tbuckley/cabot-search huggingface dataset:
Alcoholism in hereditary hemochromatosis revisited: Prevalence and clinical consequences among homozygous siblings
Authors: P C Adams, S Agnew
Journal: Hepatology (1996)

The relationship between alcoholism and hereditary hemochromatosis remains controversial. Previous studies have included patients with alcoholic siderosis rather than hereditary hemochromatosis. In this retrospective study, the clinical features, iron status, alcohol history, liver histology, and long-term survival were reviewed in 105 homozygotes for hemochromatosis using rigid diagnostic criteria including an HLA identical sibling with iron overload. Heavy alcohol consumption (>80 g ethanol/day) was found in 15 percent of hemochromatosis patients. Histological features of alcoholic liver disease (Mallory's hyaline bodies, pericentral fibrosis, polymorphonuclear infiltrate, and fatty infiltration) were uncommon in hemochromatosis. Hemochromatosis patients with heavy alcohol consumption had a higher prevalence of cirrhosis than hemochromatosis patients without heavy alcohol consumption. Hepatic iron concentration and hepatic iron index did not significantly differ between these two hemochromatosis groups. Long-term survival was significantly reduced in patients with heavy alcohol consumption (mean follow-up, 9.22 years). This suggests that chronic alcohol consumption has an additive hepatotoxic effect despite the paucity of histological features of alcoholic liver disease.
The effect of posture on central blood volume in patients with preascitic cirrhosis on a sodium-restricted diet
Authors: F Wong
Journal: Hepatology (1996)

The status of the central blood volume in cirrhosis is controversial. A combination of sodium restriction and upright posture, which redistributes intravascular volume to dependent parts of the body should further aggravate a contracted central blood volume reduction. The aim of this study was to determine the effect of upright posture and sodium restriction on central blood volume (CBV) in preascitic cirrhotic patients, compared with controls. Eight male, preascitic, alcoholic cirrhotic subjects and eight healthy male controls were studied while on a 20-mmol/d sodium diet. Measurements of CBV by radionuclide angiography, and neurohumoral factors were performed on day 7 in both supine and erect positions and cardiac output and systemic vascular resistance (SVR) was calculated. Sodium restriction resulted in less weight loss in the cirrhotic patients (P = .03), with significantly lower plasma renin activity (P = .001). Similar central blood volumes and systemic hemodynamics were observed in both groups in the supine posture. In contrast to the cirrhotic patients, in the control subjects, upright posture resulted in a significant reduction in cardiac output (P = .002) and increase in SVR (P = .005), associated with a decrease in all blood volumes which were significantly less than in the cirrhotic patients. Mean arterial pressure was maintained in both groups in both postures. In conclusion, with sodium restriction, preascitic cirrhotic patients have less intravascular volume contraction than control patients. Erect posture results in redistribution of this relatively expanded intravascular volume to the CBV. Therefore, a low-sodium diet can be safely administered in preascitic cirrhotic patients.
Cancer‐testis antigen expression and its epigenetic modulation in acute myeloid leukemia
Authors: Djordje Atanackovic, Tim Luetkens, Benjamin Kloth, Gregor Fuchs, Yanran Cao, York Hildebrandt, Sabrina Meyer, Katrin Bartels, Henrike Reinhard, Nesrine Lajmi, Susanna Hegewisch‐Becker, Georgia Schilling, Uwe Platzbecker, Guido Kobbe, Thomas Schroeder, Carsten Bokemeyer, Nicolaus Kröger
Journal: American Journal of Hematology (2011)

Abstract Cancer‐testis antigens (CTA) represent attractive targets for tumor immunotherapy. However, a broad picture of CTA expression in acute myeloid leukemia (AML) is missing. CTA expression was analyzed in normal bone marrow (BM) as well as in AML cell lines before and after treatment with demethylating agents and/or histone acetylase inhibitors. Presence of selected CTA with a strictly tumor‐restricted expression was then determined in samples of patients with AML before and after demethylating therapy. Screening AML cell lines for the expression of 20 CTA, we identified six genes (MAGE‐A3, PRAME, ROPN1, SCP‐1, SLLP1, and SPO11) with an AML‐restricted expression. Analyzing the expression of these CTA in blast‐containing samples from AML patients ( N = 64), we found all samples to be negative for MAGE‐A3 and SPO11 while a minority of patients expressed ROPN1 (1.6%), SCP‐1 (3.1%), or SLLP1 (9.4%). The only CTA expressed in substantial proportion of patients (53.1%) was PRAME. Following demethylating treatment with 5′‐aza‐2′‐deoxycytidine, we observed an increased or de novo expression of CTA, in particular of SSX‐2, in AML cell lines. In AML patients, we detected increased expression of PRAME and induction of SSX‐2 after demethylating therapy with 5‐azacytidine. With the exception of PRAME, CTA are mostly absent from AML blasts. However, demethylating treatment induces strong expression of CTA, particularly of SSX‐2, in vitro and in vivo. Therefore, we propose that CTA‐specific immunotherapy for AML should preferentially target PRAME and/or should be combined with the application of demethylating agents opening the perspective for alternative targets like CTA SSX‐2. Am. J. Hematol., 2011. © 2011 Wiley‐Liss, Inc.
Evaluating the Older Patient with Cancer: Understanding Frailty and the Geriatric Assessment
Authors: S. Kumar Pal, V. Katheria, A. Hurria
Journal: CA A Cancer Journal for Clinicians (2010)

The majority of cancer incidence and mortality occurs in individuals aged older than 65 years, and the number of older adults with cancer is projected to significantly increase secondary to the aging of the US population. As such, understanding the changes accompanying age in the context of the cancer patient is of critical importance. Age-related changes can impact tolerance of anticancer therapy and can shift the overall risk-benefit ratio of such treatment. A challenge in implementing evidence-based approaches in older adults is the under-representation of this group in oncology clinical trials. In addition, although older adults are particularly vulnerable to the side effects of cancer therapy, few oncology studies to date have incorporated a measure of health status other than the Eastern Cooperative Oncology Group or Karnofsky performance scales. Novel metrics such as frailty indices or the geriatric assessment recognize heterogeneity among older adults, and may allow for risk-adapted approaches to therapy. It is increasingly recognized that several laboratory markers may predict morbidity and mortality in older adults; these biologic variables may further aid in stratifying this group of patients based on risk. This review describes key studies from the geriatric literature that provide principles for assessing health status in the older patient, and ways that these principles can be applied to oncology care in an older population are proposed.
The Treatment of Acute Rheumatism by Morphia Injection
Authors: R. Gillard
Journal: BMJ (1871)

LFeb 4, I871.and at once tapped the swelling.The tapping was repeated every two or three days until the end of July, and after that about once a week, until the sac had been emptied twenty-four times.At the end of the series of operations, only a very slight discoloration was left over a spot not larger than a coffee-bean; and, as the skin had never been injured here, this will in time entirely disappear.Had this abscess burst as such
Subspecialty Work Force Issues
Authors: Eric G. Neilson
Journal: Annals of Internal Medicine (1995)

Letters15 May 1995Subspecialty Work Force IssuesEric G. NeilsonEric G. NeilsonFor the Association of Subspecialty Professors, Philadelphia, PA 19104. The Robert Wood Johnson Foundation, Princeton, NJ 08543-2316.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-122-10-199505150-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their editorial, Drs. Sandy and Schroeder [1] used our position paper [2] to continue the debate about the size of the physician work force. This issue retains its immediacy, despite a legislative lull, because the pipeline of young physicians wanting training has never been larger and because a surplus of physicians in all areas, including primary care, has never been more obvious [3, 4].The Association of Subspecialty Professors has taken no position on the future number of international medical graduates entering the United States because controlling the size of the physician work force is a ...References1. Sandy LG, Schroeder SA. Subspecialty leadership at a time of specialty excess (Editorial). Ann Intern Med. 1994; 121:805-6. Google Scholar2. Association of Subspecialty Professors. Training in internal medicine. On the chessboard of health care reform. Ann Intern Med. 1994; 121:810-3. Google Scholar3. Weiner JP. Forecasting the effects of health reform on U.S. physician workforce requirement: evidence from HMO staffing patterns. JAMA. 1994; 272:222-30. Google Scholar4. Cooper RA. Creating a balanced physician workforce for the 21st century. JAMA. 1994; 272:680-7. Google Scholar Author, Article, and Disclosure InformationAuthors: Eric G. NeilsonAffiliations: For the Association of Subspecialty Professors, Philadelphia, PA 19104. The Robert Wood Johnson Foundation, Princeton, NJ 08543-2316. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 May 1995Volume 122, Issue 10 Page: 804 Keywords Female contraception Forecasting Graduate medical education Health care Literacy Patients Research quality assessment Sub-specialty care ePublished: 15 August 2000 Issue Published: 15 May 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
The Debate on Antibiotic Therapy for Patients Hospitalized for Pneumonia
Authors: Jonathan S. Lee, Michael J. Fine
Journal: JAMA Internal Medicine (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 Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast 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) 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 Internal Medicine journal
The Hospital Power Equilibrium: Physician Behavior and Cost Control
Authors: Charles E. Housley
Journal: JAMA (1986)

<i>The Hospital Power Equilibrium</i>presents the political forces at work within the hospital environment that hinder cost-control efforts. The authors' definition of the problem in part 1 is excellent. Today's movement toward a market-based economy is believed to be detrimental to the health care industry. The extensive citations support their thesis through an elaboration of the multidimensional motivations present in today's hospitals. The authors present Crozier's model of organizational behavior—constant conflict with stable outcomes—as being a philosophic framework that one may adapt to the health care setting. Conflicting incentives between physicians, administrators, and other occupational groups are proposed to be the undermining of the present system. The authors present two case studies in part 2. They adequately defend the selection of this small number by stating that the lesson to be learned is not<i>what</i>happened, but<i>why</i>. The problems inherent in these two institutions give an excellent representation of
Splenectomy, Immunosuppressive Therapy, and Sepsis
Authors: William Spickler
Journal: JAMA (1978)

To the Editor. —  In the article Acute Bacteremia in Asplenic Renal Transplant Patients (237:2207, 1977), Schroter et al suggest that the occurrence of fulminant sepsis in transplant patients may be related more to prior splenectomy than to the immunosuppressive therapy required by these patients. Weitzman and Aisenberg 1 recently described three cases of fulminant sepsis in patients with prior splenectomy and immunosuppressive therapy in the form of total nodal irradiation and chemotherapy for Hodgkin's disease. We wish to report a recent case, suggesting also that the combination of splenectomy and immunosuppression is far more hazardous than splenectomy alone.  Report of a Case.—  Our patient was a 41-year-old man who seven years previously underwent prior splenectomy, total nodal irradiation, and chemotherapy with a regimen of cyclophosphamide, vincristine sulfate (Oncovin), prednisone, and procarbazine hydrochloride (COPP). He had been given no medications for the two months prior to his admission.  In December
Role of external evidence in monitoring clinical trials: experience from a perinatal trial
Authors: P. Brocklehurst
Journal: BMJ (2000)

The randomised controlled trial is the most scientifically rigorous way of evaluating interventions whose effects on important clinical outcomes are uncertain.1 Before conducting such a trial, investigators should undertake a systematic review of thevidence from existing trials, including, if appropriate, a meta-analysis. This prevents trials being carried out unnecessarily when the answer to the clinical question is already known.A priori power calculations should be made to determine how many participants will be required to answer the research question,2 and this process is increasingly being required by research ethics committees and funding bodies, among others.3 Nevertheless, under some circumstances recruitment to a trial may be halted before the planned sample size has been reached because

The process for stopping a trial early because of indications from internal data is well accepted and recognised and the statistical methodology has been discussed at length, but this is not the case for external evidence. The process by which trial investigators should consider external evidence and make decisions concerning further recruitment is unclear.

#### Summary points

Principal investigators of clinical trials should be responsible for obtaining relevant information emerging from other studies

Investigators should seek unpublished confidential information, but this requires sensitive handling

Meta-analysis is useful for incorporating ongoing trial data with existing and emerging evidence

The trial data monitoring committee is responsible for reviewing both internal and external information, but the trial steering committee should decide whether to modify or stop a trial

We describe our recent experience of stopping a large international trial because of external evidence …
Late‐onset cases of familial hemophagocytic lymphohistiocytosis with missense <i>perforin</i> gene mutations
Authors: Ikuyo Ueda, Yumi Kurokawa, Kenichi Koike, Shuichi Ito, Akifumi Sakata, Tsutomu Matsumora, Takashi Fukushima, Akira Morimoto, Eiichi Ishii, Shinsaku Imashuku
Journal: American Journal of Hematology (2007)

Abstract Since the discovery of perforin gene mutations in familial hemophagocytic lymphohistiocytosis (FHL) type 2, heterogeneous features in FHL2 patients have been identified in a report of Feldmann et al. as the beginning. This study was conducted to determine the impact of characteristic gene mutations on late‐onset (age ≥ 7 years) hemophagocytic lymphohistiocytosis episodes. We analyzed perforin gene mutations in three late‐onset cases from our registry in Japan and an additional 10 cases from the literature. Of the 13 cases with onset ages of a median of 10 (range 7–49) years, nine had homozygous and four had compound heterozygous missense mutations of the perforin gene. None had homozygous nonsense mutations. Our data suggest that nonsense perforin gene mutations yield early onset and missense mutations late onset in FHL2 cases. Am. J. Hematol., 2007. © 2007 Wiley‐Liss, Inc.
A MEMORABLE PATIENT
Authors: V. White
Journal: BMJ (1995)

It was my second shift in casualty. The first had not been as bad as expected. I had just about mastered the computer enough to order an x ray examination and was rather pleased with my sutures to a lacerated arm. This evening had been quiet; I had finished work in “minors” by midnight and I went to the “major” side to see if I could help out.

A staff nurse, looking rather hesitant, said, “I don't think you should see this one, he is best left to a male doctor. He is a homicidal, suicidal, HIV positive drug addict who needs help. And he's carrying a garrotte.”

“I'm certainly not going to see him!” said my male colleague retreating across the department.

I thought that …
CD4 <sup>+</sup> T Cells from IPEX Patients Convert into Functional and Stable Regulatory T Cells by <i>FOXP3</i> Gene Transfer
Authors: Laura Passerini, Eva Rossi Mel, Claudia Sartirana, Georgia Fousteri, Attilio Bondanza, Luigi Naldini, Maria Grazia Roncarolo, Rosa Bacchetta
Journal: Science Translational Medicine (2013)

FOXP3 gene transfer in FOXP3 -mutated CD4 + T cells is feasible and converts IPEX conventional T cells into regulatory T cells.
Multilineage dysplasia (MLD) in acute myeloid leukemia (AML) correlates with MDS-related cytogenetic abnormalities and a prior history of MDS or MDS/MPN but has no independent prognostic relevance: a comparison of 408 cases classified as “AML not otherwise specified” (AML-NOS) or “AML with myelodysplasia-related changes” (AML-MRC)
Authors: Miriam Miesner, Claudia Haferlach, Ulrike Bacher, Tamara Weiss, Katja Macijewski, Alexander Kohlmann, Hans-Ulrich Klein, Martin Dugas, Wolfgang Kern, Susanne Schnittger, Torsten Haferlach
Journal: Blood (2010)
Inactivation of Spry2 accelerates AKT-driven hepatocarcinogenesis via activation of MAPK and PKM2 pathways
Authors: Chunmei Wang, Salvatore Delogu, Coral Ho, Susie A. Lee, Bing Gui, Lijie Jiang, Sara Ladu, Antonio Cigliano, Frank Dombrowski, Matthias Evert, Diego F. Calvisi, Xin Chen
Journal: Journal of Hepatology (2012)
ASSESSING ADEQUATE P2Y12 PLATELET INHIBITION BY THE ACCUMETRICS VERIFYNOW ASSAY USING “PLATELET REACTIVITY UNITS” OR “PERCENT INHIBITION”: FINDINGS FROM A REAL WORLD REGISTRY
Authors: J. Brent Muhlestein, Heidi T. May, Donald L. Lappé, Sterling T. Bennett, Brian K. Whisenant, Jeffrey L. Anderson
Journal: Journal of the American College of Cardiology (2011)
A Family Systems Approach to Home Dialysis
Authors: Susan Stewart, Robert Johansen
Journal: Psychotherapy and Psychosomatics (1976)

Dramatic increases in the cost of the end stage renal disease program are producing an emphasis on home dialysis with the patient and his family carrying the responsibility for this treatment. This requires an adjustment of the family's emotional system and role assignment to sustain members through the continued stress of chronic catastrophic illness. We are suggesting a model of intervention in which family members are encouraged to recognize stress caused by one member's illness and to make necessary changes in the family functioning.
Acceleration of autologous in vivo recellularization of decellularized aortic conduits by fibronectin surface coating
Authors: Alexander Assmann, Christofer Delfs, Hiroshi Munakata, Franziska Schiffer, Kim Horstkötter, Khon Huynh, Mareike Barth, Volker R. Stoldt, Hiroyuki Kamiya, Udo Boeken, Artur Lichtenberg, Payam Akhyari
Journal: Biomaterials (2013)
Three-dimensional motion tracking correlates with skill level in upper gastrointestinal endoscopy
Authors: Sif Arnold, Morten Svendsen, Lars Konge, Lars Svendsen, Louise Preisler
Journal: Endoscopy (2015)

Feedback is an essential part of training in upper gastrointestinal endoscopy. Virtual reality simulators provide limited feedback, focusing only on visual recognition with no feedback on the procedural part of training. Motion tracking identifies patterns of movement, and this study aimed to explore the correlation between skill level and operator movement using an objective automated tool.In this medical education study, 37 operators (12 senior doctors who performed endoscopic retrograde cholangiopancreatography, 13 doctors with varying levels of experience, and 12 untrained medical students) were tested using a virtual reality simulator. A motion sensor was used to collect data regarding the distance between the hands, and height and movement of the scope hand. Test characteristics between groups were explored using Kruskal-Wallis H and Man-Whitney U exact tests.All motion-tracking metrics showed discriminative ability primarily between experts and novices in specific sequences.Motion tracking can discriminate between operators with different experience levels in upper gastrointestinal endoscopy. Motion tracking can be used to provide feedback regarding posture and movement during endoscopy training.
Remodeling of the Left Ventricle in Primary Aldosteronism Due to Conn’s Adenoma
Authors: Gian Paolo Rossi, Alfredo Sacchetto, Edoardo Pavan, Paolo Palatini, Gian Rocco Graniero, Cristina Canali, Achille C. Pessina
Journal: Circulation (1997)

Since hyperaldosteronism has been experimentally related to myocardial interstitial fibrosis, we investigated the effects of hypertension and excess aldosterone due to aldosterone-producing adenomas (APAs) on the heart.In 52 hypertensive individuals, we performed Doppler echocardiography for estimation of left ventricular (LV) wall thickness and dimensions, transmitral LV filling flow velocity indexes, and 24-hour ambulatory blood pressure monitoring. Consecutive patients with APAs (n = 26) and essential hypertension (EH, n = 26) were individually matched for age, sex, race, body mass index, casual blood pressure, and known duration of hypertension. The matched groups were similar for demography, casual and 24-hour blood pressure values and variability, and duration of hypertension but differed for serum potassium, plasma renin activity, and aldosterone levels (all P < .001). A thicker interventricular septum (P = .015) and posterior wall (P = .009) and a higher LV mass index (118 +/- 5 versus 100 +/- 4 g/m2, P = .009) were observed in APA compared with EH patients. Both septum and posterior wall thicknesses had a significant direct relationship with age, plasma aldosterone, and mean blood pressure. The integral of the early diastolic filling wave (Ei) (P = .011) and the ratio Ei/Ai (A wave integral) (P = .038) were lower and the atrial contribution to LV filling was higher (52 +/- 2% versus 46 +/- 2%, P = .038) in APA than in EH patients. The ratio Ei/Ai was significantly (P = .008) inversely related only to age and plasma aldosterone.In APA patients, the excess aldosterone is associated with both increased LV wall thickness and mass and decreased early diastolic LV filling indexes compared with demographically similar EH with superimposable blood pressure values, profile, and variability.