tbuckley/cabot-search huggingface dataset:
Estimating the Impact of New Clinical Trial Proven Cancer Therapy and Cancer Chemoprevention on Population Mortality: The Karnofsky Memorial Lecture
Authors: Joseph M. Unger, Michael LeBlanc, John J. Crowley, H. Barton Grossman, Ronald B. Natale, Antoinette J. Wozniak, James R. Berenson, Alan F. List, William A. Peters, Robert C. Flanigan, John S. Macdonald, Muhyi Al-Sarraf, Ian M. Thompson, Charles A. Coltman
Journal: Journal of Clinical Oncology (2003)

The 31-year "war on cancer" has focused largely on therapeutic (as opposed to preventative) cancer research, which, in both the public and private sector, has received the majority of funding. Meanwhile the prevention of cancer has received less attention.We analyzed eight positive phase III therapeutic trials of the Southwest Oncology Group, and estimated how the observed improvements in survival from the new therapies would impact mortality at the population level (utilizing Surveillance, Epidemiology, and End Results-data). We compared these results with the impact of the Prostate Cancer Prevention Trial. The measure of impact was person-years saved in the first 5 years.Estimates of person-years saved in the first 5 years included 28,534 from improved treatment of localized bladder cancer and 26,241 from improved treatment of advanced lung cancer, representing, respectively, 31.4% and 2.8% of the person-years which could have been saved for these diseases (the "relative impact of new treatment on survival"). The new therapies from all eight positive phase III trials would have saved 114,641 person-years over the first 5 years. The estimate from the Prostate Cancer Prevention Trial was 99,441 person-years over the first 5 years.New cancer therapies have a proven and quantifiable impact on population mortality. Successful cancer prevention has a similarly large impact. However, federal funding for cancer prevention is less than half that of cancer treatment. As a result of its enormous potential for extending life, cancer prevention warrants increased funding and support from federal funding agencies.
Is Proton Beam Therapy Cost Effective in the Treatment of Adenocarcinoma of the Prostate?
Authors: Andre Konski, William Speier, Alexandra Hanlon, J. Robert Beck, Alan Pollack
Journal: Journal of Clinical Oncology (2007)

New treatments are introduced routinely into clinical practice without rigorous economic analysis. The specific aim of this study was to examine the cost effectiveness of proton beam radiation compared with current state-of-the art therapy in the treatment of patients with prostate cancer.A Markov model was informed with cost, freedom from biochemical failure (FFBF), and utility data obtained from the literature and from patient interviews to compare the cost effectiveness of 91.8 cobalt gray equivalent (CGE) delivered with proton beam versus 81 CGE delivered with intensity-modulated radiation therapy (IMRT). The length of how many years the model was run, patient's age, probability of FFBF after treatment with proton beam therapy and IMRT, utility of patients treated with salvage hormone therapy, and treatment cost were tested in sensitivity analyses.Analysis at 15 years resulted in an expected mean cost of proton beam therapy and IMRT of $63,511 and $36,808, and $64,989 and $39,355 for a 70-year-old and 60-year-old man respectively, with quality-adjusted survival of 8.54 and 8.12 and 9.91 and 9.45 quality-adjusted life-years (QALY), respectively. The incremental cost effectiveness ratio was calculated to be $63,578/QALY for a 70-year-old man and $55,726/QALY for a 60-year-old man.Even when based on the unproven assumption that protons will permit a 10-Gy escalation of prostate dose compared with IMRT photons, proton beam therapy is not cost effective for most patients with prostate cancer using the commonly accepted standard of $50,000/QALY. Consideration should be given to limiting the number of proton facilities to allow comprehensive evaluation of this modality.
Prematurity and Perinatal Mortality in Pregnancies Complicated by Maternal Chlamydia trachomatis Infections
Authors: David H. Martin, Laura Koutsky, David A. Eschenbach, Janet R. Daling, E. Russell Alexander, Jacqueline K. Benedetti, King K. Holmes
Journal: JAMA (1982)

In a prospective study of morbidity associated with Chlamydia trachomatis infections during pregnancy, we isolated C trachomatis from the endocervix of 18 (6.7%) of 268 women examined before 19 weeks' gestation. Infected women were significantly younger than noninfected women, and significantly more often unmarried, supported by public assistance, and pregnant for the first time. Among women followed up from 19 weeks' gestation until delivery, the mean duration of gestation was significantly shorter for those with antepartum chlamydial infection. Stillbirth or neonatal death occurred in six (33%) of the 18 pregnancies of infected women compared with eight (3.4%) of the 238 pregnancies of noninfected women followed up from the 19th week of gestation through delivery. Stillbirth or neonatal death occurred ten times more often among Chlamydia-infected women than among uninfected controls matched for age, marital status, socioeconomic status, pregnancy order, and race.
Judge Kohlsaat and the Probate Court.
Authors: D. H. Galloway
Journal: JAMA (1898)

Chicago, Oct. 3, 1898. <h3>To the Editor:</h3> —As long as the medical profession prides itself on keeping out of politics, it will be discriminated against by the politicians and the courts. The action of Judge Kohlsaat toward our profession and our bills has become so outrageous that it is of vital importance that we take steps to protect ourselves from his lawless treatment. The judge has made some rulings about which every one of us should know and we should thoroughly understand their effects on our welfare. There have been many criticisms of his arbitrary rulings, but two in particular, which are thoroughly authenticated, I will give. It must be understood that only claims against estates come up in the probate court. The two decisions which, according to his own statement, are permanent in his court, are as follows: First: "I will not allow more than one doctor bill against
Cat's Eye Reflex
Authors: Charles S. Eby
Journal: JAMA (1972)

To the Editor.—  The cat's eye reflex, first noticed in 1765 in an infant by its father,1is the most common presenting sign in retinoblastoma. Strabismus is the second most common sign.2  The early amaurotic cat's eye is often a white, yellow, or pinkish  and nonreproducible pupillary flash best noted under diminished natural illumination. On physical examination with extraocular illumination, replacement of the normal red pupillary reflex with a white reflex may be observed.  A relatively small tumor will elicit the reflex when located at the posterior pole of the eye, whereas tumors located in the retinal periphery must be larger2and the reflex is more apt to be instantaneous and nonreproducible.  Other causes of a white reflex are tuberous sclerosis, angiomatosis, inflammatory lesions such as parasites, and congenital malformations of the eye, such as retinal dysplasia and hyperplastic vitreous.3  The Figure brilliantly demonstrates the
Emerging Infections in Asia
Authors: Preeti N. Malani
Journal: JAMA (2009)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Long-Term Trends in the Use of Complementary and Alternative Medical Therapies in the United States
Authors: Ronald C. Kessler, Roger B. Davis, David F. Foster, Maria I. Van Rompay, Ellen E. Walters, Sonja A. Wilkey, Ted J. Kaptchuk, David M. Eisenberg
Journal: Annals of Internal Medicine (2001)

Background: Although recent research has shown that many people in the United States use complementary and alternative medical (CAM) therapies, little is known about time trends in use. Objective: To present data on time trends in CAM therapy use in the United States over the past half-century. Design: Nationally representative telephone survey of 2055 respondents that obtained information on current use, lifetime use, and age at first use for 20 CAM therapies. Setting: The 48 contiguous U.S. states. Participants: Household residents 18 years of age and older. Measurement: Retrospective self-reports of age at first use for each of 20 CAM therapies. Results: Previously reported analyses of these data showed that more than one third of the U.S. population was currently using CAM therapy in the year of the interview (1997). Subsequent analyses of lifetime use and age at onset showed that 67.6% of respondents had used at least one CAM therapy in their lifetime. Lifetime use steadily increased with age across three age cohorts: Approximately 3 of every 10 respondents in the pre–baby boom cohort, 5 of 10 in the baby boom cohort, and 7 of 10 in the post–baby boom cohort reported using some type of CAM therapy by age 33 years. Of respondents who ever used a CAM therapy, nearly half continued to use many years later. A wide range of individual CAM therapies increased in use over time, and the growth was similar across all major sociodemographic sectors of the study sample. Conclusions: Use of CAM therapies by a large proportion of the study sample is the result of a secular trend that began at least a half century ago. This trend suggests a continuing demand for CAM therapies that will affect health care delivery for the foreseeable future.
RADIUM IN THE TREATMENT OF GYNECOLOGIC AND OBSTETRIC CONDITIONS
Authors: CHARLES C. NORRIS
Journal: JAMA (1928)

As a result of the study of end-results, standardization of the majority of surgical operations is nearly complete. The therapeutic use of radium has only during the last ten or fifteen years become a recognized method of treatment for gynecologic conditions and is still far from uniform. The value of different forms of treatment should he judged by their results, and for this reason I have attempted to give in a condensed form (table 1) the results secured by irradiation in three groups of cases, in all of which operations have been performed in the gynecologic clinic at the Hospital of the University of Pennsylvania.  The one death in this series resulted from uremia and occurred in a patient with advanced nephritis. It is especially noticeable that 92 per cent of the patients were cured by one application of radium, and that, even if the irradiation fails to check the
Method of sampling chorionic villi in first trimester of pregnancy under guidance of real time ultrasound.
Authors: R H Ward, B Modell, M Petrou, F Karagozlu, E Douratsos
Journal: BMJ (1983)

Samples of chorionic villi were obtained in the first trimester by aspiration using a cannula passed transcervically under the guidance of real time ultrasound. In initial studies in 47 anaesthetised patients immediately before therapeutic abortion a method was developed giving a success rate of 89%. In 10 patients successful sampling was performed as an outpatient procedure without anaesthesia. In all, seven diagnostic procedures were undertaken and four of the five unaffected pregnancies continued. The technique of chorionic villous sampling using real time ultrasound is simple to learn and yields material for biochemical analysis and chromosomal study without the need for tissue culture. The exact obstetric risk, however, remains to be defined.
Use of Abbreviations
Authors: Mason Barr
Journal: JAMA (1961)

<h3>To the Editor:—</h3> Realizing that I run the risk of being accused of "scribbling" (<i>JAMA</i><b>174</b>:2227, Dec. 31, 1960), I would like to call your attention to an error inThe Journal. In the issue cited above, your epitome of the article by Colonel Sullivan et al. (p. 2200) states that certain cells contained a polysaccharide which was stained by para-aminosalicylic acid. Colonel Sullivan actually states in his article that the staining was acomplished by periodic acid-Schiff stain. Rather than leaving it at that, I would like to reflect on the cause for such an error. As may or may not be obvious, both of the chemicals named above have the same abbreviation, PAS. Therefore, it is easily seen that a harried summarizer might well substitute one for the other. Undoubtedly it has occurred to others in the profession that similar chances for alphabetical confusion exist; does MS stand
Reproducibility of Radionuclide Left Ventricular Ejection Fraction in Patients Awaiting Cardiac Transplantatio
Authors: ANNE M. KEOGH, STEFAN EBERL, MICHAEL G. YEATES, JUDITH FREUND, JOHN B. HICKIE, DON S. ESMORE, PHIL M. SPRATT, VICTOR P. CHANG
Journal: Clinical Nuclear Medicine (1990)

Radionuclide-derived left ventricular ejection fraction (LVEF) is used to assess LV systolic function, to follow trends in the natural history of dilated cardiomyopathy, and to prioritize patients waiting for cardiac transplantation. Reproducibility of LVEF at extremely low levels has not, however, been reported. To assess the reproducibility of radionuclide LVEF at levels below 0.30 EF U, 17 highly symptomatic patients (NYHA Class III/IV) with dilated cardiomyopathy were studied on two occasions, 72 hours apart. Sequential scans were analyzed by two independent observers. Mean LVEF was 0.18±0.06 U (scan 1) and 0.17±0.06 U (scan 2). Interoperator reproducibility (SD) was 0.03 U (R=0.76), interscan reproducibility (SD) was 0.03 U (R=0.62), and overall reproducibility (SD) was 0.04 U (R=0.50). The interobserver variation of 0.03 (actually 0.027) was just over one half that seen in normal volunteers (variation 0.05, n=29) studied previously in this department. A change of ≥0.08 U (2SD) in either direction is highly likely to represent a real change in LV function in those with LVEF ≤ 0.30 units, compared with the change of at least 0.10 units required in those with normal LV function. Lower interobserver and interscan reproducibility should be taken into account when interpreting sequential scans in patients with severe LV dysfunction.
Diagnosis and management of prolactinomas and non-functioning pituitary adenomas
Authors: Angela Rogers, Niki Karavitaki, John A H Wass
Journal: BMJ (2014)

Sleep disturbances in patients with Parkinson’s disease (PD) are common, are often severe, and are typically underrecognized and ineffectively treated. After the recognition that some patients with PD could fall asleep unexpectedly when driving, with resulting dangerous consequences, it became evident not only that PD medications might be partly responsible but that there were many additional factors contributing to sleep disturbance in these patients. This review discusses the myriad sleep disorders seen in patients with PD, presents their diagnostic features, and gives recommendations on their management. Effective management of sleep disturbances and excessive daytime sleepiness can greatly improve the quality of life for patients with PD.
Properties of purified T cell subsets. II. In vivo responses to class I vs. class II H-2 differences.
Authors: J Sprent, M Schaefer, D Lo, R Korngold
Journal: The Journal of Experimental Medicine (1986)

Highly purified populations of C57BL/6 (B6) L3T4+ and Lyt-2+ T cell subsets were compared for their capacity to exert alloreactivity to class I vs. class II H-2 differences in vivo. B6 Lyt-2+ cells responded strongly to the class I different mutant, bm1, as manifested by DNA synthesis in the spleen of irradiated mice followed by entry of blast cells into thoracic duct lymph, induction of splenomegaly in newborn mice, production of lethal GVHD in irradiated mice, and skin allograft rejection. By all of these parameters, B6 Lyt-2+ cells showed almost total unresponsiveness to the class II-different mutant, bm12. Reciprocal results were observed with B6 L3T4+ cells, these cells responding strongly against bm12 but not against bm1. In the case of purified T cell subsets from other strains, CBA/Ca and B10.BR L3T4+ cells both responded well to a full H-2 difference. Responses by Lyt-2+ cells from these strains were weaker, especially for CBA/Ca cells. The implications of these findings are discussed.
A Medical Disaster Response to Reduce Immediate Mortality after an Earthquake
Authors: Carl H. Schultz, Kristi L. Koenig, Eric K. Noji
Journal: New England Journal of Medicine (1996)

During the past 20 years, natural disasters have claimed more than 3 million lives worldwide, affected at least 800 million people, and resulted in property damage exceeding $50 billion.1 The recent earthquake of magnitude 7.2 in Kobe, Japan, left more than 5000 people dead. In the United States, the great earthquake along the New Madrid fault of the Mississippi Valley in 1812 is said to have rung church bells in Boston and caused the Mississippi River to flow backward for three days.2,3 If a magnitude 8.3 earthquake were to take place along the San Andreas fault, it is estimated . . .
Overwhelming pneumococcal septicaemia in a patient with ulcerative colitis and splenic atrophy.
Authors: K J Foster, N Devitt, P J Gallagher, R M Abbott
Journal: Gut (1982)

This report describes a young woman with ulcerative colitis who developed rapidly fatal pneumococcal septicaemia. Necropsy revealed splenic atrophy. This case supports the hypothesis that splenic atrophy might contribute to the morbidity of ulcerative colitis. The occurrence of splenic atrophy in ulcerative colitis is now well established. Splenic atrophy from other causes has been associated with severe bacterial infections, often pneumococcal. It has been suggested that splenic atrophy is most severe when ulcerative colitis is active and may contribute to postoperative morbidity. This case documents overwhelming septicaemia in a patient with splenic atrophy whose colitis was in remission.
Description of Instrument Used for Talipes Equino-Varus and Valgus
Authors: R. Davy
Journal: BMJ (1872)

Ex/}criu';t 2.-The largest of the three ordinary fiddle-shaped bags was connected with the apparatus, as in Experiment I.The highest pressure reached was when the bag still retained its regularity of form; it was a little above 22 lbs.on the square inch.When the bag was further distended by the injection of more water, it lost its form, bulged out at parts, and the pressure decreased.The highest steady pressure with the apparatus at rest was about i8 lbs.Expcriicn!t 3.-The middle-sized bag behaved very nearly as the largest.Expcrimenzt 4. -The smallest bag behaved very nearly as the others.
Iodination of irrigation water as a method of supplying iodine to a severely iodine-deficient population in XinJiang, China
Authors: X-Y Cao, X-M Jiang, Z-H Dou, M.Abdul Rakeman, A Kareem, M-L Zang, X-M Jiang, T Ma, K O'Donnell, N DeLong, G.R DeLong
Journal: The Lancet (1994)
TRAUMATIC NEUROSES IN COURT.
Authors: L. BREMER
Journal: JAMA (1894)

being the publication of the "National Formulary," in 1888, by the American Pharmaceutical Associa¬ tion.The "Formulary," in its present, unrevised condition, embodies formulas and definitions for 435 preparations, covering most of the non-officinal preparations in popular demand, and replacing many that are now popularly prescribed under special trade names.Among these formulas may be enumerated eighty-six for elixirs, thirty-four for syrups, ten for emulsions, thirty-nine for liquors or solutions, twenty-six for powders, including fourteen salines and effervescents, seventeen for mixtures,
Abstract LB-316: Pharmacokinetic modeling optimizes direct inhibition of the ‘undruggable’ target EWS-FLI1 of Ewing Sarcoma
Authors: S. Peter Hong, S. Ellen Gamble, Sung-Hyeok Hong, Christina L. Kobs, Karen E. Elsass, Natalie L. South, Philip J. Monroe, Aykut Üren, Jeffrey A. Toretsky
Journal: Cancer Research (2012)

Abstract Chimeric transcription factors have long been considered ideal anti-cancer targets since they are only present in tumor cells, however, their lack of enzymatic activity has placed them in a category of ‘undruggable’ proteins. The EWS-FLI1 fusion protein of Ewing Sarcoma (ES) has been validated as an anticancer target both alone and as a partner of RNA Helicase A (RHA). Our prior work identified the small molecule YK-4-279 as a specific inhibitor of EWS-FLI1 by blocking the interaction with RHA. Blocking this interaction leads to apoptosis. Data suggests that relatively long exposures of drug are necessary to keep EWS-FLI1 and RHA apart. We have modeled YK-4-279 treatment using cell lines (TC71, TC32, A4573, SK-ES, and RD-ES) to establish the duration of YK-4-279 exposure that leads to apoptosis. Apoptosis was measured by caspase-3 cleavage. A validated plasma detection method allows for HPLC measurement of YK-4-279. Pharmacokinetic (PK) models of YK-4-279 for both intraperitoneal (IP) and intravenous (IV) administration were developed in SD rats and BL6 mice. ES cell lines were exposed to YK-4-279 over a time-course, followed by a caspase-3 activity assay that demonstrated a minimum of 16 hours exposure was necessary to achieve maximal apoptosis using either 3 or 10 microM compound. A dose-dependency assay demonstrated that while apoptosis could be achieved with 30 - 80 microM YK-4-279 after 4 hours of treatment, caspase-3 activity was less than or equal to 3 microM for 16 hours. Rat PK modeling demonstrated a t1/2 of 30 minutes following IV administration. BL6 mice demonstrated similar kinetics to the rat. SCID/bg mice, which are necessary for tumor efficacy studies, demonstrated approximately 50% faster clearance than either rat or BL6 mice. Absolute bioavailability for IP administration was 41%. Models that use cell culture based targets for plasma levels and duration of exposure will be created to optimize IP dosing regimen. The optimized IP dosage and dosing intervals will be evaluated in tumor bearing animals in order to advance development of YK-4-279. The results of these studies will be used to guide toxicology studies in animals. In addition, pharmacodynamics models are being developed to compare YK-4-279 levels with functional activity. The combined results of these investigations will lead to human clinical trials for this first-in-chemical class, first-in-mechanism drug candidate. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr LB-316. doi:1538-7445.AM2012-LB-316