tbuckley/cabot-search huggingface dataset:
Outpatient high-dose chemotherapy with autologous stem-cell rescue for hematologic and nonhematologic malignancies.
Authors: B R Meisenberg, W E Miller, R McMillan, M Callaghan, C Sloan, T Brehm, M P Kosty, J Kroener, R Longmire, A Saven, L D Piro
Journal: Journal of Clinical Oncology (1997)

A prospective study to determine the feasibility of high-dose chemotherapy (HDC) and autologous stem-cell rescue (ASCR) in the outpatient setting.One hundred thirteen consecutive patients underwent 165 cycles of HDC/ASCR for a variety of malignancies. HDC regimens were disease-specific. Initially, patients were hospitalized for HDC, discharged on completion, and maintained as outpatients unless toxicities required rehospitalization (subtotal outpatient transplantation [STOT]). Once this was established as safe, a total outpatient transplant (TOT) program was developed in which patients received all of the HDC, as well as supportive care, as outpatients. Patients who declined the outpatient programs received the same HDC and supportive care as inpatients.In 140 of 165 (85%) HDC cycles, patients agreed to participate in one of the outpatient transplant programs. Five patients in the STOT program could not be discharged from the hospital because of toxicities that developed during HDC; thus, 135 patients were monitored the outpatient setting, 95 (70%) of whom were never readmitted. The mean +/- SEM total hospital length of stay (LOS), including all readmissions and excess days after chemotherapy, was 18.33 +/- 5.06 days for patients who refused the outpatient program, 8.22 +/- 5.76 days for patients in the STOT program, and 2.81 +/- 7.66 days for those in the TOT program (P < .001). One treatment-related death occurred in each treatment setting: day 120 inpatient, day 17 STOT, and day 110 TOT.Outpatient management of HDC/ASCR is safe and acceptable for the vast majority of patients. The STOT program resulted in significant reduction in hospital LOS, while the TOT program appears equally safe and further reduces LOS. Hospitalization for HDC/ASCR is unnecessary in most patients.
Sorry to bother you but
Authors: Trisha Greenhalgh
Journal: BMJ (2001)

The doorbell always rings with particular urgency on those rare occasions when I've just found half an hour between paperwork and bedtime and curled myself up in a big armchair with a book. This time, it was a nervous, housewifely woman in a pinny who looked young and indecisive enough to be my daughter.

“You don't know me, but I live at number 121. It's a bit of an emergency.”

Like most people who live within gasping distance of a doctor, …
Islets of Langerhans in Yellow Obese Mice
Authors: C HELLERSTROM, B HELLMAN
Journal: JAMA (1963)

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
Comparison of Skindex-29, Dermatology Life Quality Index, Psoriasis Disability Index and Medical Outcome Study Short Form 36 in patients with mild to severe psoriasis
Authors: P. Fernandez-Peñas, M. Jones-Caballero, O. Espallardo, A. García-Díez
Journal: British Journal of Dermatology (2012)

Severity assessment of patients with psoriasis is a critical issue. Classical clinical assessment has recently been combined with quality of life (QoL) scores, but several instruments are used. Moreover, studies have focused on patients with moderate to severe psoriasis.To compare the characteristics of QoL instruments in patients with the full range of psoriasis severity attending dermatology clinics.Observational, prospective, multicentre study. Patients completed Skindex-29 (anchor) and a second instrument randomly selected from Dermatology Life Quality Index (DLQI), Psoriasis Disability Index (PDI) and Medical Outcome Study Short Form 36 (SF-36). Demographic data, Psoriasis Area and Severity Index and affected body surface area were not different between the three groups. Skindex-29 showed a weak but significant correlation with clinical severity; only PDI showed similar correlation. PDI, DLQI and SF-36 showed a substantial floor effect in patients with mild to severe psoriasis. Skindex-29 showed strong correlations with the other three QoL instruments. SF-36 was more sensitive than the other instruments in detecting worse QoL in male patients. Skindex-29 has better sensitivity to clinical severity with minimal floor effect, and covers the main domains explored by the other three QoL instruments in patients with mild to severe psoriasis.
Dental Enamel Growth, Perikymata and Hypoplasia in Ancient Tooth Crowns
Authors: S W Hillson
Journal: Journal of the Royal Society of Medicine (1992)

This paper describes the hypoplastic defects commonly seen on the surface of ancient human tooth crowns, excavated from archaeological sites, and presents a new method for estimating the ages at which these defects were initiated during life. The method is based upon examination of microscopic incremental structures on the enamel surface and it is possible also to apply it to reconstruction of the sequence and timing of dental crown development. The method of examination is non-destructive and allows full use to be made of the large numbers of complete, unworn dentitions which are found amongst archaeological remains.
One-year results of the thrombolysis in myocardial infarction (TIMI) IIIB clinical trial
Authors: H. Vernon Anderson, Christopher P. Cannon, Peter H. Stone, David O. Williams, Carolyn H. McCabe, Genell L. Knatterud, Bruce Thompson, James T. Willerson, Eugene Braunwald
Journal: Journal of the American College of Cardiology (1995)
Serine-like proteolytic enzymes correlated with differential pathogenicity in patients with acute Acanthamoeba keratitis
Authors: F.R. de Souza Carvalho, L.C. Carrijo-Carvalho, A.M. Chudzinski-Tavassi, A.S. Foronda, D. de Freitas
Journal: Clinical Microbiology and Infection (2010)
Carcinogenic Dose-Response Curve to Oral Diethylstilbestrol&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: George H. Gass, Don Coats, Nora Graham
Journal: JNCI Journal of the National Cancer Institute (1964)

An attempt was made to determine the relationship of mammary tumor incidence in mice to the concentration of diethylstilbestrol in the diet. Intact C3H male and female mice and castrate strain A male mice were used. In C3H female mice 6.25 parts per billion (ppb) of diethylstilbestrol in the diet throughout life caused a significant increase in tumor formation over that found in the controls. Linear log dose-response curves with significant slopes were obtained in C3H female mice (25–500 ppb) and in strain A castrate male mice (12.5–1000 ppb). Average weight of ovaries from a sample of the C3H females decreased linearly between doses of 12.5 ppb and 500 ppb.
Chronic Idiopathic Diarrhea
Authors: Lawrence R. Schiller
Journal: New England Journal of Medicine (1993)

Chronic diarrhea is defined as passage of loose stools for more than 4 weeks. In most instances the cause of chronic diarrhea can be discovered and treated effectively. A few less common causes also play a role: laxative abuse, small bowel bacterial overgrowth, and even bile acid malabsorption. Rarer syndromes account for a much smaller percentage of chronic diarrheas but may be more difficult to identify and treat. In a small number of patients, a cause for chronic diarrhea cannot be found and they are said to have chronic idiopathic secretory diarrhea, a fairly homogeneous disorder that can be sporadic or epidemic. This disorder can be diagnosed after excluding other causes of chronic diarrhea; it is associated with moderate weight loss and gradually subsides after 1.5–3 years. A sensible approach to the patient with chronic diarrhea of unexplained cause is based on a comprehensive history, focusing on the stool characteristics (watery, bloody, fatty), the occurrence of weight loss, aggravating and mitigating factors (with special emphasis on the diet); on a thorough physical examination and on the careful use of selected laboratory investigations such as complete blood count, comprehensive metabolic panel, thyroid tests, and of course stool tests such as bacterial cultures and extensive search for parasites; electrolytes, pH, occult blood test, leukocytes (or lactoferrin/calprotectin) and fat assessment. Subsequent analysis will depend on the findings from history, physical exam, and stool analysis and may or may not include more aggressive investigations such as CT enterography, small bowel follow-through radiograms, and videocapsule enteroscopy. Additional tests may have to be occasionally utilized, including plasma peptides (chromogranin, gastrin, calcitonin, VIP, somatostatin) and urine chemistry tests (5-HIAA, metanephrines, histamine).
Risk factors for injury in sport climbing and bouldering: a systematic review of the literature
Authors: Kaikanani Y Woollings, Carly D McKay, Carolyn A Emery
Journal: British Journal of Sports Medicine (2015)

Background Rock climbing is an increasingly popular sport worldwide, as a recreational activity and a competitive sport. Several disciplines including sport climbing and bouldering have developed, each employing specific movements and techniques, leading to specific injuries. Objective To examine risk factors and prevention measures for injury in sport climbing and bouldering, and to assess the methodological quality of existing studies. Methods 12 electronic databases and several other sources were searched systematically using predetermined inclusion and exclusion criteria. Eligible articles were peer-reviewed, based on primary research using original data; outcome measures included injury, morbidity or mortality in rock climbing, and included one or more potential risk factor or injury prevention strategy. Two independent reviewers assessed the methodology of research in each study using the Downs and Black Quality Index. The data extracted is summarised, and appraisals of the articles are presented with respect to the quality of evidence presented. Results 19 studies met the inclusion criteria, and introduced 35 possible risk factors or injury prevention measures in climbing. Age, increasing years of climbing experience, highest climbing grade achieved (skill level), high climbing intensity score (CIS) and participating in lead climbing are potential risk factors. Results regarding injury prevention measures remain inconclusive. Discussion This field is relatively new and, as such, the data are not as robust as for more established sports with a larger research foundation. The key need is establishing modifiable risk factors using prospective studies and high quality methodology, such that injury prevention strategies can be developed. The CIS may be a useful measure in this field of research.
Immunologic Markers of Human Bronchial Epithelial Cells in Tissue Sections and in Culture&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: Y Katoh, G D Stoner, K R McIntire, T A Hill, R Anthony, E M McDowell, B F Trump, C C Harris
Journal: JNCI Journal of the National Cancer Institute (1979)

Immunologic markers of normal human bronchial epithelial cells in vivo and in vitro were investigated. When paraffin-embedded sections of normal human bronchi were stained with antisera to blood groups A, B, or H or anti-H lectin with the use of immunoperoxldase or immunofluorescence techniques, only 2 of 14 specimens were weakly stained with antisera to blood group A and 1 specimen with both antisera to blood groups A and B; the other specimens were not stained. However, if, before staining, the specimens were treated with 0.1% trypsin for 2 hours at 37° C, all specimens were stained with antisera specific for blood typesA and Band 3 of 4 blood type H specimens stained positively with anti-H lectin from Ulex europaeus. Positive staining reactions were observed in both surface bronchial epithelium and glandular epithelium. The stromal fibroblasts were not stained. Primary cell cultures of human bronchus were composed of epithelial cells and fibroblasts. The epithelial cells were stained with the blood type-specific antisera, and fibroblasts were not stained. Tumor-associated antigens, such as carclnoembryonlcantigen, a-fetoproteln, adrenocorticotropic hormone, and human chorionic gonadotropin, were all negative in both frozen sections and paraffin-embedded sections of normal human bronchi and in primary cultures of human bronchial epithelial cells. Only carclnoembryonlc antigen was weakly positive on the luminal surface of bronchial epithelium in both frozen sections and in paraffin-embedded sections after trypsin digestion. These results indicate that blood group antigens are good markers of normal human bronchial epithelial cells and that the loss of blood group antigens and the acquisition of tumorassociated antigens might be indicative of carcinogen-Induced transformation of human bronchial epithelial cells.
Futility in Chronic Anorexia Nervosa: A Concept Whose Time Has Not Yet Come
Authors: Cynthia M. A. Geppert
Journal: The American Journal of Bioethics (2015)

Comparatively little scholarly attention has been given to the question of futility in chronic psychiatric disorders, with the exception of a small body of work on so-called end-stage anorexia nervosa (AN). A review of this literature provides the background for a critical examination of whether the concept of futility has any clinically meaningful, ethically justifiable, and legally defensible application to AN. In this article, the arguments for and against futility judgments in AN are analyzed with special emphasis on determinations of capacity in this serious mental illness. Parallels between the futility disputes in medical and psychiatric disorders, where applicable, will be drawn to further illuminate whether or not the concept that continued psychiatric treatment for AN is ever truly futile.
Proteins regulating iron metabolism in asthmatic children
Authors: Amany Abd Al-Aziz, Hala Shaaban, Walaa Ismail, Mona Awad, Radwa Ali
Journal: European Respiratory Journal (2014)

Proteomic discovery program has identified a panel of proteins indicating involvement of iron metabolism pathways in asthma. Ceruloplasmin, haptoglobin and hemopexin are predominantly liver-synthesized acute phase proteins that may modulate systemic inflammatory response through inhibition of oxidative stress and iron sequestration and may be involved in tissue repair. We aimed to study serum levels of ceruloplasmin, haptoglobin and hemopexin in asthmatic children and correlate their levels to pulmonary functions. Sixty moderate to severe persistent asthmatics (30 during attacks & 30 in-between attacks) aged 6-13 years and 30 non-atopic, non-asthmatic matched healthy control children were included. All were subjected to assessment of serum ceruloplasmin; haptoglobin and hemopexin levels. Pulmonary function tests were done for patients.  Serum ceruloplasmin and haptoglobin were significantly higher in asthmatic children between attacks (448.04±386.79),(993.33±554.56) compared to controls (168.42±13.46), (473.33±350.3) (p=0.002, p  Conclusion: Iron metabolism pathways may be involved in the pathogenesis of bronchial asthma. Serum levels of ceruloplasmin, haptoglobin and hemopexin can be used as noninvasive inflammatory markers for diagnosis of asthma.
Sympathetic activation is related to exercise limitation in COPD
Authors: Helge Haarmann, Jan Folle, Stefan Andreas, Tobias Raupach
Journal: European Respiratory Journal (2013)

INTRODUCTION: Exercise intolerance, skeletal muscle dysfunction and reduced daily activity are central in COPD patients and closely related to quality of life and prognosis. Studies assessing muscle exercise in animal models as well as in patients with heart failure have revealed an increase in sympathetic outflow as a link to muscle hypoperfusion and exercise limitation.  METHODS: 30 patients with COPD and 15 matched healthy control subjects underwent microneurographic recordings of muscle sympathetic nerve activity (MSNA) at rest and during moderate handgrip exercise. Following this, ergospirometry was performed to evaluate peak exercise capacity in watts [Wpeak].  RESULTS: 30 COPD patients (Age 67.4±1.3, BMI 28.1±0.9, FEV1/VC[%] 46.9±2.9, MSNA (at rest) [bursts/min] 37.0±2.5, Wpeak [w] 36.4±28.9) and 15 healthy control subjects (MSNA (at rest) [bursts/min] 26.1±2.4, Wpeak [w] 110.3±30.0) were included in the study.  In the collective group of study subjects (n=45), there was a negative correlation between resting MSNA and peak exercise capacity (r=-0.552; p=0.041). In COPD patients but not in healthy controls, static handgrip exercise induced a significant MSNA increase (37.4±2.3 to 45.2±4.0 bursts/min; p=0.022). The increase in MSNA during dynamic handgrip exercise was negatively correlated to peak exercise capacity (r=-0.857; p=0.014) in COPD patients only.  CONCLUSION: Our study reveals for the first time an association between increased sympathetic nerve activity and limited exercise capacity in patients with COPD. Furthermore it shows an increased sympathetic response to moderate physical exercise compared to healthy controls, which may contribute to muscle dysfunction in COPD.  Supported by DFG RA 1937/1-1.
Elevation of serum napsin A in interstitial lung diseases in comparison with KL-6 and surfactant protein-D
Authors: Takuya Samukawa, Tsutomu Hamada, Tomohiro Kumamoto, Masaki Watanabe, Keiko Mizuno, Ikkou Higashimoto, Hiromasa Inoue
Journal: European Respiratory Journal (2014)

Napsin A is an aspartic proteinase with a molecular weight of approximately 38 kDa, which is expressed in normal lung parenchyma in type II pneumocytes, and we have shown that napsin A was founded high concentration in serum of patients with idiopathic pulmonary fibrosis (IPF). However, napsin A has not been tested as a marker for other forms of interstitial lung diseases (ILDs).  The aim of this study was to investigate the potential of serum napsin A as a marker in various forms of ILD in comparison with KL-6 and surfactant protein-D (SP-D).  Subjects consisted of 32 patients with chronic fibrosing interstitial pneumonia (CFIP) including 20 with IPF and 12 with nonspecific interstitial pneumonia (NSIP), 34 with ILD associated connective tissue disease (CTD-ILD), 11 with hypersensitivity pneumonia (HP), 5 with pulmonary alveolar proteinosis (PAP), 20 with bacterial pneumonia, and 20 healthy volunteers. Each serum levels of napsin A, KL-6, and SP-D were measured by commercially available ELISA kits.  The serum napsin A levels were significantly (pl0.01) higher in patients with IPF (169.1 ± 97.1 ng/ml), NSIP (178.4 ± 221.5 ng/ml), CTD-ILD (109.0 ± 156.3 ng/ml), HP (333.1 ± 62.8 ng/ml), and PAP (500.1± 239.6 ng/ml) than those in bacterial pneumonia (38.6 ± 37.4 ng/ml) and healthy volunteers (28.9 ± 21.2 ng/ml). KL-6 and SP-D levels were also significantly higher in ILD patients than in bacterial pneumonia and healthy volunteers (pl0.01), and serum napsin A levels correlated with those of KL-6 and SP-D in patients with ILDs.  Our findings shows serum napsin A may be useful biomarker for ILDs.
Validity of phase angle as a health indicator in stable COPD
Authors: Matthew Maddocks, Samantha Kon, Sarah Jones, Jane Canavan, Claire Nolan, Michael Polkey, William Man
Journal: European Respiratory Journal (2014)

Introduction: Phase angle, derived from bioelectrical impedance analysis, is a consistent functional and prognostic indicator in health and disease states including cancer and heart failure. It reflects cellular mass and integrity, and its determinants include inflammation, nutritional status and muscularity. This study assessed the validity of phase angle as a health indicator in stable COPD via its relationship with established health outcomes.

Methods: In 502 stable COPD outpatients, phase angle as well as hand-grip and quadriceps strength, incremental shuttle walk (ISW) and 4-metre gait speed (4MGS) were measured. Patients were stratified according to normal and low phase angles; below 5th percentile sex, age and body mass index specific healthy reference values.

Results: There were significant positive correlations between phase angle and grip strength r=0.48, quadriceps strength r=0.66, ISW r=0.43 and 4MGS r=0.35 (p<0.001). Patients with a low phase angle had significantly reduced muscle strength and functional exercise capacity and reported more exacerbations and hospital days in the last year compared to those with a normal phase angle (p<0.01).

View this table:

Health outcomes according to phase angle





Conclusion: Phase angle is a valid indicator of health status in stable COPD and has potential as a simple prognostic tool in this population.
Epidemiology of persecutory ideation in an elderly population in the community
Authors: R Christenson, D Blazer
Journal: American Journal of Psychiatry (1984)

Of 997 elderly people living in the community, 40 (4%) were found to have generalized persecutory ideation. Sensory deficits and cognitive impairment were significant risk factors for the development of this symptom complex. Generalized persecutory ideation was also associated with impairments in physical health, social and economic resources, and activities of daily living. While more than 50% of the elderly individuals with this symptom complex perceived a need for psychiatric services, a much smaller percentage actually received help.
Ifosfamide and mesna in previously treated advanced epithelial ovarian cancer: activity in platinum-resistant disease.
Authors: M Markman, T Hakes, B Reichman, J L Lewis, S Rubin, W Jones, L Almadrones, F Pizzuto, W Hoskins
Journal: Journal of Clinical Oncology (1992)

PURPOSE There is a critical need to find new antineoplastic drugs that are active in platinum-refractory ovarian cancer. We conducted a phase II trial of single-agent ifosfamide with mesna uroprotection in patients with ovarian cancer previously treated with an organoplatinum compound to assess its activity in this clinical setting. PATIENTS AND METHODS Ifosfamide (1.0 or 1.2 g/m2/d for 5 days, delivered on a monthly schedule) was administered to the 57 patients entered onto this trial. Dose reductions were permitted for unacceptable toxicities. RESULTS Toxicity included severe bone marrow suppression (WBC count less than 1,000/microL and/or platelet count less than 50,000/microL), renal dysfunction (serum creatinine level greater than 2.0 mg/dL), and reversible CNS dysfunction (disorientation, hallucinations, somnolence, and agitation), which occurred in 20%, 14%, and 12% of patients, respectively. Of 41 patients with strictly defined platinum-refractory ovarian cancer, five (12%) demonstrated a partial (four) or complete (one) response to this treatment program. CONCLUSION Single-agent ifosfamide has modest but unequivocal activity in platinum-resistant ovarian cancer. Further studies of this drug used as a front-line agent along with an organoplatinum compound or as part of a dose-intensification program with bone marrow, peripheral stem cell, or colony-stimulating factor support are indicated. In addition, single-agent ifosfamide is a reasonable standard second-line treatment strategy in appropriately selected patients with platinum-refractory ovarian cancer.