tbuckley/cabot-search huggingface dataset:
Clinical investigation of pulmonary Mycobacterium avium complex infection in human T lymphotrophic virus type I carriers
Authors: W. Matsuyama
Journal: Thorax (2000)

Little is known about pulmonary Mycobacterium avium complex (MAC) infection in human T lymphotrophic virus type I (HTLV-I) carriers. A study was undertaken to investigate and clarify the characteristics of pulmonary MAC infection in these subjects.Twenty nine patients with pulmonary MAC infection without any underlying pulmonary disorder were investigated. The clinical features and radiographic appearance of HTLV-I carriers and non-carriers were compared and the bronchoalveolar lavage (BAL) fluid of these 29 patients and eight normal female control subjects was analysed.The prevalence of the HTLV-I carrier state in patients with pulmonary MAC infection was 34.5% (10/29) compared with 16.7% (529/3169) among all patients admitted to our department between 1994 and 1998 (odds ratio (OR) 2.63, 95% confidence interval (CI) 1.21 to 5.68). The HTLV-I carriers were all women and all had clinical symptoms, but they did not show systemic dissemination. Peripheral multifocal bronchiectasis with nodular shadowing was seen frequently on the chest computed tomographic (CT) scans of HTLV-I carriers. The area of the pulmonary lesions was more extensive than in non-carriers (p<0.05). White blood cell (WBC) counts and C reactive protein (CRP) levels on admission were significantly lower in HTLV-I carriers than in non-carriers (WBC: difference (D) = 1565/microl, 95% CI -68.9 to 3198.4/microl; CRP: D = 1.8 mg/dl, 95% CI -0.35 to 3.89 mg/dl). The concentrations of neutrophil elastase (NE) and interleukin (IL)-8 in BAL fluid were significantly higher in HTLV-I carriers than in non-carriers (NE: D = 1342 microg/l, 95% CI 704 to 1980.3 microg/l; IL-8: D = 304.5 pg/ml, 95% CI 89.7 to 519. 4 pg/ml).Pulmonary MAC infection causes more diffuse and widespread lesions in HTLV-I carriers than in non-carriers.
THE USE AND LIMITATIONS OF ATROPINE FOR PHARMACOLOGICAL STUDIES ON AUTONOMIC EFFECTORS
Authors: N. AMBACHE
Journal: Pharmacological Reviews (1955)

The well known fact that atropine susceptibility is not an infallible criterion of cholinergic transmission is discussed in some detail. Various examples of atropine-resistant nerve effects have been considered, and the following types of atropine-resistance can be distinguished:

1) Apparent resistance which is due to destruction of atropine in the animal. This occurs in a proportion of rabbits, in which atropinesterase is present in the blood and in some tissues. The effect of atropine is then very brief and may erroneously be thought to be absent.

2) Atropine-resistance in cholinergic neuro-effector systems, as for example in intestinal preparations from some species, and possibly in the bladder. In the intestine corroborative evidence provided by anticholinesterases and by botulinum toxin strongly suggests that the nerve endings concerned are cholinergic, and therefore supports the theory put forward by Dale and Gaddum that this type of atropine-resistance is due to proximity of the nerve endings to the effector cells. It is pointed out that the classification of intestinomotor drugs by means of atropine is influenced by these considerations.

3) The secondary formation of an atropine-resistant pharmacological agent, e.g., of bradykinin in the salivary glands. Acetylcholine or chorda stimulation lead to the extrusion of a proteolytic enzyme capable of forming bradykinin from serum proteins.

4) Atropine-resistance due to non-cholinergic transmission. Two examples of this are considered: (a) antidromic trigeminal pupillary constriction; and (b) antidromic vasodilatation in the rabbit's ear. Confirmatory evidence from other sources indicates the non-cholinergic nature of these effects.

5) Several nicotinic actions of acetylcholine are relatively resistant to atropine, but can nevertheless be blocked by the alkaloid in appropriate concentrations.
International neuroblastoma staging system stage 1 neuroblastoma: a prospective study and literature review.
Authors: B H Kushner, N K Cheung, M P LaQuaglia, P F Ambros, I M Ambros, M A Bonilla, M Ladanyi, W L Gerald
Journal: Journal of Clinical Oncology (1996)

PURPOSE To gain insight into the management of non-metastatic neuroblastoma by examining clinical and biologic features of International Neuroblastoma Staging System (INSS) stage 1 tumors. METHODS Patients were staged by both the INSS and the Evans staging system and were evaluated for biologic prognostic factors. Patients with INSS stage 1 received no cytotoxic therapy. The literature was reviewed for clinical and biologic data about INSS stage 1. RESULTS We evaluated 10 consecutive patients (median age, 17.5 months) with INSS stage 1; all remain disease-free (median follow-up duration, &gt; 5 years). Tumors were in the abdomen (n = 6), chest (n = 3), or pelvis (n = 1). Neuroblastoma involved margins of resection in six tumors. Poor-prognostic biologic findings included tumor-cell diploidy (n = 2) and unfavorable Shimada histopathology (n = 2). Two patients were to receive chemotherapy for, respectively, a tumor deemed unresectable and a tumor classified as Evans stage III; second opinions resulted in surgical management alone in each case. Published reports confirm that some INSS stage 1 patients (1) are at risk for overtreatment, and (2) have poor-prognostic biologic findings yet do well. CONCLUSION Surgery alone suffices for INSS stage 1 neuroblastoma, even if biologic prognostic factors are unfavorable, microscopic disease remains after surgery, and tumor size is suggestive of "advanced-stage" status in other staging systems. Attempts to resect regionally confined neuroblastomas should take precedence over immediate use of cytotoxic therapy; otherwise, some patients may receive chemotherapy or radiotherapy unnecessarily.
Treatment of anthracycline extravasation with dexrazoxane: Pharmacokinetics and update on efficacy and safety from three multicenter trials
Authors: G. Giacone, L. Handskemager, H. Mouridsen, J. Tjornelund, S. Langer, J. Buter, A. Rasmussen, P. Buhl, K. Dahlstrom, P. Grundtvig
Journal: Journal of Clinical Oncology (2007)

2555 Background: Dexrazoxane prevented tissue necrosis in 98% of patients (pts) with biopsy proven anthracycline extravasation (AEV) in two international multicenter studies, TT01 and TT02 (Mouridsen HT et al Ann Onc Advance Access Dec 21, 2006). However, the pharmacokinetics (PK) of IV dexrazoxane in the three-day schedule is not established. Study TT04 was initiated to investigate PK. Patients and methods: TT04 is a prospective, open-label, single-arm, multicenter studies in pts with AEV. Consecutive pts with AEV are treated with a three-day schedule of IV dexrazoxane (1,000, 1,000, and 500 mg/m 2 ) starting within 6 hr of AEV. Primary objective: Establish PK of IV dexrazoxane in the three-day schedule. Secondary objectives: obtaining additional efficacy and safety data. Plasma samples at 0, 1, 2, 4 and 24 hr day 1–3 are analyzed by HPLC-MS. PK parameters were calculated by a non compartmental method. TT01 and TT02 were open-label, single-arm, multicenter studies enrolling pts with biopsy proven AEV from 24 EU centers. Primary objective was to avoid tissue necrosis leading to surgery. Secondary objectives were to minimize delay of planned chemotherapy, reduce hospitalization, and avoid long term sequelae. Results: Six pts have entered the PK study. The average elimination was T½ ± SD of 127 ± 23, 144 ± 21, and 107 ± 29 min, day 1, 2 and 3, respectively. Pre-dose concentrations day 2 and 3 are = LOQ. Average AUC 0-t ± SD are 193 ± 93 (t= 24 hr), 196 ± 101 (t= 24 hr), and 46 ± 24 μg hr/ml (t= 4 hr), on day 1, 2 and 3, respectively. Cumulative data from the 3 studies: Surgery was avoided in 59/60 pts (98.3%). No delay in planned chemotherapy in 71%. 41% were hospitalized (median 3 days) due to the EV or its treatment. Mild pain (19%) and mild sensory disturbances (17%) were the most frequent sequelae: Reversible CTC grade 3–4 leucopenia/neutropenia in 45%, thrombocytopenia in 21% of the pts. Conclusion: There was no accumulation of dexrazoxane during the three-day schedule. Dexrazoxane was well tolerated and highly effective against anthracycline extravasation. Updated results will be presented. No significant financial relationships to disclose.
Urinary biomarkers are unreliable for diagnosing bladder cancer, study finds
Authors: Jacqui Wise
Journal: BMJ (2015)

Urine based biomarkers miss a substantial proportion of patients with bladder cancer and produce false positive results in others, research published in the Annals of Internal Medicine has found.1

The standard method for diagnosing bladder cancer involves cystoscopy, cytological evaluation of urine, and imaging. However, because cystoscopy is uncomfortable and costly, alternatives have been sought. The US Food and Drug Administration has approved five urinary biomarkers for …
Plan Needed to Prevent Infectious Disease Spread via Air Travel
Authors: Rita Rubin
Journal: JAMA (2016)

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
Cytogenetic Abnormalities Predict Clinical Outcome In Patients Diagnosed With Relapsed Acute Myeloid Leukemia (rAML): Single Center Experience
Authors: Hassan Alkhateeb, Rhett P Ketterling, Niamh Keane, Mrinal M Patnaik, Animesh Pardanani, Michelle Elliott, William J Hogan, Mark R. Litzow, Aref Al-Kali
Journal: Blood (2013)
Abstract 16098: Optimizing Door-to-Balloon Time in STEMI: Implementing a Failure Mode and Effects Analysis
Authors: Shashank S Sinha, Isaac R Whitman, Jennifer S Myers, Neha Patel, Jeffrey I Rohrbach, AnnMarie Papa, David F Gaieski, Michelle M Walsh, Howard C Herrmann, Daniel M Kolansky
Journal: Circulation (2012)

Background: Prompt PCI for patients with STEMI significantly reduces morbidity and mortality and is now standard of care. ACCF/AHA/SCAI guidelines recommend achieving door-to-balloon (D2B) time wit...
Nasopharyngeal Carcinoma in an Alaskan Eskimo Family: Report of three Cases
Authors: A P Lanier, T R Bender, C F Tschopp, P Dohan
Journal: JNCI Journal of the National Cancer Institute (1979)

Nasopharyngeal carcinoma (NPC) has been reported to occur in Alsaka Natives (Eskimos, Indians, and Aleuts) at a rate greater than 15 times the rate for U.S. whites. At least 3 cases of NPC have occurred in close relatives of a Northern Alaskan Eskimo family. All 3 patients had poorly differentiated tumors and have died. Blood groups, HLA antigens, and antibodies to Epstein-Barr virus (EBV) were studied in the family members. EBV titers were elevated in the 1 NPC patient tested and in 1 of 15 other family members tested. All family members studied except 1 were of blood group A, Rh-positive, and HLA types AW24, CW3, CW40/A2, CW2 and B27. This was the first report of more than 2 cases of NPC in a single family in the United States.
The use of warfarin for venous thromboembolism (VTE): Practical problems for patients and resource implications for an oncology unit
Authors: P. G. Morris, D. O’Dwyer, C. Davenport, C. O’Callaghan, O. S. Breathnach, L. Grogan
Journal: Journal of Clinical Oncology (2006)

6088 Background: Recent evidence has suggested improved efficacy with low molecular weight heparin (LMWH) over oral coumarins for the treatment of cancer patients with VTE. Oral anticoagulants present multiple practical problems for patients undergoing chemotherapy, including side-effects, disruption of anticoagulation for invasive procedures, multiple drug interactions and multiplicity of patient visits. To assess the practice implications of these issues, a review was carried out in a busy medical oncology unit. Methods: A retrospective review of all patients treated with the coumarin derivative, warfarin for VTE during the last year was undertaken. Patients on prophylactic warfarin for central venous devices were excluded. Computerised laboratory records were used to identify patients. Patients were assessed for adverse events and therapeutic efficacy. The extra volume of work involved in monitoring blood tests and treating complications was quantified. Results: 55 patients with VTE were treated with warfarin from 07/01/04 to 06/30/05. The majority (73%) had metastatic carcinoma. 21 invasive interventions required disruption of anticoagulation. 90% of these were in patients with metastatic disease. Each patient was subtherapeutic (International normalised ratio &lt;2.0) for a mean of 30.7 days (25% of mean duration of anticoagulation). There were 8 admissions for haemorrhage. Nine patients died on warfarin, 8 of whom had metastatic disease. In one patient with significant cardiac comorbidity warfarin therapy contributed to early death. No patterns of drug interactions were identified. A total of 1,369 coagulation tests were performed. There were 382 extra blood test visits, representing 26% of all day ward blood visits. On treatment, 13 patients (24%) were changed from warfarin therapy to LMWH. In 4 patients there was progression of VTE. In 9 patients, all with metastatic disease LMWH was substituted to qualitatively improve patient care by minimising hospital visits and facilitating home based care. Conclusions: This study identifies the high rate of treatment change to LMWH and quantifies the extra resource utilization with coumarin therapy. This supports the increased primary use of LMWH in selected cancer patients. No significant financial relationships to disclose.
Does bevacizumab increase the risk of venous thromboembolism? A cohort study.
Authors: A. A. Khorana, G. C. Connolly, M. R. Dalal, J. Lin
Journal: Journal of Clinical Oncology (2011)

e19543 Background: Bevacizumab has been associated with thrombotic events in cancer patients, but results from recent pooled analyses of clinical trials have produced conflicting data. Methods: Data were extracted from the IMS Patient-Centric Database of commercially insured patients in the United States. Demographics/clinical characteristics of ambulatory adult patients with cancer who were initiating chemotherapy (n=17,284) and a matched control cohort without cancer (n=17,284) were evaluated. Incidence of venous thromboembolism (VTE), bleeding, resource utilization, and cost were recorded during a follow-up period of 3-12 months after initiation of chemotherapy in the cancer cohort. Data from the entire cancer cohort and sub-cohort with colorectal cancer only were analyzed. Results: Overall, 2,170 (12.6%) patients experienced VTE in the cancer cohort compared with 237 (1.4%) in the control cohort (P<0.0001). The incidence of VTE events among cancer patients included 7.7% (n=1,336) deep vein thrombosis, 2.4% (n=406) pulmonary embolism, and 2.5% (n=428) both. The respective bleeding rates were 22.4% (n=3,873) and 7.0% (n=1,211; P<0.0001). Among patients with cancer, 11.8% (n=2,035) received bevacizumab. Patients treated with bevacizumab had a significantly increased risk of any VTE event (odds ratio [OR], 1.43; 95% confidence interval [CI], 1.24, 1.65; P<0.0001) and bleeding (OR, 1.39; 95% CI, 1.23, 1.57; P<0.0001) compared with patients not treated with bevacizumab. Of 4,548 patients with colorectal cancer, 480 (10.6%) experienced VTE; 1,135 (25.0%) received bevacizumab. Colorectal cancer patients treated with bevacizumab had a significantly increased risk of VTE (OR, 1.66; 95% CI, 1.32, 2.10; P<0.0001) and bleeding (OR, 1.51; 95% CI, 1.24, 1.83; P<0.0001) compared with those not treated with bevacizumab. Conclusions: The risk of VTE was high among this cohort of ambulatory patients with cancer and sub-cohort of patients with colorectal cancer. The incidence of VTE and bleeding was increased further in those who were treated with bevacizumab. Study funding and editorial support provided by sanofi-aventis U.S.
Prognostic value of mitosis-specific antibodies and computer image analysis in calculating mitotic rate in melanoma.
Authors: Christopher Hale, Meng Qian, Michelle W. Ma, Yongzhao Shao, David Polsky, Richard L. Shapiro, Russell S. Berman, Anna C. Pavlick, Iman Osman, Farbod Darvishian
Journal: Journal of Clinical Oncology (2012)

e19003 Background: Mitotic rate (MR) is an important part of staging for thin melanomas (≤1 mm) but its value in thick melanomas (&gt;1 mm) has not been determined. Additionally, accurate calculation of MR on hematoxylin and eosin (H&amp;E) stained sections can be challenging. Several mitosis-specific antibodies are commercially available but their role in predicting clinical outcome in melanoma has not been adequately assessed compared to H&amp;E. Methods: Primary tissues from 190 cutaneous melanoma patients [≤1 mm (n = 22); &gt;1 mm (n=168)] prospectively enrolled at New York University Medical Center were stained with MPM-2 and PHH3, two mitosis-specific antibodies. Using light microscopy, MR was quantified manually from corresponding H&amp;E, MPM-2, and PHH3-stained sections. Computer-assisted image analysis was then applied to detect immunolabeled mitoses on the previously examined PHH3 and MPM-2 slides. We then analyzed the association between MR and progression-free survival (PFS) and melanoma-specific survival (MSS). Results: Manual quantification of PHH3-derived MR was associated with shorter PFS in thick melanomas (P=0.042). Computer-assisted quantification of PHH3 showed a significant association with shorter PFS and MSS in thick melanomas (P=0.021, P=0.04, respectively). Relative to manual analysis of corresponding H&amp;E-stained sections, manual analysis of PHH3 and MPM-2 stains increased mean MR (86% and 159% increases, respectively). MPM-2 did not have value as mitosis-specific marker in melanoma of any thickness. Conclusions: PHH3-derived MR might be useful in predicting worse clinical outcome in primary melanoma patients with thicker melanoma.
Patterns of progression in renal cell carcinoma: antivascular therapy compared with interferon
Authors: J. C. Araujo, E. Jonasch, N. M. Tannir, B. N. Bekele, E. Lin, E. R. Plimack
Journal: Journal of Clinical Oncology (2008)

5106 Background: The standard of care for patients with advanced renal cell carcinoma (RCC) has changed to favor targeted therapy over immunotherapy. We sought to investigate differences in patterns of progression between patients treated with these two modalities. Methods: Patients who progressed on first line antivascular therapy (AVT) [bevacizumab, bevacizumab + Erlotinib, or sorafenib] or interferon (IFN) in one of three clinical trials at MD Anderson Cancer Center were identified, and their medical records reviewed. Results: Between May 2002 and June 2007, 152 patients had progressed on first line therapy with either AVT (n=50) or IFN (n=102). The AVT group had better baseline performance status, fewer patients with baseline liver metastases, but more baseline lung metastases compared with the IFN group. The groups were otherwise well matched in terms of mean age (AVT 59 yrs, IFN 60 yrs) race, gender, and other baseline sites of disease. As expected, the response rate (CR +PR) was better in the AVT group (22% vs. 5%). Patients in the AVT group were more likely to progress at new organ sites only with original sites of disease remaining stable (10% vs. 4%, p=0.01). Whereas patients in the IFN group were more likely to progress at both old and new sites concurrently (21% vs. 12%, p=0.012). Progression of old lesions or appearance of new lesions at the following sites were equally common in both groups: kidney/renal fossa, lymph node, lung, bone, and liver. Due to inconsistencies in baseline brain imaging, we were unable to asses the progression pattern of CNS disease. Patients responding to IFN (CR+PR) did not have significantly longer progression free survival (PFS) compared with non-responders (SD+PD), [7.6 mo. vs. 2.9 mo., p=0.221]. However, patients responding to AVT showed an improvement in PFS compared with non-responders [9.3 mo. vs. 3.8 mo., p=0.013]. Conclusions: Patients with RCC treated with AVT were more likely to progress at new organ sites in the setting of stable disease at baseline sites suggesting that AVT is more effective at controlling existing sites of disease than it is at preventing new metastases. Response was a good predictor of PFS in patients treated with AVT, however this relationship was not seen with IFN. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Bayer/Onyx Bayer/Onyx Genentech
Parental rheumatoid arthritis and long-term child morbidity: a nationwide cohort study
Authors: Ane Lilleøre Rom, Chun Sen Wu, Jørn Olsen, Damini Jawaheer, Merete Lund Hetland, Bent Ottesen, Lina Steinrud Mørch
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Objective</h3> To estimate the influence of parental rheumatoid arthritis (RA) on child morbidity. <h3>Design</h3> Nationwide cohort study. <h3>Setting</h3> Individual linkage to nationwide Danish registries. <h3>Participants</h3> All singletons born in Denmark during 1977–2008 (n=1 917 723) were followed for an average of 16 years. <h3>Main outcome measures</h3> Adjusted HRs for child morbidity; that is, 11 main diagnostic groups and specific autoimmune diseases within the International Classification of Diseases 8th and 10th versions. <h3>Results</h3> Compared with unexposed children, children exposed to maternal RA ('clinical' and 'preclinical') (n=13 566) had up to 26% higher morbidity in 8 of 11 main diagnostic groups. Similar tendencies were found in children exposed to paternal RA ('clinical' and 'preclinical') (n=6330), with statistically significantly higher morbidity in 6 of 11 diagnostic groups. HRs were highest for autoimmune diseases with up to three times increased risk of juvenile idiopathic arthritis (HR, 95% CI 3.30, 2.71 to 4.03 and 2.97, 2.20 to 4.01) and increased risk of up to 40% of diabetes mellitus type 1 (HR, 95% CI 1.37, 1.12 to 1.66 and 1.44, 1.09 to 1.90) and up to 30% increased HR of asthma (HR, 95% CI 1.28, 1.20 to 1.36 and 1.15, 1.04 to 1.26). Conclusions were roughly similar for children exposed to maternal clinical RA and for children only followed up to 16 years of age. <h3>Conclusion</h3> Children of parents with RA had consistent excess morbidity. If the associations reflect biological mechanisms, genetic factors seem to play an important role. These findings call for attention given to children of parents with RA.