tbuckley/cabot-search huggingface dataset:
Brief Communication: American Ginseng Reduces Warfarin's Effect in Healthy Patients
Authors: Chun-Su Yuan, Gang Wei, Lucy Dey, Theodore Karrison, Linda Nahlik, Spring Maleckar, Kristen Kasza, Michael Ang-Lee, Jonathan Moss
Journal: Annals of Internal Medicine (2004)

People using prescription medication often concurrently take herbal supplements. In a case report, the anticoagulant effect of warfarin decreased after patients consumed ginseng.To evaluate the interactions between American ginseng and warfarin.Randomized, double-blind, placebo-controlled trial.General Clinical Research Center, University of Chicago, Chicago, Illinois.20 healthy patients.In this 4-week study, 20 patients received warfarin for 3 days during weeks 1 and 4. Beginning in week 2, patients were assigned to receive either American ginseng or placebo.International normalized ratio (INR) and plasma warfarin level.The peak INR statistically significantly decreased after 2 weeks of ginseng administration compared with placebo (difference between ginseng and placebo, -0.19 [95% CI, -0.36 to -0.07]; P = 0.0012). The INR area under the curve (AUC), peak plasma warfarin level, and warfarin AUC were also statistically significantly reduced in the ginseng group as compared with the placebo group. Peak INR and peak plasma warfarin level were positively correlated.The study sample consisted of young, healthy volunteers in a research setting rather than patients taking therapeutic doses of warfarin.American ginseng reduces warfarin's anticoagulant effect. When prescribing warfarin, physicians should ask patients about ginseng use.
Prognostic Importance of Physical Examination for Heart Failure in Non–ST-Elevation Acute Coronary Syndromes
Authors: Umesh N. Khot, Gang Jia, David J. Moliterno, A. Michael Lincoff, Monica B. Khot, Robert A. Harrington, Eric J. Topol
Journal: JAMA (2003)

ContextIn acute myocardial infarction, the presence and severity of heart failure at the time of initial presentation have been formally categorized by the Killip classification. Although well studied in ST-elevation myocardial infarction, the prognostic importance of Killip classification in non–ST-elevation acute coronary syndromes is not well established.ObjectivesTo determine the prognostic importance of physical examination for heart failure analyzed according to Killip classification in non–ST-elevation acute coronary syndromes and to understand its predictive value relative to other variables.Design, Setting, and PatientsFrom April 2001 to September 2003, We analyzed information from 26 090 patients with non–ST-elevation acute coronary syndromes enrolled in the GUSTO IIb, PURSUIT, PARAGON A, and PARAGON B trials. Demographic information was categorized by Killip class. Killip classes III and IV were combined into 1 category. Multivariate Cox proportional hazard models were developed to determine the prognostic importance of Killip classification in comparison with other variables.Main Outcome MeasureAssociation between Killip classification and all-cause mortality at 30 days and 6 months.ResultsPatients in Killip class II (n = 2513) and III/IV (n = 390) were older than those in Killip class I (n = 23 187), with higher rates of diabetes, prior myocardial infarction, ST depression, and elevated cardiac enzymes (all P&lt;.001). Higher Killip class was associated with higher mortality at 30 days (2.8% in Killip class I vs 8.8% in class II vs 14.4% in class III/IV; P&lt;.001) and 6 months (5.0% vs 14.7% vs 23.0%, respectively; P&lt;.001). Patients with Killip class II, III, or IV constituted 11% of the overall population but accounted for approximately 30% of the deaths at both time points. In multivariate analysis, Killip class III/IV was the most powerful predictor of mortality at 30 days (hazard ratio [HR], 2.35; 95% confidence interval [CI], 1.69-3.26; P&lt;.001) and 6 months (HR, 2.12; 95% CI, 1.63-2.75; P&lt;.001). Killip class II was predictive of mortality at 30 days (HR, 1.73; 95% CI, 1.44-2.09; P&lt;.001) and 6 months (HR, 1.52; 95% CI, 1.31-1.76; P&lt;.001). Five factors—age, Killip classification, heart rate, systolic blood pressure, and ST depression—provided more than 70% of the prognostic information for 30-day and 6-month mortality.ConclusionsKillip classification is a powerful independent predictor of all-cause mortality in patients with non–ST-elevation acute coronary syndromes. Age, Killip classification, heart rate, systolic blood pressure, and ST depression should receive particular attention in the initial assessment of these patients.
SIMULTANEOUS ALOPECIA AREATA IN TWO BROTHERS.*
Authors: HERMAN GOODMAN, HERBERT S. ABEL
Journal: British Journal of Dermatology (1932)

Journal Article SIMULTANEOUS ALOPECIA AREATA IN TWO BROTHERS. Get access HERMAN GOODMAN, B.S., M.D., HERMAN GOODMAN, B.S., M.D. New York City Search for other works by this author on: Oxford Academic Google Scholar HERBERT S. ABEL, A.B., M.D. HERBERT S. ABEL, A.B., M.D. Providence. R.I Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology and Syphilis, Volume 44, Issue 4, 1 April 1932, Pages 198–199, https://doi.org/10.1111/j.1365-2133.1932.tb09593.x Published: 01 April 1932
Modification of the late asthmatic reaction by hyposensitization in asthmatic children allergic to house dust mite (<i>Dermatophagoides pteronyssinus</i>) or grass pollen
Authors: H. P. Van Bever, J. Bosmans, L. S. De Clerck, W. J. Stevens
Journal: Allergy (1988)

The frequency and severity of the late asthmatic reaction (LAR) was studied in asthmatic children allergic to house dust mite (HDM) or grass pollen (GP) with and without hyposensitization (HS). The four groups were comparable according to their severity of asthma. AU children were allergic to HDM ( Dermatophagoides pteronyssinus ) or GP according to history, skin testing and specific IgE determination via the RAST. The LAR occurred less frequently (29% versus 73%) ( P &lt; 0.001) and was less severe in children receiving HS. The difference was significant between the children allergic to HDM as well as between children allergic to GP. The immediate asthmatic reaction (IAR) was also less severe in children allergic to HDM who received HS, compared to those who never received HS, ( P =0.033) although the PD 20 of the HDM challenge (PD 20 HDM) was not different between the two groups. In children allergic to GP, there was no difference in PD 20 of the GP challenge (PD 20 GP) or in severity of the IAR, whether the children received HS or not. There was no difference between the PD 20 HDM in patients who developed a LAR and in patients who did not. There was no relation between the type of asthmatic reaction following the allergen provocation test and the level of circulating immune complexes (CIC) and the level of house dust mite‐specific IgG (IgGHDM) or grass pollen‐specific IgE (IgGGP) in the different groups, determined before the challenge. There was a decrease in the level of IgG containing GIG (IgGCIC) during the LAR. It is concluded that the LAR occurs less frequently and is less severe in asthmatic children who receive HS.
PREOPERATIVE INDEXED LEFT VENTRICULAR DIMENSIONS TO PREDICT PROGNOSIS AFTER AORTIC VALVE REPLACEMENT FOR CHRONIC AORTIC REGURGITATION
Authors: Sung-Ji Park, Sung-A Chang, Jin-Oh Choi, Sang-Chol Lee, Seung Woo Park, Pyo Won Park, Jae K. Oh
Journal: Journal of the American College of Cardiology (2011)
Antibodies against desmoglein 3 (pemphigus vulgaris antigen) are present in sera from patients with paraneoplastic pemphigus and cause acantholysis in vivo in neonatal mice.
Authors: M Amagai, T Nishikawa, H C Nousari, G J Anhalt, T Hashimoto
Journal: Journal of Clinical Investigation (1998)

Paraneoplastic pemphigus (PNP) is an autoimmune blistering disease that occurs in association with underlying neoplasms. Patients with PNP develop characteristic IgG autoantibodies directed against multiple antigens, most of which have been identified as cytoplasmic proteins of the plakin family (desmoplakin I, II, BPAG1, envoplakin, and periplakin). This study identified cell surface target antigens of PNP. We focused on desmoglein (Dsg) 3 and Dsg1, the autoantigens of pemphigus vulgaris and pemphigus foliaceus. ELISA using baculovirus-expressed recombinant Dsgs (rDsg3, rDsg1) has revealed that 25 out of 25 PNP sera tested were positive against Dsg3 and 16 of 25 were positive against Dsg1. All of 12 PNP sera tested immunoprecipitated Dsg3. Removal of anti-Dsg3 autoantibodies by immunoadsorption was sufficient to eliminate the ability of PNP sera to induce cutaneous blisters in neonatal mice in vivo. Furthermore, anti-Dsg3-specific antibodies that were affinity purified from PNP sera were proven to be pathogenic and caused blisters in neonatal mice. These findings indicate that Dsg3 and Dsg1 are the cell surface target antigens in PNP and that IgG autoantibodies against Dsg3 in PNP sera play a pathogenic role in inducing loss of cell adhesion of keratinocytes and causing blister formation.
Ritual abuse dismissed as mythical in Britain
Authors: O Dyer
Journal: BMJ (1994)

Claims of widespread satanic and ritual abuse of children in Britain were dismissed by a government report last week. The study was carried out by Jean La Fontaine, former professor of anthropology at the London School of Economics. She looked into 144 allegations of group abuse by paedophile rings and abusive families, as well as 84 cases in which ritual abuse was specifically alleged. The report echoes the findings of a six month investigation in the Netherlands that also found no evidence of ritual abuse of children (see p 1188, 30 April).

Professor La Fontaine found that there was corroborating material evidence, such …
Prophylactic Therapy for Stress Ulcer Bleeding: A Reappraisal
Authors: ROBERT B. SHUMAN
Journal: Annals of Internal Medicine (1987)

The combined data from 16 prospective trials (2133 patients) appear to suggest that antacids prevent stress ulcer bleeding more effectively than does cimetidine. However, the use of occult blood detection methods to diagnose stress ulcer bleeding may have led to the recognition of clinically insignificant bleeding. When the data from these trials are categorized according to the criteria used for the diagnoses of bleeding (either occult blood detection or clinically overt bleeding), there was no significant difference between antacids and cimetidine in the prevention of overt bleeding (3.3% of 458 compared with 2.7% of 402 patients who bled, respectively; p = 0.69). In addition, both agents were more effective (p < 0.001) than placebo (15% of 720 patients who bled) in the prevention of overt bleeding. Cimetidine and antacids are equal in preventing significant stress ulcer bleeding.
Précis of <i>Statistical significance: Rationale, validity, and utility</i>
Authors: Siu L. Chow
Journal: Behavioral and Brain Sciences (1998)

The null-hypothesis significance-test procedure (NHSTP) is defended in the context of the theory-corroboration experiment, as well as the following contrasts: (a) substantive hypotheses versus statistical hypotheses, (b) theory corroboration versus statistical hypothesis testing, (c) theoretical inference versus statistical decision, (d) experiments versus nonexperimental studies, and (e) theory corroboration versus treatment assessment. The null hypothesis can be true because it is the hypothesis that errors are randomly distributed in data. Moreover, the null hypothesis is never used as a categorical proposition. Statistical significance means only that chance influences can be excluded as an explanation of data; it does not identify the nonchance factor responsible. The experimental conclusion is drawn with the inductive principle underlying the experimental design. A chain of deductive arguments gives rise to the theoretical conclusion via the experimental conclusion. The anomalous relationship between statistical significance and the effect size often used to criticize NHSTP is more apparent than real. The absolute size of the effect is not an index of evidential support for the substantive hypothesis. Nor is the effect size, by itself, informative as to the practical importance of the research result. Being a conditional probability, statistical power cannot be the a priori probability of statistical significance. The validity of statistical power is debatable because statistical significance is determined with a single sampling distribution of the test statistic based on H 0 , whereas it takes two distributions to represent statistical power or effect size. Sample size should not be determined in the mechanical manner envisaged in power analysis. It is inappropriate to criticize NHSTP for nonstatistical reasons. At the same time, neither effect size, nor confidence interval estimate, nor posterior probability can be used to exclude chance as an explanation of data. Neither can any of them fulfill the nonstatistical functions expected of them by critics.
Abstract 2931: Cancer cells deficient in DNA mismatch repair (MMR) are selectively sensitive to inhibition of the DNA dependent protein kinase (DNA-PK)
Authors: Madeleine Hewish, Yari Fontebasso, Sarah A. Martin, Richard Elliott, Kerry L. Perks, Asha Konde, Ilirjana Bajrami, Antoinette Van Weverwijk, David Cunningham, Christopher J. Lord, Alan Ashworth
Journal: Cancer Research (2014)

Abstract Many solid tumors, including a significant proportion of colorectal, endometrial, gastric and urothelial tract cancers, are functionally deficient in MMR. This results in an altered clinicopathological phenotype. With the objective of identifying potential MMR-deficient (dMMR) synthetic lethal vulnerabilities, we performed a large scale screen of drugs which included a library of kinase inhibitors. Using a pair of isogenic colorectal cancer (CRC) cell lines, deficient and proficient for MLH1, we identified that exposure to an inhibitor of the catalytic subunit of DNA-PK (Ku-57788) was associated with a reduction in cell viability in MLH1-deficient cells at nanomolar concentrations. Validation studies demonstrated a ten-fold difference in sensitivity in clonogenic assays and a significant correlation between MMR status and Ku-57788 across a panel of cancer cell lines. Inhibition of expression of DNA-PK using RNA interference reproduced the dMMR selectivity. The dMMR phenotype was associated with a reduction in cellular proliferation, leading to apoptosis. Given the role of MMR in the repair of oxidative damage, we assayed levels of 8-oxo-dG, a marker of oxidatively damaged DNA, and observed increased levels in dMMR cells. Upregulation of the anti-oxidant response was observed on exposure to Ku-57788, whilst addition of antioxidants to culture media resulted in complete abrogation of dMMR selectivity. We assessed the effect of combining Ku-57788 with standard chemotherapeutics used in CRC and observed a supra-additive effect with irinotecan. In vivo, treatment of CD1 nude mice with a DNA-PK inhibitor was associated with a reduction in growth of MLH1-deficient cancer cell line xenografts with no effect observed in MLH1-proficiency. We report for the first time that inhibition of DNA-PKcs using small molecule inhibitors, either as a single agent or in combination with chemotherapeutics, may be a potential therapeutic strategy for the treatment of cancers deficient in DNA MMR. Citation Format: Madeleine Hewish, Yari Fontebasso, Sarah A. Martin, Richard Elliott, Kerry L. Perks, Asha Konde, Ilirjana Bajrami, Antoinette Van Weverwijk, David Cunningham, Christopher J. Lord, Alan Ashworth. Cancer cells deficient in DNA mismatch repair (MMR) are selectively sensitive to inhibition of the DNA dependent protein kinase (DNA-PK). [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2931. doi:10.1158/1538-7445.AM2014-2931
Epidemic Meningococcal Disease in an Elementary-School Classroom
Authors: Ralph D. Feigin, Carol J. Baker, Loreen A. Herwaldt, Richard M. Lampe, Edward O. Mason, Stephen E. Whitney
Journal: New England Journal of Medicine (1982)

Schoolmates of patients with meningococcal disease have not been considered to be at increased risk for the development of disease due to Neisseria meningitidis.1 , 2 Within a six-day period N. meningitidis serogroup C disease occurred in five children from the same elementary-school classroom and in two siblings of one child (Case 5) (Table 1). This unprecedented outbreak prompted an investigation into the factors that may have contributed to the spread of the disease among schoolmates. The evidence suggested that close contact in the classroom may have been a major factor.MethodsThe cluster of five cases of meningococcal disease in . . .
Rupture of the Sac in the Earlier Stages of Tubal Pregnancy, with Notes of Two Cases
Authors: W. J. Sinclair
Journal: BMJ (1888)

appearances, exclu(ling the consolidation of the apices due to the coin.cident pleuro-pneumonia, almost reproduce the moyst-wrtem appear- ances observed by Dr. Klein.That the snicrococenu from scarlet fever cases shouild fail to proditceo in calves fever, ulcciation of the tonsils, or scarlatiiia rash, or any condition reRembling clinically the disease in man, and yet that the result shoul(d be regarded as scarlatina in the srlf, is quite untenable; but I am quite ready to agree with l)r.Klein that similar lesions may be produced in calves, whether inocu- lated with scrapings from ulcers, or with the streptococcus from the ilendon cows, or with the streptococcus from cases of scarlet fever.The micro-organism is a septic organism (strCptorecu.spyogenes); and its inoculation or the inoculation of septic lymph may produce septiewmia.SUMMARY.-From the evidence I have adduced, and from the facts that I have described, I am led to the belief that:1.The nature of the contagium of scarlet fever is unknown.2. The micro-organiism regarded by Dr. Klein as the contagium is
Abstract OT3-1-06: CIBOMA/2004-01_GEICAM/2003-11: A randomised phase III trial assessing adjuvant capecitabine (Cap) maintenance therapy after standard chemotherapy for triple-negative early breast cancer (EBC)
Authors: CE Barrios, A Lluch, M Ruiz-Borrego, J Bines, L Torrecillas, E Carrasco, JGM Segalla, A Ruiz, JA Garcia-Saenz, R Torres, J De la Haba-Rodriguez, E Garcia-Martinez, S Morales, H Gomez, J Salvador-Bofill, A Hernando, M Martin
Journal: Cancer Research (2013)

Abstract Background: The ideal adjuvant treatment of triple negative EBC remains to be defined. CIBOMA/2004-01_GEICAM/2003-11 is a multinational randomized phase III trial exploring adjuvant Cap after the conclusion of conventional chemotherapy in triple-negative EBC patients. Materials and Methods: Patients with operable, node-positive (or node-negative with tumour diameter ≥1 cm), hormone receptor-negative, HER2-negative EBC that have received 6–8 cycles of standard anthracycline and/or taxane-containing chemotherapy in the (neo)adjuvant setting (doxorubicin–cyclophosphamide x 4 allowed for node-negative disease), followed by radiotherapy (if indicated) are eligible. After central confirmation of triple negativity by immunohistochemistry, patients were randomised to either 8 cycles of Cap (1,000 mg/m2 bid, d1–14 q21d) or observation. Stratification factors: centre, prior taxane (yes vs. no), involved nodes (0 vs. 1–3 vs. ≥4) and phenotype (basal vs. non-basal). The primary endpoint is disease-free survival (DFS). Secondary endpoints include 5-year DFS, overall survival and safety. An optional pharmacogenetic sub-study will explore polymorphisms of thymidylate synthase and methylenetetrahydrofolate reductase in relation to efficacy and tolerability of Cap. Present Status: Recruitment of 876 randomized patients was completed in September 2011. Statistical assumptions: expected 30% reduction in the risk of recurrence at 5 years (64.7% to 73.7%, HR 0.701), power of 80% and 0.05 two-sided significance level. Final efficacy analysis will be triggered by 255 events. Baseline characteristics are well balanced and shown in the table below. 75.0% of the patients completed the 8 cycles of adjuvant Cap. Baseline patients characteristics Capecitabine (n = 448)Observation (n = 428)Median Age, years (range)51 (20-79)50 (24-83)Basal Phenotype,%70.772.2Histology,% Ductal87.786.1Lobular1.82.3Other9.811.4Unknown0.70.2Grade,% 13.32.8218.119.0371.969.6Not determinable6.08.4Unknown0.70.2Chemotherapy received,% Adjuvant (only)78.982.2Neoadjuvant (only)15.615.0Adjuvant + Neoadjuvant4.22.6Unknown1.30.2Postmenopausal,%69.267.3Prior Chemotherapy Agents,% Anthracyclines without taxanes32.132.2Anthracyclines and taxanes67.267.6Unknown0.70.2 Conclusions: This randomized phase III adjuvant trial in triple negative EBC patients has completed accrual and event follow up is ongoing. The trial is sponsored by CIBOMA/GEICAM. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr OT3-1-06.
Aging Adults With Intellectual Disabilities
Authors: Elizabeth A. Perkins, Julie A. Moran
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
Families without hope
Authors: C. Brewer
Journal: BMJ (2012)

When Jesus said “the poor always ye have with you,” he presumably wasn’t joking, but governments repeatedly try to prove him wrong. Every time a new underclass disaster makes headlines, the social work equivalent of the SAS is mobilised to persuade the family to become, well, “more like us,” but it rarely works. Families Without Hope explains why and describes some typical families.

“The front garden is characteristic. An overgrowth of natural flora competes with broken bottles, sodden cardboard and the rusting remains of once-expensive toys, prams, cycle parts and other scrap. A well-worn earth path leads from the dominant …
Noninvasive Diagnosis of Reversal of Vertebral-Artery Blood Flow
Authors: Ramon Berguer, Roger Higgins, Robert Nelson
Journal: New England Journal of Medicine (1980)

THE diagnosis of a subclavian steal is entertained on clinical grounds. Classic signs are an absent radial pulse, a difference in brachial-artery pressures greater than 20 mm Hg, and sometimes a supraclavicular bruit on the involved side. These signs may also be present in chronic subclavian or axillary-artery occlusive disease without reversal of vertebral-artery blood flow (RVAF).Patel and Toole,1 in their original review of the subclavian-steal syndrome, mentioned that a delay in the radial pulse on the involved side might be felt by palpation. The radial pulse, however, is absent or difficult to palpate in most patients. The diagnosis . . .