tbuckley/cabot-search huggingface dataset:
Wilson's Disease with Reversible Renal Tubular Dysfunction
Authors: LOUIS J. ELSAS
Journal: Annals of Internal Medicine (1971)

An eighteen-year-old girl with Wilson's disease developed a systemic lupus erythematosus-like syndrome with active glomerulonephritis after 27 months of D-penicillamine therapy. Light and electron microscopy of renal biopsy material showed proliferative glomerulonephritis. The therapy was discontinued; the systemic lupus-like syndrome rapidly subsided, and antinuclear factor disappeared from her serum. Six months later a renal biopsy specimen showed healing of the glomerular lesion; tubular function was minimally impaired. Eighteen months later, despite continued copper restriction, there was increased cupruresis and tissue copper deposition associated with progressive renal tubular impairment. Glomerular capillaries were normal, but new radiodense deposits suggestive of metalloprotein complexes were found in the proximal renal tubular brush border. Reinstitution of low doses of D-penicillamine reversed the functional transport defect without reproducing the lupus-like syndrome. We conclude that D-penicillamine initiated a systemic lupus-like syndrome and that copper deposition produced progressive but reversible proximal renal tubular dysfunction.
CARDIAC STRUCTURE AND FUNCTION AND CHADS2 RISK SCORE IN PATIENTS WITH ATRIAL FIBRILLATION: THE EFFECTS ANTICOAGULATION WITH FACTOR XA NEXT GENERATION IN AFTHROMBOLYSIS IN MYOCARDIAL INFARCTION 48 (ENGAGE AF -TIMI 48) ECHOCARDIOGRAPHIC STUDY
Authors: Deepak K. Gupta, Amil Shah, Robert Giugliano, Christian Ruff, Elliott Antman, Laura T. Grip, Naveen Deenadayalu, Elaine Hoffman, Joshua Betcher, Indravadan Patel, Minggao Shi, Eugene Braunwald, Scott Solomon
Journal: Journal of the American College of Cardiology (2013)
Lapatinib Can Be Safely Given Concomitantly to EC-Doc as Neoadjuvant Chemotherapy for Breast Cancer. First Planned Safety Analysis of the Geparquinto Study (GBG 44).
Authors: M. Untch, M. Kaufmann, J. Hilfrich, D. Strumberg, T. Fehm, J. Bischoff, J. Gauwerky, S. Loibl, V. Nekljudova, G. von Minckwitz
Journal: Cancer Research (2009)

Abstract Background:Trastuzumab has significantly improved pathological complete response rates of neoadjuvant treatment in HER2 positive breast cancer (HER2+BC). The tyrosine-kinase inhibitor lapatinib (L) has shown efficacy in metastatic breast cancer. Previous data in metastatic breast cancer suggested increased hematologic toxicity of docetaxel (Doc) combined with L. As the dose and safety of L in combination with epirubicin (E), cyclophosphamide (C), and Doc has not yet been adequately tested, an integrated safety phase was conducted.Patients and Methods:The GeparQuinto trial, a neoadjuvant phase III study, planned to include 2500 patients (pts) in total and 594 HER2+BC pts for comparing L versus trastuzumab (H) given concomitantly to anthracycline-taxane based chemotherapy. Female pts with untreated, histologically confirmed uni- or bilateral, cT3/4a-d, HER2+BC and no clinically relevant cardiovascular co-morbidities received 4 cycles of E (90mg/m²) + C (600 mg/m²) q3w followed by Doc 100mg/ m² q3w. Pts were randomized to receive either H (6 mg/kg; 8mg/kg loading dose; q3w) or L given concomitantly to all cycles. The 1st cohort in the L arm received 1000 mg/d L during the 1st cycle EC and the 1st cycle Doc and 1250 mg/d L through all other cycles and received prophylactic treatment with pegfilgrastim (6 mg on day 2) and loperamide (2x2mg daily). The 2nd cohort received no loperamide, if &amp;lt;=1 diarrhea grade 3 and no pegfilgrastim if &amp;lt;=3 events of grade 4 neutropenia and &amp;lt;=1 febrile neutropenia (FN) occurred during cycles 1+2 of the 1st 10 pts of the 1st cohort. The remaining pts received 1250 mg/d L in the first cycle and no prophylaxis with loperamide if &amp;lt;=2 diarrhea grade 3 and &amp;lt;= 1 diarrhea grade 4 and no pegfilgrastim if &amp;lt;=4 events of grade 4 neutropenia and &amp;lt;=2 FN occurred during cycles 1+2 of the 1st 10 pts of the 2nd cohort. An interim safety analysis was planned when 60 pts completed all cycles.Results:As of June 1 2009 918 (178 HER+BC) pts have been recruited. 31 pts received ECH-DocH and 29 pts ECL-DocL. In the 1st cohort no grade 3 diarrhea and 2 grade 4 neutropenias occurred. In the 2nd cohort again, no grade diarrhea 3, but 8 grade 4 neutropenias (1 FN) occurred in 4 pts. L was, when compared to H, associated with less grade 1/2 anemia (27.6% vs. 51.6.%) but more grade 1/2 skin rash (27.6% vs. 6.5%) during cycle 1 (data on all cycles will be presented). No significant differences for other toxicities were seen.Conclusion:L at a dose of 1250 mg/d is feasible and well tolerated when given concomitantly to EC-Doc if G-CSF is given prophylactically during DocL. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1094.
QTc Dispersion Predicts Cardiac Mortality in the Elderly
Authors: M. C. de Bruyne, A. W. Hoes, J. A. Kors, A. Hofman, J. H. van Bemmel, D. E. Grobbee
Journal: Circulation (1998)

Increased QTc dispersion has been associated with an increased risk for ventricular arrhythmias and cardiac death in selected patient populations. We examined the association between computerized QTc-dispersion measurements and mortality in a prospective analysis of the population-based Rotterdam Study among men and women aged > or = 55 years.QTc dispersion was computed with the use of the Modular ECG Analysis System as the difference between the maximum and minimum QTc intervals in 12 and 8 leads (ie, the 6 precordial leads, the shortest extremity lead, and the median of the 5 other extremity leads). After exclusion of those without a digitally stored ECG, the population consisted of 2358 men and 3454 women. During the 3 to 6.5 years (mean, 4 years) of follow-up, 568 subjects (9.8%) died. The degree of QTc dispersion was categorized into tertiles. Data were analyzed using the Cox proportional hazards model, with adjustment for age. For QTc dispersion in 8 leads, those in the highest tertile relative to the lowest tertile had a twofold risk for cardiac death (hazard ratio, 2.5; 95% confidence interval [CI], 1.6 to 4.0) and sudden cardiac death (hazard ratio, 1.9; 95% CI, 1.0 to 3.7) and a 40% increased risk for total mortality (hazard ratio, 1.4; 95% CI, 1.2 to 1.8). Additional adjustment for potential confounders, including history of myocardial infarction, hypertension, and overall QTc, did not materially change the risk estimates. Hazard ratios for QTc dispersion in 12 leads were comparable to those found for QTc dispersion in 8 leads.QTc dispersion is an important predictor of cardiac mortality in older men and women.
Postgraduate Study of Pediatrics in Vienna
Authors: F. H. Richardson
Journal: JAMA (1910)

Egbert Lb Fevre, official list of drugs for state board examinations in materia medicaThe following list has been fri.id with the view of includ¬ ing only those drugs which are commonly conceded to lie practically indispensable in Ihe general practice of medicine mid as many preparations as are needed to bring these into play.It does mil aim to contain all the drugs which are of some interest or even of some importance, bill, as has been said, only those Which are indispensable.The others .canscarcely he deemed fair subjects for license examinations, Their selec¬ tion, for purposes of instruction, may be safely lefl to the individual teachers, who.if they wish, can obtain suggestions in the i'St of the Committee of One Hundred of the Council
Abstract P1-01-07: Pre-operative selection of patients with limited disease of the axilla using ultrasonography of the axilla: Might additional lymph node dissection (ALND) be safely omitted in the future?
Authors: AM Moorman, R Bourez, HJ Heijmans, EA Kouwenhoven
Journal: Cancer Research (2013)

Abstract Background: The sentinel lymph node biopsy (SLNB) procedure is the method of choice for the identification and monitoring of regional lymph node metastases in patients with breast cancer. In the case of a positive sentinel node additional lymph node dissection is still warranted for regional control, though 40-65% have no additional axillary disease. Recent studies showed that after breast-conserving surgery, SLNB and adjuvant systemic therapy there is no significant difference between recurrence-free interval and overall survival if there are 2 or less positive axillary nodes. Purpose: Preoperative identification of patients with limited axillary disease (≤ 2 macrometastases) using ultrasonography (US). Method: Between January 2007 and August 2011, data from 1103 consecutive primary breast cancer patients who underwent surgery in our hospital were collected into a single database. Patients were selected by clinical tumours smaller than 50mm (cT1-2), no palpable adenopathy (cN0) and a maximum of 2 SLNs containing macrometastases. The variable of interest was ultrasonography of the axilla. The population was divided into two groups: the group with 2 or fewer positive nodes and the group with more than 2 positive nodes in the axilla after ALND. Results: After selection, 1060 patients remained of which 102 (9.6%) had more than 2 positive axillary nodes on SLNB or ALND. Selected by unsuspected US, the chance of having more than 2 positive lymph nodes is substantially lower (4.2%). This is significant on univariate and multivariate analysis. The chance of more than 2 positive lymph nodes was 12.8 times as big in case of a positive axillary US. When we select this subgroup even further by excluding the patients with extra capsular extension (ECE) on SLN, the chance of more than 2 positive lymph nodes is only 2.6%. Subdivided by clinical tumour size the chances are 0.96% in case of cT1 tumour and 7.0% in case of a cT2 tumour. For pathological T-status the numbers are respectively 0.87% en 5.0%. For pT1-2 this is 2.2%. Conclusion: The risk of more than 2 positive axillary nodes is relatively small in patients with cT1-2 breast cancer. Ultrasonography of the axilla helps in further identifying patients with a minimal risk of additional axillary disease, putting ALND up for discussion. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-01-07.
Consensus Development Conferences
Authors: William R. Barclay
Journal: JAMA (1978)

The National Institutes of Health (NIH) have initiated a series of consensus development exercises that will take place during 1978 and 1979. The major purpose of these exercises or conferences is to make useful new knowledge concerning the prevention, detection, diagnosis, and treatment of major disease entities available to practicing physicians. In the normal course of events, a substantial time lag occurs between the development of new, valid information by the research community and its widespread application in the provision of medical care. In large measure, this delay is the result of a slow diffusion process that relies on medical journals, professional meetings, courses, textbooks, and interpersonal contacts and lacks, therefore, planned promotional guidance. Consequently some new interventions for the treatment of disease are applied too slowly while others may actually be used prematurely. The consensus development conferences will bring together experts in a specific field for the purpose of
MORPHOLOGICAL AND FUNCTIONAL EVALUATION OF RIGHT VENTRICLE ON ECG-GATED 320 SLICE CT CAN PREDICT A SHORT-TERM POOR PROGNOSIS IN SUBJECTS WITH PULMONARY HYPERTENSION
Authors: Koya Ozawa, Nobusada Funabashi, Noriyuki Yanagawa, Nobuhiro Tanabe, Yoshio Kobayashi
Journal: Journal of the American College of Cardiology (2013)
Evaluation of digoxin capsules in outpatients.
Authors: E M Rodgers, S M Dobbs, W I Kenyon, J W Poston
Journal: BMJ (1977)

inactive.The only reasonable correlation of the clubbing was with the growth of the glioma, which initially was too small to be detected but which grew to a large size.It may be concluded that the glioma was in some way the cause of the clubbing, an association that has not been made before.The coexistence of these two features may be important to avoid misdiagnosis in similar cases.This case also illustrates the difficulty in diagnosing the cause of transient neurological symptoms.4Although the clinical evidence pointed to a transient ischaemic attack, possibly from an endocardial thrombus, the correct diagnosis was a small cerebral tumour probably causing focal epilepsy.5
ANGIOGRAPHIC APPROPRIATENESS OF ELECTIVE PERCUTANEOUS CORONARY INTERVENTIONS IN NORTHERN NEW ENGLAND: A BLINDED ANGIOGRAPHIC REVIEW
Authors: David Malenka, Alan Wiseman, John Jayne, William Phillips, Mirle Kellett, Mark Lanzieri, Thomas Ryan, Peter Ver Lee, Frank Fedele, Richard Boss, Todd A. MacKenzie, John Robb, Michael Hearne, David Goldberg, Patrick Magnus, Cathy Ross, Matthew Watkins
Journal: Journal of the American College of Cardiology (2012)
Stress fracture of the scaphoid combined with the distal radial epiphysiolysis.
Authors: H Inagaki, G Inoue
Journal: British Journal of Sports Medicine (1997)

A stress fracture of the scaphoid combined with distal radial epiphysiolysis occurred in a 16 year old badminton player. Repeated shearing and torsional forces by excessive wrist movement from hitting a shuttle probably cause stress injuries in both the scaphoid and the distal radius.
Blood lead levels of primary school children in Dhaka, Bangladesh.
Authors: R Kaiser, A K Henderson, W R Daley, M Naughton, M H Khan, M Rahman, S Kieszak, C H Rubin
Journal: Environmental Health Perspectives (2001)

Dhaka, Bangladesh, has one of the highest air lead levels in the world. In February 2000, we evaluated children at five primary schools in Dhaka to determine blood lead (BPb) levels, sources of environmental exposure, and potential risk factors for lead poisoning. Selected schools represented a range of geographic and socioeconomic strata. A total of 779 students 4-12 years of age participated. The mean BPb level was 15.0 microg/dL (range 4.2-63.1 microg/dL). Most students (87.4%) had BPb levels above the Centers for Disease Control and Prevention's level of concern (10 microg/dL). Elevated BPb levels correlated with soil eating [odds ratio (OR) = 3.31; 95% confidence interval (CI), 1.30-8.39], low parental education (OR = 2.72; 95% CI, 1.97-3.75), living close to major roads (OR = 2.30; 95% CI, 1.23-4.29), and increasing age (OR = 1.11; 95% CI, 1.06-1.16). BPb levels measured were similar to those in other countries that use leaded gasoline. No other potential sources of lead exposure were consistently identified. Combustion of leaded gasoline is the main source of lead exposure in Dhaka, resulting in ubiquitous contamination of the environment. The increase in BPb levels with age, a finding contrary to observations in the United States and Australia, may be related to increased outdoor activities. The Bangladeshi government recently announced a plan to eliminate leaded gasoline. Baseline BPb surveys are critical to develop and evaluate intervention policies. Strategies to reduce BPb levels need to address variations in socioeconomic status, construction type and location of housing, and levels of hygiene.
Pulmonary sarcoidosis with a diffuse ground glass pattern on the chest radiograph.
Authors: A Tazi, T Desfemmes-Baleyte, P Soler, D Valeyre, A J Hance, J P Battesti
Journal: Thorax (1994)

Several chest radiographic abnormalities have been described in pulmonary sarcoidosis, but a diffuse ground glass pattern is extremely rare.The chest radiographs of more than 1600 patients with sarcoidosis evaluated in our service between 1976 and 1991 were reviewed to determine the prevalence of this pattern on chest radiography at presentation, and to assess the clinical characteristics of these patients.Ten patients (0.6%) were identified with diffuse ground glass abnormalities on the chest radiography (eight men); all had associated hilar or mediastinal adenopathy. All patients were white and nine were smokers or former smokers. Nine patients were symptomatic and six had inspiratory crackles on physical examination. As a group these patients were remarkable for the frequency and severity of physiological abnormalities and the presence of various findings typically associated with "active" disease. Nine patients were followed for more than three years. All were treated with oral corticosteroids because of significant symptoms or physiological abnormalities, or both. Symptoms and radiological abnormalities disappeared or improved in all patients, but recurred in a high proportion when steroids were tapered or discontinued. By December 1992 only three patients had been withdrawn from treatment.A diffuse ground glass pattern on the chest radiograph is unusual in patients with sarcoidosis and may occur more commonly in white subjects and cigarette smokers. Its presence suggests the existence of active disease of recent onset likely to require long term treatment with corticosteroids.
Extracorporeal Membrane Oxygenation as a First-Line Treatment Strategy for ARDS
Authors: William Checkley
Journal: JAMA (2011)

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
Identification of Gulf War Syndrome: Methodological Issues and Medical Illnesses
Authors: Anthony A. Amato
Journal: JAMA (1997)

<h3>To the Editor.</h3> —The conclusions of the articles by Dr Haley et al<sup>1,2</sup>that purport to demonstrate at least 3 distinct Gulf War syndromes are supported by the examination of only 23 patients with self-reported symptoms and exposures. In contrast, studies by the Departments of Defense and Veteran Affairs were based on the evaluations of more than 70 000 veterans.<sup>3</sup>We reported the extensive clinical, laboratory, neurophysiological, and histological evaluation (muscle biopsies) of 20 patients with the most severe neuromuscular symptoms and concluded there was no evidence to suggest a neuromuscular disorder unique to the Persian Gulf War or that our veterans' symptoms were related to toxic exposures.<sup>4</sup> Besides the limitations of their methods,<sup>5</sup>there are problems with the neurophysiological data. Evoked potentials have a limited utility in evaluating patients with possible neurologic disorders. The major efficacy of evoked potentials is in looking for paraclinical evidence of demyelination, and
Immunological Studies in Arteritis of the Aorta and Great Vessels
Authors: R. A. Asherson, G. L. Asherson, V. Schrire
Journal: BMJ (1968)

Sera from 21 patients with arteritis of the aorta and great vessels were studied. The mean level of IgG, IgM, and IgA immunoglobulin was raised. The incidence of rheumatoid and antinuclear factor and antibodies to aorta, liver, and thyroid was not raised.
Relative Risk of Mortality Associated With Diabetes as a Function of Birth Weight
Authors: Cynthia L. Leibson, James P. Burke, Jeanine E. Ransom, Jessica Forsgren, Joseph Melton, Kent R. Bailey, Pasquale J. Palumbo
Journal: Diabetes Care (2005)

OBJECTIVE—Birth weight is a risk factor for both diabetes and mortality. Diabetes is a risk factor for mortality. Whether the excess mortality observed for diabetes varies with birth weight is unclear. RESEARCH DESIGN AND METHODS—Among all 2,508 Rochester, Minnesota, residents who first met research criteria for adult-onset diabetes in 1960–1995, 171 were born locally in-hospital after 1922 (i.e., birth weights available) as singleton, term infants. Each case subject and two age- and sex-matched nondiabetic control subjects (born locally, residing locally when the case subject met the criteria for diabetes) were followed through 31 December 2000 for vital status. RESULTS—Of the diabetic case subjects, 16% (27 of 171) died vs. 7% (25 of 342) of control subjects (P = 0.004). The difference was less for normal-birth-weight (NBW) (2,948–&amp;lt;3,856 g) individuals (12% [12 of 102] vs. 8% [20 of 246], P = 0.31) than for abnormal-birth-weight individuals (low birth weight [LBW] 20% [8 of 39] vs. 2% [1 of 46], P = 0.01; high birth weight [HBW] 23% [7 of 30] vs. 8% [4 of 50], P = 0.16), as confirmed with age- and sex-adjusted Cox proportional hazards (diabetes-associated hazard ratio 1.4 [95% CI 0.69–2.90] for NBW vs. 4.8 [1.7–13.3] for abnormal birth weight, test for interaction P = 0.056). The observed diabetes deaths were greater than expected, based on mortality for the general population (27 vs. 13.3, P &amp;lt; 0.001), with 70% of excess deaths occurring among LBW (8 vs. 2.2, P &amp;lt; 0.001) and HBW (7 vs. 3.1, P = 0.03) individuals. CONCLUSIONS—The excess mortality observed for diabetes appears disproportionately concentrated among abnormal-birth-weight individuals, thus identifying a subset of at-risk diabetic individuals and reinforcing the importance of NBW deliveries.
Angina Pectoris and Arrhythmias Documented by Cardiac Telemetry
Authors: Charles C. Norland, Herbert J. Semler
Journal: JAMA (1964)

In a dynamic electrocardiographic system which allows the physician to obtain continuous electrocardiograms over a tenhour period in ambulatory subjects, ECG waveforms can be quickly analyzed using rapid-playback oscilloscopes. Diagnostic portions of the recordings can be printed on standard ECG equipment. Several cases demonstrate the numerous applications of recording continuous ECGs in detecting angina pectoris or paroxysmal arrhythmias that cannot be documented using convential electrocardiography.
TCT-525 Reduction of Apolipoprotein B/A-I Ratio During Follow-Up Predicts Lower Adverse Event Rate at One Year After Percutaneous Coronary Intervention
Authors: Jae Yeong Cho, Myung Ho Jeong, Youngkeun Ahn, Hae Chang Jeong, Sang Cheol Cho, Jong Hyun Yoo, Su Young Jang, Ji Eun Song, Ki Hong Lee, Doo Sun Sim, Keun Ho Park, Nam Sik Yoon, Hyun Ju Yoon, Kye Hun Kim, Hyung Wook Park, Young Joon Hong, Ju Han Kim, Jeong Gwan Cho, Jong Chun Park, Jung Chaee Kang
Journal: Journal of the American College of Cardiology (2012)
Intradermal Inoculation With Heptavax-B
Authors: Jessica A. Clarke
Journal: JAMA (1989)

The high cost of hepatitis B vaccine has limited its widespread use. Low-dose, intradermal injections of vaccine represent one option for reducing the cost. In this study, 92 nonimmune medical students were given three 0.1-mL intradermal injections of Heptavax-B containing 2 μg of hepatitis B surface antigen (HBsAg) at 0,1, and 6 months. By 6 months, 90% of the subjects had developed protective levels of antibody to HBsAg (≥10 mlU/mL). Follow-up at 1 year showed a geometric mean concentration of antibodies to HBsAg of 396 mlU/mL for the group, and 95% had levels of antibody to HBsAg greater than or equal to 10 mlU/mL. A level of antibody to HBsAg of greater than 100 mlU/mL also was observed in more than 75% of subjects. Side effects included induration of the inoculation site in 18% at 6 months, which disappeared by 12 months, and macules that persisted at 1 year in 63%. The administration of hepatitis B vaccine intradermally is an attractive, low-cost alternative in the United States, where universal vaccination of preschool children or adolescents is being contemplated, and where booster doses are being considered. (<i>JAMA</i>. 1989;262:2567-2571)