tbuckley/cabot-search huggingface dataset:
Immunotherapy with MUC1/CEA vaccine alone or combined with chemotherapy in patients with metastatic breast cancer.
Authors: M Mohebtash, R Madan, P Arlen, J Jacquin, P Mary, H Oksook, R Myrna, S Jeffrey, G James
Journal: Cancer Research (2009)

Abstract Abstract #4123 Background: PANVAC is a recombinant pox viral vaccine that contains transgenes for the tumor-associated antigens (TAAs), MUC1 and CEA. PANVAC also contains three T-cell co-stimulatory molecules (B7.1, LFA-3, ICAM-1) to enhance immune response. Clinical studies with a similar vaccine have shown docetaxel does not diminish specific T-cell responses to the TAAs delivered in the pox viral vaccines. We are evaluating the use of PANVAC in two ongoing trials in patients with metastatic breast cancer.&amp;#x2028; Methods: The primary end point of these two phase II trials is progression-free survival (PFS). As secondary end point specific T-cell response is measured using ELISPOT assay in HLA-A2 patients. One study uses vaccine alone, given monthly by SC injections and is accompanied by 4 days of low dose GM-CSF. The other trial randomizes to either vaccine + docetaxel or docetaxel alone; giving the same V regimen (as the first study) on day 1 followed by docetaxel at 35 mg/m2 on days 2, 9, and 16 of each 28 day cycle. The chemotherapy alone arm uses the same docetaxel dosing.&amp;#x2028; Results: Twenty three patients have been accrued with a median age of 57.6 (31-75) years. Sixteen patietns had ER/PR+ tumors. The patients had a median of 4 (0-6) previous chemotherapy regimens; their median time since their last chemotherapy was 2 months with a 10th – 90th percentile of 1-8 months. Vaccine is well tolerated with few grade 3 and no grade 4 adverse events. Most of the grade 1-2 toxicities were self-limited site reactions and flu-like symptoms. Three of 13 patients on vaccine alone study have shown measurable clinical benefits. Two were on study for 6 months, of whom one had significant improvement in pain with reduction in vertebral lesions on MRI; another had a sustained &amp;gt;20% decrease in bulky liver metastases. A third patient on vaccine alone was on study for 9 months with reduction in her mediastinal lymphadenopathy. Of the 6 patients who received vaccine + docetaxel, 5 had measurable disease. One achieved PR by RECIST criteria and remained on study for 19 months; another had a 50% reduction in the diameter of a chest wall lesion. A third patient with bone only disease was on study for 12 months with significant improvements on her bone scan.&amp;#x2028; Conclusions: Vaccine given alone or in combination with docetaxel is shown to be safe in patient with metastatic breast cancer. There is preliminary evidence that there may be some clinical benefit from vaccine alone as well as its combination with chemotherapy. Confirmation of these results and PFS determination requires additional patient enrollment and follow up in both studies. Furthermore, immunologic studies including functional analysis of CD4 and CD8 T-cells will be performed to help elucidate the immune responses these regimens may elicit. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4123.
Multifaceted Treatment Aids Depressed Young
Authors: Lynne Lamberg
Journal: JAMA (2002)

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
Severe von Willebrand's Disease During Labor and Delivery
Authors: Richard A. Lipton
Journal: JAMA (1982)

In pregnant women with severe von Willebrand's disease, the prepartum period should include monitoring for a rise in factor VIII-related activities (factor VIII coagulant activity [factor VIII:C], factor VIII-related antigen [VIII R:Ag], and factor VIII ristocetin cofactor [factor VIII R:Cof]). Two women whose pregnancies were so monitored were delivered of normal infants: one by cesarean section and one by vaginal delivery. The failure of factor VIII:Ag or factor VIII R:Cof to rise above the level of 50% at term in the woman who delivered vaginally predicted hemostatic difficulty during the postpartum period. She was, therefore, treated with cryoprecipitate. In the woman who gave birth by cesarean section, although all factor VIII-related activities rose into the normal range, the additional surgical trauma anticipated in cesarean section prompted the use of cryoprecipitate as well.
CEREBROSPINAL FLUID PRESSURE IN THE NEW-BORN
Authors: DONALD MUNRO
Journal: JAMA (1928)

The data relative to cerebrospinal fluid pressure in the new-born presented in this paper have been accumulated during the past seven years. They have been compiled from a series of 117 cases of cranial and intracranial injury. Fifty-six of the babies included in this series died while in the hospital. Of these, forty-five came to autopsy, the postmortem material being subjected to both gross and microscopic examination in twenty-three instances. Fifty-eight patients were discharged relieved. Of these, forty-eight were followed for from less than six months to more than six years. Three were duplicate entries. A detailed study of the end-results in these cases has been presented before the Southern Surgical Association<sup>1</sup>and need not be considered further at this time. <h3>METHODS OF MEASUREMENT</h3> Measurements of cerebrospinal fluid pressure were made during ventricular and lumbar punctures. A mercury manometer was used in every instance. The lowest figure read on
More than a quarter of commissioners put NHS services out to tender for fear of legal action, survey says
Authors: G. Iacobucci
Journal: BMJ (2014)

More than a quarter of senior commissioning leaders in England say that their organisation has opened up NHS services to competition owing to fears of legal action, a new survey has found.

A fifth of respondents to the poll by the Health Service Journal 1 said that their clinical commissioning group (CCG) had been formally challenged under new competition rules established by the Health and Social Care Act 2012, which came into force in April 2013.

In a poll of senior board members from 93 commissioning groups 29% of 103 respondents said that their group had invited, or was currently inviting, competition for services “in cases where they would …
Retraction notice to: ‘Reply from Authors re: Declan G. Murphy, Anthony J. Costello. How Can the Autonomic Nervous System Contribute to Urinary Continence Following Radical Prostatectomy? A “Boson-like” Conundrum. Eur Urol 2013;63:445–7: Sparing of the Neurovascular Bundle Leads to Improved Rates of Continence’ [Eur Urol 2013;63:447–9]
Authors: Ashutosh Tewari, Wesley Ludwig, Atsushi Takenaka, Abhishek Srivastava, Sameer Chopra, Anthony Pham, Prasanna Sooriakumaran, Matthieu Durand, Bilal Chughtai, Siobhan Gruschow, Alexandra Peyser, Niyati Harneja, Robert Leung, Richard Lee, Michael Herman, Brian Robinson, Maria Shevchuk
Journal: European Urology (2014)
PALB2/FANCN: Recombining Cancer and Fanconi Anemia
Authors: Marc Tischkowitz, Bing Xia
Journal: Cancer Research (2010)

Partner and localizer of BRCA2 (PALB2) was originally identified as a BRCA2-interacting protein that is crucial for key BRCA2 genome caretaker functions. It subsequently became clear that PALB2 was another Fanconi anemia (FA) gene (FANCN), and that monoallelic PALB2 mutations are associated with increased risk of breast and pancreatic cancer. Mutations in PALB2 have been identified in breast cancer families worldwide, and recent studies have shown that PALB2 also interacts with BRCA1. Here, we summarize the molecular functions and clinical phenotypes of this key DNA repair pathway component and discuss how its discovery has advanced our knowledge of both FA and adult cancer predisposition.
TIN SPRAYER FOR MELTED PARAFFIN IN TREATMENT OF BURNS
Authors: L. L. Stanley
Journal: JAMA (1918)

<h3>To the Editor:</h3> —A simple, efficient and inexpensive apparatus for spraying melted paraffin or other paraffin products in the treatment of burns is the ordinary tin sprayer, such as is used in the garden for spraying liquid insecticides on plants. It is first necessary to melt the paraffin before placing it in the tank. Before the spray is used, the tank may be immersed in boiling water or heated over a flame until the paraffin is melted. When once heated, the paraffin remains liquid sufficiently long for all purposes.
An epigenetic component of hematopoietic stem cell aging amenable to reprogramming into a young state
Authors: Martin Wahlestedt, Gudmundur L. Norddahl, Gerd Sten, Amol Ugale, Mary-Ann Micha Frisk, Ragnar Mattsson, Tomas Deierborg, Mikael Sigvardsson, David Bryder
Journal: Blood (2013)
Catherine Maureen Durkin
Authors: Catherine Durkin Green
Journal: BMJ (2006)

Plastic surgeon and creator of the first collection of American penny arcade antique toys Before movies and television, small town Americans went to penny arcades for amusement, dropping coins into devices that entertained them by making mechanical figures move or-like today's slot machines-rewarded them with more coins if they played a game correctly.The devices were also found in bars, amusement parks, restaurants, and hotels.Their popularity peaked before the first world war and they went out of style when prohibition closed America's bars.When James Smith was a boy in East Liverpool, Ohio, the son of a dignified banker, he often rode the trolley car across the state line to an amusement park in Chester, West Virginia, where he enjoyed dropping pennies and nickels (five cent pieces) into machines that told fortunes, tested one's strength, played games, or offered penny candy.He said he loved the challenge of trying to beat the machines, but his father discouraged his son's gaming habits.
Surgery in Active Endocarditis
Authors: MARK J. DINUBILE
Journal: Annals of Internal Medicine (1982)

The role of surgery before the completion of a standard course of antibiotics in endocarditis continues to evolve. The most commonly cited indications for surgery include heart failure, repeated emboli, resistant infection, large vegetations seen by echocardiography, and deep tissue involvement. It has also been suggested that any prosthetic valve infected with a nonstreptococcal pathogen should be considered for early replacement. We discuss the rationale behind surgical intervention, critically review the pertinent literature, and propose guidelines for the clinical management of these patients.
Doctors, Drug Companies, and Gifts
Authors: Mary-Margaret Chren
Journal: JAMA (1989)

Doctors often accept gifts from drug companies. We analyze this practice and conclude that accepting a gift has complex practical and ethical repercussions. Gifts cost patients money, and they may change society's perception of the profession as serving the best interest of patients. Also, accepting a gift establishes a relationship between the physician and the drug company that obliges a response from the physician. Accepting gifts and the resulting relationship have ethical implications as well. First, the use of patients' money to pay for gifts can be unjust. Second, the fiduciary relationship between physician and patient may be threatened if prescribing practices are affected (as intended by the drug company). Third, physicians' characters may be altered by a practice that fosters self-interest at patients' expense. We discuss the need for guidelines for the profession to help physicians promote their patients' well-being.The authors analyze the complex practical and ethical issues surrounding the phenomenon of gift giving by drug companies to physicians. They consider the ethical implications of the practice, pointing out that whenever a doctor accepts a gift from a pharmaceutical firm or its representative, an implicit relationship between the recipient and the giver is established. Inherent in this relationship is an obligation to respond to the gift; this obligation may conflict with the physician's obligations toward patients, and even may affect the physician's character. Chren, et al. propose that American medical organizations adopt statements about the issues raised by drug company gifts, and conclude with a discussion of five items these statements might cover.
Rapid Dissolution of Gallstones by Methyl Tert-Butyl Ether
Authors: Mark J. Allen, Thomas J. Borody, Thomas F. Bugliosi, Gerald R. May, Nicholas F. LaRusso, Johnson L. Thistle
Journal: New England Journal of Medicine (1985)

ALTHOUGH surgery has been the time-honored treatment for cholelithiasis, dissolution of gallbladder or bile-duct stones has received increasing interest in the past decade. Numerous solvents have been administered either orally or by direct infusion into the biliary system.1 However, a slow rate of stone dissolution or troublesome side effects have restricted the clinical utility of these agents. Chenodiol and ursodeoxycholic acid usually require one to three years to achieve complete stone dissolution when they are effective. The currently preferred agent for direct dissolution, mono-octanoin, usually requires 3 to 21 days to dissolve cholesterol duct stones.2 3 4 5 6 A much more useful approach . . .
Measurement of Atherosclerotic Carotid Plaque Size In Vivo Using High Resolution Magnetic Resonance Imaging
Authors: Chun Yuan, Kirk W. Beach, Llewellyn Hillyer Smith, Thomas S. Hatsukami
Journal: Circulation (1998)

Current imaging modalities, such as contrast angiography, accurately determine the degree of luminal narrowing but provide no direct information on plaque size. Magnetic resonance imaging (MRI), however, has potential for noninvasively determining arterial wall area (WA). This study was conducted to determine the accuracy of in vivo MRI for measuring the cross-sectional maximum wall area (MaxWA) of atherosclerotic carotid arteries in a group of patients undergoing carotid endarterectomy.Fourteen patients scheduled for carotid endarterectomy underwent preoperative carotid MRI using a custom-made phased-array coil. The plaques were excised en bloc and scanned using similar imaging parameters. MaxWA measurements from the ex vivo MRI were used as the reference standard and compared with MaxWA measurements from the corresponding in vivo MR study. Agreement between the in vivo and ex vivo measurement was analyzed using the Bland-Altman method. The paired in vivo and ex vivo MaxWA measurements strongly agreed: the mean difference (in vivo minus ex vivo) in MaxWA was 13.1+/-6.5 mm2 for T1-weighted (T1W) imaging (mean MaxWA in vivo=94.7 mm2, ex vivo=81.6 mm2) and 14.1+/-11.7 mm2 for proton density-weighted (PDW) imaging (mean MaxWA in vivo=93.4 mm2, ex vivo=79.3 mm2). Intraobserver and interobserver variability was small, with intraclass correlation coefficients ranging from 0.90 to 0.98.MRI is highly accurate for in vivo measurement of artery WA in atherosclerotic carotid lesions. This imaging technique has potential application monitoring lesion size in studies examining plaque progression and/or regression.
Procoagulant activity and tumor necrosis factor in rat hepatic allograft rejection
Authors: Michael H. Basista, Anne Stieffenhofer, Dong-Goo Kim, Noriko Murase, Saturo Todo, Vincents J. Dindzans
Journal: Hepatology (1991)

We used a model of rat hepatic allograft rejection to evaluate levels of procoagulant activity and tumor necrosis factor during acute cellular rejection. ACI livers were transplanted into Lewis rats, and Lewis-to-Lewis isografts and unoperated animals served as controls. Animals were killed on days 1, 2, 3, 4, 5, 6, 7 and 9. Splenic mononuclear cells were obtained by Ficoll-Hypaque gradients. Collagenase perfusion, metrizamide gradients and centrifugal elutriation were used to isolate Kupffer cells. Procoagulant activity assay of the splenic and Kupffer cells was done using a one-step clotting assay. Tumor necrosis factor was assayed using an L929 cytotoxicity assay. Histological evidence of acute rejection began on the 4th postoperative day, and rats died by the 9th or 10th postoperative day. Splenic procoagulant activity was significantly elevated in rejecting rats on day 4 and remained elevated until death. In contrast, Kupffer-cell procoagulant activity was elevated over controls by day 3 and remained significantly elevated until death. The tumor necrosis factor levels were elevated from day 1 and remained so until death. The data indicate that procoagulant activity is synthesized both by peripheral monocytes and locally by Kupffer cells and that procoagulant activity and tumor necrosis factor levels rise during hepatic allograft rejection. Because procoagulant activity and tumor necrosis factor mediate immune functions that are postulated to be important in acute rejection (immune cell adherence, vascular thrombosis and delayed-type hypersensitivity), these elevations may contribute to the pathogenesis of acute rejection.
The Community Hospital Internship
Authors: William F. Renner
Journal: JAMA (1964)

THE TRAINING of the intern is a serious responsibility. It must be considered axiomatic that only the hospital which is able to provide training of high quality should participate in such training. If, as is being suggested, the community hospital can hope to do no better in the future than to provide second-rate training, it should forfeit its present role in the education of the intern.  It is the thesis of this report that the community hospital brings to bear on the problem of internship training some important assets and that, therefore, it would be an unfortunate development for medical care in this country and for the doctors of the future if the community hospital should relinquish its role in graduate medical education.  For the purpose of this report, community hospital, unaffiliated hospital, nonuniversity hospital, and urban hospital are considered synonymous terms. Under discussion is the voluntary nonprofit hospital without
Islet cell and glutamic acid decarboxylase antibodies present at diagnosis of diabetes predict the need for insulin treatment. A cohort study in young adults whose disease was initially labeled as type 2 or unclassifiable diabetes.
Authors: B Littorin, G Sundkvist, W Hagopian, M Landin-Olsson, A Lernmark, J Ostman, H J Arnqvist, G Blohmé, J Bolinder, J W Eriksson, F Lithner, B Scherstén, L Wibell
Journal: Diabetes Care (1999)

OBJECTIVE: To clarify the predictive value of islet cell antibody (ICA) and GAD65 antibody (GADA) present at diagnosis with respect to the need for insulin treatment 6 years after diagnosis in young adults initially considered to have type 2 or unclassifiable diabetes. RESEARCH DESIGN AND METHODS: The patient material was representative of the entire Swedish population, consisting of patients who were 15-34 years old at diagnosis of diabetes in 1987-1988 but were not considered to have type 1 diabetes at onset. At follow-up, 6 years after the diagnosis, it was noted whether the patient was treated with insulin. The presence of ICA was determined by an immunofluorescence assay, and GADAs were measured by a radioligand assay. RESULTS: Six years after diagnosis, 70 of 97 patients were treated with insulin, and 27 of 97 patients were treated with oral drugs or diet alone. At diagnosis, ICAs and GADAs were present in 41 (59%) of 70 patients and 41 (60%) of 68 patients, respectively, of those now treated with insulin, compared with only 1 (4%) of 26 patients and 2 (7%) of 27 patients who were still not treated with insulin. For either ICA or GADA, the corresponding frequencies were 50 (74%) of 68 for patients who were later treated with insulin and 3 (12%) of 26 for those who were still not treated with insulin, respectively. The sensitivity for later insulin treatment was highest (74%) for the presence of ICA or GADA, and the specificity was highest (100%) for ICA and GADA. The positive predictive value was 100% for the combination of ICA and GADA, 98% for ICA alone, and approximately 95% for GADA alone. CONCLUSIONS: Determination of the presence of ICA and GADA at diagnosis of diabetes improves the classification of diabetes and predicts the future need of insulin in young adults.
Hospitals in Syria have become instruments of suppression, says Amnesty
Authors: J. Zarocostas
Journal: BMJ (2011)

Intimidation of medical staff by the Syrian government is deterring people injured during protests from seeking help and turning hospitals into instruments of repression, says a report by Amnesty International.

The report, which is based on extensive interviews with medical staff and patients, provides evidence that Syrian protestors wounded while demonstrating against the government have been subjected to torture and other ill treatment, including by medical staff, in at least four state hospitals.

Since the uprising began in March, the report says, “Syrian security officials have had ready access to state run hospitals and are reported to have intimidated health professionals working within them and on …
Extremely Preterm Birth — Defining the Limits of Hope
Authors: F. Sessions Cole
Journal: New England Journal of Medicine (2000)

I had a kind of blind faith. I believed in the collaboration between the firm will of my one-pound-twelve-ounce daughter and the expertise of modern medicine. Of course, there was more than a bit of random luck involved, too.— Wendy Wasserstein1 Despite an increase in the frequency of premature birth,2 new techniques, including surfactant-replacement therapy and increased use of antenatal glucocorticoids, have led to continued improvement in the survival of extremely premature infants in the 1990s.3,4 Most follow-up studies of survivors have been limited by small samples, reliance on referral to a tertiary care center, limited assessment, and . . .