tbuckley/cabot-search huggingface dataset:
Endoscopic ultrasound staging in gastric cancer: Does it help management decisions in the era of neoadjuvant treatment?
Authors: A. Kutup, Y. Vashist, S. Groth, E. Vettorazzi, E. Yekebas, N. Soehendra, J. Izbicki
Journal: Endoscopy (2012)

Endoscopic ultrasonography (EUS) has been shown to be the most accurate test for locoregional staging of upper gastrointestinal tumors; however, recent studies have questioned its accuracy level in daily clinical application. The present retrospective study analyzes the accuracy of EUS in guiding interdisciplinary treatment decisions.123 primarily operated patients (63 % men, mean age 61.4 years) were included; only cases with tumor-free resection margins and without evidence of distant metastases were selected. EUS and histopathological findings were compared. Main outcome parameter was the distinction between tumors to be primarily operated (T1 /2N0) and those to be treated by neoadjuvant or perioperative chemotherapy (T3/4, or any N + ), based on an assumed algorithm for treatment stratification.Overall staging accuracy of EUS was 44.7 % for T and 71.5 % for N status irrespective of tumor location. Overstaging was the main problem (44.9 % for T, 42.9 % for N staging). The overall EUS classification was correct in 79.7 % (accuracy), with a sensitivity 91.9 % and specificity 51.4 %; only 19 out of 37 cases with histopathological T1/2N0 were correctly classified by EUS. Positive and negative predictive values of EUS in diagnosing advanced tumor stage for assignment to neoadjuvant therapy were 81.4 % and 73.1 %, respectively.Whereas EUS has a high sensitivity in the diagnosis of locally advanced gastric cancer, endosonographic overstaging of T2 cancers appears to be a frequent problem. EUS stratification between local (T1 /2N0) and advanced (T3/4 or any N + ) tumors would thus result in incorrect assignment to neoadjuvant treatment in half of cases.
Dopamine Reward Pathway in Adult ADHD—Reply
Authors: Nora D. Volkow
Journal: JAMA (2010)

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
Comparative Determinants of 4-Year Cardiovascular Event Rates in Stable Outpatients at Risk of or With Atherothrombosis
Authors: Deepak L. Bhatt, Kim A. Eagle, E. Magnus Ohman, Alan T. Hirsch, Shinya Goto, Elizabeth M. Mahoney, Peter W. F. Wilson, Mark J. Alberts, Ralph D’Agostino, Chiau-Suong Liau, Jean-Louis Mas, Joachim Röther, Sidney C. Smith, Geneviève Salette, Charles F. Contant, Joseph M. Massaro, Ph. Gabriel Steg, for the REACH Registry Investigators
Journal: JAMA (2010)

Clinicians and trialists have difficulty with identifying which patients are highest risk for cardiovascular events. Prior ischemic events, polyvascular disease, and diabetes mellitus have all been identified as predictors of ischemic events, but their comparative contributions to future risk remain unclear.To categorize the risk of cardiovascular events in stable outpatients with various initial manifestations of atherothrombosis using simple clinical descriptors.Outpatients with coronary artery disease, cerebrovascular disease, or peripheral arterial disease or with multiple risk factors for atherothrombosis were enrolled in the global Reduction of Atherothrombosis for Continued Health (REACH) Registry and were followed up for as long as 4 years. Patients from 3647 centers in 29 countries were enrolled between 2003 and 2004 and followed up until 2008. Final database lock was in April 2009.Rates of cardiovascular death, myocardial infarction, and stroke.A total of 45,227 patients with baseline data were included in this 4-year analysis. During the follow-up period, a total of 5481 patients experienced at least 1 event, including 2315 with cardiovascular death, 1228 with myocardial infarction, 1898 with stroke, and 40 with both a myocardial infarction and stroke on the same day. Among patients with atherothrombosis, those with a prior history of ischemic events at baseline (n = 21,890) had the highest rate of subsequent ischemic events (18.3%; 95% confidence interval [CI], 17.4%-19.1%); patients with stable coronary, cerebrovascular, or peripheral artery disease (n = 15,264) had a lower risk (12.2%; 95% CI, 11.4%-12.9%); and patients without established atherothrombosis but with risk factors only (n = 8073) had the lowest risk (9.1%; 95% CI, 8.3%-9.9%) (P < .001 for all comparisons). In addition, in multivariable modeling, the presence of diabetes (hazard ratio [HR], 1.44; 95% CI, 1.36-1.53; P < .001), an ischemic event in the previous year (HR, 1.71; 95% CI, 1.57-1.85; P < .001), and polyvascular disease (HR, 1.99; 95% CI, 1.78-2.24; P < .001) each were associated with a significantly higher risk of the primary end point.Clinical descriptors can assist clinicians in identifying high-risk patients within the broad range of risk for outpatients with atherothrombosis.
Cigarette smoking by socioeconomic group, sex, and age: effects of price, income, and health publicity
Authors: J Townsend, P Roderick, J Cooper
Journal: BMJ (1994)

<h3>Abstract</h3> <b>Objective:</b> To assess effects of price, income, and health publicity on cigarette smoking by age, sex, and socioeconomic group. <b>Design:</b> Econometric multiple regression analysis of data on cigarette smoking from the British general household survey. <b>Subjects:</b> Random sample of adult population in Britain interviewed for biennial general household surveys 1972-90. Main outcome measures - Changes in cigarette consumption and prevalence of smoking. <b>Results:</b> Price elasticities of demand for cigarettes (percentage change in cigarette consumption for a 1% change in price) were significant at -0.5 (95% confidence interval -0.8 to -0.1) for men and -0.6 (-0.9 to -0.3) for women, were highest in socioeconomic group V (-1.0 for men and -0.9 for women), and lowest (not significantly different from zero) in socioeconomic groups I and II. The gradient in price elasticities by socioeconomic group was significant for men (F=5.6, P=0.02) and for women (F=6.1, P=0.02). Price was a significant factor in cigarette consumption by age for women in every age group and for men aged 25-34. Cigarette consumption by young men aged 16-34 increased with income. There was a significant decrease in smoking over time by women in socioeconomic groups I and II and by men in all age and social groups except socioeconomic group V attributable to health publicity. Price significantly affected smoking prevalence in socioeconomic group V (-0.6 for men and -0.5 for women) and for all women (-0.2). <b>Conclusions:</b> Men and women in lower socioeconomic groups are more responsive than are those in higher socioeconomic groups to changes in the price of cigarettes and less to health publicity. Women of all ages, including teenagers, appear to have been less responsive to health publicity than have men but more responsive to price. Response to health publicity decreased linearly with age. Real price increases in cigarettes could narrow differences between socioeconomic groups in smoking and the related inequalities in health, but specific measures would be necessary to ameliorate effects on the most deprived families that may include members who continue to smoke. The use of a policy to steadily increase cigarette tax is likely to help achieve the government9s targets for smoking and smoking related diseases.
Erythropoietin to treat head and neck cancer patients with anaemia undergoing radiotherapy: randomised, double-blind, placebo-controlled trial
Authors: Michael Henke, Roland Laszig, Christian Rübe, Ulrich Schäfer, Klaus-Dieter Haase, Burkhard Schilcher, Stephan Mose, Karl T Beer, Ulrich Burger, Chris Dougherty, Hermann Frommhold
Journal: The Lancet (2003)
[378] IRON STATUS MODULATES THE EXPRESSION OF THE UBIQUITIN LIGASE MDM-2 AND ITS TARGET p53 IN MOUSE HEPATOCYTES AND HUMAN MONOCYTES; EFFECT ON THE ANTI-OXIDANT RESPONSE
Authors: L. Valenti, P. Dongiovanni, C. Megazzini, A.L. Fracanzani, S. Fargion
Journal: Journal of Hepatology (2007)
Book: Over our dead bodies: Port Arthur and Australia's fight for gun control
Authors: M. E Black
Journal: BMJ (1999)

Simon Chapman Pluto Press, $A24.95, pp 218 ISBN 1 86403 037 2 Rating: ![Graphic][1]</img>![Graphic][2]</img>![Graphic][3]</img> On Sunday 28 April 1996, 23 year old Martin Bryant entered a tourist complex 100 km south of Hobart, Tasmania, and shot dead 35 people, wounding 18 others. The media described it as “the worst massacre by a single gunman in Australian history,” although Chapman points out on page 1 that the wholesale slaughter of aborigines in the 19th century often involved far higher individual tallies. Before this watershed tragedy, Australia's eight states and … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif
WATER HEMLOCK POISONING
Authors: Myrl M. Miller
Journal: JAMA (1933)

Cases of hemlock poisoning, though relatively unusual, are not at all rare. The following case is reported not because of the rarity of the condition but because of the striking efficacy of the treatment employed; namely, the use of sodium amytal intravenously. "The number of poisonous plants which are to be found growing wild or in gardens is much larger than is generally supposed, and the cases of poisoning annually reported are more numerous than is commonly realized. One of the most common ways in which poisoning occurs is from the eating of underground parts of plants which resemble more or less closely species that are known to be edible. Thus it has often happened that young folks off for a ramble in the country come across some wild plant that suggests parsnip or some similar herb and has an attractive looking root which has perhaps been uncovered by recent
Effect of cigarette smoking on cultured human endothelial cells
Authors: A A Noronha-Dutra, M M Epperlein, N Woolf
Journal: Cardiovascular Research (1993)

Objective: The aim was to investigate whether the morphological changes previously described in endothelium exposed to cigarette smoke are linked with the oxidative burden imposed on the cells. Methods: Cultured human umbilical vein endothelial cells (HUVEC) were exposed to samples of plasma taken from volunteer smokers and to samples of plasma to which small doses of fresh cigarette smoke derived from a smoking machine had been added. Measurements of the pentose phosphate pathway and the extruded total glutathione (GSSG) were performed to assess the presence and degree of oxidative stress on cells. Angiotensin converting enzyme (ACE) release into the medium and the ATP content of the cells were used to assess early membrane damage and cytotoxicity. Results: Treatment of endothelial cells with plasma exposed to cigarette smoke in vitro resulted in activation of the pentose phosphate pathway of glucose metabolism, increased extrusion of glutathione from the cells into the medium, a decrease in the ATP pool, and release of ACE from the cells into the medium. Plasma taken from volunteers immediately after smoking showed, as might be expected, similar but less marked changes in the release of glutathione and ACE. Conclusions: Plasma from human volunteer smokers or human plasma exposed to cigarette smoke in vitro produced injury in HUVEC as assessed by changes in the ATP pool and ACE release. The extrusion of glutathione from the cells and the activation of the hexose monophosphate shunt, which is necessary to keep glutathione in the reduced state, is indicative of oxidative stress. These findings support the view that cigarette smoke related endothelial injury is, at least in part, mediated by the oxidative burden imposed by the free radicals present in cigarette smoke. Cardiovascular Research 1993;27:774-778
Abstract 1047: Suppression of the chromatin remodeling protein CHD3 and platinum resistance in ovarian cancer
Authors: Noelle Cutter, Michele Vigliotti, Elena Lum, Kazimierz O. Wrzeszczynski, Vinay Varadan, Nevenka Dimitrova, Douglas A. Levine, Robert Lucito
Journal: Cancer Research (2012)

Abstract Epithelial ovarian cancer is the leading cause of death from gynecological malignancies. Currently platinum-based chemotherapy, coupled with a taxane based drug is the primary treatment for ovarian cancer. Approximately 25% of patients either present with or rapidly develop resistance to platinum based chemotherapy and all recurrent tumors ultimately become resistant. Epigenetic modifications have been associated with tumor formation and progression and may contribute to therapy response. We hypothesize that Epigenetic changes such as DNA CpG methylation is in part responsible for the onset of chemoresistance of EOC. To identify epigenetically regulated genes associated with ovarian cancer chemotherapy resistance, a genome wide approach was used. For the most significant genes an in vitro culture system was developed to study platinum resistance. Candidate genes were screened by addition of shRNAs to model the transcriptional suppression caused by DNA methylation and genes that scored positive for increasing resistance were identified, one of them being the CHD3 gene. Here we show that loss of expression of CHD3, a member of the Mi-2/NuRD complex, causes increased resistance to platinum chemotherapy drugs. Additionally, ovarian cell lines transcriptionally silenced for CHD3 are more invasive, and have increased migratory ability. Recent evidence suggests molecular and phenotypic associations between chemo resistance and the acquisition of epithelial-mesenchymal transition of cancer cells. The transition of epithelial cell to a mesenchymal cell requires an alteration in morphology, cellular architecture, adhesion, and migration capacity. Cancer cells undergoing EMT can acquire invasive properties and enter the surrounding stroma, resulting in the creation of a favorable microenvironment for cancer progression and metastasis. Our results indicate that when CHD3 is silenced, cells undergo an EMT-like transition thereby allowing them to bypass apoptosis and resist platinum based therapy. Taken together, we provide the first evidence of a role for CHD3 as an important epigenetic regulator of chemoresistance in ovarian cancer and hypothesize EMT as one of the underlying mechanisms. Furthermore, CHD3 expression might represent a therapy response predictor and could be a future therapeutic target for ovarian cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 1047. doi:1538-7445.AM2012-1047
Regulation of the proapoptotic BH3-only protein BIM by glucocorticoids, survival signals and proteasome in chronic lymphocytic leukemia cells
Authors: D Iglesias-Serret, M de Frias, A F Santidrián, L Coll-Mulet, A M Cosialls, M Barragán, A Domingo, J Gil, G Pons
Journal: Leukemia (2006)
Mut of malady.
Authors: H G Egdell
Journal: BMJ (1973)

and is more effective than other alkylating agents in suppressing antibody production.3Accepting the fact that patients may be too few for a controlled trial, I feel that patients given treatment of this type should have frequent scientific assessment of the activity of their disease.In the case of S.L.E.one might expect a record of frequent estimations of a2-globulins, complement components, cryoglobulins, serum DNA, and RNA antibodies, as well as L.E. cells and antinuclear factor.
THU0194 Lipid Profile of Rheumatoid Arthritis Patients Treated with Anti-TNF-Alpha Drugs Changes According to Disease Activity Response
Authors: F. Cacciapaglia, M. G. Anelli, A. Rinaldi, L. Serafino, L. Coladonato, M. Covelli, C. Scioscia, F. Iannone, G. Lapadula
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Rheumatoid arthritis (RA) patients present increased mortality due to cardiovascular (CV) events, particularly by inflammation in addition to traditional CV risk factors (mainly changes in lipid profile). Although anti-TNF agents have been proven effective in controlling joint damage and systemic inflammation, nowadays there is still controversy about the real effect of anti-TNF treatment on the lipid profile. <h3>Objectives</h3> The aim of this study is to evaluate the evolution of the lipid profile after the onset of anti-TNF therapy. <h3>Methods</h3> Eighty RA patients (65 female, age 53±13 years, disease duration 7±5 years), who failed treatment with DMARDs, have been enrolled in this study, and evaluated, before and at 24 and 52 weeks from the start of anti-TNF treatment, for the following lipid profile: Total-cholesterol (Tot-C), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), triglycerides (TG), and cholesterol risk ratio (CRR) [Tot-C/HDL-C] was also calculated. At the same time the disease activity scores CDAI, SDAI, DAS44 and DAS28, four variables, were assessed. Twenty-nine patients were treated with etanercept, 19 with adalimumab, 18 with infliximab, 7 with certolizumab-pegol and 7 with golimumab. <h3>Results</h3> The levels of Tot-C, HDL-C, LDL-C and TG, as well as CRR, didn't significantly changed during the follow-up period of treatment. Considering the disease activity according to CDAI, SDAI, DAS44 and DAS28, about 50% of patients achieved low disease activity/remission state after 24weeks and about 60% achieved this state after 52 weeks of treatment. In this latter group of patients we observed significantly lower levels of Tot-C, LDL-C, and TG, and a lower CRR compared to those observed in patients with moderate/high disease (see Table). No significant differences were found between the anti-TNF evaluated. <h3>Conclusions</h3> Our study suggest that anti-TNFα treatment per se do not interfere with the lipid profile of RA patients. While according to response to TNFα treatment, assessed by CDAI, SDAI, DAS44 or DAS28, patients that achieved low disease activity/remission seems to have a protective lipid profile for CV events, so a better control of the disease can also affect the lipid metabolism. <h3>Disclosure of Interest</h3> None Declared
NONALCOHOLIC CIRRHOSIS OF THE LIVER IN THE LEBANON AND SYRIA
Authors: H. A. YENIKOMSHIAN
Journal: JAMA (1934)

Hepatic disorders are common in Syria and the Lebanon. In addition to the enlarged livers due to congestive heart failure and disease of the biliary tract, hydatid cysts and amebic abscesses of the liver are frequently seen. More frequently encountered is a third group of patients with hepatic enlargement associated with splenomegaly. The clinical features of this group are epigastric distention, irregular bowel action and drowsiness after meals. Many of the patients have had repeated febrile attacks associated with jaundice, often accompanied by transient hepatic enlargement, epigastric tenderness, nausea and vomiting, lasting from a few days to a few weeks. Many live a reasonably long life without marked evidence of liver insufficiency. Rowntree<sup>1</sup>says that their cirrhosis is probably compensated. A number sooner or later develop evidences of advanced portal cirrhosis with ascites. Cirrhosis of the liver is seen more commonly at the American University of Beirut among clinic
IMPACT OF EJECTION FRACTION ON LONG-TERM OUTCOME AFTER ELECTIVE AORTIC VALVE REPLACEMENT IN OCTOGENARIANS WITH AORTIC STENOSIS
Authors: Kentaro Shibayama, Hiroyuki Watanabe, Shunsuke Sasaki, Keitaro Mahara, Toshihiro Fukui, Shuichiro Takanashi, Tetsuya Sumiyoshi
Journal: Journal of the American College of Cardiology (2012)
One physician's perspective
Authors: Jean Claude Koenig
Journal: British Journal of Sports Medicine (2010)

<h3>Objective</h3> Focused assessment with sonography in trauma (FAST) examination is a widely known initial evaluation for patients with trauma. However, it remains unclear whether FAST contributes to patient survival in patients with haemodynamically stable trauma. In this study, we compared in-hospital mortality and length of stay between patients undergoing initial FAST vs initial CT for haemodynamically stable torso trauma. <h3>Methods</h3> This was a retrospective cohort study using data from 264 major emergency hospitals in the Japan Trauma Data Bank between 2004 and 2016. Patients were included if they had torso trauma with a chest or abdomen abbreviated injury scale score of ≥3 and systolic blood pressure of ≥100 mm Hg at hospital arrival. Eligible patients were divided into those who underwent initial FAST and those who underwent initial CT. Multivariable logistic regression analysis for in-hospital mortality and multivariable linear regression for length of stay were performed to compare the initial FAST and initial CT groups with adjustment for patient backgrounds while also adjusting for within-hospital clustering using a generalised estimating equation. <h3>Results</h3> There were 9942 patients; 8558 underwent initial FAST and 1384 underwent initial CT. Multivariable logistic regression showed no significant difference in in-hospital mortality between the initial FAST and initial CT groups (OR 1.37, 95% CI 0.94 to 1.99, p=0.10). Multivariable linear regression revealed that the initial FAST group had a significantly longer length of stay than the initial CT group (difference: 3.5 days; 95% CI 1.0 to 5.9, p&lt;0.01). <h3>Conclusions</h3> In-hospital mortality was not significantly different between the initial FAST and initial CT groups for patients with haemodynamically stable torso trauma. Initial CT should be considered in patients with haemodynamically stable torso trauma.