tbuckley/cabot-search huggingface dataset:
Switching from morphine to oral methadone in treating cancer pain: what is the equianalgesic dose ratio?
Authors: C Ripamonti, L Groff, C Brunelli, D Polastri, A Stavrakis, F De Conno
Journal: Journal of Clinical Oncology (1998)

To define the dose ratio between morphine and methadone in relation to the previous morphine dose and the number of days needed to achieve the same level of analgesia in a group of patients with advanced cancer with pain who switched from morphine to oral methadone.A cross-sectional prospective study of 38 consecutive cancer patients who switched from morphine to oral methadone was performed. The intensity of pain before, during, and after the switching period was assessed through a four-point verbal Likert scale. The relationship between previous morphine dose and the final equianalgesic methadone dose, dose ratio between morphine and methadone, and the number of days required to achieve equianalgesia have been examined by means of Pearson's correlation coefficient, scatter plots, and Cuzick's test for trend respectively.Before the switch, the median oral equivalent daily dose of morphine was 145 mg/d; after the switch, the median equianalgesic oral methadone dose was 21 mg/d. A median time of 3 days (range, 1 to 7 days) was necessary to achieve the equianalgesia with oral methadone; the lower the preswitching morphine dose, the fewer days necessary to achieve equianalgesia with oral methadone (P < .001). Dose ratios ranged from 2.5:1 to 14.3:1 (median, 7.75:1), which indicated that, in most cases, the dose ratio was much higher than that suggested by the published equianalgesic tables. A strong linear positive relationship between morphine and methadone equianalgesic doses was obtained (Pearson's correlation coefficient, 0.91). The dose ratio increased with the increase of the previous morphine dose with a much higher increase at low morphine doses.The results of our study confirm that methadone is a potent opioid, more potent than believed. Caution is recommended when switching from any opioid to methadone, especially in patients who are tolerant to high doses of opioids.
Human immunodeficiency virus-related lymphomas: a possible association between tumor proliferation, lack of ploidy anomalies, and immune deficiency.
Authors: S H McDunn, J N Winter, D Variakojis, A W Rademaker, J H Von Roenn, M S Tallman, L I Gordon, K D Bauer
Journal: Journal of Clinical Oncology (1991)

In an attempt to identify a biologic basis for the aggressive clinical behavior of human immunodeficiency virus (HIV)-associated lymphomas (HAL), dual-parameter flow-cytometric analysis was performed on 22 paraffin-embedded biopsy specimens. Cases were analyzed for DNA ploidy, the percentage of cells in S-phase (proliferative activity), and content of a recently identified proliferation-associated nuclear antigen, p105. The DNA-content analysis of 22 HALs was compared with that of 109 cases of intermediate-grade non-Hodgkin's lymphoma (NHL) unrelated to the acquired immune deficiency syndrome (AIDS) studied previously in our laboratory and 125 cases of high-grade NHL reported in the literature. The proliferative activity was higher in intermediate-grade HAL relative to non-AIDS NHL (24.0% v 10.4%; P = .03), and in high-grade HAL in comparison with NHLs of similar histology unassociated with HIV infection (24.8% v 19%), although the latter did not reach statistical significance. The number of mitoses per 10 high-power fields was found to correlate with the percentage of cells in S-phase (r = .68; P = .0004). Although p105 content tended to be higher in HAL than in an AIDS-related complex (ARC)-associated hyperplastic lymph node control, no statistically significant associations were found between p105 content and proliferative activity or the number of mitoses per 10 high-power fields. When compared with non-AIDS NHLs of comparable grade, there was a trend toward a lower incidence of DNA aneuploidy in both intermediate- (25% v 56%) and high-grade (38.5% v 60%) HALs. The higher proliferative activity and lower incidence of DNA aneuploidy found in HAL relative to non-AIDS NHL of comparable histologic grade may represent differences in pathogenesis and may underlie the poor prognosis of HIV-associated NHL.
Asthma at treated patients correlations between treatment, level of control and exacerbations in a pneumology department
Authors: Diana Dimitriu, Carmen Ardelean, Stefan Frent, Voicu Tudorache, Iosif Marincu, Stefan Mihaicuta
Journal: European Respiratory Journal (2011)

Introduction: Uncontrolled bronchial asthma (BA) is a serious problem, altering the quality of live, and consuming a lot of resources.

Aim: Evaluation of the factors related to lack of control.

Material and method: Between October 2007 and Mars 2009 we evaluated 584 consecutive patients at V.Babes Hospital, Timisoara, Romania, known and treated for BA, and collected general data, medical history, disease onset, spirometry, treatment duration, treatment, asthma control test (ACT), level of control GINA 2007. The association of variables was analyzed by calculating the odds ratio (OR) together with confidence intervals (CI) in a univariate analysis. The significant independent variables were utilized to create models of multivariate logistical analysis in order to identify the most important predictors.

Results: 584 patients, 162 males (27,74%), 422 females (72,26%), mean age 45,38 17,48 years (14-85), 14% smokers, ACT <19 (36,2%), 20-24 (48,8%), 25 (15%), 43,1% exacerbations, 78,46% patients with inhaled corticosteroids (ICS) in combination or in monotheraphy, 63,4% with normal spirometry, 52,5% with allergy, 31,3% occupational exposure, 4 predictors for uncontrolled BA: exacerbations OR 4,11, CI 3,30-7,48, p <0,001, occupational exposure OR 2,29, CI 1,23-4,26, p =0,009, altered lung function on spirometry OR =1,18, CI 1,02-1,36, p=0,021 (obstruction OR 3,78 CI 1,76-7,78, p =0,0001), duration of disease (months) OR=1,02, CI 1,00-1,03, p=0,021.

Conclusions: Despite treatment with ICS, more than 1/3 (36, 2%) of patients had uncontrolled asthma. Exacerbation and occupational exposure are the most powerful predictors.
Lipid Transport in the Human Newborn
Authors: P. F. Bougnères, I. E. Karl, L. S. Hillman, D. M. Bier
Journal: Journal of Clinical Investigation (1982)

Free fatty acid (FFA) transport was measured in 11 and glycerol turnover in 5 newborns with continuous tracer infusion of [1-13C]palmitate or [2-13C]glycerol, respectively. In addition, simultaneous determination of glucose production in the latter group with [6,6-2H2]glucose tracer and measurement of the appearance rate of [13C]glucose derived from [13C]glycerol allowed calculation of gluconeogenesis from glycerol.
Unusual Presentations of Uncommon Tumors
Authors: Vinay Raja, Craig China, Kamal H. Masaki, Gordon Nakano
Journal: Journal of Clinical Oncology (2002)

Article Tools DIAGNOSIS IN ONCOLOGY Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2002.20.9.2400 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 11981014 Unusual Presentations of Uncommon Tumors Case 1. Benign Metastasizing Pleomorphic Adenoma Vinay RajaxVinay RajaSearch for articles by this author , Craig ChinaxCraig ChinaSearch for articles by this author , Kamal H. MasakixKamal H. MasakiSearch for articles by this author , Gordon NakanoxGordon NakanoSearch for articles by this author Show More University of Hawaii, Honolulu, HI https://doi.org/10.1200/JCO.2002.20.9.2400 First Page Full Text PDF Figures and Tables © 2002 by American Society of Clinical Oncology
The respiratory microbiome in chronic obstructive pulmonary disease (COPD) exacerbations: Relationships with clinical characteristics
Authors: Bethan Barker, Mona Bafadhel, Koirobi Haldar, Ian Pavord, Mike Barer, Chris Brightling
Journal: European Respiratory Journal (2012)

Background:  There has been recent interest in the significance of the respiratory microbiome in COPD.   Methods:  Within an observational COPD study, spontaneous and/or induced sputum samples were obtained from 30 COPD patients at four time points: stable state, exacerbation onset, 2 and 6 weeks post exacerbation. 454 high-throughput pyrosequencing was performed on samples from each of these visits to examine changes to the global microbiome.   Results:  Firmicutes and Proteobacteria were the major phylum groups in most of the samples. Streptococcus, Haemophilus and Moraxella were the most frequently occurring operational taxonomic units at genus level. Cluster analysis revealed 3 groups that could be defined by the Proteobacteria:Firmicutes(P:F) ratio; 1)high firmicutes, 2)mixed proteo-firmicutes and 3)high proteobacteria.  Comparing clinical characteristics of these patients, there were no significant differences between groups with regards to GOLD stage, gender, smoking history, BMI, number of exacerbations in the previous 12 months and post bronchodilator FEV1. In the high proteobacteria group the sputum neutrophil count was increased and there was a non-significant trend towards better quality of life as measured by the SGRQ and CRQ.  Dynamic changes in the microbiome were observed between stable, exacerbation and recovery visits, although these changes did not reach statistical significance.   Conclusions:  The COPD microbiome can be defined using molecular techniques, but more research is required to further determine its clinical importance in COPD exacerbations.
MANIC PSYCHOSIS IN A NEGRO
Authors: E. J. WIGGINS, R. S. LYMAN
Journal: American Journal of Psychiatry (1944)

A 57-year-old rural Negro of unusually rugged and independent disposition, owner of a 150-acre farm, went through a series of depressing incidents prior to the build-up of hypomanic activity which terminated with psycholeptic suddenness in the outbreak of a definite manic attack. In the excitement he praised God, sang and shouted, with the feeling of satisfaction and even power through his allegiance to God. In so doing he obviously was acquiring a position above that of any person in the community, even in the country, if not in the world, without in any way challenging the social structure of the society in which he was living, since religious exaltation is one of the few outlets he has always been encouraged to find. Treatment included a period of rest in the hospital, during which the patient gave an account of his whole life, including the excitement, and this story was recorded on a series of sound records which were later edited. After return to the farm, the acute phases of the psychosis were re-enacted by the patient and his family before the camera. This re-enactment was said by the patient and his children to have had a beneficial effect on his feelings about his psychotic experience. Note is made of preserving clinical material for later presentation by means of edited sound records with enough photographs to pictorialize significant scenes.
Persistent Superior Vena Caval Syndrome Due to Totally Implantable Venous Access Systems
Authors: P A Stockton, M J Ledson, M J Walshaw
Journal: Journal of the Royal Society of Medicine (2001)

Totally implanted venous access systems are widely used in cystic fibrosis and have a low incidence of complications. Whilst local venous thromboses are described with these devices, we have found no previous reports of permanent superior vena caval occlusion.
Diabetes Remission 3 Years After Bariatric Surgery
Authors: Anita Slomski
Journal: JAMA (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 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
Arterial blood gases in elderly persons with chronic obstructive pulmonary disease (COPD)
Authors: B Delclaux, B Orcel, B Housset, WA Whitelaw, JP Derenne
Journal: European Respiratory Journal (1994)

With the increasing number of elderly people in developed countries, physicians are often confronted with patients whose arterial oxygen tension, PaO2, is lower than that of normal young adults. The normal values predicted in the literature for very old individuals are generally extrapolated from younger subjects. The purpose of the present study was to obtain PaO2 values from a large population of elderly subjects with normal and obstructive ventilatory function. We measured arterial blood gases in 274 subjects, aged 65-100 yrs (mean 82 yrs), with chronic bronchitis and moderate airways obstruction (mean forced expiratory volume in one second (FEV1), 53% pred). Mean PaO2 was 10.0 +/- 1.4 kPa (75.2 +/- 10.8 mmHg) and mean arterial carbon dioxide tension (PaCO2) was 5.4 +/- 0.8 kPa (40.5 +/- 6.1 mmHg). Both PaO2 and PaCO2 were independent of age. Blood gas abnormalities were associated with airways obstruction: PaO2 was positively correlated to FEV1 and PaCo2 was negatively correlated to FEV1. PaO2 was 10.8 +/- 1.4 kPa (81.5 +/- 10.7 mmHg) in the patients with FEV1 > or = 90% predicted versus 9.5 +/- 1.3 kPa (71.5 +/- 10.1 mmHg) in those with FEV1 < or = 35% pred. These findings suggest that the predicted PaO2 extrapolated from younger normal values are often erroneously underestimated. It is probably more accurate to accept as normal a PaO2 of 10.6-11.3 kPa (80-85 mmHg) for all subjects over 65 yrs, irrespective of their age.
Oral ampicillin inhibits liver regeneration by breaking hepatic innate immune tolerance normally maintained by gut commensal bacteria
Authors: Xunyao Wu, Rui Sun, Yongyan Chen, Xiaodong Zheng, Li Bai, Zhexiong Lian, Haiming Wei, Zhigang Tian
Journal: Hepatology (2015)

Commensal bacteria have been proposed to play a role in liver repair after partial (67%) hepatectomy. However, the underlying immune mechanisms remain elusive. Here, we show that liver regeneration was impaired in antibiotic (Atb) water‐treated mice and this impairment strongly correlated with commensal bacterial load. Among the various Atbs used in our cocktail, ampicillin‐sensitive commensal bacterial was associated with normal liver regeneration. The number of CD1d‐dependent natural killer T (NKT) cells in Atb‐treated hepatectomized mice was markedly increased, and these NKT cells were functionally overactivated to produce higher interferon‐γ. Deficiency of NKT cells or antibody blockade of the CD1d‐NKT interaction increased hepatocyte proliferation, which improved liver regeneration. Importantly, an increased number of Kupffer cells were observed in Atb‐treated mice, and these Kupffer cells produced higher interleukin‐12, which then functioned to activate hepatic NKT cells. Interleukin‐12p40 deficiency or treatment with an anti‐interleukin‐12 antibody significantly inhibited NKT cell overactivation and recovered liver regeneration in Atb‐treated mice. Conclusion: Commensal bacteria play a critical role in maintaining Kupffer cells in a tolerant state, preventing subsequent NKT cell overactivation during liver regeneration. Moreover, our data suggest that long‐term Atb use, which can impair the gut microbiota, may influence liver function by retarding liver regeneration. (H epatology 2015;62:253‐264)
Prevalence of human papilloma virus type 5 DNA in lesional and non-lesional skin scales of Italian plaque-type psoriatic patients: association with disease severity
Authors: G. Prignano, C. Ferraro, A. Mussi, F. Stivali, E. Trento, V. Bordignon, E. Crescimbeni, G. Salvati, A.M. Degener, F. Ameglio
Journal: Clinical Microbiology and Infection (2005)
Corynebacterium parvum versus bacille Calmette-Guérin adjuvant immunotherapy of stage II malignant melanoma.
Authors: A Lipton, H A Harvey, C M Balch, C E Antle, R Heckard, A A Bartolucci
Journal: Journal of Clinical Oncology (1991)

Two separate studies have been reported comparing Corynebacterium parvum and bacille Calmette-Guérin (BCG) as adjuvant immunotherapy for stage II melanoma patients (The Milton S. Hershey Medical Center, 48 patients; Southeastern Cancer Study Group [SECSG], 162 patients). As the criteria for patient selection and drugs used were similar, we have pooled the data to analyze the effects of these two treatments. Both studies used BCG (Tice, Chicago, IL) 3 x 10(8) live organisms per treatment by Tine technique and C parvum (Burroughs-Wellcome, Triangle Park, NC) subcutaneous at a dose of 4 mg/m2 (SECSG) or 5 micrograms/m2 (Hershey) per treatment. The only difference in these studies was the frequency of immunization, with patients in Hershey receiving 22 doses and the SECSG patients receiving 55 doses during the 2-year period of treatment. Kaplan-Meier life-table analysis for the 210 patients shows a prolonged disease-free interval for patients treated with C parvum (P = .02, two-sided Mantel procedure). In similar fashion, patients treated with C parvum had an improved survival rate (from all causes) when compared with BCG-treated patients (P = .012). An analysis of the results for the 170 patients for which the number of positive nodes was available was performed using Cox's model, with nodes as a stratification variable and with covariates of place, treatment, age, and sex. In this analysis, an observed benefit for C parvum on the disease-free interval had a P value of .37 while the benefit of C parvum on the survival times (from all causes) had a P value of .04. When the same analysis was performed using only patients aged younger than 60 years, the observed benefit of C parvum on disease-free interval had a P value of .08 and the benefit of C parvum on survival times (from all causes) had a P value of .008.
The difference of FENO levels according to gender in healty subjects never smoked
Authors: Mehmet Bayram, Muhammed Emin Akkoyunlu, Hatice Kutbay Özçelik, Fatmanur Karakose, Fatih Yakar, Murat Sezer, Didem Özkan, Levent Kart
Journal: European Respiratory Journal (2014)

INTRODUCTION:Very little known with the differences of fractional exhaled nitric oxide (FENO) according to genders and the published data is controversial. We aimed to investigate whether the FENO levels differ according to gender in healthy subjects. METHOD: Sixtyfive male and 65 female subjects within 18-65 years old never smoked and have no chronic air way disease were included. FENO, bodypletsymography and spirometry were performed.RESULTS:Distribution of FENO levels and other parameters according to gender is shown Table-1. FENO, BMI, Body surface area(BSA), weight, height, FVC, FEV1, TLC, PEF were significantly higher in males. Age, gender, BSA were associated with FENO in univariate lineer regression analysis. In models with multiple linear regression analysis; age, gender and BSA were associated with FENO. CONCLUSION:The difference between males and females should be kept in mind when evaluating the FENO levels.
Central alterations during prolonged exercise in normoxia and hypoxia
Authors: Samuel Verges, Marc Jubeau, Thomas Rupp, Stéphane Perrey, Bernard Wuyam, Patrick Levy, Guillaume Millet
Journal: European Respiratory Journal (2012)

Introduction:  Prolonged cycling exercise in normoxia (N) induces fatigue due to both peripheral and central alterations. Interestingly, it has been reported that cerebral perturbations are greater during short-duration isolated exercise in hypoxia (H) compared to N 1 . The purpose of this study was to test the hypothesis that central alterations are accentuated in H compared to N during prolonged whole-body exercise.   Methods:  Ten subjects performed two sessions consisting of 3 80-min cycling bouts at 45% of their relative maximal aerobic power in N and H (FIO 2  = 12%). Before exercise and after each bout, transcranial magnetic stimulation was used to assess corticospinal excitability (motor evoked potential; MEP) and intracortical inhibition (cortical silent period; CSP) of knee extensors. Femoral nerve electrical stimulation was used to measure muscle characteristics. Voluntary activation was also assessed with both types of stimulation.   Results:  A significant but similar torque reduction was observed at the end of the exercise in N and H. With the exception of CSP, a significant time effect was observed for all parameters. CSP was longer and the reduction of twitch peak torque was lower in H than in N. No other significant differences were observed between N and H.   Discussion:  Fatigue level was found to be similar between N and H when exercise is performed at the same relative intensity. Even if the brain is importantly affected by hypoxia 2  as shown by the greater intracortical inhibition, this does not appear to further affect central motor drive.   References:     1  Goodall et al, J Appl Physiol 109: 1842–1851 (2010);  2  Verges et al. Am J Physiol Regul Integr Comp Physiol (In press).
Research pointers: Mortality from cardiovascular disease more than 10 years after radiotherapy for breast cancer: nationwide cohort study of 90 000 Swedish women
Authors: S. Darby
Journal: BMJ (2003)

Increased cardiovascular mortality more than 10 years after diagnosis of breast cancer is compatible with radiotherapy causing a substantial hazard 

During radiotherapy for breast cancer there is often some irradiation of the heart and major blood vessels, which could increase cardiovascular mortality many years later.1–3 The dose of radiation to the heart is generally higher when the left rather than the right breast is affected. Therefore, indirect evidence on the magnitude of any risk is available where the tumour laterality (left or right breast) can be linked to subsequent cardiovascular mortality. 1 2 Studies of the survivors of the atomic bombing of Japan who received single doses to the whole body of 0–4 Gy show that the cardiovascular disease risk is dose related and increases by about 14% per gray.4

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Mortality ratio for women with left sided breast cancer versus women with right sided breast cancer during and after the first 10 …