tbuckley/cabot-search huggingface dataset:
Maintenance Rituximab After Cyclophosphamide, Vincristine, and Prednisone Prolongs Progression-Free Survival in Advanced Indolent Lymphoma: Results of the Randomized Phase III ECOG1496 Study
Authors: Howard Hochster, Edie Weller, Randy D. Gascoyne, Thomas M. Habermann, Leo I. Gordon, Theresa Ryan, Lijun Zhang, Natalia Colocci, Stanley Frankel, Sandra J. Horning
Journal: Journal of Clinical Oncology (2009)

To determine if maintenance rituximab (MR) after standard chemotherapy improves progression-free survival (PFS) in advanced-stage indolent lymphoma.Patients with stage III-IV indolent lymphoma with responding or stable disease after cyclophosphamide, vincristine, and prednisone (CVP) chemotherapy were stratified by initial tumor burden, residual disease after CVP (minimal or gross), and histology, and randomly assigned to observation (OBS) or MR 375 mg/m(2) once per week for 4 weeks every 6 months for 2 years. PFS was the primary end point.Three hundred eleven (282 with follicular lymphoma) evaluable patients who received CVP were randomly assigned to OBS (n = 158) or MR (n = 153). Best response improved in 22% MR versus 7% OBS patients (P = .00006). Toxicity was minimal in both study arms. Three-year PFS after random assignment was 68% MR versus 33% OBS (hazard ratio [HR] = 0.4; P = 4.4 x 10(-10) [all patients]) and 64% MR v 33% OBS (HR = 0.4; P = 9.2 x 10(-8) [patients with follicular lymphoma]). There was an advantage for MR regardless of Follicular Lymphoma International Prognostic Index score, tumor burden, residual disease, or histology. In multivariate analysis of MR patients, minimal disease after CVP was a favorable prognostic factor. OS at 3 years was 92% MR versus 86% OBS (HR = 0.6; log-rank one-sided P = .05) and, among patients with follicular lymphoma, OS was 91% MR versus 86% (HR = 0.6; log-rank one-sided P = .08). A trend favoring MR was observed among patients with high tumor burden (log-rank one-sided P = .03).The E1496 study provides the first phase III data in untreated indolent lymphoma that MR after chemotherapy significantly prolongs PFS.
Primary Care Medicine: Office Evaluation and Management of the Adult Patient
Authors: Daniel Levinson
Journal: JAMA (1995)

As the practice of medicine changes, so do textbooks of medicine. Among the most significant trends in today's medical practice is the move toward office-based primary care and away from specialization.<i>Primary Care Medicine</i>anticipated this shift with the first edition in 1981; the third edition carries on a successful educational philosophy and format. <i>Primary Care Medicine</i>begins with chapters of special relevance to primary care: health maintenance, estimating risk and prognosis, screening techniques, preventive medicine, immunization, and compliance. The remainder of the text is organized into 13 sections. Except for "Psychiatric and Behavioral Problems," the classification system is anatomic. With a few exceptions, each system-oriented section is subdivided by screening, evaluation or approach, management, and, where appropriate, prevention. All commonly encountered medical problems of the ambulatory patient are discussed, and despite the inevitable publishing delay associated with any textbook, the text is surprisingly current: recent developments in hepatitis D
Screening for Tuberculosis
Authors: James Bayuk
Journal: JAMA (1995)

<h3>To the Editor.</h3> —The study of tuberculosis (TB) screening of schoolchildren by Dr Mohle-Boetani and colleagues<sup>1</sup>highlights targeted screening of non—US-born children as a cost-effective mechanism to detect and treat TB infection. In the accompanying Editorial, Dr Starke<sup>2</sup>reinforces this finding with multiple studies that document the high tuberculin skin test reactivity in non—US-born children. Both articles are compassionate and realistic in their concern about stigmatization of the target groups as an impediment to effective public health programs. Stigmatization occurs because a new population—immigrants attempting to blend into the resident population of the United States—is identified with a negative attribute, TB infection. Targeting part of an already blended population guarantees stigma. Unfortunately, a school examination is commonly the first time a new immigrant child is evaluated for TB. This situation is complicated by our current immigration medical screening system, which has no functioning mechanism to test anyone younger
Use of serial qualitative interviews to understand patients' evolving experiences and needs
Authors: S. A Murray, M. Kendall, E. Carduff, A. Worth, F. M Harris, A. Lloyd, D. Cavers, L. Grant, A. Sheikh
Journal: BMJ (2009)

Interviewing patients over the course of their illness can give a much better picture of their experience than single interviews, but the approach is rarely used. <b>Scott Murray and colleagues</b> explain how to get the most from it
Divided Renal Function Studies in Hypertension
Authors: I. G. Graber, R. Shackman
Journal: BMJ (1956)

necessary for epithelial development; and (3) they are abnormal cells secondary to severe inflammation in the colonic mucosa.The abnormal cells have many of the features of malignant cells, a point of interest in view of the fact that patients with ulcerative colitis are unduly liable to develop carcinoma of the colon.We are grateful to Miss Shirley Thomas for lher assistance, and to Mr. M. Morris and Miss Rowden for the photomicrographs.
Gastrin-cholecystokininB receptor expression in AGS cells is associated with direct inhibition and indirect stimulation of cell proliferation via paracrine activation of the epidermal growth factor receptor
Authors: A Varro
Journal: Gut (2002)

Activation of the gastrin-cholecystokinin(B) (CCK(B)) receptor stimulates cell proliferation and increases production of ligands for the epidermal growth factor receptor (EGF-R).To determine the role of gastrin-CCK(B) activation in stimulation of cell proliferation via paracrine activation of EGF-R.AGS cells were transfected with the gastrin-CCK(B) receptor (AGS-G(R) cells) or with green fluorescent protein (AGS-GFP cells). Proliferation was determined by [(3)H] thymidine incorporation, flow cytometry, and cell counting.Gastrin inhibited proliferation of AGS-G(R) cells by delaying entry into S phase. However, when AGS-G(R) cells were cocultured with AGS-GFP cells, gastrin stimulated proliferation of the latter. Immunoneutralisation and pharmacological studies using metalloproteinase and kinase inhibitors indicated that the proliferative response was mediated by paracrine stimulation of EGF-R and activation of the mitogen activated protein kinase pathway through release of heparin binding EGF.Gastrin can directly inhibit, and indirectly stimulate, proliferation of gastric AGS cells.
Canadian Implantable Defibrillator Study (CIDS)
Authors: Stuart J. Connolly, Michael Gent, Robin S. Roberts, Paul Dorian, Denis Roy, Robert S. Sheldon, L. Brent Mitchell, Martin S. Green, George J. Klein, Bernard O’Brien
Journal: Circulation (2000)

Background —Patients surviving ventricular fibrillation (VF) or sustained ventricular tachycardia (VT) are at a high risk of death due to a recurrence of arrhythmia. The implantable cardioverter defibrillator (ICD) terminates VT or VF, but it is not known whether this device prolongs life in these patients compared with medical therapy with amiodarone. Methods and Results —A total of 659 patients with resuscitated VF or VT or with unmonitored syncope were randomly assigned to treatment with the ICD or with amiodarone. The primary outcome measure was all-cause mortality, and the secondary outcome was arrhythmic death. A total of 328 patients were randomized to receive an ICD. A thoracotomy was done in 33, no ICD was implanted in 18, and the rest had a nonthoracotomy ICD. All 331 patients randomized to amiodarone received it initially. At 5 years, 85.4% of patients assigned to amiodarone were still receiving it at a mean dose of 255 mg/day, 28.1% of ICD patients were also receiving amiodarone, and 21.4% of amiodarone patients had received an ICD. A nonsignificant reduction in the risk of death was observed with the ICD, from 10.2% per year to 8.3% per year (19.7% relative risk reduction; 95% confidence interval, −7.7% to 40%; P =0.142). A nonsignificant reduction in the risk of arrhythmic death was observed, from 4.5% per year to 3.0% per year (32.8% relative risk reduction; 95% confidence interval, −7.2% to 57.8%; P =0.094). Conclusions —A 20% relative risk reduction occurred in all-cause mortality and a 33% reduction occurred in arrhythmic mortality with ICD therapy compared with amiodarone; this reduction did not reach statistical significance.
Abstract LB-235: BCL6 enables Ph+ acute lymphoblastic leukemia cells to survive BCR-ABL1 kinase inhibition
Authors: Cihangir Duy, Christian Hurtz, Phillip H. Koeffler, Ari M. Melnick, Markus Müschen
Journal: Cancer Research (2011)

Abstract Tyrosine kinase inhibitors (TKI) are widely used to treat patients with leukemia driven by BCR-ABL1 and other oncogenic tyrosine kinases. Recent efforts focused on the development of more potent TKI that also inhibit mutant tyrosine kinases. However, even effective TKI typically fail to eradicate leukemia-initiating cells, which often cause recurrence of leukemia after initially successful treatment. Here we report on the discovery of a novel mechanism of drug-resistance, which is based on protective feedback signaling of leukemia cells in response to TKI-treatment. We identified BCL6 as a central component of this drug-resistance pathway and demonstrate that targeted inhibition of BCL6 leads to eradication of drug-resistant and leukemia-initiating subclones. BCL6 is a known proto-oncogene that is often translocated in diffuse large B cell lymphoma (DLBCL). In response to TKI-treatment, BCR-ABL1 acute lymphoblastic leukemia (ALL) cells upregulate BCL6 protein levels by ∼90-fold, i.e. to similar levels as in DLBCL. Upregulation of BCL6 in response to TKI-treatment represents a novel defense mechanism, which enables leukemia cells to survive TKI-treatment: Previous work suggested that TKI-mediated cell death is largely p53-independent. Here we demonstrate that BCL6 upregulation upon TKI-treatment leads to transcriptional inactivation of the p53 pathway. BCL6-deficient leukemia cells fail to inactivate p53 and are particularly sensitive to TKI-treatment. BCL6-/-leukemia cells are poised to undergo cellular senescence and fail to initiate leukemia in serial transplant recipients. A combination of TKI-treatment and a novel BCL6 peptide inhibitor markedly increased survival of NOD/SCID mice xenografted with patient-derived BCR-ABL1 ALL cells. We propose that dual targeting of oncogenic tyrosine kinases and BCL6-dependent feedback represents a novel strategy to eradicate drug-resistant and leukemia-initiating subclones in tyrosine kinase-driven leukemia. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr LB-235. doi:10.1158/1538-7445.AM2011-LB-235
Regenerative stimulus increases hepatocyte tight junctional permeability
Authors: Siria Poucell, William G.M. Hardison, Katsumi Miyai
Journal: Hepatology (1992)

ABSTRACT Experience with young animals, animals administered certain hepatotoxins and animals with two–thirds hepatectomy suggests that tight junctional permeability is increased in states characterized by architectural remodeling in the liver. In this work we correlate changes in tight junctional morphometry induced by two–thirds hepatectomy with changes in biliary permeability assessed by sucrose and horseradish peroxidase permeation and by alterations in biliary outputs of anionic and cationic cholephilic probes. By freeze–fracture examination tight junctional strand counts, density and orientation parallel to canaliculi were all reduced 24 hr after two–thirds hepatectomy. Occasionally, strands were perpendicular to the canaliculi, creating an unobstructed communication between bile and intercellular spaces. These morphological changes correlated with increased sucrose and paracellular horseradish peroxidase access into bile, with reduced biliary outputs of low molecular weight and especially with cationic cholephilic probes. The data support an increased but still charge–selective permeability of the biliary tree, which was induced by two–thirds hepatectomy 24 hr before. Presumably, fixed intercellular connections (tight junctions and gap junctions) must be loosened or lysed to allow the architectural reorganization required by the hepatocellular regenerative process. (HEPATOLOGY 1992;16:1061-1068.)
Control of Colonization and Transmission of Pathogenic Bacteria in the Hospital
Authors: DENNIS G. MAKI
Journal: Annals of Internal Medicine (1978)

A hospital is a milieu conducive to the development and spread of infection. Patients' own flora, microorganisms in the hospital environment or those carried by medical personnel, intrinsically contaminated commercial products, and infected patients are major reservoirs of nosocomial pathogens. Use of invasive devices greatly amplifies transmission, colonization, and susceptibility to infection. Staphylococcus aureus infections are caused by autochthonous strains or exposure to medical personnel who are carriers; infections with gram-negative bacilli are endogenously acquired or derive from contact with contaminated aqueous sources within the hospital. Carriage of microorganisms on the hands of noncolonized medical personnel appears to be a major mode of cross-infection. Research is needed to better define the epidemiology of endemic nosocomial infections in order to develop more effective control measures, to evaluate more widely the efficacy of protective isolation, and to improve the safety of devices. More consistent application of infection control measures would have considerable immediate benefit.
The exercise test in variant angina: results in 114 patients.
Authors: S de Servi, C Falcone, A Gavazzi, A Mussini, E Bramucci, M T Curti, C Vecchio, G Specchia, P Bobba
Journal: Circulation (1981)

One hundred fourteen patients with variant angina performed bicycle exercise stress tests, and were divided into three groups. Group 1 included 37 patients with a normal exercise test. Coronary arteriography revealed absence of significant coronary stenoses in 18 patients, one-vessel disease in 17 and involvement of two or more vessels in two. Group 2 consisted of 40 patients who had ST-segment elevation during or just after exercise. Coronary arteriography in these cases revealed absence of significant coronary stenoses in nine patients, one-vessel disease in 18 and disease of two or more vessels in 13. Group 3 included 37 patients who had ST-segment depression during exercise. Absence of coronary artery disease was found in only two patients, one-vessel disease was found in 19 and disease of two or more vessels was found in 16. Sixty-one patients repeated the exercise test after a mean of 18 months after hospital discharge. Exercise-induced ST-segment elevation was no longer present in surgically or medically treated patients; ST-segment depression was still evident in all the medically treated patients, but was absent in eight of 13 patients who underwent aortocoronary bypass surgery. Exercise testing can be useful in the follow-up of patients with variant angina and in selecting patients most likely to be helped by bypass surgery.
Detection of left atrial myxoma by gated radionuclide cardiac imaging.
Authors: G M Pohost, J O Pastore, K A McKusick, P N Chiotellis, G Z Kapellakis, G S Myers, R E Dinsmore, P C Block
Journal: Circulation (1977)

Gated radionuclide cardiac blood pool scans (GCS) of end-systole and end-diastole or eight images subtending the entire cardiac cycle were performed on seven patients with left atrial myxomas documented by pulmonary cineangiography with left atrial follow-through. The ethocardiogram was either suggestive or diagnostic in all patients. In addition to demonstration of the tumor (6 patients), the GCS detected three patterns of tumor motion: 1) a defect which moved from the left atrium in end systole to the left ventricle in end diastole (2 patients); 2) a defect which remained within the region of the left atrium but decreased in size between end diastole and end systole (3); and 3) a defect which was observed within the region of the left ventricle in end diastole but disappeared in end systole (1). Thus, the GCS is a noninvasive method for detection and evaluation of motion of left atrial myxomas.
Current Status of Therapy in Paranasal Sinusitis
Authors: Clyde A. Heatly
Journal: JAMA (1961)

Sinusitis has become a popular and much-abused diagnosis, one which is often carelessly made to explain a variety of totally unrelated complaints. Many nasal disturbances caused by allergies, as well as headaches of systemic, emotional, or neurogenic origin, are frequently attributed to sinusitis. It is a common experience to encounter patients who have made their own diagnosis and instituted their own therapy based upon information gained from commercial promotion. Abuses in therapy arise not only from improper diagnosis but also from the use of improper medications, from overtreatment, and from the unnecessary use of antibiotic agents, as well as from the use of preparations which impair the protective functions of the nasal mucosa. Proper therapy in sinusitis implies accurate diagnosis and the use of drugs and techniques which have a sound physiological basis.  The maxillary and ethmoidal sinuses are present at birth. The frontal and sphenoid sinuses begin their development
Plasma concentrations of tumour necrosis factor‐alpha, tumour necrosis factor‐related apoptosis‐inducing ligand, and FasLigand/CD95L in patients with Chagas cardiomyopathy correlate with left ventricular dysfunction
Authors: Jamille Fernandes Lula, Manoel Otavio da Costa Rocha, Maria do Carmo Pereira Nunes, Antônio Luiz Pinho Ribeiro, Mauro Martins Teixeira, Maria Terezinha Bahia, André Talvani
Journal: European Journal of Heart Failure (2009)
Technetium-99m Labeled Monoclonal Antibodies in the Detection of Metastatic Melanoma
Authors: A N SERAFINI, J KOTLER, L FEUN, M DEWANJEE, D ROBINSON, D SALK, G SFAKIANAKIS, P ABRAMS, N SAVARAJ, D GOODWIN, W NELP
Journal: Clinical Nuclear Medicine (1989)

Twenty-six stage ll/lll malignant melanoma patients with 321 measurable metastatic lesions were imaged using Fab fragments of an IgG murine monoclonal antibody labeled specifically with 10-30 mCi Tc-99m with a bifunctional chelating method (NeoRx, Seattle, WA). There were no side effects or adverse reactions. Immunoscintigraphy demonstrated 66.6% of lesions larger than 1 cm and 92.5% of lesions larger than 3 cm. Most frequently detected metastases were in lymph nodes, subcutaneous areas, and bone. Of lesions less than 1 cm, 23.6% were detected if superficial cutaneous lesions were excluded. The smallest detectable lesion was 4 mm. Twenty-one additional clinically unsuspected sites were visualized in 12 of the 26 patients studied. Of these, 56% were confirmed as metastasis by other tests. There were apparent nonspecific localizations owing to other causes, including fracture, varicosities, skin abscess and pneumonitis. Increased experience in image analysis facilitates correct interpretation of these localizations. This study demonstrates that imaging with Tc-99m labeled antibody fragments detects melanoma lesions in organs routinely surveyed and in other areas not routinely assessed by other imaging techniques. The procedure is readily performed and safe. The principal advantage of the test is its ability to survey the entire body and all organs with a single test. Its principal limitation, in common with other diagnostic imaging procedures, is its poor sensitivity for detecting lesions less than 1 cm.
Correction: Data on Acidosis
Authors: ROBERT A. KREISBERG
Journal: Annals of Internal Medicine (1978)

Letters and Corrections1 December 1978Correction: Data on AcidosisROBERT A. KREISBERG, M.D.ROBERT A. KREISBERG, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-89-6-1013_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: One of my faculty has pointed out that the quotation in my recent review article on diabetic ketoacidosis (Ann Intern Med88:681-695, 1978) of the information from Reference 130, by Fulop and Hoberman, was incorrect. The first complete paragraph on page 693 should read, beginning with the second sentence, "In Fulop and Hoberman's series of 24 patients, mild acidosis (pH 7.2 to 7.3) occurred in four patients and severe acidosis (pH ≤ 7.2) in an additional five. However, most patients in this series were not acidotic; 25% had arterial pH values greater than 7.5. Analysis of the... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: University of South Alabama College of Medicine Mobile, AL 36617 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 December 1978Volume 89, Issue 6Page: 1013-1014 Issue Published: 1 December 1978 PDF DownloadLoading ...
Increasing Immunization Rates Among Inner-City, African American Children
Authors: David Wood, Neal Halfon, Cathy Donald-Sherbourne, Rebecca M. Mazel, Mark Schuster, Julie Shea Hamlin, Margaret Pereyra, Patricia Camp, Mark Grabowsky, Naihua Duan
Journal: JAMA (1998)

Immunization rates in the inner city remain lower than in the general US population, but efforts to raise immunization levels in inner-city areas have been largely untested.To assess the effectiveness of case management in raising immunization levels among infants of inner-city, African American families.Randomized controlled trial with follow-up through 1 year of life.Low-income areas of inner-city Los Angeles, Calif.A representative sample of 419 African American infants and their families.In-depth assessment by case managers before infants were 6 weeks of age, with home visits 2 weeks prior to when immunizations were scheduled and additional follow-up visits as needed.Percentage of children with up-to-date immunizations at age 1 year, characteristics associated with improved immunization rates, and cost-effectiveness of case management intervention.A total of 365 newborns were followed up to age 1 year. Overall, the immunization completion for the case management group was 13.2 percentage points higher than the control group (63.8% vs 50.6%; P=.01). In a logistic model, the case management effect was limited to the 25% of the sample who reported 3 or fewer well-child visits (odds ratio, 3.43; 95% confidence interval, 1.26-9.35); for them, immunization levels increased by 28 percentage points. Although for the case management group intervention was not cost-effective ($12022 per additional child immunized), it was better ($4546) for the 25% of the sample identified retrospectively to have inadequate utilization of preventive health visits.A case management intervention in the first year of life was effective but not cost-effective at raising immunization levels in inner-city, African American infants. The intervention was demonstrated to be particularly effective for subpopulations that do not access well-child care; however, currently there are no means to identify these groups prospectively. For case management to be a useful tool to raise immunizations levels among high-risk populations, better methods of tracking and targeting, such as immunization registries, need to be developed.