapy. Three hundred seven patients receiving their first dose of cisplatin, either alone or in combination with other antineoplastic agents, were randomized to receive ondansetron 0.15 mg/kg IV every 4 hours for three doses or metoclopramide 2 mg/kg IV every 2 hours for three doses, then every 3 hours for three additional doses. The study prohibited the concurrent administration of other antiemetics or dexamethasone. Patients receiving ondansetron had a higher rate of complete protection from emesis (40% v 30%, P = .07), a higher complete plus major response rate (65% v 51%, P = .016), a lower rate of failure (21% v 36%, P = .007), and a lower median number of emetic episodes (one v two, P = .005) than did those receiving metoclopramide. The median time to the first emetic episode was longer on ondansetron (20.5 v 4.3 hours, P less than .001). Adverse events occurred in 48% of patients receiving ondansetron and 69% of those receiving metoclopramide (P less than .001). Akathisia and acute dystonic reactions occurred only on metoclopramide; headache (controlled with acetaminophen) was significantly more frequent with ondansetron. Ondansetron is more effective, produces fewer adverse events, and is easier to administer than metoclopramide for the prevention of emesis associated with high-dose cisplatin chemotherapy.
Lung function and anxiety in association with dyspnoea – The HUNT study
Authors: Linda Leivseth, Tom Ivar Lund Nilsen, Xiao-Mei Mai, Roar Johnsen, Arnulf Langhammer
Journal: European Respiratory Journal (2011)

Background:  Anxiety is common among people with obstructive lung diseases. However, reduced lung function in combination with anxiety in relation to the reporting of dyspnoea is not well studied.   Objectives:  To study the association between reduced lung function and dyspnoea, and how anxiety affects this association.   Methods:  We analysed data on 5627 women and 5066 men who participated in the Lung substudy of the Nord-Trondelag Health Study in 1995-97. In a cross-sectional design we used logistic regression to calculate multivariably adjusted odds ratios (ORs) for dyspnoea associated with levels of FEV1% predicted and anxiety (measured by the Hospital Anxiety and Depression scale).   Results:  Among women with FEV1 ≥100% predicted, those who had anxiety had an OR (95% confidence interval) for reporting dyspnoea when walking of 2.00 (0.68-5.90) compared to those without anxiety. Using the same reference group (FEV1 ≥100% predicted and no anxiety), women with FEV1 80-99% predicted had an OR of 2.46 (1.26-4.83) without anxiety and 7.67 (3.66-16.08) with anxiety, whereas those with FEV1 50-79% predicted had an OR of 4.61 (2.49-8.52) without anxiety and 14.37 (6.50-31.78) with anxiety. The corresponding ORs among men without and with anxiety were 1.00 (reference) and 4.55 (0.87-23.70); 1.15 (0.46-2.88) and 5.00 (1.82-13.73); and 4.10 (1.49-11.29) and 14.03 (4.04-48.76), respectively. The ORs for reporting dyspnoea at rest and waking up by dyspnoea showed similar patterns in both women and men.   Conclusions:  Reduced lung function in combination with anxiety had a stronger association with dyspnoea than reduced lung function alone.
Pleural drain management - A clinical practice improvement project
Authors: Boloor Rao, Vinod Aiyappan, Jeff Bowden, Anand Rose, Adriana Thanh-Thao.Le
Journal: European Respiratory Journal (2012)

Introduction :

An audit performed in Year 2010 at Flinders Medical Centre showed significant number of complications with intercostal chest drain insertion and management, with only 28% of patients being complication free.

Aims and Objectives 

Our mission was to reduce the incidence of complications associated with management of pleural drains, in respiratory unit at Flinders Medical Centre, by 80% within 6 months.

Methods 

We used validated tools, introduced by Deming, Shewart, Juran et al, customized to the health environment to tackle this problem. We assembled a team and undertook diagnostics. This included brainstorm sessions, cause and effect diagram and prioritized problems using a pareto graph. We then designed interventions and evaluated the outcome.

Results 

View this table:

Audit :Pre and Post project





We found that the three main issues impacting on pleural drain management was a lack of protocol, lack of patient information and Nursing education. This was followed by targeted intervention. Already available protocol was reviwed and customized to our local setting. A formal patient information sheet was adapted from British Thoracic Society and American Thoracic Society guidelines. A nursing education session was undertaken and a continuous refresher course was set-up. Documentation sticker was prepared. Subsequently a re-audit was performed, which showed a reduction of complications from 72% to 12.5%.
Overview: hypochondriasis, bodily complaints, and somatic styles
Authors: Arthur J. Barsky, Gerald L. Klerman
Journal: American Journal of Psychiatry (1983)

Hypochondriasis can be conceptualized in four ways: 1) as a psychiatric syndrome composed of "functional" somatic symptoms, fear of disease, bodily preoccupation, and the persistent pursuit of medical care, 2) psychodynamically, as a derivative of aggressive or oral drives or as a defense against guilt or low self-esteem, 3) as a perceptual amplification of bodily sensations and their cognitive misinterpretation, and 4) as socially learned illness behavior eliciting interpersonal rewards. There is evidence supporting each of these views, but much more investigation is needed. The authors propose the general concept of somatic style--in particular, an amplifying style--which could be used to investigate symptom formation, bodily perception, and medical illness as a psychological and social event.
Prevalence of HIV-1 integrase mutations related to resistance to dolutegravir in raltegravir naïve and pretreated patients
Authors: F. Saladini, G. Meini, C. Bianco, L. Monno, G. Punzi, M. Pecorari, V. Borghi, M. Di Pietro, G. Filice, M.R. Gismondo, V. Micheli, G. Penco, T. Carli, A. De Luca, M. Zazzi
Journal: Clinical Microbiology and Infection (2012)
Doing More vs Doing Good
Authors: Shawn L. Ralston, Alan R. Schroeder
Journal: JAMA Pediatrics (2015)

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 Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 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 Pediatrics journal
Health-Related Quality-of-Life Effects of Radical Prostatectomy and Primary Radiotherapy for Screen-Detected or Clinically Diagnosed Localized Prostate Cancer
Authors: Joanna B. Madalinska, Marie-Louise Essink-Bot, Harry J. de Koning, Wim J. Kirkels, Paul J. van der Maas, Fritz H. Schröder
Journal: Journal of Clinical Oncology (2001)

PURPOSE: The current study was undertaken within the framework of a screening trial to compare the health-related quality-of-life (HRQOL) outcomes of two primary treatment modalities for localized prostate cancer: radical prostatectomy and external-beam radiotherapy. PATIENTS AND METHODS: We conducted a prospective longitudinal cohort study among 278 patients with early screen-detected (59%) or clinically diagnosed (41%) prostate cancer using both generic and disease-specific HRQOL measures (SF-36, UCLA Prostate Cancer Index [urinary and bowel modules] and items relating to sexual functioning) at three points in time: t1 (baseline), t2 (6 months later), and t3 (12 months after t1). RESULTS: Questionnaires were completed by 88% to 93% of all initially enrolled patients. Patients referred for primary radiotherapy were significantly older than prostatectomy patients (63 v 68 years, P &lt; .01). Analyses (adjusted for age and pretreatment level of functioning) revealed poorer levels of generic HRQOL after radiotherapy. Prostatectomy patients reported significantly higher (P &lt; .01) posttreatment incidences of urinary incontinence (39% to 49%) and erectile dysfunction (80% to 91%) than radiotherapy patients (respectively, 6% to 7% and 41% to 55%). Bowel problems (urgency) affected 30% to 35% of the radiotherapy group versus 6% to 7% of the prostatectomy group (P &lt; .01). Patients with screen-detected and clinically diagnosed cancer reported similar posttreatment HRQOL. CONCLUSION: Prostatectomy and radiotherapy differed in the type of HRQOL impairment. Because the HRQOL effects may be valued differently at the individual level, patients should be made fully aware of the potential benefits and adverse consequences of therapies for early prostate cancer. Differences in posttreatment HRQOL were not related to the method of cancer detection.
Markers of bone metabolism in men with chronic obstructive pulmonary disease (COPD) aged 40-70 years
Authors: Sviatlana Lemiasheuskaya
Journal: European Respiratory Journal (2014)

Aim  was to study the imbalance of markers of bone metabolism in men with COPD.   Methods:  Bone markers b-crosslaps (b-CTX) and osteocalcin were determined by the electrochemiluminiscence immunoassays.  We examined 3 groups of patients and control group (15 healthy men). The COPD pts were subdivided into groups according to COPD severity: the 1 st  was made of 20 men; GOLD I degree; mean age 55 years; BMI 27 kg/m 2 ; the 2 nd  included 43 patients; GOLD II degree; mean age 57; BMI 28 kg/m 2 ; the 3 d  -20 patients; GOLD III degree; mean age 60; BMI 24,5 kg/m 2 .   Results : The level of b-CTX (bone resorption marker) increased during COPD progression: in the control – 0.29 ng/ml; 1st group – 0.30; 2nd– 0.40 and 3rd group – 0.37; p  st  group, in 24% patients in the 2 nd  group (p = 0,12). Increased b-crosslaps was noted in 11% patients in the 3 rd  group, but without significant differences with 1 st  and 2 nd  groups (p = 0.96 and p = 0.46, respectively). Osteocalcin level (bone formation marker) was decreased in 32% patients in the 1 st  group and 45% in the 2 nd  group (p = 0.35). Osteocalcin was reduced in 47% patients in the 3 rd  group, but with no significant differences with 1 st  and 2 nd  groups (p = 0.31 and p = 0.86, respectively).   Conclusions : Bone metabolic imbalance caused predominantly disturbance of bone formation then increasing bone resorption in men with COPD. This is supported by a significant number of patients (43%) with a marked reduction of osteocalcin as compared with patients (9%) with high level of b - crosslaps (p
Superficial Thrombophlebitis followed by Pulmonary Embolism
Authors: Patrick Kesteven, Brian Robinson
Journal: Journal of the Royal Society of Medicine (2001)

Superficial thrombophlebitis is often thought of as a benign self-limiting disorder, warranting only symptomatic treatment with non-steroidal anti-inflammatory drugs. Lately, however, several reports have suggested an association with deep-vein thrombosis, with one study finding an unexpectedly high rate of pulmonary embolism in patients with saphenous vein thrombosis and no obvious deep-vein involvement1.
Abstract 3003: Central or Peripheral Systolic or Pulse Pressure: Which Best Predicts Target-Organ Damage and Mortality?
Authors: Kang-Ling Wang, Hao-Min Cheng, Shao-Yuan Chuang, Harold A Spurgeon, Chih-Tai Ting, Edward G Lakatta, Frank C.P. Yin, Pesus Chou, Chen-Huan Chen
Journal: Circulation (2008)

Background : Pulse pressure (PP) and systolic blood pressure (SBP), in central and peripheral arteries, may contribute differently to predictions of damage to different target organs and mortality. Method : We examined the relations of PP and SBP in central (calibrated tonometric carotid pulse) and peripheral (brachial, mercury sphygmomanometer) arteries to left ventricular mass index (LVMI), carotid intima-media thickness (IMT), glomerular filtration rate (GFR), and 10-year all-cause and cardiovascular (CV) mortality in 1272 participants (47% women, aged 30 –79 years) from a community of homogeneous Chinese. Result : LVMI was more strongly related to SBP (r = 0.420 and 0.379 for central and brachial arteries, respectively) than PP (r = 0.374 and 0.285, correspondingly). In contrast, IMT and GFR were more strongly related to central PP and SBP (r = 0.265 and 0.252 for IMT, and r = −0.256 and −0.218 for GFR, respectively) than brachial PP and SBP. A total of 130 participants died, 37 from CV causes. In univariate analysis, all four blood pressure variables significantly predicted all-cause and CV mortality. After adjustment for age, sex, current smoking, glucose, cholesterol/high-density-lipoprotein-cholesterol ratio, carotid-femoral pulse wave velocity, LVMI, IMT, and GFR, none of the blood pressure variables predicted all-cause mortality (Figure 1A ). Only central SBP independently predicted CV mortality (Hazards ratio = 1.21 per 10 mmHg) in multivariate analysis (Figure 1B ). Conclusion : PP and SBP contribute differently to damage to different target organs. Central SBP is more valuable than other blood pressure variables in predicting CV mortality.
OSAS and oxidative stress before and after CPAP therapy
Authors: Marco Brunori, Francesca Serena Pignataro, Roberto Pierro, Giulio Onelli
Journal: European Respiratory Journal (2011)

Obstructive Sleep Apnea Syndrome is frequently associated with oxidative stress which might contribute to the onset of some of the systemic co-morbidities. Repeated hypoxia/re-oxygenation cycles may cause increase in Reactive Oxygen Species (ROS) with a reduction of Nitric Oxide (NO) availability.  This study was undertaken to assess oxidative stress in patients with severe OSAS (Apnea-Hypopnea index > 30/h) by evaluation of brachial artery Flow mediated dilation (FMD), gp91 phox  and serum levels of nitrite and nitrate (NOx), and to test the hypothesis that Continuous Positive Airway Pressure (CPAP) therapy can reduce oxidative stress.  We choose FMD as indirect marker of endothelial NO-mediated reactivity; gp91 phox  for NADPH oxidase activity and serum levels of NOx, markers of nitric oxide generation.  We enrolled 10 patients with severe OSAS. After polysomnography, for evaluation AHI and oxygen desaturation index (ODI), FMD, gp91 phox  and NOx were measured before and after 90 days of CPAP treatment.None of the patients smoked.  The mean AHI and ODI prior to CPAP were respectively 43.3±11.9/h and 35.8±22.3/h, which decreased to 7±5/h and 2.8±1.6/h (p 2  and it didn9t change during 90 days of therapy. Gp91 phox  decreased from 38.2±7.4 to 23.6±5.1 (p  FMD and NOx were not statistically significant.  While confirming the association between OSAS and oxidative stress, we found CPAP therapy managed to reduce gp91 phox  in patients who adhered to treatment for at least 4 hours daily, for 90 days, although there was no significant change in body weight.  CPAP treatment could therefore decrease Oxidative stress in patients with OSAS by correction of apnea and restoring normal oxygenation.
The natural history of chronic urticaria and angioedema in patients visiting a tertiary referral centre
Authors: P.G.M. Van Der Valk, G. Moret, L.A.L.M. Kiemeney
Journal: British Journal of Dermatology (2002)

Data on the natural history and prognostic variables of chronic urticaria and its subtypes are scarce.In order to inform our patients better about their prognosis we conducted an historical cohort study of patients who visited a tertiary referral centre at a university hospital between 1968 and 1990. Of 950 patients who were seen in our clinic we could trace 544 patients by using telephone directories, general practitioner records and population registers. These patients were sent a questionnaire.The response to the questionnaire was 68.4% (372 patients). Patients with severe disease and longer lasting disease at the time of the first visit proved to have a worse prognosis than patients with milder disease. The proportion cleared after 5 and 10 years was 29% and 44%, respectively. Dermographism showed the best prognosis and cold urticaria the worst. Patients with idiopathic urticaria without angioedema and the patients with angioedema did not differ significantly in prognosis.Although in this retrospective study patients with severe disease may have been more inclined to respond, we may conclude that the study results indicate a very refractory course of chronic urticaria in patients visiting a specialized dermatological unit. The study is not comparable with studies in patients visiting a general practitioner or a dermatology unit in a general hospital, but highlights the chronicity of the disease in this subgroup of patients with severe urticaria.