tbuckley/cabot-search huggingface dataset:
One year following a real life experience of omalizumab for moderate to severe persistent allergic asthma in Malta
Authors: Caroline Gouder, Lorna West, Stephen Montefort
Journal: European Respiratory Journal (2013)

Background: The efficacy and safety of omalizumab as add on therapy in moderate-severe persistent allergic IgE-mediated asthma has been widely demonstrated in several randomised controlled trials (Schumann et al, 2012).  Aim: The aim of this study was to evaluate the clinical effectiveness and tolerability of omalizumab following one year of treatment in such patients in Malta.  Method: Adult patients who were started on omalizumab for moderate-severe persistent (IgE-mediated) asthma were included in this on-going prospective study. Patients’ clinical response was evaluated using the Asthma Control Test (ACT) and physician’s assessment. Treatment effectiveness was evaluated at 16 and 52 weeks. Outcomes including unscheduled asthma-related hospitalizations and GP visits, exacerbations and oral corticosteroid (OCS) required one year pre- and post-treatment initiation were compared.  Results: Our cohort included 17 patients (65% males, mean age 52±12) Omalizumab was stopped at 16 weeks in two patients in view of clinical ineffectiveness, in one patient prior to 16 weeks in another thereafter due to myalgias. Baseline FEV1 improved by 11% (p=0.25) and ACT score by 47% (p  Conclusion: Omalizumab therapy showed a response rate of 82% at 16 weeks and 76% at 12 months. Our local experience shows that omalizumab is a clinically effective and well tolerated add-on treatment option.
Medicare ACOs Improving Quality of Care: CMS Report
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
High rates of antibiotic resistance among normal fecal flora Escherichia coli isolates in children from Greece
Authors: A.C. Vatopoulos, E. Varvaresou, E. Petridou, M. Moustaki, M. Kyriakopoulos, D. Kapogiannis, S. Sarafoglou, A. Fretzagias, V. Kalapothaki
Journal: Clinical Microbiology and Infection (1998)
High-dose CHOP as initial therapy for patients with poor-prognosis aggressive non-Hodgkin's lymphoma: a dose-finding pilot study.
Authors: M A Shipp, D Neuberg, M Janicek, G P Canellos, L N Shulman
Journal: Journal of Clinical Oncology (1995)

PURPOSE To purpose of this study was to develop a more effective approach to the treatment of patients with poor-prognosis aggressive non-Hodgkin's lymphoma (NHL). PATIENTS AND METHODS Thirty newly diagnosed patients with bulky (&gt; or = 10 cm) advanced-stage aggressive NHL were enrolled onto a pilot study. The study was designed to determine the maximum-tolerated dosages (MTD) of cyclophosphamide and doxorubicin that could be used in a high-dose cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) regimen with granulocyte colony-stimulating factor (G-CSF) support and to assess preliminarily the efficacy of the regimen. RESULTS In the initial dose-finding portion of the study, cumulative thrombocytopenia was the dose-limiting toxicity. At the MTD, the regimen included four 21-day cycles of cyclophosphamide 4 gm/m2, doxorubicin 70 mg/m2, vincristine 2 mg, and prednisone 100 mg for 5 days with mesna and G-CSF support. At the MTD, 65% of treatment cycles were complicated by febrile neutropenia, 84% of patients received at least one platelet transfusion for platelet counts less than 20,000/microL, and there was one treatment-related death. Nineteen of 22 (86%; 90% confidence interval [CI], 68 to 96) patients treated at the MTD achieved an initial complete response (CR), and 79% (90% CI, 58 to 92) of the complete responders and 69% of all patients remain progression-free with 20 months median follow-up. CONCLUSION The high-dose CHOP regimen may be an effective alternative for patients with poor-prognosis aggressive NHL.
Strategies for Multivessel Revascularization in Patients with Diabetes
Authors: Michael E. Farkouh, Michael Domanski, Lynn A. Sleeper, Flora S. Siami, George Dangas, Michael Mack, May Yang, David J. Cohen, Yves Rosenberg, Scott D. Solomon, Akshay S. Desai, Bernard J. Gersh, Elizabeth A. Magnuson, Alexandra Lansky, Robin Boineau, Jesse Weinberger, Krishnan Ramanathan, J. Eduardo Sousa, Jamie Rankin, Balram Bhargava, John Buse, Whady Hueb, Craig R. Smith, Victoria Muratov, Sameer Bansilal, Spencer King, Michel Bertrand, Valentin Fuster
Journal: New England Journal of Medicine (2012)

In some randomized trials comparing revascularization strategies for patients with diabetes, coronary-artery bypass grafting (CABG) has had a better outcome than percutaneous coronary intervention (PCI). We sought to discover whether aggressive medical therapy and the use of drug-eluting stents could alter the revascularization approach for patients with diabetes and multivessel coronary artery disease.In this randomized trial, we assigned patients with diabetes and multivessel coronary artery disease to undergo either PCI with drug-eluting stents or CABG. The patients were followed for a minimum of 2 years (median among survivors, 3.8 years). All patients were prescribed currently recommended medical therapies for the control of low-density lipoprotein cholesterol, systolic blood pressure, and glycated hemoglobin. The primary outcome measure was a composite of death from any cause, nonfatal myocardial infarction, or nonfatal stroke.From 2005 through 2010, we enrolled 1900 patients at 140 international centers. The patients' mean age was 63.1±9.1 years, 29% were women, and 83% had three-vessel disease. The primary outcome occurred more frequently in the PCI group (P=0.005), with 5-year rates of 26.6% in the PCI group and 18.7% in the CABG group. The benefit of CABG was driven by differences in rates of both myocardial infarction (P<0.001) and death from any cause (P=0.049). Stroke was more frequent in the CABG group, with 5-year rates of 2.4% in the PCI group and 5.2% in the CABG group (P=0.03).For patients with diabetes and advanced coronary artery disease, CABG was superior to PCI in that it significantly reduced rates of death and myocardial infarction, with a higher rate of stroke. (Funded by the National Heart, Lung, and Blood Institute and others; FREEDOM ClinicalTrials.gov number, NCT00086450.).
Isocapnic and small hypercapnic single-breath stimuli: evidence for an inhibitory inflation reflex in conscious man
Authors: SS Fernando, KB Saunders
Journal: European Respiratory Journal (1994)

We wished to find out if a deep inspiration had any influence on subsequent breathing which was mediated by neural rather than chemical stimuli. We therefore compared the effect on ventilation of a deep isocapnic breath with that of a similar breath containing 6% CO2, and with the effect of two successive tidal volume breaths of 6% CO2. We studied five normal subjects, each of whom repeated the three manoeuvres 20 times, and we used ensemble averaging to increase the signal-to-noise ratio. The isocapnic deep inspiration was followed by a significant inhibition of ventilation in the group in the second post-stimulus breath, and in 4 of the 5 subjects in first and second post-stimulus breaths. This was due to an increase in both inspiratory and expiratory time, with a variable effect on tidal volume. A similar initial ventilatory inhibition was seen in the response to a deep breath of 6% CO2. When the isocapnic response was subtracted from the hypercapnic response, the result was similar to that observed from two tidal volume breaths of 6% CO2. We conclude that a single deep inflation of the lungs in awake man inhibits subsequent ventilation by a neural mechanism, and that this may affect the CO2 response measured by single-breath techniques using such manoeuvres.
Abstract 11517: Inhibition of CaMKII- and ERK-Mediated eNOS Phosphorylation Impairs Endothelial Function in Renal Failure Mice: New Effect of Asymmetric Dimethylarginine
Authors: Hidemi Kajimoto, Hisashi Kai, Suguru Yasuoka, Takahiro Anegawa, Hiroki Aoki, Tsutomu Imaizumi
Journal: Circulation (2011)

Background- Patients with chronic kidney disease (CKD) showed the elevation of circulating asymmetric dimethylarginine (ADMA). Recent studies suggested that ADMA impairs endothelial nitric oxide sy...
Real-world prescribing patterns among newly diagnosed COPD patients receiving ICS: An analysis of UK patient dataset
Authors: David Price, Rupert Jones, Kevin Gruffydd-Jones, Guy Brusselle, Marc Miravitlles, Michael Baldwin, Rebecca Stewart, Dorothy L. Keininger
Journal: European Respiratory Journal (2014)

Introduction 

Real-life prescribing patterns for COPD patients may differ from GOLD strategy recommendations. This study examined prescribing patterns during one year prior to and including initial date of COPD diagnosis during study interval from 1997 to 2010, without asthma as comorbidity in different GOLD 2013 categories (GOLD A=low risk, less symptoms; GOLD B=low risk, more symptoms; GOLD C=high risk, less symptoms; GOLD D=high risk, more symptoms).

Methods 

This retrospective observational cohort study used data from a large UK patient dataset Optimum Patient Care Research that included 387 primary care practices across UK. Patients (n=16,185) were included in the analysis who were ≥40 years of age and diagnosed since 1997 with 1 year of pre- and 2 years of post-diagnosis data and spirometry supportive of COPD (FEV1/FVC<0.7).

Results 

Of the patients with known GOLD group, 79.9% did not have asthma. At the time of diagnosis, an ICS containing regimen was prescribed to 37.2% of these patients, while 32% did not receive any treatment for COPD. Prescribing patterns of COPD (non-asthma) patients with ICS containing regimens using GOLD classification was 32.8%, 36%, 42.9% and 45.8% in GOLD A, B, C, and D patients respectively.

Conclusion 

Contrary to GOLD strategy, many patients in GOLD categories A and B without asthma comorbidity are prescribed and remained on ICS containing regimen regardless of risk of exacerbations, symptoms and lung function. Many patients with COPD also remained untreated after initial diagnosis.
Intensification of preoperative chemotherapy for osteogenic sarcoma: results of the Memorial Sloan-Kettering (T12) protocol.
Authors: P A Meyers, R Gorlick, G Heller, E Casper, J Lane, A G Huvos, J H Healey
Journal: Journal of Clinical Oncology (1998)

PURPOSE It has been observed previously in osteosarcoma (OS) that the degree of necrosis of the resected primary tumor following a period of preoperative chemotherapy is predictive of subsequent event-free survival (EFS). The aim of this study was to determine if more intensive preoperative chemotherapy would increase the proportion of patients with a good histologic response and improve EFS. PATIENTS AND METHODS Seventy-three patients with OS were treated at Memorial-Sloan Kettering Cancer Center (MSKCC) on the T12 protocol between 1986 and 1993. Patients were randomized between therapy based on the T10 protocol and therapy with more intensive preoperative chemotherapy. The more intensive preoperative regimen consisted of two courses of cisplatin (CDDP) and doxorubicin (DOX) in addition to the usual preoperative regimen of high-dose methotrexate (HD MTX) and bleomycin, cyclophosphamide, and dactinomycin (BCD). RESULTS The regimen with more intensive preoperative chemotherapy achieved a modest increase in the proportion of patients with a good histologic response (44% with a grade III or IV histologic response v 37% in the control arm, 33% with grade IV histologic response v 13% in the control arm). EFS continued to correlate with histologic response. The actuarial 5-year EFS in patients with localized disease was 78% for the regimen with more intensive preoperative chemotherapy and 73% for the control arm. CONCLUSION Despite modest increases in the proportion of patients with good histologic response with intensified preoperative chemotherapy, no improvement in EFS was observed.
Botulinum toxin promoted healing and relieved symptoms of chronic anal fissure.
Authors: R K S PHILLIPS
Journal: Gut (1998)

QuestionIn patients with chronic anal fissures, is local infiltration of botulinum toxin eVective for healing fissures and relieving symptoms?Design 2 month randomised, double blind, placebo controlled trial. SettingClinical centre in Rome, Italy.Patients 30 patients (mean age 44 y, 67% men) with chronic, idiopathic anal fissures.Exclusion criteria were acute fissures, anal fissures with various causes (haemorrhoids, fistula in ano, or inflammatory bowel diseases), or previous anal surgery.Follow up was complete. InterventionPatients were allocated to 0.4 ml in 2 injections of either botulinum toxin A (Botox, Allergan, Irvine, CA, USA), 20 U (n=15), or saline placebo (n=15), injected with a 27 gauge needle.Patients were advised to eat food with a high fibre content and received a prescription for laxatives. Main outcome measuresAnal fissure healing and symptomatic relief (persistence of anal fissure without symptoms).Patients were assessed at 1 and 2 months. Main resultsAt 1 and 2 months, more patients allocated to botulinum toxin than to placebo had healed fissures (p=0.05 at 1 month and p=0.003 at 2 months) and symptomatic relief (p=0.003
Preponderance of lysosomal bodies in cultured fibroblasts from patients with recessive epidermolysis bullosa dystrophica.
Authors: M.W. KANAN, M.J.O. FRANCIS, B. SYKES, W.B. REED, T.J. RYAN, P. DIEST, A. MARSDEN
Journal: British Journal of Dermatology (1977)

Fibroblasts of skin explants from three normal men and six patients with recessive epidermolysis bullosa dystrophica (EBD-R) were cultured in Dulbecco's medium, grown to confluence, sectioned and studied with the electron microscope. The normal control fibroblasts from the 6th to 13th passage (secretory phase) showed irregular or lobed nuclei with centrally scattered chromatin. They also had prominent RER, Golgi complexes, variously shaped mitochondria and cytoskeletal microfibrils. Their peripheral cytoplasm exhibited many vacuoles and a small number of these were autophagic lysosomes. In addition to the ultrastructural features described in the control fibroblasts, the EBD-R cells from the 6th passage contained remarkable numbers of strongly electron dense lysosomal bodies through their entire cytoplasm with very few empty vacuoles. It is speculated that the accumulation of these lysosomes may be connected with a primary metabolic cellular defect in the dermal fibroblasts of patients with EBD-R akin to that described in mucopolysaccharide storage diseases.
Persistence of the asthmatic response after exposure to ammonium persulfate in an animal model
Authors: Xavier Munoz, Marta Ollé-Monge, Jeroen Vanoirbeek, Ferran Morell, Maria-Jesus Cruz
Journal: European Respiratory Journal (2012)

Introduction:  The aim of the study is to evaluate the persistence of respiratory symptoms after the end of exposure to ammonium persulfate (AP) in a validated model of occupational asthma (OA) 1 .   Material and methods:  BALB/c mice received dermal applications of AP or dimethylsulfoxide (DMSO) on days 1 and 8. On day 15, they receive a single nasal instillation of AP or saline. The ventilatory function (Penh) was monitored by whole body plethysmography for 40 minutes after the nasal instillation. Bronchial hyperresponsiveness was assessed using methacholine provocation, while pulmonary inflammation was evaluated in BAL and total serum IgE was measured in blood, 1 day (day 16), 2 days (day 17), 3 days (day 18), 4 days (day 19), 1 week (day 23) or 2 weeks (day 30) after the single challenge on day 15.   Results:  There was a significant increase in bronchial hyperresponsiveness and the percentage of neutrophils (12%) 24h after the challenge with AP in AP-sensitized mice. The peak response in AHR and neutrophil inflammation was found 48h post-challenge. From then onwards, both the bronchial hyperresponsiveness and the percentage of neutrophils decrease gradually. Levels of total serum IgE increased significantly, reaching a peak three days after challenge, after which the levels return to baseline 23 days post-challenge.   Conclusions:  Overall, after two dermal sensitizations, followed by a single challenge, the asthmatic response decreases in time, with initially only decreases in respiratory and inflammatory responses, but later also in the immunological responses.   Study funded by FIS PI080730    1  De Vooght V  et al.  Thorax 2010; 65 :252-257.
Acute implementation of high intensity non invasive ventilation
Authors: Patricio Rioseco, Paula Cruces, Patricia Velazquez
Journal: European Respiratory Journal (2013)

High Intensity Non Invasive Ventilation refers to use of IPAP up to 40 cm H2O after 15 day habituation to achieve optimal PC02.We assessed feasibility of implementing HINIV in acute setting by submitting patients failing to improve after 3 days of traditional NIV to a 60 minutes ramp to reach a mean IPAP of 31.4 and EPAP of 4 in controlled mode.We measured ABG prior to installation, at 2 hours and at return to initial programming. Tolerance was estimated by visual analogue scale:1 being unacceptable;5 good tolerance;hemodynamics was controlled every 10 minutes.5 patients of 41 years (21-56) were admitted with MAP 78.6 mmHg,CR 92.2/min, in severe respiratory acidosis: pH7.22 PC02 78.3. At day 3 of treatment with traditional NIV they show no improvement: pH 7.26 PC02 74.2. After 2 hours of HINIV significant change is obtained: pH 7.38, PC02 38 PAM 81.8 CR 91.2. One hour after returning to original programming there is de nuovo deterioration: pH 7.34 PC02 56.26. 2 patients refer regular tolerance, 3 tolerated well the procedure.One patient after discharge returned and was treated with the same protocol for 2 hours.We measured ABG, FEV1 and VC on admission, at 2 hours of HINIV, at 24, 48 and 72 hours after ventilation.We observed rapid correction of PaC02 at 2 hours of support which was maintained at 24 hours post weanning reaching initial values at 72 hours post procedure. As PaC02 declined, we saw improvement on FEV1 up to 350 cc from baseline which was maintained for 48 hours after weanning. In these patients acute HINIV proved easy to implement, well tolerated and improved faster respiratory failure compared to traditional NIV,no major complications were seen. In addition,it may ameliorate respiratory function.
IgG4 antibodies against rodents in laboratory animal workers do not protect against allergic sensitization
Authors: E. J. M. Krop, G. Doekes, D. J. J. Heederik, R. C. Aalberse, J. S. van der Zee
Journal: Allergy (2010)

To cite this article: Krop EJM, Doekes G, Heederik DJJ, Aalberse RC, van der Zee JS. IgG4 antibodies against rodents in laboratory animal workers do not protect against allergic sensitization. Allergy 2011; 66 : 517–522. Abstract Background: The modified Th2 response, defined as an IgG4 response in the absence of IgE, is suggested to protect against the development of allergic sensitization. However, studies suggesting this protective effect all had a cross‐sectional design, making it impossible to study the development of both responses. Aim of the study: We aimed to study the dynamics in IgG4 antibodies in relation to allergic sensitization in an occupational cohort of starting laboratory animal workers. Moreover, we studied the relation between exposure, antibody responses, atopy and self reported allergic symptoms. Methods: A total of 110 starting animal workers were followed for 2 years. IgG4 antibodies against rats and mice were assessed. Workers were tested for allergic sensitization and exposure to animal allergens was estimated. Symptom status was assessed using questionnaires. Results: Rat and mouse specific IgG4 antibodies were present before the development of allergy and did not significantly change over time. Allergic sensitization was related to exposure and atopic status but high levels of IgG4 showed no protective effect. In contrary, workers that developed mouse specific sensitization during follow up had higher levels of mouse specific IgG4. Symptoms were related to allergic sensitization and IgG4 levels did not influence that relationship. Conclusions: IgG4 antibodies are present before IgE antibodies develop and IgG4 levels are stable over time. In our occupational cohort, the modified Th2 response had no protective effect on development of sensitization or allergic symptoms.
Common Controversies in the Management of Gallbladder Cancer
Authors: Chandrakanth Are
Journal: Journal of the National Comprehensive Cancer Network (2014)

Gallbladder cancer is a rare and lethal malignancy. Most patients are best served at high-volume centers of excellence, where they are likely to receive evidence-based care derived from a multidisciplinary approach. Surgical resection is recommended for early-stage disease, whereas if the disease is unresectable, the treatment options include biliary drainage, gemcitabine-based combination chemotherapy, fluoropyrimidine chemoradiation, clinical trial enrollment, or best supportive care. While treatment by T-stage is straightforward in many cases, the debate regarding simple versus radical cholecystectomy is still active for patients with T1b disease. Other controversies exist over the necessity of resecting the bile duct and port sites, the extent of lymph node dissection and hepatic resections, and the value of resection for patients with jaundice.
Increasing African American Representation in Dermatology
Authors: Sotonye Imadojemu, William D. James
Journal: JAMA Dermatology (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 Dermatology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Dermatology journal