tbuckley/cabot-search huggingface dataset:
Outcome in Children With Relapsed Acute Myeloid Leukemia After Initial Treatment With the French Leucémie Aiquë Myéloïde Enfant (LAME) 89/91 Protocol of the French Society of Pediatric Hematology and Immunology
Authors: Nathalie Aladjidi, Anne Auvrignon, Thierry Leblanc, Yves Perel, Antoine Bénard, Pierre Bordigoni, Virginie Gandemer, Isabelle Thuret, Jean Hugues Dalle, Christophe Piguet, Brigitte Pautard, André Baruchel, Guy Leverger
Journal: Journal of Clinical Oncology (2003)

After present first-line therapies for childhood acute myeloid leukemia (AML), nearly 40% of patients still relapse. The goals of this retrospective study were to determine whether these children could be treated successfully with a salvage regimen and to establish the optimal therapeutic strategy.In the multicentric, prospective, Leucémie Aiquë Myéloïde Enfant 89/91 protocol, 106 of the 308 children enrolled between 1988 and 1998 relapsed. Initial treatment after the first complete remission (CR1) had been allogenic HLA-identical bone marrow transplantation (BMT; n = 21) or chemotherapy (n = 85). Treatment procedures were scheduled according to the choice of each participating institution.When reinduction therapy was attempted, second complete remission (CR2) was obtained in 71% of patients (68 of 96 patients). BMT was performed in 53 (78%) of these 68 patients (autograft, mainly harvested in CR1, n = 25; matched sibling-donor BMT, n = 12; or alternative-donor BMT, n = 16). The 5-year overall survival (OS) rate for all 106 patients was 33%, and the disease-free survival (DFS) rate for children in CR2 was 45%. Multivariate analysis of re-treated children showed that the 5-year OS was higher if the CR1 had been longer than 12 months compared with less than 12 months (54% v 24%, respectively; P =.001) and lower if maintenance therapy had been given after CR1 compared with chemotherapy without maintenance therapy or HLA-identical BMT (12% v 40% v 52%, respectively; P =.002). For patients attaining CR2, the 5-year DFS rate was not significantly different for matched sibling-donor BMT (60%), autograft (47%), or alternative-donor BMT (44%).After aggressive first-line therapy, one third of unselected, relapsing AML children could be cured. Further prospective trials are warranted to define the optimal reinduction regimen and megadose chemotherapy and to evaluate the late effects of these therapies.
Electroconvulsive Therapy -- A Modern Medical Procedure
Authors: William Z. Potter, Matthew V. Rudorfer
Journal: New England Journal of Medicine (1993)

Electroconvulsive therapy is more firmly established than ever as an important method of treating certain severe forms of depression. Less than a decade ago, a review article in the Journal was considered necessary to provide a perspective on electroconvulsive therapy for nonspecialists and to help respond to the attacks of those who wished to limit or even ban its use1. At that time, there was extensive evidence of the efficacy of the treatment as it is generally administered, but acknowledged uncertainty about the details of electrode placement and stimulus characteristics needed to achieve the best balance between efficacy and . . .
Change of residual strains in arteries due to hypertrophy caused by aortic constriction.
Authors: Y C Fung, S Q Liu
Journal: Circulation Research (1989)

The stress and strain that remain in an organ when the external load is removed are called residual stress and strain. They can be revealed by cutting up the organ in such a way as to reveal the zero-stress configuration. The function of the organ depends on the residual strain. For a blood vessel, the zero-stress configuration is very different from that of the no-load condition, and it changes over time when the physical stress acting on the vessel is changed. Data on rat aorta are presented. Physical changes were obtained by constricting the aorta at the celiac trunk level with a band of metal. Banding causes an increase of blood pressure and hypertrophy of the vessel in the upper body and a transient decrease of blood pressure in the lower body. If the aorta is cut transversely into rings and each ring is cut radially, it will open up into a noncircular arc, which may be characterized by its opening angle. It is shown that the opening angle varies systematically along the aorta and that it changes significantly together with changes of blood pressure and hypertrophy. In the ascending aorta, the opening angle increased from 171 degrees and to 214 degrees in 4 days after banding, then decreased gradually to an asymptotic value of 126 degrees in 40 days. At other sections, the swing of opening angle is smaller. The implications are discussed.
A RESEARCH PROJECT IN PSYCHIATRIC AIDE TRAINING
Authors: RUFUS M. VAUGHN, STANLEY TEITELBAUM, HELEN KUMPAN
Journal: American Journal of Psychiatry (1962)

Overall, we can clearly say this program was not an effective means of bringing about attitude changes or significantly changing work performance. We believe that the effectiveness of a program will probably be greatly hampered by the very nature of the aide group. There is such a diverse educational background as to make any program planning difficult. It is our feeling that the aide as now selected is a much less potent force in the growth of a positive program than is usually believed. Aides, in order to maintain adequate functioning, require aggressive nursing programs, staffed by properly trained nurses as key people. Although there is a great need for further study, there is a possibility that the good performer can be pre-selected. It may well be that hopes of upgrading patient care through in-service training of aides are not entirely realistic. Some more fundamental changes are probably needed in our concept of the job and in our concept of proper care of the hospitalized patient. This involves changes in educational requirements, selection procedures, pay scales and perhaps a total restructuring of responsibility within the hospital.
Outcomes of Carotid Endarterectomy and Stenting in Elderly Patients
Authors: Bruce A. Perler
Journal: JAMA (2014)

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
Risk factors for thrombophilia in extrahepatic portal vein obstruction
Authors: Massimo Primignani, Ida Martinelli, Paolo Bucciarelli, Tullia Battaglioli, Raffaella Reati, Federica Fabris, Alessandra Dell'Era, Emanuela Pappalardo, Pier Mannuccio Mannucci
Journal: Hepatology (2005)

Scant information exists on the role of thrombophilia in extrahepatic portal vein obstruction (EHPVO). We studied 65 patients with EHPVO, 500 with deep vein thrombosis (DVT) of the lower limbs, and 700 healthy controls referred for thrombophilia screening, including the search for gain-of-function mutations in genes encoding coagulation factor V (factor V Leiden) and prothrombin (prothrombin G20210A); antithrombin, protein C, and protein S deficiency; and hyperhomocysteinemia. At least one abnormality in the thrombophilia screening was found in 40% of patients with either EHPVO or lower limb DVT and in 13% of controls, for odds ratios of 4.0 (95% CI, 2.3-7.0) and 4.4 (95% CI, 3.3-5.9), respectively. Statistically significant associations with EHPVO were observed for the prothrombin G20210A mutation (odds ratio, 8.1; 95% CI, 3.8-17.5) and the deficiencies of antithrombin, protein C, or protein S taken together (odds ratio, 4.5; 95% CI, 1.1-18.0). The odds ratio for the prothrombin G20210A was approximately twice that for lower limb DVT. Patients with factor V Leiden had an odds ratio for EHPVO of 0.8 (95% CI, 0.1-6.4) and for lower limb DVT of 7.5 (95% CI, 4.4-13.0). The odds ratio for EHPVO in patients with hyperhomocysteinemia was 2.0 (95% CI, 0.9-4.9). At variance with lower limb DVT, oral contraceptive use was not associated with an increased risk of EHPVO. Myeloproliferative disorders were diagnosed in 35% of patients with EHPVO. In conclusion, the risk for EHPVO is increased in the presence of thrombophilia resulting from the prothrombin G20210A mutation and from the deficiencies of the naturally occurring anticoagulant proteins, but not from factor V Leiden.
Intestinal microflora and digestive toxicity of irinotecan in mice.
Authors: Giovanni Brandi, Jean Dabard, Pierre Raibaud, Monica Di Battista, Chantal Bridonneau, Anna Maria Pisi, Antonio Maria Morselli Labate, Maria Abbondanza Pantaleo, Antonello De Vivo, Guido Biasco
Journal: Clinical Cancer Research (2006)

Abstract PURPOSE: Delayed diarrhea is the most important side effect of irinotecan. The aim of this study was to investigate the role of intestinal microflora on the induction of systemic and intestinal toxicity and diarrhea, studying germ-free and holoxenic mice i.p. injected with irinotecan. EXPERIMENTAL DESIGN: To evaluate the lethal dose, starting with 100 mg/kg/4 d, we treated the holoxenic mice with 100, 80, and 60 mg/kg/4 d and germ-free mice with 60, 80, 100, and 150 mg/kg/4 d. We recorded the percentage of dead animals, diarrhea, and the epithelial damage to the jejunum, ileum, cecum, and colon at optical and scanning electron microscopy. RESULTS: Germ-free mice were more resistant to irinotecan than the holoxenic group. The lethal dose was between 60 and 80 mg of irinotecan for holoxenic mice and &amp;gt; or =150 mg for the germ-free. The intestinal damage score was higher in holoxenic than germ-free mice at 100 mg and equally diffuse in the small and large bowel. The damage in germ-free mice was less severe (8 of 40 samples) prevailing in the ileum. The differences were significant for all sites (jejunum, P &amp;lt; 0.001; ileum, P = 0.012; cecum, P = 0.001; colon, P &amp;lt; 0.001). No damage was found in germ-free mice at 60 mg. Diarrhea was present in all 100 and 80 mg holoxenic mice and in 19 of 20 cases at 60 mg whereas it was absent in 60 mg or sporadic in 80 and 100 mg germ-free mice. CONCLUSIONS: The intestinal microflora plays a key role in the intestinal toxicity of irinotecan.
Smoking and Radon
Authors: R. T. Ravenholt
Journal: JAMA (1987)

<h3>To the Editor.—</h3> When the foremost determinant of a phenomenon is omitted from consideration, researchers are necessarily perplexed—as revealed in the Aug 7, 1987, issue of<i>JAMA</i>, which was largely devoted to articles on radiation hazards: "One of the strangest things about radon is that its level in any given house is totally unpredictable. Speakers from Canada and Ireland told how the highest and lowest levels measured in their countries were in identical houses standing side by side, and other participants nodded in frustrated agreement."<sup>1</sup> Their frustration will continue until they integrate the following facts and considerations into their research: Household radon levels, derivative of radium present in the earth's crust, are ordinarily estimated from the number of alpha particles detected in measured quantities of household air during a unit of time.<sup>2</sup> Tobacco smoke contains polonium 210, also an alpha particle-emitting radioisotope and a descendent of radon that
Management of malignant pleural effusions
Authors: G ANTUNES
Journal: Thorax (2000)

Malignant pleural effusion is a common problem in respiratory medicine and oncology and in some series accounts for up to 50% of all pleural effusions.1 2 The median survival following diagnosis ranges from three to 12 months and is largely dependent upon the underlying malignancy. Currently, lung cancer is the most common metastatic tumour to the pleura in men and breast cancer in women. Both malignancies account for 50–65% of all malignant effusions while lymphomas, genitourinary, and gastrointestinal tumours account for a further 25%, and 7–15% of all malignant effusions have no identifiable primary.3-5 

Malignant effusions result predominantly from obstruction and disruption of lymphatic channels by malignant cells. However, vascular endothelial growth factor (VEGF), a potent angiogenic mediator and promoter of endothelial permeability, is produced in significant amounts by diseased pleural tissue and is thought to play a part in the formation of malignant effusions and local tumour growth.6 7 

The general approach to managing malignant effusions is determined by symptoms (dyspnoea, exercise tolerance limitation, and chest discomfort), performance status of the patient, expected survival, and response of the known primary tumour to systemic treatment. Intervention options range from observation in the case of asymptomatic effusions through simple thoracentesis to more invasive methods such as thoracoscopy, pleuroperitoneal shunting, and pleurectomy. Repeated aspiration is favoured in patients with limited survival and poor performance status and obviates lengthy hospitalisation. In the patient with reasonable survival expectancy and good performance status, every attempt should be made to prevent recurrence of the effusion. Intercostal tube drainage with instillation of a sclerosing agent, resulting in the obliteration of the pleural space, is the most widely used and cost effective method to control recurrent symptomatic malignant effusions.

Over the last two decades several new developments have modified the method originally described by Adler …
TWO CASES OF ABDOMINAL SURGERY--BOTH SURGERY--BOTH.
Authors: J. P. THOMAS
Journal: JAMA (1883)

[Read before McDowell Medical Society, Oct. 24, 1883. ] OVARIOTOMY. Case I.—On Aug. I, 1878, I was called to visit Mrs. M.; white; æt. 51 years; on account of an attack of malarial fever. I found her unusually prostrated, but learned that she had been the subject of chills for two months, which had finally resulted in remittent fever, which satisfactorily accounted for her anæmic and prostrated condition. In a few days the fever was arrested. Prescribing a simple tonic, I was about to discharge the patient, when she called my attention to an enlargement of the abdomen, of which she gave the following history: About the 1st of June (1878), while dropping tobacco plants for her husband to transplant, she felt something give way in her right side, which caused most excruciating pain for a short time, but as the pain soon ceased, she continued her occupation until night
Abdominal pain and swelling
Authors: S. Mirsadraee, D. Kessel
Journal: BMJ (2009)

A 78 year old woman presented with a sudden onset tender palpable lump just to the right of the midline in the infraumbilical region. The patient was taking warfarin for previous prosthetic heart valve surgery. No history of trauma was present. An ultrasound examination showed a cystic mass with echogenic sediment in the rectus abdominis muscle. Two days later, the patient’s abdominal pain increased, her abdomen became distended, and she became hypotensive with a blood pressure of 75/45 mm Hg despite fluid resuscitation. Blood tests showed a drop in haemoglobin concentration—from 100 g/l to 70 g/l—and an increase in serum creatinine—from normal (45-90 μmol/l) to 230 μmol/l over the two day period. The patient had an international normalised ratio (INR) of 7. ### Short answers
The health-related quality of life was not improved by targeting higher hemoglobin in the Normal Hematocrit Trial
Authors: Daniel W. Coyne
Journal: Kidney International (2012)

The Normal Hematocrit Trial (NHT) was the largest trial of epoetin randomizing 1265 hemodialysis patients with cardiac disease to lower (9-11 g/dl) or higher (13-15 g/dl) hemoglobin (Hgb), hypothesizing that higher Hgb would reduce mortality, and improve survival and quality of life. The trial was terminated early, and a 1998 publication reported that targeting higher hematocrit levels led to an insignificant increase in the primary end points (death or myocardial infarct), or risk ratio 1.3, 95% confidence interval (CI), 0.9-1.90, but the P-value was not given, and all-cause death risk was not reported. A higher target reportedly did not increase hospitalization rates, but did significantly improve the 'physical function' domain of quality of life. Comparing the 1996 Food and Drug Administration (FDA)-filed clinical trial report to the 1998 publication, however, found several discrepancies. Among these, the 1998 article reported interim trial results with only the adjusted CI but did not state that the unadjusted CIs were 99.912th percentile, and despite being a secondary end point, reported only the association of achieved Hgb with higher quality of life score. Randomization to the higher target had actually increased the risk for the primary end point (risk ratio 1.28, 95% CI=1.06-1.56; P=0.0112; 99.92% CI=0.92-1.78), the risk of death (risk ratio 1.27, 95% CI=1.04-1.54), non-access thrombotic events (P=0.041), and hospitalization rate (P=0.04), while 'physical function' did not improve (P=0.88). Hence, disclosure of these results in the 1998 publication or access to the FDA-filed report on the NHT in the late 1990s would likely have led to earlier concerns about epoetin safety and greater doubts about its benefits.
Hemodynamic Events during the Development of Cyanosis and Heart Failure in a Patient with Large Ventricular Septal Defect
Authors: HARRY A. BLISS, JEAN E. MOFFAT
Journal: Circulation (1964)

A patient with large ventricular septal defect experienced cardiac failure in childhood but improved and participated vigorously in competitive athletics during adolescence. Subsequently exertional dyspnea gradually developed, followed by increasing cyanosis and cardiac failure. Repeated cardiac catheterizations during the latter period showed that cardiac output into both the pulmonary and the systemic circuits gradually fell to very low levels while vascular resistance rose progressively. The ratios of flows, pressures, and resistances in the two circuits did not change. Left-to-right shunting always predominated. Right atrial pressure rose but pulmonary artery "wedge" pressure remained unaltered. Progressive reduction in output from both sides of the heart explained the appearance of reduced arterial oxygen saturation, increased cyanosis, and the manifestations of cardiac failure.
Cytochemical localization of Na+, K+-ATPase in the rat hepatocyte.
Authors: B L Blitzer, J L Boyer
Journal: Journal of Clinical Investigation (1978)

The enzyme Na+,5+-ATPase was cytochemically localized in the rat hepatocyte by a modification of the Ernst potassium-dependent nitrophenyl phosphatase technique. Measurement of nitrophenol release from 50-micrometer liver slices confirmed the presence of ouabain-inhibitable nitrophenyl phosphatase activity that increased over the 30-min incubation period. Electron micrographs demonstrated that sinusoidal and lateral membrane reaction product deposition was K+-dependent, Mg++-dependent, inhibited by ouabain but not by alkaline phosphatase inhibitors, and was localized to the cytoplasmic side of the membrane. In contrast, canalicular reaction product was K+-independent, Mg++-dependent, inhibited by alkaline phosphatase inhibitors but not by ouabain, and was localized to the luminal side of the membrane. These findings indicate that Na+,K+-ATPase is localized to the sinusoidal and lateral portions of the rat hepatocyte plasma membrane and is not detectable on the bile canaliculus where alkaline phosphatase is confined. This basolateral localization of Na+,K+-ATPase is similar to that found in epithelia where secretion is also directed across the apical membrane.
LMNA, encoding lamin A/C, is mutated in partial lipodystrophy
Authors: Sue Shackleton, David J. Lloyd, Stephen N.J. Jackson, Richard Evans, Martinus F. Niermeijer, Baldev M. Singh, Hartmut Schmidt, Georg Brabant, Sudesh Kumar, Paul N. Durrington, Simon Gregory, Stephen O'Rahilly, Richard C. Trembath
Journal: Nature Genetics (2000)
Validation of the REMA Score for Predicting Systemic Mastocytosis in Patients with Mast Cell Activation Disorders
Authors: I. Alvarez-Twose, D. González-de-Olano, L. Sánchez-Muñoz, A. Matito, J. Morgado, M. Jara-Acevedo, C. Teodosio, A. García-Montero, A. Orfao, L. Escribano
Journal: Journal of Allergy and Clinical Immunology (2011)
TUBERCULOSIS — ITS ZOOLOGIC AND GEOGRAPHIC DISTRIBUTION.
Authors: W. A. EVANS
Journal: JAMA (1900)

should be asked of any climatic resource, and it is ex- tremely unwise to journey to a distant country at great inconvenience and expense, and to expect, by so doing, to excuse the omission and neglect of those measures of wholesome living for the sick, that can be had in almost any climate, and that are justified by the experience of all time, as well as by common sense.