tbuckley/cabot-search huggingface dataset:
Comparison of vancomycin and linezolid in patients with peripheral vascular disease and/or diabetes in an observational European study of complicated skin and soft-tissue infections due to methicillin-resistant Staphylococcus aureus
Authors: C. Eckmann, D. Nathwani, W. Lawson, S. Corman, C. Solem, J. Stephens, C. Macahilig, J. Li, C. Charbonneau, N. Baillon-Plot, S. Haider
Journal: Clinical Microbiology and Infection (2015)

Suboptimal antibiotic penetration into soft tissues can occur in patients with poor circulation due to peripheral vascular disease (PVD) or diabetes. We conducted a real-world analysis of antibiotic treatment, hospital resource use and clinical outcomes in patients with PVD and/or diabetes receiving linezolid or vancomycin for the treatment of methicillin-resistant Staphylococcus aureus complicated skin and soft-tissue infections (MRSA cSSTIs) across Europe. This subgroup analysis evaluated data obtained from a retrospective, observational medical chart review study that captured patient data from 12 European countries. Data were obtained from the medical records of patients ≥ 18 years of age, hospitalized with an MRSA cSSTI between 1 July 2010 and 30 June 2011 and discharged alive by 31 July 2011. Hospital length of stay and length of treatment were compared between the treatment groups using inverse probability of treatment weights to adjust for clinical and demographic differences. A total of 485 patients had PVD or diabetes and received treatment with either vancomycin (n = 258) or linezolid (n = 227). After adjustment, patients treated with linezolid compared with vancomycin respectively had significantly shorter hospital stays (17.9 ± 13.6 vs. 22.6 ± 13.6 days; p < 0.001) and treatment durations (12.9 ± 7.9 vs. 16.4 ± 8.3 days; p < 0.001). The proportions of patients prescribed oral, MRSA-active antibiotics at discharge were 43.2% and 12.4% of patients in the linezolid and vancomycin groups, respectively (p < 0.001). The reduction in resource use may result in lower hospital costs for patients with PVD and/or diabetes and MRSA cSSTIs if treated with linezolid compared with vancomycin.
Frequency of First Metastatic Events in Breast Cancer: Implications for Sequencing of Systemic and Local-Regional Treatment
Authors: Howard D. Thames, Thomas A. Buchholz, Cynthia D. Smith
Journal: Journal of Clinical Oncology (1999)

PURPOSE: The sequencing of treatment for early breast cancer is controversial. The purpose of this study was to quantify the risk of delaying surgery, using estimates of the frequency of first metastases from breast primary tumors. PATIENTS AND METHODS: The probability that 560 (node-negative), 657 (with one to three positive nodes), and 505 (with more than three positive nodes) women treated without adjuvant chemotherapy would be free of distant disease at presentation was fit to a mathematical model of the seeding of distant metastases and combined with estimates of the growth rate to calculate the frequency of first distant disseminations per month. RESULTS: Frequencies of first distant metastases were approximately 1% to 2% per month, 2% to 4% per month, and 3% to 6% per month in T1 patients who were node-negative, had one to three positive nodes, or more than three positive nodes, respectively. As a result, the typical patient with T1 disease, who has a 70% to 80% chance of being free of distant disease, runs a 1% to 4% risk of distant dissemination for each month surgery is delayed. Assuming a 30% reduction in mortality caused by adjuvant chemotherapy, the model predicts that T1 patients treated with neoadjuvant chemotherapy would potentially have a higher rate of distant metastasis development than those treated with an initial surgical resection followed by adjuvant chemotherapy. CONCLUSION: We formulate the hypothesis that optimal sequencing of surgery and systemic treatment of breast cancer may be size-dependent, with a disadvantage or no benefit from neoadjuvant treatment for T1 patients but an increasing benefit with increasing size of the primary tumor.
Cardiovascular Sound and the Stethoscope, 1816 to 2016
Authors: H N SEGALL
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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Usefulness of respiratory evaluation before bariatric surgery in morbidly obese patients
Authors: Amaia Urrutia, Ruth Diez, Sandra Pedrero, Amaia Sagarna, Estibaliz Perez, Teresa Ruiz de Azua, Gaizka Errazti, Valentin Cabriada, Jose Amilibia
Journal: European Respiratory Journal (2013)

INTRODUCTION  Bariatric surgery is a useful treatment for morbidly obese patients, in which breathing/sleep disorders are highly prevalent. Our aim is to study the usefulness of a respiratory evaluation before surgery, analyzing complications  METHODS  192 patients who underwent surgery between 2000-2010  Presurgery evaluation: clinical features, spirometry, gasometry and sleep study SS if sleep disorder is suspected  Retrospective study of complications: respiratory RC, abdominal AC and others OC  RESULTS  69 patients (35.9%) had a complication, 41 (21.4%) mild abdominal origin, 21 (11%) RC. 4 of the RC (2.1% from total) were due to weaning. 8 patients (4.2%) needed to be reoperated, 14 (7.3%) were readmitted. Immediate mortality was nil and 0.5% at 3 months  Patients with a RC had a greater AHI (34.1 vs 28.8, p 0.04), higher reoperation rate (26.3% vs 2.3%, p 0.001),  readmissions (5.3% vs 0%, p 0.0001) and higher mortality (5.2% vs 0%, ns)  None of the patients with RC underwent gastrectomy (gastrectomy 0%, bypass 89.5%, other 10.5%, p = o, 018)  No differences were seen in blood gas and functional variables, realization of SS or comorbidities  CONCLUSIONS  OSA is a common disease in morbidly obese patients, 62.5% of symptomatics and 44,3% of those seen in clinics  The RC rate with our protocol is less than 10%  Patients with RC had an greater AHI and had a higher need for readmission or reoperation  There was no RC in patients who underwent gastrectomy.
Taste Aversions in Man
Authors: JANE L. GARB, ALBERT J. STUNKARD
Journal: American Journal of Psychiatry (1974)

A survey of 696 subjects revealed that taste aversions may be acquired by a special kind of learning that has previously been demonstrated clearly only in animals. Gastrointestinal illness was associated with acquisition of aversions in 87 percent of the subjects. One pairing of food and illness was sufficient to produce aversions that lasted for many years. Onset of aversions was most common between ages 6 and 12, when the prevalence rate reached 30 percent; it then fell steadily to a low of 6 percent after age 60. The authors believe that a better understanding of taste aversions may help improve conditioned aversion procedures in the treatment of alcoholism and obesity.
Long-Term Effects of Ramipril on Cardiovascular Events and on Diabetes
Authors: Jackie Bosch, Eva Lonn, Janice Pogue, J Malcolm O Arnold, Gilles R Dagenais, Salim Yusuf
Journal: Circulation (2005)

Background— We have previously demonstrated that ramipril reduces vascular events and new diagnoses of diabetes when given for a 4.5-year period. However, it is not known whether the benefits are observed in subgroups of patients at varying risk or on other proven therapies and whether the benefits are sustained beyond the current trial. The 2 aims of this investigation were to assess whether the benefits observed during the HOPE trial were (1) maintained after trial cessation during an additional 2.6 years of follow-up and (2) observed in subgroups based on risk and ancillary treatments. Methods and Results— Of the initial 267 study centers and 9297 patients, 174 centers and 4528 patients agreed to further follow-up. The rates of use of angiotensin-converting-enzyme inhibitors (ACEIs) in the 2 groups (72% ramipril versus 68% placebo) were similar after the end of the trial. During the posttrial follow-up, patients allocated to ramipril had a 19% further lower relative risk (RR) of myocardial infarction (95% confidence interval [CI], 0.65 to 1.01), a 16% lower RR (95% CI, 0.70 to 0.99) of revascularization, and a 34% lower RR of a new diagnosis of diabetes (95% CI, 0.46 to 0.95). Similar RR reductions in vascular events were observed during and after the active phase of the trial, regardless of baseline risk (RR of 0.76, 0.89, and 0.83 for low-, medium-, and high-risk patients, respectively) or ancillary treatments (RR of 0.90 for aspirin, 0.76 for β-blockers, and 0.84 for lipid-lowering medication). Conclusions— The benefits of ramipril observed during the active period of the HOPE trial were maintained during posttrial follow-up for cardiovascular death, stroke, and hospitalization for heart failure. Additional reductions in myocardial infarction, revascularization, and the development of diabetes were observed during the follow-up phase despite similar rates of ACEI use in the 2 randomized groups. These benefits were consistent regardless of patient risk or ancillary treatments.
Marinopyrroles: Unique Drug Discoveries Based on Marine Natural Products
Authors: Rongshi Li
Journal: Medicinal Research Reviews (2015)

Abstract Natural products provide a successful supply of new chemical entities (NCEs) for drug discovery to treat human diseases. Approximately half of the NCEs are based on natural products and their derivatives. Notably, marine natural products, a largely untapped resource, have contributed to drug discovery and development with eight drugs or cosmeceuticals approved by the U.S. Food and Drug Administration and European Medicines Agency, and ten candidates undergoing clinical trials. Collaborative efforts from drug developers, biologists, organic, medicinal, and natural product chemists have elevated drug discoveries to new levels. These efforts are expected to continue to improve the efficiency of natural product‐based drugs. Marinopyrroles are examined here as a case study for potential anticancer and antibiotic agents.
Systemic Therapy for Advanced Pancreatic Neuroendocrine Tumors: An Update
Authors: Diane L. Reidy-Lagunes
Journal: Journal of the National Comprehensive Cancer Network (2012)

Well-differentiated neuroendocrine tumors (NETs) can be subdivided into carcinoid and pancreatic NETs (pancNETs). Although these tumors share many morphologic and clinical characteristics, carcinoid tumors appear to be far less sensitive to therapeutic agents than pancNETs, and recent advances approved for pancNETs have not been submitted for FDA approval in patients with carcinoid tumors. Treatment options for patients with advanced pancNETs are multidisciplinary and include surgical resection, liver-directed therapies, and systemic therapies. Cytotoxic therapies, such as temozolomide, fluorouracil, oxaliplatin, and streptozocin-based chemotherapy regimens, are active against some pancNETs, and can play a role in the palliation of patients with advanced disease and symptoms related to tumor bulk. Two therapies were recently approved for progressive well-differentiated pancNETs: sunitinib and everolimus. Both agents showed improved progression-free survival in patients with progressive pancNETs, but can also result in nontrivial toxicities, and therefore should only be considered in patients with progressing and advanced or symptomatic disease. This article discusses these recent trials and provides an update of systemic treatment options in patients with well-differentiated pancNETs.
Chemotherapy of L1210 Leukemia With 5-Azacytidine in Combination With Vincristine, Adriamycin, or β-Cytosine Arabinoside&lt;xref ref-type="fn" rid="fn2"&gt;2&lt;/xref&gt;&lt;xref ref-type="fn" rid="fn3"&gt;3&lt;/xref&gt;&lt;xref ref-type="fn" rid="fn4"&gt;4&lt;/xref&gt;
Authors: C A Presant, T J Vietti, F Valeriote, D M Coulter
Journal: JNCI Journal of the National Cancer Institute (1981)

The cytotoxicity of vincristine (VCR), beta-cytosine arabinoside (Ara-C), or adriamycin (ADRIA) in combination with 5-azacytidine (Aza-CR) to L1210 leukemia in vivo was measured to determine if schedule-dependent synergistic or antagonistic drug interaction occurred. Two dose levels of Aza-CR were studied (0.1 and 0.5 mg/mouse), and cytotoxicity was measured by the spleen colony assay. For the combination of Aza-CR plus VCR, cytotoxicity was essentially additive or antagonistic when VCR preceded Aza-CR and additive or synergistic when VCR followed Aza-CR. When Aza-CR was combined simultaneously with either Ara-C or ADRIA, cytotoxicity was markedly antagonistic but was additive if drugs were given sequentially. When Ara-C was given as a 24-hour infusion before Aza-CR, the resultant cell kill was antagonistic (although slightly greater than that obtained for Ara-C alone). However, antagonism was even more marked when Aza-CR was given before the 24-hour infusion of Ara-C; cell kill was less than that observed with Ara-CR alone. Synergistic cytotoxicity was observed only with VCR administered after a low dose of of Aza-CR. Therefore, scheduling of drugs in combination with Aza-CR may be critical in the determination of the antileukemic cytotoxic effects.
Mammary Adenocarcinoma (72j) Blood Flow in Mice Treated With ThioTEPA
Authors: Adolph W. Vogel, John Haynes
Journal: JNCI Journal of the National Cancer Institute (1966)

Journal Article Mammary Adenocarcinoma (72j) Blood Flow in Mice Treated With ThioTEPA Get access Adolph W. Vogel, Adolph W. Vogel Search for other works by this author on: Oxford Academic PubMed Google Scholar John Haynes John Haynes Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 37, Issue 3, September 1966, Pages 293–300, https://doi.org/10.1093/jnci/37.3.293 Published: 01 September 1966 Article history Received: 16 November 1965 Revision received: 31 March 1966 Published: 01 September 1966
End results of treating children with localized non-Hodgkin's lymphomas with a combined modality approach of lessened intensity.
Authors: S B Murphy, H O Hustu, G Rivera, C W Berard
Journal: Journal of Clinical Oncology (1983)

From 1978 to 1982, 28 children with localized non-Hodgkin's lymphomas, stages I and II, were treated with a combined modality protocol, reduced in intensity in comparison to our previous institutional protocol (1975-1978, reported in Cancer 45: 630-637, 1980), and modest by comparison to many current intensive regimens in widespread use. Induction consisted of vincristine (6 weekly doses, 1.5 mg/m2), cyclophosphamide (3 doses, on days 0, 21, and 42, 600 mg/m2 IV), and oral prednisone (40 mg/m2, daily for 1 mo) combined with low-dose, involved-field, supervoltage radiotherapy (2000 rads). Prophylactic treatment of the central nervous system was not given to all children, but only to those with primary tumors in the head and neck region, and consisted of intermittent intrathecal methotrexate only (12 mg/dose, three times in induction, and subsequently every 6 wk). Maintenance therapy, consisting of oral daily 6-mercaptopurine (75 mg/m2) and oral weekly methotrexate (30 mg/m2), was continued for a total duration of 15 mo from diagnosis. Overall, there were 15 children with stage I and 13 with stage II disease, and the majority of the cases (17 of 28) were localized to the head and neck. In addition, 7 children, all stage II, had completely resected gastrointestinal tumors; the other 4 cases presented in inguinal nodes. Histologically, 27 of the 28 tumors were high-grade diffuse (13 undifferentiated, i.e., small noncleaved cell type; 11 histiocytic, i.e., 5 large noncleaved cell type, and 6 immunoblastic type; and 3 lymphoblastic type); 1 case was mixed cell type, nodular and diffuse. All children were judged to be in complete remission at the end of induction, and 24 of 28 (85.7%) remain free of disease 4+ mo to nearly 4 yr from diagnosis (median 24+ mo); 19 have completed all planned therapy and are in unmaintained remission. The 4 cases failing therapy all were characterized by diffuse undifferentiated (small noncleaved cell) histology and exhibited regrowth of local tumor, resulting in a failure rate for this group (4 of 13, 30%) significantly different than for all remaining cases of other histologies (0 of 15), p less than 0.02 by log rank analysis. Patient tolerance to therapy was excellent, with negligible acute toxicity, and ambulatory outpatient management was the norm. Long-term follow-up will be necessary to judge whether adverse late consequences of treatment have been reduced by this approach. We conclude that a reduction in the intensity of therapy for children with stage I and II non-Hodgkin's lymphomas is feasible, apparently without significantly jeopardizing their excellent chance for cure.
Early effect of whole lung lavage (WLL) on surfactant homeostasis in pulmonary alveolar proteinosis (PAP)
Authors: Ilaria Campo, Francesca Mariani, Mara De Amici, Cristina Torre, Elena Paracchini, Zamir Kadija, Michele Zorzetto, Carmine Tinelli, Maurizio Luisetti
Journal: European Respiratory Journal (2014)

Autoimmune PAP is caused by autoantibodies to GM-CSF, leading to a defective function of alveolar macrophages linked to the disruption of surfactant homeostasis.WLL is the standard treatment and although it is effective in the majority of cases, disease persistence is not unusual.We aim to explain the effect of WLL on hematopoietic cytokines and on surfactant proteins in PAP.These cytokines contributes to the differentiation and function of leukocyte subpopulations and have clinical importance in protective immunity and in the pathophysiology of PAP.From July 2009, 18 patients affected by autoimmune PAP were submitted to WLL.By ELISA on patients serum, we compared the protein levels of GM-CSF,IL-3,IL-5,IL-10,KL6 and SP-D, at the baseline and 1 week after the WLL. At the baseline we observed a positive expression of all the biomarkers examined, with the exception of GM-CSF (<7.8 pg/ml n.v.).One week after the WLL, we assisted to a decrease of the biomarkers levels (tab.1).The statistical analysis showed a significant difference in IL-10 (p=0.0050) and surfactant protein D (p=0.0018) levels, pre and post WLL.

View this table:

Tab.1





In conclusion WLL would have not only a mechanistic role of removing cellular debris from airspaces, but it would remove inhibitory factors, partially restoring the impaired surfactant homeostasis. Funding. AIFA(FARM7MCPK4), eRARE(EuPAPNet).
CANCER COMPLICATING AND MODIFYING THE COURSE OF EPILEPSY
Authors: Morgan B. Hodskins, Riley H. Guthrie
Journal: American Journal of Psychiatry (1933)

The data which have been presented seem to indicate that acidosis and alkalosis are not immediate factors in controlling and precipitating seizures, although they may act indirectly by favoring dehydration and hydration respectively. The influence of oxygen tension on the capillary permeability and the effect of oxygen administration on cerebral functions have been suggested as important factors in controlling convulsions. Attention has been directed to the relation of vasomotor activity to brain metabolism and other, equally obscure, physicochemical processes. In a review of 55 cases of malignancy complicating epilepsy it was shown that the number of seizures decreased as the malignancy progressed. Only eight of the 55 cases showed an increase in seizures during the progress of the malignancy. There was either no change or a decrease in seizures in 47 cases. There was a definite decrease in frequency of seizures in 32 of the total 55 cases. Alkalosis, which may be associateci with cancer, obviously does not induce seizures in epileptic patients. Cachexia and dehydration incident to malignant neoplasms probably raise the convulsion threshold which accounts for the decrease in seizures.
Inhaler technique blind spot
Authors: G. K. Crompton
Journal: European Respiratory Journal (2006)

We would like to thank D. Stanescu for giving us the opportunity to clarify the definition of airflow obstruction recently given in the interpretative strategies document from the American Thoracic Society/European Respiratory Society (ERS) Task Force [1].The document states that in most cases a ratio of forced expiratory volume in one second (FEV1) to vital capacity (VC) below the lower limits of normality is the parameter that best and most frequently embodies the concept of airflow obstruction with few exceptions.However, in some cases, a low FEV1 with a normal FEV1/VC may also be consistent with an obstructive pattern if total lung capacity is normal.This pattern has been observed after exposing the airways to a constrictor agent [2,3] or in natural respiratory diseases [4], reproduced in healthy subjects [5,6], and has already been interpreted as consistent with airway narrowing in the 1993 ERS guidelines on lung function testing [7].The fact that this may be caused by a patchy collapse of the small airways on early expiration or expiratory flow limitation that, in turn, would cause an increase in residual volume was suggested by OLIVE and HYATT [2] in 1972 and then by other investigators in the years that followed [3,5,6].However, this hypothesis still needs confirmation, especially after the demonstration that even the large airways may close with induced bronchoconstriction [8], thus suggesting that the small airways are not the only ones that may contribute towards the generation of air trapping and an increase in residual volume.