tbuckley/cabot-search huggingface dataset:
EPOCH chemotherapy: toxicity and efficacy in relapsed and refractory non-Hodgkin's lymphoma.
Authors: W H Wilson, G Bryant, S Bates, A Fojo, R E Wittes, S M Steinberg, D R Kohler, E S Jaffe, J Herdt, B D Cheson
Journal: Journal of Clinical Oncology (1993)

PURPOSE Based on in vitro evidence that tumor cells are less resistant to prolonged exposure to low concentrations of the natural product class, compared with brief higher concentration exposure, we developed a chemotherapy regimen (etoposide, vincristine, doxorubicin, cyclophosphamide, and prednisone [EPOCH]) in which the natural products are administered as a continuous infusion. PATIENTS AND METHODS This is a phase II study of etoposide, vincristine, and doxorubicin, administered as a 96-hour continuous infusion, with intravenous (IV) bolus cyclophosphamide and oral prednisone (EPOCH) in 74 consecutive patients who relapsed from or failed to respond to most of the same drugs administered on a bolus schedule. Patients with aggressive lymphomas who achieved a good response after EPOCH were eligible to undergo bone marrow transplantation. RESULTS Patients with intermediate- or high-grade lymphoma comprised 76% of this series and 77% had stage IV disease. Seventy-one percent had previously received all of the drugs contained in the EPOCH regimen and 92% had received at least four of the drugs. Seventy patients were assessable for response, of whom 19 (27%) achieved a complete remission (CR) and 42 (60%) a partial remission (PR). Among 21 patients who had no response to prior chemotherapy, 15 (71%) responded, but only one achieved a CR. Patients who relapsed from an initial CR had a 100% response rate, with 76% CRs. With a median potential follow-up duration of 19 months, there was a 28% probability of being event-free at 1 year. Toxicity was primarily hematologic with neutropenia during 51% of cycles, but only a 17% incidence of febrile neutropenia. Gastrointestinal, neurologic, and cardiac toxicity were minimal. CONCLUSION EPOCH chemotherapy was well tolerated and highly effective in patients who were resistant to or relapsed from the same drugs administered on a bolus schedule, suggesting that continuous infusion of the natural drug component of this regimen is capable of partially reversing drug resistance and reducing toxicity. Dose-intensity (DI) was &gt; or = that achieved in primary treatment regimens for aggressive lymphomas.
Drug resistant tuberculosis among Greek and immigrant patients in a pulmonary department in northern Greece
Authors: Evangelia Fouka, Nikolaos Aggelis, Xrysovalantis Parisis, Dimosthenis Vlaikos, Penelope Stefanopoulou, Sofia Lambaki, Nikolaos Galanis
Journal: European Respiratory Journal (2011)

Introduction: The proportion of TB cases among immigrants is gradually increasing in Western European countries, posing a threat to disease elimination in the coming decades.

Aim: To evaluate differences in prevalence of drug resistant tuberculosis among native and immigrant patients treated in a respiratory department of a regional general hospital in Northern Greece.

Subjects - methods: Clinical records data of patients with tuberculosis (new detected cases-43, relapses-21) treated in our department during 2007-2010 were retrospectively studied.

Results: 64 patients were recorded, 50 males and 14 females, 38 natives and 26 immigrants recently moved from Former Soviet Union countries. 13 natives (34.2%) and 17 immigrants (65.2%) patients presented with extensive disease. 13 (34.2%) natives and 10 (38.4%) immigrants received therapy for a second time due to relapse, interrupted treatment or treatment failure. Resistance was confirmed in 11 natives (28.9%) and 12 immigrants (46.2%) (p: 0.253), monoresistance in 11, polyresistance in 8 and MDR TB in 4 patients.

View this table:

Resistance patterms





Conclusions: TB cases among immigrants tend to increase, contributing significantly to overall higher incidence rates. Immigrants also tend to present with more severe disease and emerge more frequent relapses and higher prevalence of resistant and MDR-TB.
Managing asthma in the outpatient clinic - Can the FEV1/FVC indicate when to do a reversibility test?
Authors: Celeste Porsbjerg, Asger Sverrild, Lise Stensen, Birgitte Nybo Jensen, Backer Vibeke
Journal: European Respiratory Journal (2012)

Background: Testing for reversibility to SABA often constitutes the first step of a diagnostic assessment of asthma. However, patients with a normal or near-normal lung function often do not have significant reversibility, and performing reversibility testing in these patients may not be cost-effective.  Aim: To describe the value of the FEV1/FVC ratio using lower limit of normal (LLN) for predicting significant reversibility to SABA, and to define optimum cut-points that might be applied clinically.  Methods: The MAPOut I study is a retrospective observational study of all patients consecutively referred to a tertiary hospital specialist clinic over a 12- month period, on suspicion of asthma (n=221).  Results: In total, 122 subjects (55%) had a reversibility test performed, among whom 28 (23%) had a significant response to beta-2-agonist, defined as an increase in FEV1 of 12% or more, and at least 200 mL. The area under the curve of the FEV1/FVC % of the LLN for predicting reversibility was 0,76 (p  Conclusion: Absence of significant airflow obstruction at rest was associated with a low likelihood of reversibility to beta-2-agonist. The majority of subjects referred for specialist assessment on the suspicion of asthma did not have airflow obstruction. In these subjects, alternative diagnostic strategies may be more cost-effective.
Genetics and risk factors for basal cell carcinoma
Authors: V. Madan, P. Hoban, R. C. Strange, A. A. Fryer, J. T. Lear
Journal: British Journal of Dermatology (2006)

Nonmelanoma skin cancer (NMSC) is the commonest cancer in whites and its incidence is increasing worldwide. The prevalence of this cancer is predicted to equal that of all others combined and it was estimated that there were over 2 million cases diagnosed in the U.S.A. in 2004. Patients exhibit marked differences in clinical phenotype with variations in tumour numbers, rate of tumour accrual, site and histological subtype. Furthermore, patients are at increased risk of other cutaneous and noncutaneous cancers. The factors accounting for this variation are complex and still not completely understood. Clearly, ultraviolet light (UV) exposure is a major influence but its relationship to clinical phenotype is not yet clear. In addition, immunosuppression is a significant risk factor. Our group has identified high-risk groups for the development of further basal cell carcinoma (BCC), namely patients with truncal BCC and those presenting with tumour clusters. This presentation will concentrate on these clinical subgroups as well as immunosuppressed patients. These groups represent significant management challenges and are areas where novel, nonsurgical treatment options may make a significant clinical impact in patient care. The risk factors predisposing to these clinical phenotypes will be discussed, including genetic factors and UV exposure. Potential clinical applications, including predictive indices, will be considered.
The Association between Smoking Abstinence and Mortality in the National Lung Screening Trial
Authors: Nichole T. Tanner, Neeti M. Kanodra, Mulugeta Gebregziabher, Elizabeth Payne, Chanita Hughes Halbert, Graham W. Warren, Leonard E. Egede, Gerard A. Silvestri
Journal: American Journal of Respiratory and Critical Care Medicine (2015)

Rationale: Smoking is the largest contributor to lung cancer risk, and those who continue to smoke after diagnosis have a worse survival. Screening for lung cancer with low-dose computed tomography (LDCT) reduces mortality in high-risk individuals. Smoking cessation is an essential component of a high-quality screening program.Objectives: To quantify the effects of smoking history and abstinence on mortality in high-risk individuals who participated in the NLST (National Lung Screening Trial).Methods: This is a secondary analysis of a randomized controlled trial (NLST).Measurements and Main Results: Measurements included self-reported demographics, medical and smoking history, and lung cancer–specific and all-cause mortality. Cox regression was used to study the association of mortality with smoking status and pack-years. Kaplan-Meier survival curves were examined for differences in survival based on trial arm and smoking status. Current smokers had an increased lung cancer–specific (hazard ratio [HR], 2.14–2.29) and all-cause mortality (HR, 1.79–1.85) compared with former smokers irrespective of screening arm. Former smokers in the control arm abstinent for 7 years had a 20% mortality reduction comparable with the benefit reported with LDCT screening in the NLST. The maximum benefit was seen with the combination of smoking abstinence at 15 years and LDCT screening, which resulted in a 38% reduction in lung cancer–specific mortality (HR, 0.62; 95% confidence interval, 0.51–0.76).Conclusions: Seven years of smoking abstinence reduced lung cancer–specific mortality at a magnitude comparable with LDCT screening. This reduction was greater when abstinence was combined with screening, highlighting the importance of smoking cessation efforts in screening programs.
Gemcitabine: a promising new agent in the treatment of advanced urothelial cancer.
Authors: M J Moore, I F Tannock, D S Ernst, S Huan, N Murray
Journal: Journal of Clinical Oncology (1997)

PURPOSE To evaluate the efficacy and toxicity of gemcitabine (2',2'-difluorodeoxycytidine) in previously untreated patients with advanced transitional cell carcinoma. PATIENTS AND METHODS Forty-one patients with measurable advanced transitional cell carcinoma who had received no prior chemotherapy for metastatic disease were scheduled to receive gemcitabine 1,200 mg/m2 intravenously over 30 minutes on days 1, 8, and 15 of a 28-day cycle. Prior adjuvant or neoadjuvant therapy for locally advanced disease was allowed if this was completed greater than 1 year prior to study entry. All patients were treated on an outpatient basis. RESULTS There were three complete responses and six partial responses seen in 37 assessable patients, for an overall response rate of nine of 37 (24.3%; 95% confidence interval, 12 to 41). Four patients remain in remission at 14, 23, 24, and 31 months. The median survival was 8 months with 17% of patients alive at 2 years. Treatment generally was well-tolerated with three patients having &gt; or = grade 3 nonhematologic toxicity, five having grade 3 neutropenia, two having grade 3 thrombocytopenia, and two episodes of febrile neutropenia. Most patients were able to receive the drug as scheduled with the primary reason for dose reduction or dose delay being neutropenia. CONCLUSION Gemcitabine has promising single-agent activity against urothelial cancer with a favorable toxicity profile. Further studies in combination with other active agents are warranted.
Increased urinary LTE4 excretion following inhalation of LTC4 and LTE4 in asthmatic subjects
Authors: PE Christie, P Tagari, AW Ford-Hutchinson, C Black, A Markendorf, M Schmitz-Schumann, TH Lee
Journal: European Respiratory Journal (1994)

Urinary leukotriene E4 (LTE4) increases during exacerbations of asthma and following antigen challenge. We determined whether urinary LTE4 excretion reflects sulphidopeptide leukotrienes in the airways of asthmatic patients. Urinary LTE4 concentration was measured prior to and 1.5 and 3.5 h following inhalation of bronchoconstrictive doses of leukotriene C4 (LTC4) or LTE4 in eight asthmatic subjects. Increasing doses of agonist were inhaled until a 35% fall in specific airways conductance (sGaw) was achieved. There was no significant difference between the 53 +/- 3% (mean +/- SEM) fall in sGaw following inhalation of LTC4 (63.1 ng geometric mean, GM, range 5.8-527.5 ng) and the 43 +/- 4% fall in sGaw following inhalation of LTE4 7.94 ng/GM (range 132-3701 ng). The LTE4 excretion rate increased significantly from 2.95 (range 0.6-17.5) ng.h-1 to 4.67 (range 0.8-20) ng.h-1 at 1.5 h following LTC4 inhalation; and from 1.8 (range 0.07-6.7) ng.h-1 to 6.9 (range 2.9-27.3) ng.h-1 at 1.5 h following LTE4 inhalation; and had returned from baseline by 3.5 h. There was a correlation between the dose of LTC4 inhaled and LTE4 excreted in the urine (r = 0.82 and r = 0.72, respectively). The % recovery of LTE4 in the urine, of the total dose of inhaled LTC4 or LTE4 administered, was 6.9 +/- 4.1% and 0.8 +/- 0.3%, respectively. Thus, inhalation of bronchoconstricting doses of LTC4 or LTE4 alter urinary LTE4 excretion in a dose-dependent fashion. This indicates that urinary LTE4 can be used as a marker of sulphidopeptide leukotriene synthesis in the lungs of patients with asthma.
Diabetes Management Remains Suboptimal
Authors: Mike Mitka
Journal: JAMA (2005)

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
Use of injectable hormonal contraception and women's risk of herpes simplex virus type 2 acquisition: a prospective study of couples in Rakai, Uganda
Authors: Mary K Grabowski, Ronald H Gray, Fred Makumbi, Joseph Kagaayi, Andrew D Redd, Godfrey Kigozi, Steven J Reynolds, Fred Nalugoda, Tom Lutalo, Maria J Wawer, David Serwadda, Thomas C Quinn, Aaron A R Tobian
Journal: The Lancet Global Health (2015)

BackgroundThe injectable hormonal contraceptive depo-medroxyprogesterone acetate (DMPA) has been associated with increased risk of HIV acquisition, but findings are inconsistent. Whether DMPA increases the risk of other sexually transmitted viral infections is unknown. We assessed the association between DMPA use and incident herpes simplex virus type 2 (HSV2) infection in women.MethodsIn this prospective study, we enrolled HIV-negative and HSV2-negative women aged 15–49 years whose HIV-negative male partners were concurrently enrolled in a randomised trial of male circumcision in Rakai, Uganda. We excluded women if either they or their male partners HIV seroconverted. The primary outcome was HSV2 seroconversion, assessed annually. The male circumcision trial was registered with ClinicalTrials.gov, number NCT00425984.FindingsBetween Aug 11, 2003, and July 6, 2006, we enrolled 682 women in this study. We noted HSV2 seroconversions in 70 (10%) women. Incidence was 13·5 per 100 person-years in women consistently using DMPA (nine incident infections per 66·5 person-years), 4·3 per 100 person-years in pregnant women who were not using hormonal contraception (18 incident infections per 423·5 person-years), and 6·6 per 100 person-years in women who were neither pregnant nor using hormonal contraception (35 incident infections per 529·5 person-years). Women consistently using DMPA had an adjusted hazard ratio for HSV2 seroconversion of 2·26 (95% CI 1·09–4·69; p=0·029) compared with women who were neither pregnant nor using hormonal contraception. Of 132 women with HSV2-seropositive partners, seroconversion was 36·4 per 100 person-years in consistent DMPA users (four incident infections per 11 person-years) and 10·7 per 100 person-years in women who were neither pregnant nor using hormonal contraception (11 incident infections per 103 person-years; adjusted hazard ratio 6·23, 95% CI 1·49–26·3; p=0·012).InterpretationConsistent DMPA use might increase risk of HSV2 seroconversion; however, study power was low. These findings should be assessed in larger populations with more frequent follow-up than in this study, and other contraceptive methods should also be assessed. Access to a wide range of highly effective contraceptive methods is needed for women, particularly in sub-Saharan Africa.FundingBill and Melinda Gates Foundation, Doris Duke Charitable Foundation, US National Institutes of Health, and Fogarty International Center.
Treating Hoarseness With Proton Pump Inhibitors
Authors: Gregory Dion, Milan R. Amin, Ryan C. Branski
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 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
Psychological Aftermath of the King's Cross Fire
Authors: R Rosser, S Dewar, J Thompson
Journal: Journal of the Royal Society of Medicine (1991)

The King's Cross fire occurred at the end of the evening rush hour, on 18 November 1987. King's Cross station is within the department's health district and we felt a responsibility to respond to the psychological aftermath. The unique features of our intervention were the degree of inter agency coordination, the use of a systematic outreach and screening programme, the collection of psychotherapy outcome measures and the development of an ongoing clinic. The work represents a sustained attempt to assess the nature and prevalence of post-traumatic reactions and the most medically and economically effective form of intervention. In this paper we describe the way our team responded to the high level of psychological distress that we found, we present some preliminary results, outline two therapeutic trials, and refer to the long-term consequences for the work of our department.
Quantitative Bone Single-Photon Emission Computed Tomography for Prediction of Pain Relief in Metastatic Bone Disease Treated With Rhenium-186 Etidronate
Authors: Ora Israel, Zohar Keidar, Rafael Rubinov, Galina Iosilevski, Alex Frenkel, Abraham Kuten, Lise Betman, Gerald M. Kolodny, David Yarnitsky, Dov Front
Journal: Journal of Clinical Oncology (2000)

PURPOSE: To calculate radiation doses of rhenium-186 ( 186 Re) etidronate in painful bone metastases using quantitative bone single-photon emission computed tomography (SPECT) and to determine the threshold dose for predicting pain relief. We also wanted to determine whether technetium-99m ( 99m Tc) methylene diphosphonate (MDP) concentrations predict radiation doses of 186 Re etidronate in painful lesions. MATERIALS AND METHODS: Forty-eight patients with breast and prostate cancer were evaluated. Patients received therapeutic doses of 186 Re etidronate. The area under the pain over time curve (AUPC) was measured for 8 weeks after treatment. Response was calculated as the percentage of change in AUPC. Quantitative bone SPECT (QBS)–measured concentration of 186 Re etidronate was used for calculating radiation doses. Receiver operating characteristics curve analysis determined the radiation dose threshold that best separated responders from nonresponders. SPECT-measured concentration of 186 Re etidronate in the urinary bladder was correlated with its concentration in the voided urine. Concentration of 99m Tc MDP was compared with radiation doses to painful metastases. RESULTS: The radiation dose threshold was 2.10 Gy. For a decrease of 50% in the AUPC, the positive predictive value (PPV) of this value was 75% and the negative predictive value (NPV) was 88%. For a decrease in pain of 33%, the PPV was 84% and the NPV was 81%. In prostate cancer patients only, the PPV was 81% and the NPV was 92%. The correlation between in vivo/in vitro measured urine concentration was 0.90. The correlation between 99m Tc MDP concentration and radiation doses of 186 Re etidronate was 0.92. CONCLUSION: QBS-measured radiation doses of 186 Re etidronate in painful metastases are a good predictor of pain relief. Bone SPECT using 99m Tc MDP predicts radiation doses delivered by 186 Re etidronate.