tbuckley/cabot-search huggingface dataset:
Carcinoma of the Lung: Changing Pattern of Mortality in Ontario
Authors: S GRZYBOWSKI, R B SUTHERLAND
Journal: JAMA (1963)

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
Healthcare for Syrian refugees
Authors: Jonathan Gornall
Journal: BMJ (2015)

As Syria’s civil war rages on, promised aid money has not materialised and the UN is struggling to provide healthcare for more than four million refugees. Jonathan Gornall reports

During a snow storm on New Year’s Day this year, triplets Riyadh, Ahmed, and Khalid were born in a refugee camp in Lebanon’s Bekaa Valley. Their mother developed heavy bleeding and died shortly after the births; the smallest of the boys died three weeks later.1 The UN High Commission for Refugees (UNHCR), which drew global attention to the family’s tragedy, could not confirm whether the births had taken place in the family’s tent or in a medical facility. But in June, the head of the agency, Antonio Guterres, warned that there are “70 000 pregnant women at risk of unsafe deliveries” because “life-saving health services are becoming too expensive for many.”2

In Lebanon, UNHCR covers 75% of the cost of life saving, obstetric, and emergency hospital care for refugees. But increasingly refugees cannot scrape together their 25%. The agency told The BMJ that it had spent $40.25m (£25.80m; €36.60m) subsidising healthcare costs for 55 000 refugees in Lebanon in 2014—approximately $727 a head. Given that in 90% of cases UNHCR pays only 75% of the costs, with the patient being left to find the balance, this suggests an average cost per patient of about $1000.

“We do our best to refer refugees to non-governmental organisations or charities who are able to assist them with the remaining fees as most have depleted whatever resources they had and are often unable to cover outstanding costs,” …
Expression profiling in ependymoma reveals differences between benign and anaplastic ependymoma
Authors: Blanca Suarez-Merino, Mike Hubank, Richard Hayward, William Harkness, Dominic Thompson, Kim Phipps, Tamas Revesz, John L. Darling, David G. Thomas, Tracy Warr
Journal: Neuro-Oncology (2003)

Abstracts from Neuro-Oncology are provided here courtesy of Society for Neuro-Oncology and Duke University Press
Risk of Colorectal Cancer After Ovarian Stimulation for In Vitro Fertilization
Authors: Mandy Spaan, Alexandra W. van den Belt-Dusebout, Curt W. Burger, Flora E. van Leeuwen, R. Schats, C.B. Lambalk, M. Kortman, J.S.E. Laven, C.A.M. Jansen, L.A.J. van der Westerlaken, B.J. Cohlen, D.D.M. Braat, J.M.J. Smeenk, J.A. Land, F. van der Veen, J.L.H. Evers, M.M.E. van Rumste
Journal: Clinical Gastroenterology and Hepatology (2015)
The Bcl10–Malt1 complex segregates FcεRI-mediated nuclear factor κB activation and cytokine production from mast cell degranulation
Authors: Stefanie Klemm, Jan Gutermuth, Lothar Hültner, Tim Sparwasser, Heidrun Behrendt, Christian Peschel, Tak W. Mak, Thilo Jakob, Jürgen Ruland
Journal: The Journal of Experimental Medicine (2006)

Mast cells are pivotal effector cells in IgE-mediated allergic inflammatory diseases. Central for mast cell activation are signals from the IgE receptor FcεRI, which induce cell degranulation with the release of preformed mediators and de novo synthesis of proinflammatory leukotrienes and cytokines. How these individual mast cell responses are differentially controlled is still unresolved. We identify B cell lymphoma 10 (Bcl10) and mucosa-associated lymphoid tissue 1 (Malt1) as novel key regulators of mast cell signaling. Mice deficient for either protein display severely impaired IgE-dependent late phase anaphylactic reactions. Mast cells from these animals neither activate nuclear factor κB (NF-κB) nor produce tumor necrosis factor α or interleukin 6 upon FcεRI ligation even though proximal signaling, degranulation, and leukotriene secretion are normal. Thus, Bcl10 and Malt1 are essential positive mediators of FcεRI-dependent mast cell activation that selectively uncouple NF-κB–induced proinflammatory cytokine production from degranulation and leukotriene synthesis.
Anaesthesia for Bronchoscopy: Examination of a Standard Technique
Authors: John P Newell, John M Collis
Journal: Journal of the Royal Society of Medicine (1980)

An anaesthetic technique for bronchoscopy is described, based on increments of methohexitone given in strict relation to body weight and time, suxamethonium being used to produce relaxation. There was no awareness in the 75 patients studied, while the recovery was rapid and unrelated to the duration of bronchoscopy. The efficacy of small aliquots of lignocaine in reducing injection pain was the same whether given before, or mixed with, the initial methohexitone injection. Other sequelae relating to the anaesthetic technique were minimal.
Abstract 55: Novel Genetic Risk Variants for Kidney Function: A Large-Scale Exome Array Analysis of 111,666 European Ancestry Individuals
Authors: Man Li
Journal: Circulation (2015)

Introduction:  Chronic kidney disease (CKD) is a worldwide public health problem. Although genome-wide association studies (GWAS) have identified 29 loci for estimated glomerular filtration rate (eGFR, a measure of kidney function), they account for only a small proportion of the variation in eGFR. Exonic genetic variants with minor allele frequency (MAF)    Hypothesis:  Multiple low frequency (MAF 1-5%) and rare (MAF   Methods:  We meta-analyzed the association result from 24 studies between eGFR as estimated from serum creatinine with the MDRD equation and up to 134,329 genetic variants genotyped on the Illumina HumanExome Beadchip (“Exome Array”) in up to 111,666 European ancestry participants. We conducted inverse-variance weighted fixed-effect meta-analysis for single variants. To test for within-gene enrichment of rare exonic variants, we performed gene-based collapsing tests (T1 and sequence kernel association test [SKAT]) incorporating variants annotated as nonsynonymous or splice site with MAF    Results:  Among 29 known kidney function loci, 28 of them achieved exome array wide significance (p    Conclusions:  Using the exome array, we have not identified single rare exonic variants associated with eGFR. With the identification of common and low-frequency variants and one gene with enrichment of rare coding variants associated with eGFR, our findings provide further insight into the genetic architecture of kidney function and offer the potential to provide new insights into the pathogenesis of CKD.
Paclitaxel injectable emulsion: Phase 2a study of weekly administration in patients with non-small cell lung cancer (NSCLC)
Authors: N. Bogdanova, N. Karaseva, N. Ognerubov, O. Golubeva, P. Weiden
Journal: Journal of Clinical Oncology (2004)

7133 Background: Paclitaxel Injectable Emulsion (PIE; TOCOSOL Paclitaxel) is a convenient, ready-to-use, Cremophor-free unmodified paclitaxel product administered over 15 min. Methods: As part of a Phase 2A program, a multicenter study of 2nd line, single agent PIE was performed in pts with Stage IIIB or IV NSCLC. First line chemo had to have resulted in stable disease or an objective response (OR). PIE was given IV over 15 min weekly. Dose cohorts were 80, 100, and 120 mg/m2. Results: 43 pts were enrolled: median age = 58 yrs; 33/10 M/F; median ECOG PS=1; 11/31 Stage IIIB/IV (one IIIA patient is included in safety but not efficacy analysis). Prior chemo was non-platinum-based in 12 early pts, but all subsequent pts had platinum-based chemotherapy, 24 also with etoposide, navelbine or gemcitabine. By study design, 6 pts received 80, 6, 100 and 31, 120 mg/m2/wk. Therapy has been completed, but follow-up for progression and survival continues. Grade 3–4 toxicities observed in more than 5% of pts across the entire Phase 2A program (n=145) included neutropenia (G3 17%; G4 16%; febrile 2%), anemia (G3 11%; G4 1%), peripheral neuropathy (G3 9%; G4 0%) and dyspnea (G3 4%; G4 1%). Infusion related symptoms were generally mild and resolved without treatment if the infusion was interrupted for several minutes. In the NSCLC study, pts received PIE for 1 to 53 (median 15) weeks. PIE was discontinued in 24 pts for progressive disease, in 7 for unspecified reasons and in 2 for adverse events; 5 pts died, 3 completed planned therapy, and 2 were withdrawn by the investigator. OR by RECIST and preliminary time to disease progression (with 36% of patients still censored) are summarized in the table. Conclusion: PIE given weekly by 15-min infusion is well tolerated and shows encouraging efficacy in pts with Stage IIIB/ IV NSCLC who have progressed after platinum-based therapy. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration PSI Pharma Support Intl; Sonus Pharmaceuticals Sonus Pharmaceuticals Sonus Pharmaceuticals Sonus Pharmaceuticals
Influenza 1959
Authors: J. Fry
Journal: BMJ (1959)

Unexpected and unwelcome a violent influenza epidemic hit my general practice in January, 1959, and went n until the last weeks of March.It produced the usual ectic strain on doctors and caused a great deal of 4erious illness in the community at risk.Since it is only Wa the field of general practice that influenza is seen in Its true natural state, it is of some interest and importance to describe such epidemics so that each might be compared with its predecessors and an overaU picture be built up over the years.Influenza is a most important illness to our community.Its highly infectious nature leads to an enormous incidence, and it is not unusual to have more than 10% of the population of the country sick with influenza at any one time, and during the whole epidemic gver 50% of those at risk in some areas may be affected.The loss of work-time is collosal.The Times of February 26, 1959, estimated that the 1957 Asian influenza cost the nation almost £100 million.As will be seen, the 1959 epidemic, in this practice, was as extensive as that of 1957.In addition to the large numbers affected, the complications account for much Ferious illness and for many deaths.Some 5,000 persons died in the 1957 epidemic in Great Britain, and this was very much less than in the epidemic of 1919.In spite of its frequency, its importance, and the vast amount of research undertaken there is still a lot to be ilearnt, and a need to add more and new facts.The generaI practitioner is in a position to contribute clinical Ind epidemiological data.This paper from a south-eastLondon surburban general practice aims to relate the incidence of the epidemic, the clinical features, and the complications and their management, and as a result of these findings some suggestions are made for the future.The patients of the practice belong chiefly to social groups 2, 3, and 4. The numbers at risk in January, 1959, are shown in Table I.TABLE I.
Health is a dynamic process [letter]
Authors: Das Pc
Journal: BMJ (2004)

In 1999 I joined as a haematologist the one medical school in Malawi Africa. I was asked to see a young pregnant woman with fever confusion and oral thrush. The pinprick-like marks apparent on her abdomen were explained by the resident my translator—she had already seen a traditional healer. History and the few available laboratory tests led to a tentative diagnosis of haemolytic uraemic syndrome related to AIDS. Realising that this case may be the first observed in the country we presented the latest knowledge on the disease in a seminar including the roles and interactions of high molecular vW factor endotoxins etc. The resident doctor conveyed the probable diagnosis and treatment. The next day the sister informed me that the family discharged the patient. I felt inadequate and sad; it struck me that such a diagnosis implied a considerable burden of costs. Furthermore the cause of her ailments sounded like mumbo-jumbo. The village healer may have provided similar sounding explanations with treatment that was cheaper and near home.  (excerpt)
Strategies to improve delivery of anticancer drugs across the blood–brain barrier to treat glioblastoma
Authors: Rajneet K. Oberoi, Karen E. Parrish, Terence T. Sio, Rajendar K. Mittapalli, William F. Elmquist, Jann N. Sarkaria
Journal: Neuro-Oncology (2015)

Glioblastoma (GBM) is a lethal and aggressive brain tumor that is resistant to conventional radiation and cytotoxic chemotherapies. Molecularly targeted agents hold great promise in treating these genetically heterogeneous tumors, yet have produced disappointing results. One reason for the clinical failure of these novel therapies can be the inability of the drugs to achieve effective concentrations in the invasive regions beyond the bulk tumor. In this review, we describe the influence of the blood–brain barrier on the distribution of anticancer drugs to both the tumor core and infiltrative regions of GBM. We further describe potential strategies to overcome these drug delivery limitations. Understanding the key factors that limit drug delivery into brain tumors will guide future development of approaches for enhanced delivery of effective drugs to GBM.
Assessment of Surgical Downstaging in an Open-Label Phase 2 Trial of Denosumab in Patients with Giant Cell Tumor of Bone
Authors: S. Ferrari, P. Rutkowski, R.J. Grimer, P.D. Stalley, S.P.D. Dijkstra, A. Pienkowski, G. Vaz, L.L. Seeger, A. Feng, B.A. Bach
Journal: Annals of Oncology (2014)
Meeting the 12 lymph nodes (LN) benchmark in colorectal cancer surgery: A comparison of NCCN and SEER data
Authors: A. Rajput, J. Skibber, P. Engstrom, M. Weiser, J. Wilson, S. Shibata, D. Romanus, A. terVeer, C. Earle, D. Schrag
Journal: Journal of Clinical Oncology (2007)

4015 Background: The American College of Pathology has suggested that 12 or more LN be examined from colorectal cancer surgical specimen. Both ASCO and NCCN have considered adopting the 12 LN threshold as a quality metric. The purpose of this study was to determine whether the 12 LN benchmark is achieved at NCCN specialty centers. Methods: Patients with newly diagnosed stage I-III colon or rectal cancer, who had primary surgery at NCCN centers in 2005–6 were selected (n=345). Similarly, data from 14,019 stage I-III colorectal patients diagnosed in 2002 in a SEER region were obtained to determine the extent to which this goal was met in a population-based sample. Patient characteristics of age, gender, location, stage and number of positive nodes were compared for NCCN and SEER data in regards to number of nodes evaluated. Univariate logistic regression models were developed to identify factors associated with the 12 LN target at the NCCN. Factors evaluated were number of positive nodes, age, gender, comorbidity score, ECOG performance status, insurance, location, stage, surgery technique, and NCCN center. Results: As detailed in the Table , 89% of the 2005–6 NCCN sample and 45% of the SEER sample had at least 12 LN evaluated. For patients treated at NCCN centers, stage I compared to stage III (OR=0.20; 95% CI=0.08 to 0.48, p&lt;0.0001) and rectal cancer (OR=0.44; 95% CI=0.22 to 0.88, p=0.02) were each less likely to achieve the 12 LN target. Conclusions: For patients operated on at NCCN centers, at least 12 LN are almost always removed and examined as part of an oncologic resection. In population based samples, this target is achieved in less than half of cases. With longer follow-up we will be able to link this potential quality metric directly to outcomes and thereby better inform whether increasing the number of nodes evaluated is an important priority for cancer control. Table 1 . Characteristics of CRC patients who did and did not have 12 or more LN evaluated at primary resection. [Table: see text] No significant financial relationships to disclose.
Abstract P141: Non-alcoholic Fatty Liver Disease, Insulin Resistance, and the Risk of Incident Ischemic Heart Disease and Stroke - The Kangbuk Samsung Health Study
Authors: Yoosoo Chang, Seungho Ryu, Juhee Cho, Sanjay Rampal, Yiyi Zhang, Di Zhao, Yuni Choi, Jiin Ahn, Miguel Cainzos-Achirica, Roberto Pastor-Barriuso, Joao A Lima, Hocheol Shin, Eliseo Guallar
Journal: Circulation (2015)

Objective: Nonalcoholic fatty liver disease (NAFLD) is associated with insulin resistance (IR) and with other metabolic abnormalities, but the association of NAFLD with the risk of clinical cardiovascular disease (CVD) is controversial. Furthermore, the risk associated with the combination of NAFLD and IR has not been evaluated in prospective studies. The aim of this study was to evaluate the association of NAFLD with or without IR on the incidence of coronary heart disease (CHD) and stroke. Methods: We performed a cohort study in 166,126 adults without CVD at baseline who underwent a health checkup exam during 2008 - 2011 and were followed-up through December 31, 2012 (average follow-up of 3.2 years). NAFLD was defined as hepatic steatosis on ultrasonography in the absence of excessive alcohol use or other identifiable causes. IR was defined as a homeostasis model assessment of IR (HOMA-IR) value ≥ 2.5. Incident hospitalizations for CHD events and strokes were ascertained through data linkage with the Korean Health Insurance Review and Assessment Service (HIRA) database. Results: At baseline, the prevalence of NAFLD and of IR were 25.1 and 6.3%, respectively. During follow-up, 831 participants developed CHD and 582 subjects developed stroke. After adjusting for age, sex, center, year of screening exam, BMI, smoking, alcohol intake, physical activity, family history of CVD, and education, the hazard ratios (95 % confidence intervals) for CHD comparing NAFLD without IR, IR without NAFLD, and NAFLD with IR vs. no NAFLD without IR were 1.07 (0.91 - 1.27), 1.19 (0.74 - 1.91) and 1.55 (1.18 - 2.03), respectively. The corresponding hazard ratios for stroke were 0.93 (0.75 - 1.16), 1.40 (0.83 - 2.35) and 1.82 (1.32 - 2.52), respectively. The P-values for the interaction of NAFLD and IR for CHD and stroke were 0.48 and 0.28, respectively. These associations did not differ by clinically relevant subgroups. Conclusions: The combination of NAFLD and IR was associated with an increased incidence of CHD and of stroke, but this was not observed in those with either NAFLD or IR alone. The combination of NAFLD and IR may identify individuals at high cardiometabolic risk who may need to receive more intensive preventive intervention.
THE BUSCAINO BLACK REACTION IN URINE
Authors: S. Katzenelbogen
Journal: American Journal of Psychiatry (1929)

1. Buscaino's reaction was studied chiefly in psychoses and for purposes of control in diseases of other systems and in normal individuals. 2. In the group of nervous and mental diseases of the total number of 147 patients, 43, or 29.25 per cent, showed a positive reaction. The latter was most frequently positive in anergastic disorders (organic reaction types) namely, in 47.5 per cent of our 40 cases. In the groups of thymergastic (manic-depressive), merergastic (psychoneuroses), parergastic reaction types (schizophrenia, paranoia), epilepsy and some unclassified cases, it was positive in a percentage between 11.1. and 33.3 per cent. 3. In the control cases we obtained a positive reaction in 42.5 per cent of our 40 cases of acute and chronic affections of different systems and in 8.6 per cent in the group of 35 normal individuals. 4. In the specimens of urines with positive black reaction the ratio between uric and sodium chloride was higher than in the urines with negative reaction. 5. Both uric acid and sodium chloride were found in lower amounts in the positive cases than in the negative ones; and the high ratio between these two chemical compounds in the urines with black deposit, as it was noted, is essentially due to a low concentration of sodium chloride. 6. In the light of the fact that, on the one hand the black reaction was found positive in varying pathologic conditions and even in a few normal individuals, and on the other hand that the positive reaction was accompanied in most cases by a higher ratio between uric acid and sodium chloride than the negative reaction, we are justified in concluding that the Buscaino reaction does not depend upon the diseases themselves, but only upon epiphenomena (such as changes in the relation between uric acid and sodium chloride). These changes are very likely, at least partly if not altogether, due to the diet of hospital patients which is usually reduced in proteins and salt. Our findings are thus completely unfavorable as to the value of the reaction.
The interferon type I signature is present in systemic sclerosis before overt fibrosis and might contribute to its pathogenesis through high BAFF gene expression and high collagen synthesis
Authors: Zana Brkic, Lenny van Bon, Marta Cossu, Cornelia G van Helden-Meeuwsen, Madelon C Vonk, Hanneke Knaapen, Wim van den Berg, Virgil A Dalm, Paul L Van Daele, Adriana Severino, Naomi I Maria, Samara Guillen, Willem A Dik, Lorenzo Beretta, Marjan A Versnel, Timothy Radstake
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Interferon (IFN) signature has been reported in definite systemic sclerosis (SSc) but it has not been characterised in early SSc (EaSSc). We aim at characterising IFN type I signature in SSc before overt skin fibrosis develops. <h3>Methods</h3> The expression of 11 IFN type I inducible genes was tested in whole-blood samples from 30 healthy controls (HCs), 12 subjects with primary Raynaud9s phenomenon (RP), 19 patients with EaSSc, 7 patients with definite SSc without cutaneous fibrosis, 21 limited cutaneous SSc and 10 diffuse cutaneous SSc subjects. The correlation between IFN activity in monocytes, B cell activating factor (BAFF) mRNA expression and type III procollagen N-terminal propeptide (PIIINP) serum levels was tested. <h3>Results</h3> In all the SSc groups, higher IFN scores were observed compared with HC. An IFN score ≥7.09 discriminated HCs from patients with SSc (sensitivity=0.7, specificity=0.88, area under receiving operating characteristic (AUROC)=0.82); the prevalence of an elevated IFN score was: HC=3.3%; RP=33.3%, EaSSc=78.9%, definite SSc=100%, limited cutaneous SSc=42.9%, diffuse cutaneous SSc=70.0%. In monocytes an IFN score ≥4.12 distinguished HCs from patients with fibrotic SSc (sensitivity=0.62, specificity=0.85, AUROC=0.76). Compared with IFN-negative subjects, IFN-positive subjects had higher monocyte BAFF mRNA levels (19.7±5.2 vs 15.20±4.0, p=2.1×10<sup>−5</sup>) and serum PIIINP levels (median=6.0 (IQR 5.4–8.9) vs median=3.9 (IQR 3.3–4.7), p=0.0004). <h3>Conclusions</h3> An IFN type I signature is observed in patients with SSc from the earliest phases of the disease, even before overt skin fibrosis. The presence of IFN type I signature in monocytes is correlated with BAFF mRNA expression and serum PIIINP levels, supporting a contribution in the pathogenesis and progression of SSc.