tbuckley/cabot-search huggingface dataset:
Racial Disparities in Pain Management of Children With Appendicitis in Emergency Departments
Authors: Monika K. Goyal, Nathan Kuppermann, Sean D. Cleary, Stephen J. Teach, James M. Chamberlain
Journal: JAMA Pediatrics (2015)

Racial disparities in use of analgesia in emergency departments have been previously documented. Further work to understand the causes of these disparities must be undertaken, which can then help inform the development of interventions to reduce and eradicate racial disparities in health care provision.To evaluate racial differences in analgesia administration, and particularly opioid administration, among children diagnosed as having appendicitis.Repeated cross-sectional study of patients aged 21 years or younger evaluated in the emergency department who had an International Classification of Diseases, Ninth Revision diagnosis of appendicitis, using the National Hospital Ambulatory Medical Care Survey from 2003 to 2010. We calculated the frequency of both opioid and nonopioid analgesia administration using complex survey weighting. We then performed multivariable logistic regression to examine racial differences in overall administration of analgesia, and specifically opioid analgesia, after adjusting for important demographic and visit covariates, including ethnicity and pain score.Receipt of analgesia administration (any and opioid) by race.An estimated 0.94 (95% CI, 0.78-1.10) million children were diagnosed as having appendicitis. Of those, 56.8% (95% CI, 49.8%-63.9%) received analgesia of any type; 41.3% (95% CI, 33.7%-48.9%) received opioid analgesia (20.7% [95% CI, 5.3%-36.0%] of black patients vs 43.1% [95% CI, 34.6%-51.4%] of white patients). When stratified by pain score and adjusted for ethnicity, black patients with moderate pain were less likely to receive any analgesia than white patients (adjusted odds ratio = 0.1 [95% CI, 0.02-0.8]). Among those with severe pain, black patients were less likely to receive opioids than white patients (adjusted odds ratio = 0.2 [95% CI, 0.06-0.9]). In a multivariable model, there were no significant differences in the overall rate of analgesia administration by race. However, black patients received opioid analgesia significantly less frequently than white patients (12.2% [95% CI, 0.1%-35.2%] vs 33.9% [95% CI, 0.6%-74.9%], respectively; adjusted odds ratio = 0.2 [95% CI, 0.06-0.8]).Appendicitis pain is undertreated in pediatrics, and racial disparities with respect to analgesia administration exist. Black children are less likely to receive any pain medication for moderate pain and less likely to receive opioids for severe pain, suggesting a different threshold for treatment.
High-dose polychemotherapy with autologous bone marrow transplantation in children with relapsed lymphomas.
Authors: O Hartmann, F Pein, F Beaujean, C Kalifa, C Patte, C Parmentier, J Lemerle
Journal: Journal of Clinical Oncology (1984)

Sixteen children with non-Hodgkin's lymphoma (NHL) who had relapsed were treated with high-dose chemotherapy with BCNU, cyclophosphamide, cytarabine, 6-thioguanine (high-dose chemotherapy [HDC]) and autologous bone marrow transplantation (ABMT). Eleven complete responses were obtained and five patients remain in prolonged complete unmaintained remission 77+ to 152+ weeks after treatment. The best results were obtained in patients with CNS involvement and when this regimen was used after complete remission or partial response was obtained by other means. The results appear to be better in B-cell than in T-cell lymphomas, but the numbers are too small for statistical assessment. The use of ABMT rendered the pancytopenic period short and safe, despite the use of drug doses higher than those previously described for this HDC. The frequency of interstitial pneumonitis, possibly related to pulmonary toxicity of chemotherapy, remains a major concern. These results show that this regimen can help to cure some patients but its toxicity prohibits its use in primary therapy.
Electromyographic activity of the respiratory muscles in health adults and asthmatic
Authors: Thaisy Silva, Rafaela Pedrosa, Ivanízia Silva, Nelson Lima Filho, Ítalo Queiroz, Tainá Fernandes, Victor Oliveira, Renata Delgado, Gardenia Ferreira
Journal: European Respiratory Journal (2014)

The obstruction to the airflow present in asthmatic generates lung hyperinflation, causing changes in respiratory function, which may alter the activity of the respiratory muscles. Thus, the aim of this study was to compare the electromyographic activity of the respiratory muscles between adults and asthmatic subjects. In a cross-sectional and analytical study, twenty adults were divided into two groups: healthy (GH) and asthmatic (GA). The GA had mild and controlled asthma. The volunteers underwent clinical, anthropometrical, spirometry, of the inspiratory muscle strength evaluation and the electromyographic signal was captured by surface electromyography. The electromyographic activity was recorded during baseline, deep breathing and in the maximal inspiratory pressure (MIP) maneuver, of the sternocleidomastoid (SCM), intercostal (IC) and diaphragm were assessed. The muscle activation was higher during the MIP compared to the electromyographic activity recorded at baseline and deep breathing, both for healthy and asthmatic ( P  P >0,005). The MIP maneuver, the SCM and diaphragm electromyographic activity was lower in the asthmatic group than in the control group ( P
Six-minute walk distance improvement in patients with pseudo-tumoral silicosis after a pulmonary rehabilitation program
Authors: Manuel Vaz, Filipa Soares, Mafalda van Zeller, Paulo Viana, Paula Martins, Luis Gaspar, Isabel Gomes
Journal: European Respiratory Journal (2013)

Background:Pulmonary rehabilitation (PR) outcomes in patients with pseudo-tumoral silicosis are poorly described in literature. The six-minute walk test is a helpful simple test used to assess changes in exercise functional capacity following PR in patients with lung disease.  Aim: To assess the impact of rehabilitation program in six-minute walk distance (6MWD) in patients with this severe form of silicosis.  Methods: Retrospective analysis of 10 patients with pseudo-tumoral silicosis who attended PR. Pre and post-PR 6MWD were compared, as well as pre and post-test saturation and heart rate. In all patients exercise training included stationary bicycle exercise for 30 min (after initial evaluation with cardiopulmonary exercise test in 7 patients) as well as upper and lower limb strength training three times a week.  Results: All patients were male and Caucasian, median (med) age 56 years, med body mass index 25.75 Kg/m2. All but one had severe obstruction as noted in baseline function tests (med FEV1– 37.35% predicted value). Med PR duration was 12 weeks. Med 6MWD increased after PR from 300m to 377.5m (+ 77.5m), which, while clinically significant, did not achieve statistical significance (p  Conclusion: PR programs seem to improve clinically significant exercise capacity in patients with pseudo-tumoral silicosis as seen in the six-minute walk test in spite of severe lung function. The increase in desaturation and heart rate at the end of the test after PR can be explained by the increase in the distance walked.
Abstract 3682: Heterozygous Knockout of the Insulin-like Growth Factor 1 Receptor in Mice Leads to Enhanced Insulin Sensitivity and Increased Endothelial Nitric Oxide Production
Authors: Afroze Abbas, Helen Imrie, Adil Rajwani, Hema Viswambharan, Richard M Cubbon, Matthew B Kahn, Stephen B Wheatcroft, Peter J Grant, Mark T Kearney
Journal: Circulation (2008)

Introduction Insulin like growth factor-1 (IGF-1) enhances glucose uptake and nitric oxide (NO) production, acting via similar signalling pathways to insulin. Several cross sectional and longitudinal studies have demonstrated an inverse relationship between IGF-1 bioactivity and cardiovascular disease. We assessed the hypothesis that a putative mechanism for these findings may be the modulation of endothelial NO bioavailability by IGF-1. Methods and Results We investigated the effect of reduced IGF-1 bioactivity on metabolic and endothelial function in male mice, heterozygous for knockout of the IGF-1 receptor (IGF1RKO) and their wildtype littermates (WT). Glucose tolerance tests revealed impaired glucose handling in IGF1RKO mice compared to WT (mean AUC for IGF1RKO mice=1086 ± 26.82(mmol/L)minutes, mean AUC for WT mice=950.5 ± 22.5(mmol/L)minutes, n=5 in each group, p=0.005). However, using an insulin tolerance test, IGF1RKO mice were more insulin sensitive than controls (mean AUC for IGF1RKO=552.2 ± 25.18(mmol/L)minutes, n=10; mean AUC for WT=651.4 ± 22.26(mmol/ L)minutes, n=11, p=0.008). Ex-vivo assessment of vascular function was performed using thoracic aortic rings in an organ bath. Aortic rings from IGF1RKO mice were hypocontractile to phenylepherine compared to those from WT (mean Emax for IGF1RKO mice=0.60 ± 0.05g n=11 versus mean Emax for WT mice=0.79 ± 0.06g, n=10, p=0.03). Addition of the nitric oxide synthase inhibitor, NG-monomethyl-L-arginine (L-NMMA), led to a 65.40 ± 13.40% (n=9) increase in mean Emax in IGF1RKO mice compared to a 15.78 ± 12.00% (n=9) increase in WT mice (p=0.01). In addition IGF1RKO aortic rings were resistant to IGF-1 exposure compared to WT (percentage change in mean Emax for IGF1RKO mice=32.80 ± 11.01%, n=9 versus 66.28 ± 10.60% in WT mice, n=8, p=0.05), but maintained sensitivity to insulin. Conclusion IGF1RKO mice demonstrate impaired glucose handling but enhanced sensitivity to insulin compared to WT. Aortic rings from IGF1RKO mice are hypocontractile to phenylepherine and have increased basal NO production. These data raise the possibility that reduced IGF-1 action in the endothelium may have a favourable effect on NO bioavailability, possibly by a novel interaction with insulin signalling.
Abstract 11564: Oral Administration of Telmisartan Causes Sympathoinhibition through the Blockade of AT1 Receptor in the Cardiovascular Center of Brainstem and the Activation of the Systemic PPAR-γ in Metabolic Syndrome
Authors: Takuya Kishi, Yoshitaka Hirooka, Kenji Sunagawa
Journal: Circulation (2011)

Backgrounds:  Activation of the sympathetic nervous system (SNS) is involved in the pathogenesis of metabolic syndrome (MetS). We have demonstrated that angiotensin II type 1 receptor (AT 1 R)-induced oxidative stress in the rostral ventrolateral medulla (RVLM) of the brainstem activates the SNS. Telmisartan, an AT 1 R blocker (ARB) and partial agonist for peroxisome proliferator-activated receptor gamma (PPARγ), is approved for the treatment of MetS with hypertension. The aim of this study was to determine whether oral administration of telmisartan decreases the activity of the SNS through the blockade of AT 1 R in the RVLM and activation of systemic PPAR-γ in MetS.   Methods and Results:  Male Sprague-Dawley rats were fed on a high-fat diet and segregated into obesity-prone (OP) showed a MetS profile and obesity-resistant (OR) after 13 weeks. OP was divided into OP treated with the pral administration of telmisartan (TLM-OP), OP treated with the oral administration of telmisartan and GW9662, PPARγ antagonist, (TLM+GW-OP) and vehicle (VEH-OP). Urinary norepinephrine excretion (uNE), as a marker of the activity of the SNS, was significantly lower in TLM-OP than in VEH-OP (1.2±0.2 ug vs 1.9±0.2 ug, n=5, p   Conclusion:  In MetS, oral administration of telmisartan suppresses SNS through the blockade of AT 1 R in the RVLM and activation of systemic PPARγ. Since telmisartan has powerful sympathoinhibitory effects, it would be a reasonable choice in treating patients with MetS.
Effect of Immunologic Intervention on In Vivo Murine Rous Sarcoma Virus Tumorigenesis&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: R A Banks, G F Babcock, A C Whitmore, G Haughton
Journal: JNCI Journal of the National Cancer Institute (1979)

Journal Article Effect of Immunologic Intervention on In Vivo Murine Rous Sarcoma Virus Tumorigenesis Get access Richard A. Banks, Richard A. Banks Search for other works by this author on: Oxford Academic PubMed Google Scholar George F. Babcock, George F. Babcock Search for other works by this author on: Oxford Academic PubMed Google Scholar Alan C. Whitmore, Alan C. Whitmore Search for other works by this author on: Oxford Academic PubMed Google Scholar Geoffrey Haughton Geoffrey Haughton Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 63, Issue 6, December 1979, Pages 1423–1431, https://doi.org/10.1093/jnci/63.6.1423 Published: 01 December 1979 Article history Received: 31 January 1979 Accepted: 18 June 1979 Published: 01 December 1979
HHS Establishes Training and Education Center for Ebola
Authors: Julie A. Jacob
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
Incidence and duration of chemotherapy-induced nausea and vomiting in the outpatient oncology population.
Authors: C M Lindley, S Bernard, S M Fields
Journal: Journal of Clinical Oncology (1989)

Nausea and vomiting are commonly recognized side effects of chemotherapy. However, the incidence and duration of these effects have not been systematically studied in a large outpatient oncology population. This survey was conducted over two consecutive 6-week periods in the adult oncology clinics of two university teaching hospitals. The objectives were: (1) to document the incidence and duration of chemotherapy-induced nausea and vomiting; (2) to identify variables that influence nausea and vomiting; and (3) to describe patterns of antiemetic prescribing and compliance. One hundred thirty-eight completed patient-maintained diaries were returned (70% response rate). Anticipatory nausea and vomiting were reported by 9.4% and 6.5% of patients, respectively. Fifty percent and 27% of patients reported nausea and vomiting, respectively, on the day chemotherapy was administered (day 1: acute nausea and vomiting phase). Percentages fell to 22% and 11% by day three and 14% and 2.5% on day 5. Of patients who reported nausea and vomiting during the five-day period, 52% and 33% experienced nausea and vomiting, respectively, during the delayed period only (days 2 through 5: delayed emesis phase). Emetogenicity of chemotherapy significantly influenced incidence and duration of those symptoms. Sixty-seven percent of patients reported taking antiemetics on one or more days during the survey period. Of patients who reported antiemetic use, 92% reported antiemetics on day 1, 51% on day 3, and 31% on day 5. At-home antiemetic use was related to the emetogenicity of chemotherapy received. Patients who receive moderate to strong emetogens as defined in this report should receive antiemetic therapy for a minimum of three days. Increasing the dose of antiemetic prescribed both in the clinic and at home may be of benefit.
In vitro lung deposition of fluticasone propionate/formoterol (FP/FORM) pressurized metered dose inhaler (pMDI) with different inhalation profiles
Authors: Cedric Van Holsbeke, Jonathan Marshall, Jan De Backer, Wim Vos
Journal: European Respiratory Journal (2014)

Rationale   When assessing simulated deposition of pMDIs, it is normal to use a Sinusoidal Inhalation (SI) profile, similar to tidal inhalation. However, in real-life some patients with a pMDI inhale rapidly straightaway, with peak flow near the start of manoeuvre, a Rapid Inhalation (RI) profile. This study examined the influence of inhalation profile on lung deposition with FP/FORM pMDI (  flutiform  ®) using Functional Respiratory Imaging (FRI).   Methods   3D airway models of 6 asthma patients (mean FEV1 83%), treated with an ICS/LABA combination, were included. Total lung (TLD), central (C) and peripheral (P) airway deposition of FP/FORM were assessed using FRI. Simulations were performed with both SI and RI profiles, which were matched for the average flow rate (30L/min and 60L/min) and duration of inhalation (3s); actuation was timed with the start of inhalation.   Results   TLD and C/P ratios for both SI and RI profiles at 30 and 60L/min are shown in the table.   Conclusions   In vitro lung deposition was high with both profiles and both flow rates. Both SI and RI profiles resulted in mostly peripheral deposition although this was higher with SI profile, which may be more optimal for pMDIs. These data predict FP/FORM may provide high levels of lung deposition (∼40% and above) of nominal dose with both RI and SI profiles, when used optimally, with deposition throughout central and peripheral airways.  This study was funded by MundiPharma International.
Hairy cell leukemia: lessons learned in twenty-five years.
Authors: H M Golomb
Journal: Journal of Clinical Oncology (1983)

This review was written to highlight the lessons learned in HCL in the past 25 years. It should serve as a guideline to practicing hematologists and oncologists regarding the diagnosis and management of HCL patients. It should stimulate investigators in training to realize that a disease can be understood with time; however, additional clinical observations and laboratory experiments may help to improve the survival rate even more.
Late-onset non-infectious pulmonary complications after allogenic-stem cell transplant (LONIPC). Results of treatment strategy with multidisciplinary cooperation
Authors: Marco Brunori, Serena Melandri, Stephane K. Nkwenze, Gloria Pane, Luigi Panza, Eugenia Pipitone, Stefano Ungaro, Daniela Parola
Journal: European Respiratory Journal (2014)

Pulmonary complications are a major cause of morbidity and mortality in patients undergoing allogenic stem cell transplant (HSCT). If advances in prophylaxis and treatment of HSCT-related infections have significantly improved, it9s not the same for the non-infectious counterparts. Our aim was to improve management of LONIPC through evaluation of clinical and functional response to targeted therapies and define standardized time points to start specific therapies in pre-symptomatic stage to decrease morbidity and mortality. From 2010 we analyzed 25 consecutive adult patients in follow-up at a median time of 35 months post-HSCT with a normal lung function before HSCT. 14/25 had a ventilatory defect: obstructive (OD)8; restrictive (RD)5; mixed (MD)1. They were treated by ICS-LABA and tiotropium for mild/moderate OD (4 pts); as above + oral prednisone (PDN), acetyilcistein, pulmonary rehab with respiratory devices (Ez-pap) for severe OD (4 pts); oral PDN, acetyilcistein and pulmonary rehab (Cliniflo), for RD (5 pts). Oral PDN and inhaled BD for MD (1 pts).7 patients were in treatment for GVHD, that remained stable. The 2-year cumulative incidence of response to therapy was 76%; 3/14 died of LONIPC, with a 15 year overall survival of 35%. TBI pre-HSCT was the only variable associated with a worse response to therapy. LONIPC appear early after HSCT, even if with mild clinical or spirometric signs; the cooperation between pneumologists and hematologists allows its early recognition and specific treatments with good response, avoiding clinical evolution, gaining better QOL and reducing the employment of anti-GVHD therapy.
Patient dies of alternative cancer remedy
Authors: Scott Gottlieb
Journal: BMJ (2000)

A patient with cancer died of kidney and liver failure after refusing conventional treatment and taking an alternative medicine known as hydrazine sulfate, researchers have reported.

Dr Mark Hainer from Moncrief Army Community Hospital in Fort Jackson, South Carolina, and colleagues cared for the 55 year old man, who had previously been diagnosed with cancer of his left maxillary sinus. According to the report, the patient had refused surgery, radiation, and chemotherapy for his cancer (Annals of Internal Medicine 2000; 133: 877-80).

The man obtained hydrazine sulfate, which has been touted as a chemotherapeutic agent, as well as treatment for the wasting seen with advanced cancer, through an alternative medicine …
VITAMIN B<sub>12</sub> DEFICIENCY IN THE ELDERLY
Authors: H.W. Baik, R.M. Russell
Journal: Annual Review of Nutrition (1999)

▪ Abstract Vitamin B 12 deficiency is estimated to affect 10%–15% of people over the age of 60, and the laboratory diagnosis is usually based on low serum vitamin B 12 levels or elevated serum methylmalonic acid and homocysteine levels. Although elderly people with low vitamin B 12 status frequently lack the classical signs and symptoms of vitamin B 12 deficiency, e.g. megaloblastic anemia, precise evaluation and treatment in this population is important. Absorption of crystalline vitamin B 12 does not decline with advancing age. However, compared with the younger population, absorption of protein-bound vitamin B 12 is decreased in the elderly, owing to a high prevalence of atrophic gastritis in this age group. Atrophic gastritis results in a low acid-pepsin secretion by the gastric mucosa, which in turn results in a reduced release of free vitamin B 12 from food proteins. Furthermore, hypochlorhydria in atrophic gastritis results in bacterial overgrowth of the stomach and small intestine, and these bacteria may bind vitamin B 12 for their own use. The ability to absorb crystalline vitamin B 12 remains intact in older people with atrophic gastritis. The 1998 recommended daily allowance for vitamin B 12 is 2.4 μg, but elderly people should try to obtain their vitamin B 12 from either supplements or fortified foods (e.g. fortified ready-to-eat breakfast cereals) to ensure adequate absorption from the gastrointestinal tract. Because the American food supply is now being fortified with folic acid, concern is increasing about neurologic exacerbation in individuals with marginal vitamin B 12 status and high-dose folate intake.