tbuckley/cabot-search huggingface dataset:
Ethnicity, Age, and Employment Associated with Persistent Symptoms in Breast Cancer Survivors.
Authors: O. Fu, K. Crew, J. Jacobson, H. Greenlee, G. Yu, J. Campbell, Y. Ortiz, D. Hershman
Journal: Cancer Research (2009)

Abstract Background: Increases in breast cancer survival rates have prompted research on the quality of life (QOL) of breast cancer survivors, but relatively few studies have included nonwhite women or women who do not speak English.Patients and Methods: We administered a survey to patients who were ≥3 months post-completion of their adjuvant treatment for stage 0-III breast cancer at Columbia University Medical Center. The questionnaire asked patients about their experience of 16 physical and emotional symptoms in the last 7 days. Univariate analysis was performed to compare differences in each symptom measure by clinical, demographic, and treatment-related factors. Factor analysis is a statistical tool used to describe the covariance relationships among many inter-related variables in terms of a few underlying factors. Maximum likelihood factor analysis of the 16 symptoms using a varimax rotation identified 4 underlying symptom clusters that we termed depression-related, chemotherapy-related, hormone-related, and pain-related based on our clinical impression of the symptom clusters. We then used analyses of variance (ANOVA) to evaluate the associations of each of the sociodemographic and clinical characteristics (race, age, income, education, language, employment, years since diagnosis, and stage) individually with each of the four factors and multiple linear regression analysis to evaluate the associations of all of the sociodemographic and clinical characteristics with each of the four factors.Results: Of 139 patients surveyed, 58 were white, 63 Hispanic, and 18 black. Most women were &amp;lt;5 years post-diagnosis. The symptom most commonly reported was fatigue (76%). The most common severe symptom was muscle aches (40%). Most patients (70%) complained of ≥6 symptoms. Hispanic women were more likely than others to report &amp;gt;10 symptoms (chi2 11.8, df: 4, p&amp;lt;0.05), chemotherapy-related symptoms (beta 1.06±0.465; p&amp;lt;0.05) and pain-related symptoms (beta 0.778±0.362; p&amp;lt;0.05). Unemployed women were more likely than employed women to report chemotherapy-related symptoms (beta 0.472±0.228; p&amp;lt;0.05). Women &amp;lt;45 years old were less likely than women &amp;gt;65 years old to report chemotherapy (beta -0.883±0.364; p&amp;lt;0.05) and pain-related symptoms (beta -0.569±0.283; p&amp;lt;0.05).Conclusions: The majority of women in this population of breast cancer survivors, especially those who were Hispanic, elderly, or unemployed, were burdened by symptoms, most commonly fatigue. As the number of breast cancer survivors increases, and the U.S. population diversifies, it is important to identify, characterize and alleviate perceived post-treatment physical and emotional symptoms in women of different backgrounds. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1064.
Test Your Knowledge: HIV Infection—Epidemiology and Diagnosis
Authors: Yamey Gavin
Journal: PLoS Medicine (2005)

roughly how many people were living with HIV? 20 million 40 million 60 million Question 2. Roughly how many new cases of HIV infection were there in 2004? 1 million 3 million 5 million Question 3. What is the prognosis of untreated adult HIV infection?About 50% of people will become ill and die from AIDS over about ten years About 75% of people will become ill and die from AIDS over about fi ve years About 90% of people will become ill and die from AIDS over about three years Answer 10.Advanced maternal age Young maternal age is a risk factor, as are a high maternal viral load, a low maternal CD4 count, a history of stillbirth, prolonged rupture of the membranes, breastfeeding, sexually transmitted diseases, chorioamnionitis, vaginal delivery, advanced maternal HIV disease, and obstetric events that increase bleeding [1].
Captopril-Induced Functional Renal Insufficiency in Patients with Bilateral Renal-Artery Stenoses or Renal-Artery Stenosis in a Solitary Kidney
Authors: Donald E. Hricik, Philip J. Browning, Richard Kopelman, Warren E. Goorno, Nicolaos E. Madias, Victor J. Dzau
Journal: New England Journal of Medicine (1983)

Medical Intelligence from The New England Journal of Medicine — Captopril-Induced Functional Renal Insufficiency in Patients with Bilateral Renal-Artery Stenoses or Renal-Artery Stenosis in a Solitary Kidney
Book Review Frontiers in Antimicrobial Resistance: A Tribute to Stuart B. Levy Edited by David G. White, Michael N. Alekshun, and Patrick F. McDermott. 570 pp., illustrated. Washington, D.C., ASM Press, 2005. $119.95. 1-55581-329-1
Authors: Victor L. Yu
Journal: New England Journal of Medicine (2006)
How do you choose antibiotic treatment? Commentary: Resist jumping to conclusions Commentary: A matter of good clinical practice Commentary: Honesty is the best policy
Authors: L. Leibovici, I. Shraga, S. Andreassen, S. G Pauker, M. Rothberg, J. R Weinberg, B. I Duerden, M. A Drickamer
Journal: BMJ (1999)

# How do you choose antibiotic treatment? {#article-title-2} Even the most common problems in antibiotic treatment do not have simple solutions. Choosing one antibiotic drug from among several candidates entails balancing the benefits and the detriments associated with each. In this article we engage the reader in a common scenario—deciding which drug to prescribe for a patient with urosepsis—which illustrates the dilemmas in antibiotic prescribing. #### Summary points You are a hospital doctor. An 83 year old man is admitted to your department at 2 am because of fever (temperature 38.7°C), dysuria, and chills. On the basis of clinical findings and microscopic examination of his urine, you decide that the patient has a severe urinary tract infection and needs intravenous antibiotic treatment. In people of his age with urinary tract infection, the most common pathogens are Escherichia coli (about 60% of cases), Proteus mirabilis (10%), and Klebsiella pneumoniae (10%). 1 2 The susceptibility of common pathogens to a range of antibiotics is reported yearly by the microbiology laboratory at your hospital. From this you calculate that ampicillin will cover 40% of pathogens, second generation cephalosporins 75%, gentamicin 92%, third generation cephalosporins 95%, and imipenem 100%. You believe that empirical antibiotic treatment matching the in vitro susceptibility of the pathogen will afford the patient the best chance of survival and an uneventful recovery.3–5 However, you have been told repeatedly by the head of the department that the … Correspondence to: S G Pauker Correspondence to: Professor Duerden
Don't ignore home grown medical systems
Authors: S. Aarabi, C. J. Smithers, J. Mukharjee
Journal: BMJ (2010)

Almost three weeks after the January earthquake in Haiti, two of us went to Port au Prince to take part in the medical relief efforts. We were stationed at the University Hospital with other volunteers from Partners in Health and the International Medical Corps. The conditions at the hospital were grim, with about 400 patients housed in tents on the grounds of the largely destroyed facility. 

University Hospital is the only academic referral centre in the country, is the site of the only public medical and nursing schools, and is known by locals as the place to go for emergency medical care. It wasn’t a surprise, then, that the stream of patients coming through University Hospital remained steady in the weeks after the earthquake. Most of the patients we saw were no longer considered “earthquake victims,” but they were certainly victims of a natural event that had struck a mortal blow to their already dysfunctional medical system. We didn’t treat traumatic injuries or fractures but rather wound infections, tetanus, bowel perforations associated with typhoid infection, and ruptured ectopic pregnancies. 

Despite the impressive number of well equipped temporary field hospitals that were functioning in the vicinity of Port au Prince, University Hospital remained severely understaffed. University Hospital was largely neglected …
Rational Respiratory Therapy
Authors: Thomas L. Petty
Journal: New England Journal of Medicine (1986)

The unplanned shift from the cost-reimbursement method of paying for all medical services to fixed-dollar allowances has created a need to look critically at what we are doing in our entire health care delivery system. The burgeoning field of respiratory therapy was quickly targeted as a likely example of undisciplined practices and excesses, for reasons that included a dearth of good scientific data on many techniques in common use. The new scrutiny of respiratory services came at the time when some health economists had begun to fear that the country was rapidly going broke because of the costs of health . . .
Enhancing Patient-Centered Communication and Collaboration by Using the Electronic Health Record in the Examination Room
Authors: Amina White, Marion Danis
Journal: JAMA (2013)

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
Progressive decrease in tissue glycogen content in rats with long-term cholestasis
Authors: L Krahenbuhl
Journal: Hepatology (1996)

Liver and skeletal muscle glycogen metabolism were investigated in rats 1 and 4 weeks after bile duct ligation (BDL) and in pair-fed, sham-operated control rats. Livers were subjected to morphometric analysis to express glycogen content and enzyme activities per mL hepatocytes. One week after BDL, the hepatic glycogen content was 28.8 +/- 13.8 versus 38.6 +/- 16.4 mg/mL hepatocyte in BDL and control rats, respectively. Total activity of glycogen synthase (50.2 +/- 7.0 vs. 63.5 +/- 9.4 mU/mL hepatocytes) and glycogen phosphorylase (59.4 +/- 12.9 vs. 90.8 +/- 18.9 U/mL) were significantly reduced in BDL whereas the active fraction of glycogen synthase (27 +/- 6 vs. 38 +/- 5%) but not of glycogen phosphorylase was reduced. The skeletal muscle glycogen content was not different between BDL and control rats. Four weeks after BDL, hepatic glycogen content was further reduced (20.5 +/- 14.2 vs. 52.9 +/- 6.4 mg/mL). Total activity of glycogen synthase (38.8 +/- 12.1 vs. 60.1 +/- 4.6 mU/mL hepatocytes) and glycogen phosphorylase (127 +/- 19 vs. 178 +/- 33 U/mL hepatocytes) were both reduced in BDL rats as were their corresponding active fractions (30 +/- 18 vs. 66 +/- 8% and 58 +/- 10 vs. 76 +/- 10). At this time point, the glycogen content in soleus muscle was decreased by 64% in BDL. The glucagon plasma concentration was increased in BDL rats at both time points. There were positive correlations between the volume fraction and both hepatic glycogen content and total activity of hepatic glycogen synthase. Plasma glucagon and the active fraction of hepatic glycogen synthase were negatively correlated. The current studies show a progressive decrease in the hepatic and skeletal muscle glycogen content in BDL rats. The observed decrease in the activities of glycogen synthase and phosphorylase suggest that reduced glycogen synthesis is the major mechanism leading to the reduction in the hepatic glycogen content in BDL rats.
Abstract A29: Discovery and preclinical to clinical evaluation of biomarkers for Anti-DLL4, a monoclonal antibody targeting cancer stem cells
Authors: Ann M. Kapoun, Min Wang, Gilbert O'Young, Lucia Beviglia, Yu-Wang Liu, Pete Yeung, Marcus Fischer, Dave Smith, John Lewicki, Tim Hoey
Journal: Clinical Cancer Research (2010)

Abstract Blockade of DLL4 signaling reduces tumor growth in preclinical human xenograft models by disrupting productive angiogenesis and reducing proliferation of tumor cells. Importantly in these models, blocking DLL4 also reduces cancer stem cell (CSC) frequency in multiple solid tumor types. Currently, there exists an important need to identify and evaluate pharmacodynamic biomarkers that indicate the biological activity of agents, such as anti-DLL4, that are in clinical studies. Towards this aim, we used numerous human xenograft models derived from primary human tumors to identify and characterize biomarkers for anti-DLL4. Here, we present data from these studies and describe anti-DLL4 biomarkers in tumors, in hair follicles, and in blood. We show that several vascular-related genes are significantly upregulated by anti-DLL4 in tumors including, Egfl7, Apln, Cldn5, and Notch4. We also demonstrate significant downregulation of CSC gene signatures and modulation of differentiation genesets. A subset of the identified markers were validated at the protein level and also tested in a human skin graft model, where the human tumor is engrafted in a human microenvironment/vasculature. Finally, a DLL4-Notch gene signature was identified that showed a significant association with breast cancer survival using publicly available cancer gene sets. In surrogate tissues, we identified anti-DLL4 biomarkers in blood and in hair follicles. These markers from surrogate tissues were translated into a phase I trial of Anti-DLL4 antibody (OMP-21M18), and an interim analysis of this data demonstrates that OMP-21M18 affects the Notch pathway in patient samples. Citation Information: Clin Cancer Res 2010;16(14 Suppl):A29.
Upper Airway Muscle Inflammation and Denervation Changes in Obstructive Sleep Apnea
Authors: John H. Boyd, Basil J. Petrof, Qutayba Hamid, Richard Fraser, R. John Kimoff
Journal: American Journal of Respiratory and Critical Care Medicine (2004)

Inflammatory cell infiltration and afferent neuropathy have been shown in the upper airway (UA) mucosa of subjects with obstructive sleep apnea (OSA). We hypothesized that inflammatory and denervation changes also involve the muscular layer of the pharynx in OSA. Morphometric analysis was performed on UA tissue from nonsnoring control subjects (n = 7) and patients with OSA (n = 11) following palatal surgery. As compared with control subjects, inflammatory cells were increased in the muscular layer of patients with OSA, with CD4+ and activated CD25+ T cells (both increased ∼ threefold) predominating. Inflammation was also present in UA mucosa, but with a different pattern consisting of CD8+ (2.8-fold increase) and activated CD25+ (3.2-fold increase) T cell predominance. As ascertained by immunoreactivity for the panneuronal marker PGP9.5, there was a dramatic (5.7-fold) increase in intramuscular nerve fibers in OSA patients compared with control subjects, as well as direct evidence of denervation based on positive immunostaining of the muscle fiber sarcolemmal membrane for the neural cell adhesion molecule in patients with OSA. These data suggest that inflammatory cell infiltration and denervation changes affect not only the mucosa, but also the UA muscle of patients with OSA. This may have important implications for the ability to generate adequate muscular dilating forces during sleep.
Polychlorinated Biphenyls and Their Hydroxylated Metabolites (OH-PCBs) in Pregnant Women from Eastern Slovakia
Authors: June-Soo Park, Linda Linderholm, M. Judith Charles, Maria Athanasiadou, Jan Petrik, Anton Kocan, Beata Drobna, Tomas Trnovec, Åke Bergman, Irva Hertz-Picciotto
Journal: Environmental Health Perspectives (2006)

Our aim in the present study was to characterize and quantify the levels of polychlorinated biphenyls (PCBs) and specific polychlorobiphenylol (OH-PCB) metabolites in maternal sera from women delivering in eastern Slovakia.During 2002-2004, blood samples were collected from women delivering in two Slovak locations: Michalovce district, where PCBs were formerly manufactured, and Svidnik and Stropkov districts, about 70 km north.A total of 762 and 341 pregnant women were sampled from Michalovce and Svidnik/Stropkov, respectively, and OH-PCBs were measured in 131 and 31. EVALUATION/MEASUREMENTS: We analyzed PCBs using gas chromatography (GC)/electron capture detection. OH-PCBs and pentachlorophenol (PCP) were determined as methyl derivatives using GC-electron capture negative ionization/mass spectrometry. We characterized distributions in the full cohort using inverse sampling weights.The concentrations of both PCBs and OH-PCB metabolites of Michalovce mothers were about two times higher than those of the Svidnik/Stropkov mothers (p < 0.001). The median weighted maternal serum levels of the sum of PCBs (sigmaPCBs) were 5.73 ng/g wet weight (Michalovce) and 2.82 ng/g wet weight (Svidnik/Stropkov). The median sum of OH-PCBs (ZOH-PCBs) was 0.55 ng/g wet weight in Michalovce mothers and 0.32 ng/g wet weight in Svidnik/Stropkov mothers. 4-OH-2,2',3,4',5,5',6-Heptachlorobiphenyl (4-OH-CB187) was a primary metabolite, followed by 4-OH-2,2',3,4',5,5'-hexachlorobiphenyl (4-OH-CB146). Only four PCB congeners-CBs 153, 138, 180, and 170--had higher concentrations than 4-OH-CB187 and 4-OH-CB146 (p < 0.001). The median ratio of the sigmaOH-PCBs to the sigmaPCBs was 0.10.Mothers residing in eastern Slovakia are still highly exposed to PCBs, and their body burdens of these pollutants and OH-PCB metabolites may pose a risk for adverse effects on health for themselves and their children.
Diagnostic and therapeutic efficacy of barium meal examination.
Authors: M Deakin
Journal: BMJ (1990)

neutron therapy in both the BMJ and the national press.'4It is important not to let the political issue obscure the scientific facts, and there have been many mis-statements and half truths printed regarding Hammersmith Hospital's experience, the Edinburgh trials, and the present role of the National Cancer Institute in the funding of trials in the United States.The Hammersmith Hospital studies on the response of normal and tumour tissues to neutron treatment in predictably resistant disease: * Offset the bad results of previous unsuccessful clinical studies in the United States' * Showed the benefit of neutron radiation therapy of resistant tumours * Defined the limits of low energy (short penetration) neutron beams, showing especially the predictable problems of using a low energy beam to treat deeply placed tumours (pelvic and abdominal) * Defined acceptable doses and treatment schedules to produce tumour control with the lowest possible rate of complications using the then available equipment * Defined the characteristics of an ideal neutron therapy unit * Defined through clinical trials several tumour types that do not benefit from neutron radiation therapy.These efforts required careful clinical observation and documentation of responses in both tumour and normal tissues.These careful observations stimulated reviews of the original studies carried out by Stone and his collaborators' in the United States during 1935-43 (a period during which any form of radiation therapy was relatively primitive compared with current sophistication).Reviews ofthe study explain the excessive incidence of late injury that occurred owing to retreatment of some patients and lack of knowledge of the relative biological effectiveness of small dose/fraction treatments.'The careful and deliberate studies at the Medical Research Council unit at Hammersmith Hospital provided well documented time-dose studies that permit effective treatment of slow growing resistant tumours in several body sites.Unfortunately, in the Medical Research Council programme at Edinburgh many of the lessons learnt at Hammersmith Hospital were ignored, so that: * The unit had energy and beam characteristics similar to the inadequate Hammersmith unit * They treated many deep seated pelvic tumours for which the beam was inadequate * They used time-dose schedules that were different, so the trials are not comparable with the Hammersmith trials * They produced an inordinately large number of patients with complications, including some that resulted in death.
Prevention and management of neutropenic sepsis in patients with cancer: summary of NICE guidance
Authors: R. Phillips, B. Hancock, J. Graham, N. Bromham, H. Jin, S. Berendse
Journal: BMJ (2012)

Neutropenic sepsis is a potentially fatal complication of treatment for cancer, with mortality rates of 2-21%.1 An investigation by the National Confidential Enquiry into Patient Outcome and Death and a follow-up report by the National Chemotherapy Advisory Group highlighted problems in the management of neutropenic sepsis in adults receiving chemotherapy.2 3 The problems included inadequate management of neutropenic sepsis leading to avoidable deaths, and the lack of systems for urgent assessment and of policies at organisation level for dealing with neutropenic sepsis. This article summarises the most recent recommendations from the National Institute for Health and Clinical Excellence (NICE) on the prevention and management of neutropenic sepsis in patients of any age with cancer.4 NICE recommendations are based on systematic reviews of the best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on the Guideline Development Group's experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets. ### Information and support for patients and carers ### Training for healthcare professionals ### Reducing the risk of septic complications of anticancer treatment
Neural transplants are grey matters
Authors: Britt Anderson, Anjan Chatterjee, George Graham
Journal: Behavioral and Brain Sciences (1995)

Abstract The lesion and transplantation data cited by Sinden et al., when considered in tandem, seem to harbor an internal inconsistency, raising questions of false localization of function. The extrapolation of such data to cognitive impairment and potential treatment strategies in Alzheimer's disease is problematic. Patients with focal basal forebrain lesions (e.g., anterior communicating artery aneurysm rupture) might be a more appropriate target population.
Screening Mammography Under Age 50
Authors: Karen Antman
Journal: JAMA (1999)

MAMMOGRAPHY IS A SCREENING procedure that has decreased the risk of death from breast cancerby25%to30%,asshownin7randomized studies (TABLE 1). It can detect breast cancer or carcinoma in situ at 5 to10mmindiameter.Mostphysicians cannotreliablydetectlesionssmallerthan 10mmonphysicalexamination,andpatientsgenerallyseekmedicalattentionfor lesions that are 25 mm or larger. Of women with known breast cancer who undergo mammography, 80% to 90% have a positive test result. A negative mammogram result does not preclude clinical breast cancer and should not dissuade physicians from biopsy of a palpable abnormality. The remainder of this article discusses screening mammography only. No controversy exists over diagnostic mammography in any woman or man with a suspicious breast examination finding whether older or younger than 50 years. The most common malpractice suit against primary care physicians is failure to diagnose cancer, and, of these, failure to diagnose breast cancer is most common. A substantially higher proportion of these lawsuits involve women younger than 50 years than what is expected based on their relative incidence of breast cancer.