tbuckley/cabot-search huggingface dataset:
Allergy to rocuronium: from clinical suspicion to correct diagnosis
Authors: J. Leysen, C. H. Bridts, L. S. De Clerck, M. Vercauteren, J. Lambert, J. J. Weyler, W. J. Stevens, D. G. Ebo
Journal: Allergy (2011)

To cite this article: Leysen J, Bridts CH, De Clerck LS, Vercauteren M, Lambert J, Weyler JJ, Stevens WJ, Ebo DG. Allergy to rocuronium: from clinical suspicion to correct diagnosis. Allergy 2011; 66: 1014–1019. Background: Allergy to rocuronium can be life-threatening. Correct diagnosis is a prerequisite because of serious consequences of diagnostic error. Objective: To assess skin testing, quantification of specific IgE (sIgE) and flow-assisted activation of basophils [basophil activation test (BAT)] in the diagnosis of rocuronium allergy. Methods: This study comprises 104 curarized patients with a history of profound hypotension and severe bronchospasm immediately after induction of anaesthesia. All patients had skin tests, quantification of sIgE and BAT to rocuronium, together with investigations for all relevant compounds administered during anaesthesia that could have evoked the reaction. Diagnosis of rocuronium allergy was considered definite when the patient demonstrated a positive outcome for at least two of the three aforementioned tests. Results: The positive predictive value for skin testing, BAT and sIgE was 98% (CI 95%: 92–99%), 97% (CI 95%: 88–100%) and 83% (CI 95%: 74–89%), respectively. The negative predictive value for skin testing, BAT and sIgE was 96% (CI 95%: 86–99%), 75% (CI 95%: 67–75%) and 72% (CI 95%: 58–83%), respectively. Cross-reactivity with vecuronium was documented in 69% of the patients. Conclusion: Skin testing merits the status of primary diagnostic investigation to document rocuronium allergy and cannot be substituted by quantification of sIgE or BAT. SIgE can offer a diagnostic advantage in cases where skin tests yield negative results. However, additional tests (e.g. BAT) are of capital importance in patients with negative skin tests and positive sIgE results to help in interpreting the clinical significance of a positive sIgE result. Optimal assessment of cross-reactivity between rocuronium and vecuronium implies both skin testing and BAT.
Gefitinib treatment affects androgen levels in non-small cell lung cancer patients
Authors: M. Nishio, F. Ohyanagi, A. Horiike, Y. Satoh, S. Okumura, K. Nakagawa, T. Horai, Y. Ishikawa
Journal: Journal of Clinical Oncology (2005)

7290 Background: Gefitinib is an inhibitor of the epidermal growth factor receptor (EGFR, HER1/ErbB1) tyrosine kinase and has been shown to have clinical activity against non-small cell lung cancer (NSCLC). Clinical responses to gefitinib have been observed most frequently in women, in non-smokers, and in patients with adenocarcinoma. The aim of the present study was to clarify the relationship between androgen levels and gefitinib treatment in patients with advanced NSCLC. Methods: Sera from 67 patients (36 men and 31 women) with advanced NSCLC were obtained at pretreatment and during the time of treatment with gefitinib monotherapy (days 14 to 18). Androgen levels (testosterone, dehydroepiandrosterone sulphate (DHEA), and dehydroepiandrosterone sulphate (DHEAS) were examined. Results: Testosterone and DHEA levels during treatment were significantly lower than the pretreatment levels seen in both women and men. The DHEAS levels during treatment were significantly lower than the pretreatment levels found in women. In addition, the hormone levels in women that responded to gefitinib treatment were significantly lower during the treatment than that seen in women who did not respond. Conclusions: Gefitinib treatment deceased serum androgen levels and androgens may play a role in gefitinib efficacy. No significant financial relationships to disclose.
Abstract P218: Long-term Risk Of Recurrent Stroke After Ischemic Stroke Among Younger Adults Under 55 Years Of Age, Sweden
Authors: Kok Wai Giang, Lena Björck, Tatiana Zverkova Sandström, Christina-Heden Ståhl, Kjell Torén, Annika Rosengren
Journal: Circulation (2014)

Purpose: The purpose of the present study was to investigate the 4-year risk of recurrent stroke among patients below 55 years with a first ischemic stroke (IS), 1987-2006. Methods: All men and women (17,149 cases) aged 18-54 years who survived at least 28 days after a first IS were identified in the Swedish Inpatient register (IPR) from 1987 until 2006. All patients were followed-up at 1 year, 2 years, 3 years and 4 years for a first recurrent stroke after index event. Results: From 1987 to 2006 a total of 1808 first recurrent stroke were identified. Long-term risk of a first recurrent stroke declined over time in both men and women. Among men, the absolute 4-year cumulative risk of a recurrent stroke decreased from 17.5% (95% CI 15.7%-19.4%) to 8.8% (95% CI, 7.7%-10.0%) from the first to the last 5-year period. Corresponding result for women was 15.6% (95% CI, 13.3%-18.2%) and 6.0% (95% CI, 4.9%-7.3%). Despite an overall decrease, the risk of a recurrent stroke was highest during the first year after index stroke (men=3.9%, 95% CI, 3.3%-4.8%, women=2.9%, 95% CI, 2.2%-3.8%). Conclusions: Over the 20-year period, the 4-year cumulative risk of a first recurrent stroke decreased over time. For both men and women the risk was greatest during the first year, emphasizing the importance of early secondary prevention in young stroke victims.
Audit Commission blames managers for variations in waiting times.
Authors: Sally Hargreaves
Journal: BMJ (2002)

The length of time that patients wait for outpatient appointments and for surgery in ear, nose, and throat departments in the United Kingdom varies widely by NHS trust. But waiting times are not directly linked to levels of demand and capacity, according to a report released this week by the country's public spending watchdog, the Audit Commission.

“We noted very wide variations in waiting times within trusts and between trusts,” Jane Laughton, author of the report, told the BMJ. “This is to do with how the process is managed locally, both in terms of managing patients who need to access care, and in managing waiting lists.”

Despite such wide variations, no link was found between demand and capacity indicators and the proportion of patients with very short or very long waits. Ms Laughton warned, therefore, against relying on waiting times alone to make resource allocation decisions.

The report noted “unacceptably long waits” for assessment for and fitting of a hearing aid, ranging from 8 to 55 weeks. It also highlighted the absence of national standards on waiting times for audiology, “so the length of time that patients wait goes unreported.”
Abstract 20185: Serial Changes of Neointimal Hyperplasia and Coverage on the Drug Eluting Stent Struts Crossing the Side-branch Vessels Evaluated by Optical Coherence Tomography Imaging.
Authors: Tairo Kurita, Kennya Nasu, Euihong Ko, Tsuyoshi Ito, Maoto Habara, Yoshihisa Kinoshita, Mitsuyasu Terashima, Takahiko Suzuki
Journal: Circulation (2010)
An Ethical Debate: Should older women be offered in vitro fertilisation? The interests of the potential child
Authors: T. Hope, G. Lockwood, M. Lockwood
Journal: BMJ (1995)

TABLE iII-Advice on portions for consumers on "eatingfive portions of fruit and vegetables a day." (The term "serving spoonfiIl" has been used to emphasise that the amounts offfruit and vegetables are as served on to the plate, rather than raw ingredients) Food type Practical description of portion (approx 80 g) Examples Fruit: Very large fruit One large slice Melon, pineapple Large fruit One whole Apple, banana Medium fruit Two whole Plum, kiwi Berries Cupful Raspberries, grapes Stewed and Three serving spoonfuls Stewed apple, canned canned fruit peaches Dried fruit Half serving spoonful Apricots, raisins Fruit juice Full wine glass Orange juice, fresh and from concentrate Vegetables: Green vegetables Two serving Broccoli, spinach spoonfuls Root vegetables Two serving spoonfuls Carrots, parsnip Very small Three serving spoonfuls Peas, sweetcom vegetables Pulses and beans Two serving spoonfuls Baked beans, kidney beans Salad Bowlful Lettuce, tomatoHow much in a portion?Whether advice to "eat five a day" should refer to the number of occasions of eating fruit and vegetables or the number of portions is uncertain.To achieve the kind of dietary changes proposed in health strategies such as the Health of the Nation and The Scottish Diet advice needs to promote consumption of five "decent sized" servings or portions.A couple of slices of tomato in a sandwich or a few mushrooms in a chicken and mushroom pie should not count.Nutrition information which uses a mean portion size of around 80 g as a decent sized portion ties in well with average serving sizes used by households in Britain.20The main area of discrepancy is with salad foods: consumers and caterers should be told that it is necessary to eat a "bowlful" of salad to count as one portion.Table III uses this approach to show amounts which constitute a "portion" of fruit and vegetables.Supporting advice should explain that serving size should reflect age, sex, and activity and that active young men would be expected to eat larger portions.Similarly, small children can still aim to "eat at least five" but their portions may be smaller.I thank the policy unit of the Consumers' Association for supporting initial development work for this paper and for comments received from interested parties, particularly the Department of Health.A more detailed list is available on request for use in preparing photographs and illustrations of portion sizes and for interpreting dietary surveys.
EFFECT OF THYMECTOMY ON INDUCTION OF TUMORS AND ON THE TRANSPLANTABILITY OF POLYOMA-INDUCED TUMORS.
Authors: V. Defendi, R. A. Roosa
Journal: Cancer Research (1965)

The influence of thymectomy on tumor induction by polyoma virus and on the transplantability of polyoma-induced tumors in hamsters and mice has been investigated. Animals were thymectomized either within 24 hr. after birth or at 7 days; in the latter case, they were given 350 r total body irradiation 1 week later. Controls consisted of sham and nonoperated animals.

The inoculation of polyoma virus 7 days after neonatal thymectomy in hamsters resulted in the early appearance of tumors and in a higher incidence of tumors per animal. Inoculation into neonatally thymectomized hamsters at 3–4 months of age produced tumors in 85% of the animals versus 35% of the controls. Here again tumors were multiple in the thymectomized group; when present in the controls, tumors appeared only at the site of inoculation.

Mice immunized with polyoma virus were resistant to the challenge of polyoma-induced tumor cells. When this experiment was performed with thymectomized C3H/Bi and C57/BL/6J mice it was possible to demonstrate almost complete abolition of resistance to an inoculum of 105 isologous polyoma-induced tumor cells. In addition, 7 out of 18 thymectomized and X-irradiated C57/BL/6J mice, inoculated with polyoma virus as late as 2 months of age, developed primary tumors within 4 months. The serum titer against polyoma hemagglutinating activity in all the thymectomized groups was either slightly lower than or equal to that of the controls.

On the basis of these results it is suggested that neonatal thymectomy enhances tumorgenicity of polyoma virus by depressing the immunologic response to the polyoma-induced tumor cell antigen(s).
Prevalence of methicillin-resistant Staphylococcus aureus and factors associated with colonization among residents in community long-term-care facilities in Spain
Authors: A. Manzur, L. Gavalda, E. Ruiz de Gopegui, D. Mariscal, M.A. Dominguez, J.L. Perez, F. Segura, M. Pujol
Journal: Clinical Microbiology and Infection (2008)
The dectection of pancreatic cancer from peripheral blood mononuclear cells.
Authors: August R. Bauer
Journal: Clinical Cancer Research (2006)

A20   Pancreatic cancer is a deadly disease with over 31,000 new cases in the United States each year and over 30,000 deaths. This cancer has metastasized or spread from the pancreas in more than 85% of the patients by the time the diagnosis is made with the present imaging and other diagnostic tests. Earlier and accurate diagnosis of this fatal disease is needed. (1,2)The tumor starts in the lining cells of the pancreatic duct as a hyperplasia of these cells, progressing to a papillary hyperplasia, dysplasia, cancer and finally an invasive ductal pancreatic adenocarcinoma. Early in its development the dendritic cells recognize a change in the cells of the growth and convey altered proteins to the lymphocyte system. The lymphocytes are programmed against these altered proteins and send TIL cells or 9tumor infiltrating lymphocytes9 to fight the abnormal cells of the developing tumor. In doing this the lymphocytes change their patterns of gene expression. Microarray analysis of the gene expression patterns of the peripheral blood mononuclear cells, consisting of 80% to 95% lymphocytes, allows the specific significant diagnosis of this developing tumor. (3-8)In this preliminary study a method was developed in which 16ml of intravenous peripheral blood was drawn from patients with ductal pancreatic adenocarcinoma. The mononuclear cells were analyzed with microarray gene analysis and compared to similarly processed specimens drawn from age and gender approximated controls without pancreatic disease. Statistically significant specific genes displayed over expression and suppression in the specimens of patients with pancreatic cancer as compared to the controls. These specific genes were consistently identified by different statistical methods across different specimens. The noted genes appear to identify the specific ductal pancreatic adenocarcinoma which constitutes most of the pancreatic cancers, as distinct from other pancreatic diseases and tumors and were not the genes noted in other cancers and diseases.This increasingly accepted concept of utilizing the peripheral blood mononuclear cells and lymphocytes for the diagnosis of disease and measurement of therapeutic response, when combined with a developing microfluidic device, could allow the earlier, easily obtained diagnosis of this dreaded disease and better treatment design. (9-12)1. Jemal A. CA Cancer J Clin 2005 Jan-Feb; 55(1):10-302. Ros PR. JBR-BTR 2001; 84(6):239-2493. Fujii H. Am J Pathol 1997 Nov; 151(5):1447-544. Rosty C. Hematol Oncol Clin North Am 2002 Feb; 16(1):37-525. Baxevanis CN J Immunol 2000 April; 164(7) 3902-126. Zeng G. J Immunother 2001 May; 23(3): 195-2047. Pages F. NEJM 2005 Dec; 353(25):2654-668. Parmiani G. NEJM 2005 Dec; 353(25) 2640-419. Burczynski ME. J Mol Diag 2006 Feb; 8(1): 51-6110. Satoh J. J Neuroimmunol 2006; 174: 108-11811. Potti A. Blood 2006 Feb 15; 107(4): 1391-612. Tang Y. J Cereb Blood Flow Metab 2006 Jan; 4: 1-14
Clinical impact of HSV-1 detection in the lower respiratory tract from hospitalized adult patients
Authors: C. Costa, F. Sidoti, A. Saldan, F. Sinesi, C. Balloco, S. Simeone, M. Lorusso, S. Mantovani, C. Merlino, P. Solidoro, R. Cavallo
Journal: Clinical Microbiology and Infection (2012)
Medicare Reform Signed
Authors: Brian Vastag
Journal: JAMA (2004)

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
Abstract 9381: Comparison of Clinical Characteristics and Adverse Outcomes in Pregnant Women with Cardiomyopathy Subtypes at the Time of Delivery in the US: 2006-2010
Authors: Fabio V Lima, Puja B Parikh, Jiawen Zhu, Jie Yang, Kathleen Stergiopoulos
Journal: Circulation (2014)

Introduction: Investigation of patient characteristics and outcomes in women with cardiomyopathy (CDM) at the time of delivery has been limited. The aim of this study was to determine the clinical characteristics and outcomes in women with peripartum (PCDM) and hypertrophic cardiomyopathy (HCDM), and the predictors for adverse clinical outcomes in pregnant women at the time of delivery. Methods and Results: The Healthcare Cost and Utilization Project’s National Inpatient Sample was screened for hospital admissions for delivery in pregnant women with CDM subtypes (peripartum, hypertrophic and all others) from 2006-2010. Clinical characteristics and maternal outcomes were identified in women with subtypes of CDM and without. The primary outcome of interest was major adverse clinical events (MACE), a composite of in-hospital death, acute myocardial infarction, heart failure, arrhythmia, cerebrovascular event, or embolic event. Our study population consisted of 2,078 patients with CDM and 4,438,439 patients without CDM. Of those with CDM, 52 (2.5%) had HCDM, 1039 (50.0%) had PCDM, and 987 (47.5%) were classified as other CDM (OCDM). PCDM cohort was more likely to be insured by Medicaid and the HCDM patients were more likely to deliver at a teaching hospital (p&lt;0.01 for all). The PCDM and all OCDM cohorts had a larger proportion of black patients and most were from the South. PCDM patients experienced the highest rates of MACE (46%), compared with HCDM (23%) or OCDM (38.9%), mainly driven by heart failure and arrhythmia. Maternal mortality in all CDM subgroups was extremely low (&lt; 0.5%). Significant predictors of MACE in the PCDM cohort were the presence of valvular heart disease (OR 2.16, 95% CI 1.49-3.14), severe pre-eclampsia (OR 1.54, 95% CI: 1.08-2.21), and Cesarean delivery (OR 1.36, 95% CI: 1.04-1.78); delivery at a teaching hospital was associated with a reduction in MACE. In multivariable analysis, the presence of PCDM (OR 2.22, 95% CI 1.07-4.55) was independently predictive of MACE. Conclusions: Peripartum CDM patients had the highest likelihood of MACE compared to hypertrophic and all other CDM subtypes.
Abstract P400: Assessing the Fatty Acid Profiles of Dried Blood and Breast Milk Collected on Filter Paper
Authors: Kristina A Harris, William Harris
Journal: Circulation (2014)

Introduction: Assessment of the fatty acid status [particularly the highly labile, long-chain omega-3 species eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)] of both blood and breast milk is important in epidemiological studies that seek to discover relationships between fatty acid status and health outcomes. Both blood and milk samples are difficult to collect and process in the field, and they are expensive to ship frozen to the laboratory. Hence improved approaches to sample acquisition and transport are needed to expand the research base for these metrics. Methods: The purpose of this study was to validate methods to collect, preserve and analyze the fatty acid composition of dried blood spots (DBS) and dried milk spots (DMS). Single drops of blood from 5 volunteers and of milk from 5 lactating women were applied to Whatman 903 cards which had been pretreated with an antioxidant preservative cocktail (OxyStop®). The omega-3 fatty acid content of the milk and the blood samples spanned a 5-fold range. These cards were then kept in the dark at room temperature, 4°C, -20°C, and -80°C for 28 days. Samples were analyzed weekly (in triplicate) and were compared to baseline values and to liquid samples stored under the same conditions. Red blood cells (RBC) from the 5 blood samples were also included in the experiment. Samples were considered stable up until the week that the mean omega-3 fatty acid content had decreased by &gt;10% from baseline. In a separate experiment, the RBC omega-3 index was estimated from the DBS EPA+DHA value using blood samples from 106 healthy subjects. Results: Based on the stability criterion, both DBS and DMS samples were stable for 4 weeks under all storage conditions. RBC EPA+DHA (the omega-3 index) was also stable for 4 weeks under all conditions except storage at -20°C at which temperature degradation occurred within 1 week. The correlation between the omega-3 index and DBS EPA+DHA was 0.98 (p&lt;0.0001) indicating that the RBC omega-3 levels can be accurately estimated from whole blood analysis. DHA levels in liquid vs. dried milk were also strongly correlated (r&gt;0.99; p&lt;0.0001). Conclusion: Both blood and milk omega-3 fatty acid content can be accurately assessed from samples collected and transported at room temperature on filter paper.
SOME LIMITATIONS IN PREVENTIVE MEDICINE
Authors: Henry A. Christian
Journal: Annals of Internal Medicine (1939)

Article1 March 1939SOME LIMITATIONS IN PREVENTIVE MEDICINEHENRY A. CHRISTIAN, F.A.C.P.HENRY A. CHRISTIAN, F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-12-9-1499 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSince death from old age is inevitable, and since death of the aged in all probability will continue to result most frequently, as at present, from processes of deterioration and degeneration of body organs and tissues, what limitations on preventive medicine should be expected, and how will all of this influence the work of doctors? This is the problem I have set myself for discussion. Let me make it clear at the outset that I write not as one expert in preventive medicine but as one, who has spent his life time chiefly in teaching medicine and directing a medical... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Boston, Massachusetts*Read at the New York Meeting of the American College of Physicians, April 4, 1938. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 March 1939Volume 12, Issue 9Page: 1499-1506KeywordsPreventive medicine Issue Published: 1 March 1939 PDF downloadLoading ...