tbuckley/cabot-search huggingface dataset:
Psoriasis treatment with etanercept and efalizumab: clinical strategies influencing treatment outcome
Authors: R.J.B. Driessen, M.A.M. Berends, J.B. Boezeman, P.C.M. van de Kerkhof, E.M.G.J. de Jong
Journal: British Journal of Dermatology (2008)

Multiple trials have been conducted in which the safety and efficacy of different biological therapies for psoriasis have been studied. However, the treatment course in clinical practice is different from the setting in which trials are conducted.The evaluation of the efficacy, safety and adverse events of etanercept and efalizumab treatment in daily practice and the investigation of interfering clinical strategies that could be of influence on treatment outcome.A prospective cohort consisting of 101 patients with high-need psoriasis was followed for 2 years and analysed. Patients were treated with etanercept or efalizumab between February 2005 and May 2007. Efficacy, safety and adverse events were investigated. Furthermore, all accompanying factors of which an influence on treatment efficacy outcome was suspected were registered, including treatment interruptions, dosage adjustments and combinations of therapies.Etanercept and efalizumab treatment was effective and safe in most patients. However, in many cases the treatment course was characterized by unsatisfactory efficacy (83%), necessitating combination therapies or dosage adjustments. Treatment interruptions occurred in 56% (etanercept 2x50 mg group), 84% (etanercept 2x25 mg group) and 10% (efalizumab-treated patients).Treatment of high-need psoriasis patients in daily practice is highly different from treatment courses in clinical trials. Frequently applied clinical strategies such as treatment interruptions, dosage adjustments and combinations of treatments influence treatment outcome in routine treatment in comparison with randomized controlled trials. Information about treatment with these new drugs in daily clinical practice is important for adjusting treatment schedules and guidelines.
Glue ear and speech development.
Authors: A G Maran, J A Wilson
Journal: BMJ (1986)

remaining 43% further investigations were arranged as appropriate.The examination takes place in an unhurried manner (and is preferred by patients to the indirect exaitination) and the patient may view his own larynx with a teaching attachment.This "'feedback" technique is helpful in the management of certain disorders-of speech; students may look through this attachment; and a photographic record may be obtained.Nasoscopes, nasopharyngoscopes, sinus scopes, and tracheoscopes are available with the Hopkins rod lens system.With the flexible fibreoptic rhinolaryngoscope, however, there is in one instrument a facility for the examination and photodocumentation of the entire upper respiratory tract.'0
Plasmapheresis Therapy in Rheumatoid Arthritis
Authors: Isaac L. Dwosh, Alan R. Giles, Peter M. Ford, Joseph L. Pater, Tassos P. Anastassiades
Journal: New England Journal of Medicine (1983)

Twenty-six patients with rheumatoid arthritis (average age, 57 years; average duration of disease, 11 years) who were unresponsive to antiinflammatory and slow-acting antirheumatic drug therapy were entered into a controlled, double-blind, crossover study to assess the efficacy of plasmapheresis therapy. All patients received 10 true and 10 sham aphereses as outpatients and continued to take their usual drugs. Twenty patients completed the study, and six were withdrawn — three because of poor venous access. Standard clinical and laboratory measures were assessed by personnel blinded to the therapy administered. Paired t-test analysis of seven clinical measures failed to show significant differences between the true and sham procedures (P = 0.36 to 0.96), although transient, mild improvement did occur during both cycles of apheresis, probably because of a placebo response. Significant reductions in the erythrocyte-sedimentation rate, rheumatoid factor titer, and levels of hemoglobin, IgM, and C3 occurred only with true therapy (P = 0.001, 0.01, 0.03, 0.045, and 0.005, respectively). We conclude that plasmapheresis does not have clinical benefit in chronic rheumatoid arthritis, in spite of impressive laboratory changes. (N Engl J Med 1983; 308: 1124–9.)
Effects of PCB exposure on biochemical and hematological findings in capacitor workers.
Authors: R W Lawton, M R Ross, J Feingold, J F Brown
Journal: Environmental Health Perspectives (1985)

Certain former operations in capacitor manufacturing resulted in extensive direct contact of the workers with electrical grade polychlorinated biphenyls (PCBs). A study group of 194 such individuals, all exposed to Aroclor 1016 and many previously exposed to Aroclors 1242 and/or 1254, was examined before (1976) and after (1979) discontinuance of PCB use in the operations (1977). At the two examinations, the approximate geometric mean serum levels (in ppb) and 5 to 95% ranges were for lower PCBs (LPCB), 363 (57-2270) and 68 (12-392); and for higher PCBs (HPCB), 30 (6-142) and 19 (4-108), respectively. The statistical associations among 42 measured clinical chemical and hematological parameters, five different measures of PCB exposure, and seven confounding variables observed in the two examinations were determined by three regression procedures. Similar regressions were performed with DDE, which was present at background levels. The principal statistical findings were a depression in serum bilirubin and elevations in serum GGTP and lymphocyte levels at the time of the first examination, and only an elevation in monocytes at the second. Appraisal of the results suggested an induction of microsomal enzymes which appeared to be subsiding after the cessation of direct exposure to PCBs. The statistical association between serum levels of PCBs and lipids reported by others was confirmed, but shown to be explained by the partitioning behavior of PCB in the body, rather than to changes in liver function. No evidence for health impairment related to PCBs was found, despite the high serum levels of PCBs in the study population.
Res Ipsa Loquitur
Authors: Heinrich Lamm
Journal: JAMA (1964)

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
Interpretation of electrocardiograms by doctors
Authors: H. Montgomery, S. Hunter, S. Morris, R Naunton-Morgan, R M Marshall
Journal: BMJ (1994)

Predictive values, sensiivities, and specficitiesforperipheral lymphadenopathy as marker ofHIVinfection b site and size oflymph nodes Positive predictive Negative predictive Sensitivity Specificity Odds ratio (95% Site (size (cm)) of lymph node value (Rate (%/6)) value (Rate (%/6)) Rate (%)) (Rate (%/o)) confidence interval)
Nephrotic Syndrome in Monkey Infected with Human Quartan Malaria
Authors: A. Voller, C. C. Draper, T. Shwe, M. S. R. Hutt
Journal: BMJ (1971)

A splenectomized aotus monkey infected with human quartan malaria (<i>Plasmodium malariae</i>) developed oedema and proteinuria. Histological examination revealed a generalized diffuse glomerulonephritis and immunofluorescent staining showed granular deposits of IgM in the glomeruli. The pathological picture resembled that shown by human patients with the quartan malaria nephrotic syndrome.
Possible Effectiveness of Clarithromycin and Rifabutin for Cryptosporidiosis Chemoprophylaxis in HIV Disease
Authors: Scott D. Holmberg
Journal: JAMA (1998)

Context.—Cryptosporidium parvum infection, a common cause of diarrhea in persons infected with the human immunodeficiency virus (HIV), is difficult to treat or prevent.Objective.—To evaluate relative rates of cryptosporidiosis in HIV-infected patients who were either receiving or not receiving chemoprophylaxis or treatment for Mycobacterium avium complex.Design.—Analysis of prospectively collected data from HIV-infected patients' visits to their physicians since 1992.Setting.—Ten (8 private, 2 publicly funded) HIV clinics in 9 US cities.Patients.—A total of 1019 HIV-infected patients with CD4+ cell counts less than 0.075×109/L.Main Outcome Measures.—Incidence of clinical cryptosporidiosis during treatment with clarithromycin, rifabutin, and azithromycin.Results.—Five of the 312 patients reportedly taking clarithromycin developed cryptosporidiosis vs 30 of the 707 patients not taking clarithromycin (relative hazard [RH], 0.25 [95% confidence interval (CI), 0.10-0.67]; P =.004).Two of the 214 patients taking rifabutin developed cryptosporidiosis vs 33 of the 805 not taking rifabutin (RH, 0.15 [95% CI, 0.04-0.62]; P=.01). Prophylactic efficacy of either drug was 75% or greater. No protective effect was seen in the 54 patients reportedly taking azithromycin (RH, 1.48 [95% CI, 0.44-5.04]; P=.46).Conclusions.—Clarithromycin and rifabutin were highly protective against development of cryptosporidiosis in immune-suppressed HIV-infected persons in this analysis; further study is warranted.
Evaluation of the Peritoneal-Button Operation for Ascites
Authors: Thomas C. Chalmers, Richard D. Eckhardt, Charles S. Davidson
Journal: New England Journal of Medicine (1950)

THE failure until recently of the nonsurgical management of ascites has led to several operative approaches to the problem. Omentopexy is no longer considered of value. Portacaval and splenorenal anastomoses1,2 are long and difficult operations, with a high mortality rate in patients with intractable ascites. The successful treatment of 5 out of 6 patients by the insertion of a glass Murphy button connecting the peritoneal cavity and the subcutaneous tissues of the abdominal wall was reported in 1946.3 Previously sporadically employed, the button operation had been discarded because of consistent plugging of the lumen by the patient's omentum. The button . . .
A Randomized Phase II Trial of Two Regimens of Moderate Dose Chemoradiation Therapy for Patients with Non-small Cell Lung Cancer Not Suitable for Curative Therapy: Trans Tasman Radiation Oncology Study TROG 03.07
Authors: Bryan H. Burmeister, Michael Michael, Elizabeth Burmeister, Sharon Cox, Margot Lehman, Andrew Wirth, Keith Horwood, Giuseppe Sasso, Barham Forouzesh, David Ball
Journal: Journal of Thoracic Oncology (2011)
In Vivo Depletion of CD4+CD25+ Regulatory T Cells Enhances the Antigen-Specific Primary and Memory CTL Response Elicited by Mature mRNA-Electroporated Dendritic Cells
Authors: Sonja Van Meirvenne, Melissa Dullaers, Carlo Heirman, Lieven Straetman, Annelies Michiels, Kris Thielemans
Journal: Molecular Therapy (2005)

We previously described mRNA electroporation as an efficient gene delivery method to introduce tumor-antigens (Ag) into murine immature dendritic cells (DC). Here, we further optimize the protocol and evaluate the capacity of mRNA-electroporated DC as a vaccine for immunotherapy. First, the early DC maturation kinetics and the effect of different lipopolysaccharide incubation periods on the phenotypic maturation profile of DC are determined. Next, we show that either immature or mature DC are equally well electroporated and express and present the transgene at a comparable level after electroporation. We point out that the mRNA electroporation results in a negative effect on the interleukin (IL)-12p70, IL-6, and tumor necrosis factor-alpha secretion after maturation. Nevertheless, mRNA-electroporated DC induce an effective cytotoxic T lymphocyte (CTL) response in vivo. Mature electroporated DC are significantly more potent in eliciting an Ag-specific CD8+ CTL response compared to their immature electroporated counterparts. In addition, a significant improvement in CTL response is obtained both in the primary and in the memory effector phases when CD4+CD25+ regulatory T cells (Treg) are depleted in vivo prior to immunization. These findings are further substantiated in tumor protection experiments and hold convincing evidence for the merit of Treg cell depletion prior to immunization with mRNA-electroporated DC.
Points: Preventable blindness in giant cell arterius
Authors: C M Wood, J W Howe
Journal: BMJ (1987)

causalgia.Clinical experience suggests that superficial mechanical stimulation of P6 is as effective as elec- trical stimulation, but confirmation by a properly controlled clinical trial is required. Dangers from dissolution of latex in Celestin endo-oesophageal tubeDr A E HANWELL (Keymed, Essex SS2 5QH) writes: Dr S A Hussain and others (14 February, p 413) state, in their report of the dangers of the disintegration of Celestin tubes, that this problem is well recognised, but is it?In addition to the five references listed with the case report we found a further five reports of similar disintegration, going back as far as 1976.'-5 For this period we cannot find a single report of similar problems encountered with a prosthesis constructed from silicone rubber, which is much more resistant to disintegration.6 1 Brown P, Hughes RG.Late complication of endoscopic oeso-
Effects of hyperinsulinemia on lipoprotein lipase, angiopoietin-like protein 4, and glycosylphosphatidylinositol-anchored high-density lipoprotein binding protein 1 in subjects with and without type 2 diabetes mellitus
Authors: Toralph Ruge, Valentina Sukonina, Olessia Kroupa, Elena Makoveichuk, Magdalena Lundgren, Maria K. Svensson, Gunilla Olivecrona, Jan W. Eriksson
Journal: Metabolism (2011)
Sample-Size Nomograms
Authors: DAVID D. CLARKE
Journal: Annals of Internal Medicine (1983)

Letters and Corrections1 December 1983Sample-Size NomogramsDAVID D. CLARKE, M.D.DAVID D. CLARKE, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-99-6-875 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The nomograms described by Young and associates (1) enable rapid estimation of sample size appropriate for study of an hypothesis. However, in evaluating completed negative clinical studies Feinstein (2) uses a more appropriate formula for dichotomous variables to calculate a precise value for the probability of a type 2 error.Young and associates describe a study with two groups of 150 subjects each, one given drug A and the other drug B. The first group has a 40% cure rate and the second a 45% cure rate. The null hypothesis is accepted but a concern is raised:...References1. YOUNG M, BRESNITZ E, and STROM B. Sample size nomograms for interpreting negative clinical studies. Ann Intern Med. 1983;99:248-51. LinkGoogle Scholar2. FEINSTEIN A. Clinical Biostatistics. St. Louis: C. V. Mosby; 1977:320-34. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: DAVID D. CLARKE, M.D.Affiliations: Harbor/UCLA Medical Center Torrance, CA 90509 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMapping the Cochrane evidence for decision making in health care 1 December 1983Volume 99, Issue 6Page: 875-876KeywordsDrugs ePublished: 1 December 2008 Issue Published: 1 December 1983 PDF downloadLoading ...
Effect of Arginine and Glutamate on the Removal of Ammonia from the Blood in Normal and Cirrhotic Patients
Authors: Samuel P. Bessman, Sheila Shear, Joseph Fitzgerald
Journal: New England Journal of Medicine (1957)

THE increasing documentation of a specific toxic effect of ammonia1 2 3 4 5 6 as the cause of mental symptoms in a number of clinical conditions stimulates interest in methods of removing, or increasing the metabolism of, this intermediate.Two compounds have been suggested as therapeutic agents, glutamate and arginine. Glutamate, first demonstrated to be effective in animals by Sapirstein7 and used clinically by Walshe,8 is supposed to act by stimulating the synthesis of glutamine, and arginine, suggested by Greenstein's9 group, stimulates urea synthesis by providing intermediates for the urea cycle. Both these agents have been compared in patients with and without liver disease . . .
Polycythemia and Uterine Myomata
Authors: Thomas J. Yeh
Journal: JAMA (1967)

<h3>To the Editor:—</h3> In the letter from Drs. Morton, Evans, and Daines on "Polycythemia and Uterine Myomata" (<b>200</b>:419, 1967) it is significant that the arterial oxygen tension prior to surgery was 68.1 mm Hg, representing a significant degree of hypoxia. This obviously cannot be explained on the basis of hypoventilation, since the carbon dioxide tension was only 33.5 mm Hg. I wonder if there is a veno-arterial shunting taking place in the lung in some caes of uterine myomata, as has been observed in cases of cirrhosis of the liver associated with cyanosis and polycythemia. I do not believe the arteriovenous shunting taking place in the uterine myomata can produce either hypoxia or polycythemia. If the hypoxia is corrected by removal of the uterine myomata, this might indicate that the fibroid in some way or other produces substance which increases veno-arterial shunting in the lung. It would be of
Immunization of woodchucks with recombinant hepatitis delta antigen does not protect against hepatitis delta virus infection
Authors: Peter Karayiannis, John Saldanha, John Monjardino, Robert Goldin, Janice Main, Shashi Luther, Mark Easton, Antonio Ponzetto, Howard C. Thomas
Journal: Hepatology (1990)

To assess the role of immunization against hepatitis delta antigen in the prevention of hepatitis delta virus infection, woodchuck carriers of woodchuck hepatitis virus were immunized with a 64 amino acid portion of hepatitis delta antigen from its N-terminal region. The protein was expressed in Escherichia coli and contained a major immunogenic epitope. A significant anti-hepatitis delta response was observed that did not, however, protect the animals from hepatitis delta virus superinfection. Unexpectedly, the period of detectable viremia was longer in the immunized than in the control animals. We conclude that immunization with this recombinant hepatitis delta antigen does not afford protection against subsequent hepatitis delta virus exposure. (HEPATOLOGY 1990;12:1125-1128).
Endotoxin-induced Ileal Mucosal Injury and Nitric Oxide Dysregulation Are Temporally Dissociated
Authors: ELLIOTT D. CROUSER, MARK W. JULIAN, DAVID M. WEINSTEIN, RUAIRI J. FAHY, JOHN A. BAUER
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Despite recent investigations, the mechanisms responsible for intestinal epithelial injury during endotoxemia remain unclear. The present study tests the hypothesis that epithelial necrosis and/or apoptosis correlate with nitric oxide (NO) dysregulation in a nonischemic model of sepsis-induced ileal injury. To test this hypothesis, a well-established in situ, autoperfused, feline ileal preparation was employed. After endotoxin (lipopolysaccharide [LPS], 3 mg/ kg, intravenously; n = 9) or vehicle (control; n = 5) treatment, ileal segments were obtained at baseline, 2 and 4 h for simultaneous evaluations of cellular and mitochondrial ultrastructure, immunoprevalence of inducible nitric oxide synthase (iNOS) and 3-nitrotyrosine (a stable biomarker of peroxynitrite), and histochemical evidence of apoptosis. Epithelial necrosis was prominent by 2 h post-LPS, despite unaltered global ileal tissue oxygen content, blood volume, and blood flow. Significant evidence of apoptosis and increases in the immunoprevalence of iNOS and 3-nitrotyrosine were not evident until 4 h post-LPS. These results suggest that the early ileal mucosal necrosis may be due to LPS-induced activation of inflammatory pathways and/or microcirculatory disturbances, whereas NO dysregulation may participate in later events, including protein nitration and epithelial apoptosis.
Geriatricians can be the lynchpin of integrated care for older people
Authors: P. Knight, G. Turner
Journal: BMJ (2013)

D’Souza and Guptha argue that frail older people who are unwell need hospital admission for assessment and immediate treatment.1 We agree, but we also believe that active community services achieve more than is suggested.

The King’s Fund review quoted by the authors finds that “hospital at home” services can help to manage the crises that precipitate admissions. …
Poor Prognosis Patients with Inoperable Locally Advanced NSCLC and Large Tumors Benefit from Palliative Chemoradiotherapy: A Subset Analysis from a Randomized Clinical Phase III Trial
Authors: Hans H. Strøm, Roy M. Bremnes, Stein H. Sundstrøm, Nina Helbekkmo, Ulf Aasebø
Journal: Journal of Thoracic Oncology (2014)

Poor prognosis patients with bulky stage III locally advanced non-small-cell lung cancer may not be offered concurrent chemoradiotherapy (CRT). Following a phase III trial concerning the effect of palliative CRT in inoperable poor prognosis patients, this analysis was performed to explore how tumor size influenced survival and health-related quality of life (HRQOL).A total of 188 poor prognosis patients recruited in a randomized clinical trial received four courses intravenous carboplatin day 1 and oral vinorelbine day 1 and 8, at 3-week intervals. The experimental arm (N = 94) received radiotherapy with fractionation 42 Gy/15, starting at the second chemotherapy course. This subset study compares outcomes in patients with tumors larger than 7 cm (N = 108) versus tumors 7 cm or smaller (N = 76).Among those with tumors larger than 7 cm, the median overall survival in the chemotherapy versus CRT arm was 9.7 and 13.4 months, respectively (p = 0.001). The 1-year survival was 33% and 56%, respectively (p = 0.01). Except for a temporary decline during treatment, HRQOL was maintained in the CRT arm, regardless of tumor size. Among those who did not receive CRT, patients with tumors larger than 7 cm experienced a gradual decline in the HRQOL. The CRT group had significantly more esophagitis and hospitalizations because of side effects regardless of tumor size.In patients with poor prognosis and inoperable locally advanced non-small-cell lung cancer, large tumor size should not be considered a negative predictive factor. Except for performance status 2, patients with tumors larger than 7 cm apparently benefit from CRT.
TCT-91 Impact of Untreated Coronary Artery Disease After Percutaneous Coronary Intervention in Patients With Prior CABG: The Residual CABG SYNTAX score
Authors: Sebastian Lluberas, Leandro Jubany, Natalia Esmite, Marcela Delpiano, Daniela Korytnicki, Carolina Artucio, Andres Tuzman, Daniel Mallo, Ricardo Lluberas
Journal: Journal of the American College of Cardiology (2014)
Circadian variation in onset of epistaxis: analysis of hospital admissions
Authors: R. Manfredini
Journal: BMJ (2000)

Circadian patterns have been shown in several acute cardiovascular events-for example, myocardial infarction and stroke-and such patterns could be related to blood pressure rhythms. 1 We reviewed all cases of epistaxis from 1 January 1992 to 31 December 1998 in the emergency department of St Anna Hospital, the emergency hospital for the 150 000 people in the city and suburbs of Ferrara, Italy.In Ferrara epistaxis is considered a medical emergency, for which help is generally sought in hospitals, as practitioners do not make emergency house calls.