tbuckley/cabot-search huggingface dataset:
Adjuvant Chemotherapy in Older Women with Early-Stage Breast Cancer
Authors: Hyman B. Muss, Donald A. Berry, Constance T. Cirrincione, Maria Theodoulou, Ann M. Mauer, Alice B. Kornblith, Ann H. Partridge, Lynn G. Dressler, Harvey J. Cohen, Heather P. Becker, Patricia A. Kartcheske, Judith D. Wheeler, Edith A. Perez, Antonio C. Wolff, Julie R. Gralow, Harold J. Burstein, Ahmad A. Mahmood, Gustav Magrinat, Barbara A. Parker, Ronald D. Hart, Debjani Grenier, Larry Norton, Clifford A. Hudis, Eric P. Winer
Journal: New England Journal of Medicine (2009)

Older women with breast cancer are underrepresented in clinical trials, and data on the effects of adjuvant chemotherapy in such patients are scant. We tested for the noninferiority of capecitabine as compared with standard chemotherapy in women with breast cancer who were 65 years of age or older.We randomly assigned patients with stage I, II, IIIA, or IIIB breast cancer to standard chemotherapy (either cyclophosphamide, methotrexate, and fluorouracil or cyclophosphamide plus doxorubicin) or capecitabine. Endocrine therapy was recommended after chemotherapy in patients with hormone-receptor-positive tumors. A Bayesian statistical design was used with a range in sample size from 600 to 1800 patients. The primary end point was relapse-free survival.When the 600th patient was enrolled, the probability that, with longer follow-up, capecitabine therapy was highly likely to be inferior to standard chemotherapy met a prescribed level, and enrollment was discontinued. After an additional year of follow-up, the hazard ratio for disease recurrence or death in the capecitabine group was 2.09 (95% confidence interval, 1.38 to 3.17; P<0.001). Patients who were randomly assigned to capecitabine were twice as likely to have a relapse and almost twice as likely to die as patients who were randomly assigned to standard chemotherapy (P=0.02). At 3 years, the rate of relapse-free survival was 68% in the capecitabine group versus 85% in the standard-chemotherapy group, and the overall survival rate was 86% versus 91%. Two patients in the capecitabine group died of treatment-related complications; as compared with patients receiving capecitabine, twice as many patients receiving standard chemotherapy had moderate-to-severe toxic effects (64% vs. 33%).Standard adjuvant chemotherapy is superior to capecitabine in patients with early-stage breast cancer who are 65 years of age or older. (ClinicalTrials.gov number, NCT00024102.)
Retrovirus mediated hypoxia-responsive element-regulated neurotrophin-3 transduction attenuates brain injury following focal cerebral ischemia in rats
Authors: Junfeng Zhang, Qindong Shi, Pengbo Yang, Xi Xu, Xinlin Chen, Cunfang Qi, Jianshui Zhang, Haixia Lu, Pengbo Zhang, Bingqiao Zhao, Ping Zheng, Yong Liu
Journal: Molecular Neurodegeneration (2012)

Background Exogenous delivery of Neurotrophin-3 (NT-3) gene may provide a potential therapeutic strategy for ischemic stroke. But uncontrolled expression of NT-3 may cause deleterious side effects. Recently, hypoxia-specific gene expression systems have been developed in various ischemic diseases. To explore ischemia/hypoxia-controlled expression of NT-3 in rats, we constructed a recombinant retrovirus vector with 5HRE and NT-3 and delivered it to rat brain to investigate the neuroprotective effects of hypoxia induced NT-3 overexpression on focal cerebral ischemia.
Bioavailability of Ascorbic Acid in Orange Juice
Authors: Isadore Horowitz
Journal: JAMA (1976)

Several orange-juice preparations were analyzed for biologically active and inactive ascorbic acid derivatives—L-ascorbic acid, dehydro-L-ascorbic acid, and inactive 2,3-diketo-L-gulonic acid. Fresh orange juice contained from 4 to 7 mg/100 ml of inactive ascorbic acid. In contrast, pasteurized orange juice contained from 15 to 30 mg/100 ml of inactive ascorbic acid (up to 400% more than fresh orange juice). Samples of fresh orange juice contained as much as 100% more active ascorbic acid than samples of pasteurized orange juice. There is great variability in prepared orange-juice derivatives with a substantial decrease in bioavailability of active ascorbic acid. (<i>JAMA</i>235:2624-2625, 1976)
Assessing an Unknown Evolutionary Process: Effect of Increasing Site-Specific Knowledge Through Taxon Addition
Authors: David D. Pollock, William J. Bruno
Journal: Molecular Biology and Evolution (2000)

Assessment of the evolutionary process is crucial for understanding the effect of protein structure and function on sequence evolution and for many other analyses in molecular evolution. Here, we used simulations to study how taxon sampling affects accuracy of parameter estimation and topological inference in the absence of branch length asymmetry. With maximum-likelihood analysis, we find that adding taxa dramatically improves both support for the evolutionary model and accurate assessment of its parameters when compared with increasing the sequence length. Using a method we call "doppelgänger trees," we distinguish the contributions of two sources of improved topological inference: greater knowledge about internal nodes and greater knowledge of site-specific rate parameters. Surprisingly, highly significant support for the correct general model does not lead directly to improved topological inference. Instead, substantial improvement occurs only with accurate assessment of the evolutionary process at individual sites. Although these results are based on a simplified model of the evolutionary process, they indicate that in general, assuming processes are not independent and identically distributed among sites, more extensive sampling of taxonomic biodiversity will greatly improve analytical results in many current sequence data sets with moderate sequence lengths.
Acrimonious acronyms and sanctimonious synonyms
Authors: S. Vaisrub
Journal: JAMA (1971)

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
Behavioral Assessment of Lead Intoxication in Children
Authors: Ralph Barocas, Bernard Weiss
Journal: Environmental Health Perspectives (1974)

Current questions about lead exposure focus on the consequences of levels too low to have erupted into blatantly discernible defects. The present paper addresses two sets of interrelated problems derived from this issue. One is how to define the behavioral consequences of asymptomatic lead absorption, and the second focuses on behavioral assessment procedures. Current primary prevention programs emphasize environmental monitoring, and early detection programs emphasize lead body burden measurements. The evaluation of behavioral problems in school children as a function of body burden is rarely performed. Epidemiologic data indicate sufficient natural variability to determine the degree of association between indices of total body burden and behavior. Assessment procedures are described and research suggestions offered that sample concretely defined target behaviors in social environments.
Pathophysiology of hypotension in patients with fulminant hepatic failure.
Authors: P N Trewby, R Williams
Journal: Gut (1977)

Studies on the incidence and pathophysiology of hypotension in fulminant hepatic failure showed that 82 out of 94 patients developed arterial hypotension with a systolic blood pressure of less than 80 mmHg. Such episodes accounted for 16% of the total time spent in grade IV coma. Factors such as haemorrhage, cardiac or respiratory abnormalities, extracorporeal perfusion, or hypotension which occurred during the terminal stages of the illness, could be implicated for only 40% of this time, leaving 60% as unexplained. Further investigation of these unexplained factors showed that peripheral vasodilatation rather than primary heart failure was responsible, and in all but three patients construction of ventricular function curves showed a normal ventricular response to volume expansion with a corresponding increase in blood pressure. A small, but significant, slowing of the heart rate occurred during these periods of unexplained hypotension. This, together with the association that was found between the occurrence of hypotension and cerebral oedema with coning, suggests that central vasomotor depression may be important in its pathogenesis.
A Biethnic Community Survey of Cognition in Participants With Type 2 Diabetes, Impaired Glucose Tolerance, and Normal Glucose Tolerance
Authors: Robert D. Lindeman, Linda J. Romero, Asenath LaRue, C. Lillian Yau, David S. Schade, Kathleen M. Koehler, Richard N. Baumgartner, Phillip J. Garry
Journal: Diabetes Care (2001)

OBJECTIVE—To determine whether elderly individuals with type 2 diabetes or impaired glucose tolerance are at increased risk for cognitive impairment compared with individuals with normal glucose tolerance. RESEARCH DESIGN AND METHODS—Elderly Hispanic individuals (n = 414) and non-Hispanic white individuals (n = 469) aged ≥65 years, randomly selected from the Medicare rolls of Bernalillo County (Albuquerque), NM, were recruited for an interview/examination that included an evaluation of glucose tolerance. Information on nine tests of cognitive function and two measures of depression allowed comparisons between diabetic status and these functions. Comparisons also were made between glycosolated hemoglobin concentrations and these cognitive tests in the 188 participants with diabetes. RESULTS—None of the mean scores on the tests of cognitive function was significantly lower in the participants with diabetes compared with those participants with normal glucose tolerance after adjustments for ethnicity, sex, age, level of education, and presence of depression, with or without elimination of those with dementia (Mini-Mental State Exam &amp;lt;18). Interestingly, participants with impaired glucose tolerance tended to score higher than those with normal glucose tolerance. No significant associations were found between glycosolated hemoglobin concentrations and cognitive test scores in participants with diabetes. CONCLUSIONS—We could not show any increased risk for cognitive impairment in participants with diabetes compared with those with normal glucose tolerance after adjustments for ethnicity, sex, age, education, and presence of depression, before or after elimination of dementia in this random sample from a biethnic population of predominantly community-dwelling elders.
Potentiation of Cocaine-Induced Coronary Vasoconstriction by Beta-Adrenergic Blockade
Authors: Richard A. Lange
Journal: Annals of Internal Medicine (1990)

Study Objective: To determine whether beta-adrenergic blockade augments cocaine-induced coronary artery vasoconstriction. Design: Randomized, double-blind, placebo-controlled trial. Setting: A cardiac catheterization laboratory in an urban teaching hospital. Patients: Thirty clinically stable patient volunteers referred for catheterization for evaluation of chest pain. Interventions: Heart rate, arterial pressure, coronary sinus blood flow (by thermodilution), and epicardial left coronary arterial dimensions were measured before and 15 minutes after intranasal saline or cocaine administration (2 mg/kg body weight) and again after intracoronary propranolol administration (2 mg in 5 minutes). Measurements and Main Results: No variables changed after saline administration. After cocaine administration, arterial pressure and rate-pressure product increased; coronary sinus blood flow fell (139 ± 28 [mean ± SE] to 120 ± 20 mL/min); coronary vascular resistance (mean arterial pressure divided by coronary sinus blood flow) rose (0.87 ± 0.10 to 1.05 ± 0.10 mm Hg/mL · min); and coronary arterial diameters decreased by between 6% and 9% (P < 0.05 for all variables). Subsequently, intracoronary propranolol administration caused no change in arterial pressure or rate-pressure product but further decreased coronary sinus blood flow (to 100 ± 14 mL/min) and increased coronary vascular resistance (to 1.20 ± 0.12 mm Hg/mL · min) (P < 0.05 for both). Conclusions: Cocaine-induced coronary vasoconstriction is potentiated by beta-adrenergic blockade. Beta-adrenergic blocking agents probably should be avoided in patients with cocaine-associated myocardial ischemia or infarction.
Early Predictors of Survival to and After Heart Transplantation in Children With Dilated Cardiomyopathy
Authors: Biagio A. Pietra, Paul F. Kantor, Heather L. Bartlett, Clifford Chin, Charles E. Canter, Ranae L. Larsen, R. Erik Edens, Steven D. Colan, Jeffrey A. Towbin, Steven E. Lipshultz, James K. Kirklin, David C. Naftel, Daphne T. Hsu
Journal: Circulation (2012)

Background— The importance of clinical presentation and pretransplantation course on outcome in children with dilated cardiomyopathy listed for heart transplantation is not well defined. Methods and Results— The impact of age, duration of illness, sex, race, ventricular geometry, and diagnosis of myocarditis on outcome in 261 children with dilated cardiomyopathy enrolled in the Pediatric Cardiomyopathy Registry and Pediatric Heart Transplant Study was studied. End points included listing as United Network for Organ Sharing status 1, death while waiting, and death after transplantation. The median age at the time of diagnosis was 3.4 years, and the mean time from diagnosis to listing was 0.62±1.3 years. Risk factors associated with death while waiting were ventilator use and older age at listing in patients not mechanically ventilated ( P =0.0006 and P =0.03, respectively). Shorter duration of illness ( P =0.04) was associated with listing as United Network for Organ Sharing status 1. Death after transplantation was associated with myocarditis at presentation ( P =0.009), nonwhite race ( P &lt;0.0001), and a lower left ventricular end-diastolic dimension z score at presentation ( P =0.04). In the myocarditis group, 17% (4 of 23) died of acute rejection after transplantation. Conclusions— Mechanical ventilator use and older age at listing predicted death while waiting, whereas nonwhite race, smaller left ventricular dimension, and myocarditis were associated with death after transplantation. Although 97% of children with clinically or biopsy-diagnosed myocarditis at presentation survived to transplantation, they had significantly higher posttransplantation mortality compared with children without myocarditis, raising the possibility that preexisting viral infection or inflammation adversely affects graft survival.
Violence, Values, and Gender
Authors: Anne H. Flitcraft
Journal: JAMA (1992)

"I want to do a study of battered women." "Fine. There are data from the rape crisis team in the ED that need to be pulled together." "No, not rape. I want to study battered women." "What's a battered woman?" Dialogue between medical student and adviser New Haven, Conn, 1975 Violence epidemiology is still in its infancy. In our offices, clinics, and emergency departments we all see injury and its consequences, perhaps daily. And yet, like a clinical Heisenberg's uncertainty principle, the more closely we focus on injuries, the less we seem to understand the violent relationships that culminate in these injuries. When we begin to make the connection between our patients' health problems and violence, we experience the same sort of epiphany that came with child abuse in the 1960s. I was shocked into recognizing the complex interplay of poor health, injury, and violence during residency when I was
Flaubert and parrotry
Authors: Theodore Dalrymple
Journal: BMJ (2008)

When, exactly, did it become a sign of superior sensibility and intellect to decry the bourgeoisie and the bourgeois virtues? No doubt it is impossible to put a date on it as exactly as that of, say, the Battle of Hastings; but there is no doubt that one of the chief critics of the bourgeois mentality was that arch-bourgeois Gustave Flaubert.

In his Dictionary of Received Ideas —which he started in 1849 and never finished, and which was not published until 1911, 30 years after his death—Flaubert makes ironical fun of the bourgeois cliches of his time, among which are many relating to medicine. He disliked intensely …
The Right to Expert Testimony
Authors: Arthur Harris Rosenberg
Journal: New England Journal of Medicine (1970)

THE trial of a criminal case is often a lopsided matter. On the prosecution side there is frequently a complete battery of medical experts, laboratories and a seemingly inexhaustible supply of funds with which to obtain other, expert testimony if needed. In contrast to this, on the defense side, one usually finds the client and his attorney; their pretrial access to medical experts and tests and later to in-court testimony is frequently limited by the financial resources of the client. For the indigent accused, the lack of finances has been an insuperable barrier to the availability of such assistance and, . . .
Medium-Term Survival after Hospitalization with Community-Acquired Pneumonia
Authors: Grant W. Waterer, Lori A. Kessler, Richard G. Wunderink
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

An episode of community-acquired pneumonia (CAP) has been suggested to predict greater than expected mortality after discharge from hospital. We ascertained the survival status as of December 2002 of a cohort of patients with CAP identified prospectively between November 1998 and June 2001. Cox regression analysis was used to examine the impact of demographic factors, comorbid illnesses, and CAP severity on subsequent mortality. Of 378 CAP survivors we ascertained the survival status of 366 (96.9%), 125 (34.1%) of whom had died. The mean length of follow-up was 1,058 days (range, 602-1,500 days). Independent predictors of mortality were increasing age (p < 0.001), comorbid cerebrovascular (p = 0.002) and cardiovascular (p = 0.023) disease, an altered mental state (p < 0.001), a hematocrit of less than 35% (p = 0.035), and increasing blood glucose level (p = 0.025). In 41- to 80-year-olds without significant comorbidities there was a trend to greater than expected mortality. In conclusion, an episode of CAP in young adults without significant comorbid illnesses does not appear to be an adverse prognostic marker of medium-term survival. The trend to greater than expected mortality in patients over 40 years of age needs further study and physicians should be particularly alert for underlying life-limiting disease processes in patients presenting with acute confusion or a hematocrit of less than 35%.
Dispersion of repolarization and the genotype of long QT syndrome
Authors: Wojciech Zareba, Craig R. Narins, Arthur J. Moss, Jesaia Benhorin, Emanuela H. Locati, Silvia G. Priori, Peter J. Schwartz, G.Michael Vincent, Michael Lehmann, W. Jackson Hall, Jennifer L. Robinson, Li Zhang, Jeffrey A. Towbin, Mark T. Keating, Jean W. MacCluer, Katherine W. Timothy
Journal: Journal of the American College of Cardiology (1996)
Serum bilirubin studies in patients with intermittent intrahepatic cholestasis.
Authors: R Brodersen, N Tygstrup
Journal: Gut (1967)

EDITORIAL COMMENT Rapid elimination of injected bilirubin with low serum concentrations of unconjugated bilirubin indicates a hyperactive conjugation mechanism.The cholestatic syndrome may be due to an excess of alkali-stable monoconjugate.
Hepatic Expression of Class I and Class Ii Major Histocompatibility Complex Molecules in Primary Biliary Cirrhosis: Effect of Ursodeoxycholic Acid
Authors: Yvon Calmus, Pierre Gane, Philippe Rouger, Raoul Poupon
Journal: Hepatology (1990)

Aberrant hepatic expression of HLA molecules has been shown to be present in primary biliary cirrhosis and may play a determining role in the pathogenesis of the disease. We have studied the effect of the long-term administration of ursodeoxycholic acid on hepatic HLA expression. Nine untreated patients with primary biliary cirrhosis, eight patients treated for at least a year with ursodeoxycholic acid and eight control subjects without hepatobiliary disease were compared. HLA expression was studied on liver biopsy sections using a direct immunofluorescence technique with specific monoclonal antibodies directed against class I or class II HLA molecules. Aberrant biliary HLA class II expression was not modified by chronic administration of ursodeoxycholic acid. In contrast, aberrant hepatocyte HLA class I expression was markedly reduced. Reduction in HLA class I expression may lead to decreased cytotoxic T cell-dependent lobular necrosis, which is thought to contribute to the progression of primary biliary cirrhosis to advanced stages. These findings suggest that the beneficial effect of ursodeoxycholic acid treatment in primary biliary cirrhosis could result not only from a reduction in the intrahepatic accumulation of cytotoxic bile acids but also from a reduction in immunological injury.
Incidence of Type 1 Diabetes in Finland
Authors: Valma Harjutsalo, Reijo Sund, Mikael Knip, Per-Henrik Groop
Journal: JAMA (2013)

Incidence of Type 1 Diabetes in FinlandThe incidence of type 1 diabetes (T1D), one of the most prevalent chronic disease in children, has increased worldwide. 1The highest recorded incidence in children younger than 15 years was 64.2 per 100 000 person-years in Finland in 2005. 2 We examined the incidence rates between 2006 and 2011 in Finnish children younger than 15 years as well as the 32-year trend (1980-2011).Methods | All children with newly diagnosed T1D were ascertained using several nationwide registers as previously described. 2Age-standardized and age-specific annual incidence rates for age groups 0-4, 5-9, and 10-14 years were calculated.Changes in trends between 1980 and 2011 were identified using the Joinpoint Regression Program version 4.0.1 (Na-
Nine-year follow-up of a case of Grzybowski type multiple keratoacanthomas and failure to demonstrate human papillomavirus
Authors: N. Haas, D. Schadendorf, B.M. Henz, P.G. Fuchs
Journal: British Journal of Dermatology (2002)

Journal Article Nine‐year follow‐up of a case of Grzybowski type multiple keratoacanthomas and failure to demonstrate human papillomavirus Get access N. Haas, N. Haas Department of Dermatology, Medical Faculty (Charité), Humboldt University Berlin, Schumannstrasse 20/21, 10117 Berlin, Germany Norbert Haas. E‐mail: norb.haas@charite.de Search for other works by this author on: Oxford Academic Google Scholar D. Schadendorf, D. Schadendorf Skin Cancer Unit, German Cancer Research Centre, Heidelberg, Germany Search for other works by this author on: Oxford Academic Google Scholar B.M. Henz, B.M. Henz Department of Dermatology, Medical Faculty (Charité), Humboldt University Berlin, Schumannstrasse 20/21, 10117 Berlin, Germany Search for other works by this author on: Oxford Academic Google Scholar P.G. Fuchs P.G. Fuchs Institute of Virology, Cologne University, Cologne, Germany Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 147, Issue 4, 1 October 2002, Pages 793–796, https://doi.org/10.1046/j.1365-2133.2002.04925.x Published: 01 October 2002 Article history Accepted: 17 March 2002 Published: 01 October 2002