tbuckley/cabot-search huggingface dataset:
Judge tells trust it can treat minor for paracetamol overdose against her wishes
Authors: C. Dyer
Journal: BMJ (2014)

Manually delivered intermittent bolus (MIB) and programmable intermittent bolus (PIB), alternatives to continuous infusion (CI), involve administering a set volume of solution at a set interval of time. The benefits of intermittent bolus techniques in truncal and peripheral nerve blockade (TPNB) are unclear, and studies have largely demonstrated conflicting results. Using MEDLINE, Embase, Google Scholar, and the Cochrane Library, we conducted an evidenced-based review of published randomized controlled trials comparing intermittent bolus and CI methods in TPNB. In total, 13 randomized controlled trials were identified and evaluated. Outcomes data addressed in these studies included assessments of pain, opioid and local anesthetic consumption, patient satisfaction, adverse events, and physical therapy metrics. The overall quality of current evidence was found to be low given the small sample sizes, heterogeneity of data, and the variations in intermittent bolus techniques between studies. At this time, we found limited supportive data to endorse MIB or PIB over CI in TPNB. While unable to provide data-driven conclusions for local anesthetic delivery methods at this time, we propose that future studies and quantitative analysis between techniques should be on an anatomic, site-specific basis, with greater focus on evaluation of opioid use, adverse events, patient satisfaction, and rehabilitative metrics.
Influenza pandemic: preparedness planning in Germany
Authors: R Fock, H Bergmann, H Bußmann, G Fell, E J Finke, U Koch, M Niedrig, M Peters, K Riedmann, D Scholz, A Wirtz
Journal: Eurosurveillance (2002)

The following conceptual framework formed the basis for a common decision made by the health ministers of Germany's 16 federal states to set up an influenza pandemic preparedness plan. The worst case scenario was used, on the basis of the data from the pandemic of 'Spanish flu', in 1918-20. The priority groups for vaccination were assessed, as well as the potentially available antiviral treatments. National policies could be highly improved by a common European view.
A small proportion of mesenchymal stem cells strongly expresses functionally active CXCR4 receptor capable of promoting migration to bone marrow
Authors: Robert F. Wynn, Claire A. Hart, Carla Corradi-Perini, Liam O'Neill, Caroline A. Evans, J. Ed Wraith, Leslie J. Fairbairn, Ilaria Bellantuono
Journal: Blood (2004)
VIRUS III ENCEPHALITIS
Authors: Thomas M. Rivers, Fred W. Stewart
Journal: The Journal of Experimental Medicine (1928)

Virus III, an active, filterable agent indigenous to rabbits, under experimental conditions produces, in addition to lesions in the cornea, skin, and testicles, an encephalitis which is at times quite similar to that induced by herpetic virus. Virus III and herpetic virus, however, are not immunologically related.
Rethinking the Standard for Ductal Carcinoma In Situ Treatment
Authors: Laura Esserman, Christina Yau
Journal: JAMA Oncology (2015)

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 Oncology HomeNew OnlineCurrent IssueFor Authors Podcast 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 Oncology journal
Trauma and Long-term Mortality
Authors: Vafa Rahimi-Movaghar
Journal: JAMA (2011)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Predicting Survival After Curative Colectomy for Cancer: Individualizing Colon Cancer Staging
Authors: Martin R. Weiser, Mithat Gönen, Joanne F. Chou, Michael W. Kattan, Deborah Schrag
Journal: Journal of Clinical Oncology (2011)

Purpose Cancer staging determines extent of disease, facilitating prognostication and treatment decision making. The American Joint Committee on Cancer (AJCC) TNM classification system is the most commonly used staging algorithm for colon cancer, categorizing patients on the basis of only these three variables (tumor, node, and metastasis). The purpose of this study was to extend the seventh edition of the AJCC staging system for colon cancer to incorporate additional information available from tumor registries, thereby improving prognostic accuracy. Methods Records from 128,853 patients with primary colon cancer reported to the Surveillance, Epidemiology and End Results Program from 1994 to 2005 were used to construct and validate three survival models for patients with primary curative-intent surgery. Independent training/test data sets were used to develop and test alternative models. The seventh edition TNM staging system was compared with models supplementing TNM staging with additional demographic and tumor variables available from the registry by calculating a concordance index, performing calibration, and identifying the area under receiver operating characteristic (ROC) curves. Results Inclusion of additional registry covariates improved prognostic estimates. The concordance index rose from 0.60 (95% CI, 0.59 to 0.61) for the AJCC model, with T- and N-stage variables, to 0.68 (95% CI, 0.67 to 0.68) for the model including tumor grade, number of collected metastatic lymph nodes, age, and sex. ROC curves for the extended model had higher sensitivity, at all values of specificity, than the TNM system; calibration curves indicated no deviation from the reference line. Conclusion Prognostic models incorporating readily available data elements outperform the current AJCC system. These models can assist in personalizing treatment and follow-up for patients with colon cancer.
Chronic exogenous hyperinsulinemia in pregnancy
Authors: E Podjarny, J Bernheim, B Katz, J Green, J Mekler, M Bursztyn
Journal: Journal of the American Society of Nephrology (1998)

Insulin resistance and hyperinsulinemia are associated with essential hypertension. There is also evidence of hyperinsulinemia in women who developed hypertension in pregnancy (P). The present study examines whether chronic hyperinsulinemia in pregnant rats plays a role in the development of hypertension in pregnancy. A sustained-release insulin pellet was implanted subcutaneously in 15 Wistar rats (P-INS) 1 wk before and on day 7 of pregnancy; 14 control rats were sham-implanted (P-SHAM). Tail-cuff systolic BP (SBP), serum triglycerides, glucose, insulin, renal function, and urinary excretion of Na+ and of metabolites of nitric oxide were determined throughout pregnancy. Data were analyzed by ANOVA with basal body weight as covariate analysis of covariance. Results are expressed as the mean +/- SD. Body weight; water and food intake; urine volume; creatinine clearance; and level of proteinuria at the end of pregnancy were similar in both groups. The number of fetuses was 9 +/- 2.3 in P-INS versus 11 +/- 2.4 in pregnant control rats (P < 0.05). Before mating, SBP was similar, but at the end of pregnancy SBP was 110 +/- 18 mmHg in P-INS versus 85 +/- 12 mmHg in pregnant rats (P < 0.05). Serum triglycerides and Na+ were also higher in P-INS rats. The fractional excretion of Na+ was 3.1 +/- 1.0 versus 4.4 +/- 1.5, respectively (P < 0.01). The percent increase in nitric oxide metabolite excretion was 233 +/- 14 versus 370 +/- 17%, respectively (P < 0.01). Chronic hyperinsulinemia, without sugar supplementation, and hypertriglyceridemia may cause a decrease in the synthesis of nitric oxide in P-INS rats. The development of hypertension in these rats may be associated with an impaired vasodilatation, together with an increased renal sodium reabsorption.
Myeloproliferative Neoplasm (MPN) Symptom Assessment Form Total Symptom Score: Prospective International Assessment of an Abbreviated Symptom Burden Scoring System Among Patients With MPNs
Authors: Robyn M. Emanuel, Amylou C. Dueck, Holly L. Geyer, Jean-Jacques Kiladjian, Stefanie Slot, Sonja Zweegman, Peter A.W. te Boekhorst, Suzan Commandeur, Harry C. Schouten, Federico Sackmann, Ana Kerguelen Fuentes, Dolores Hernández-Maraver, Heike L. Pahl, Martin Griesshammer, Frank Stegelmann, Konstanze Doehner, Thomas Lehmann, Karin Bonatz, Andreas Reiter, Francoise Boyer, Gabriel Etienne, Jean-Christophe Ianotto, Dana Ranta, Lydia Roy, Jean-Yves Cahn, Claire N. Harrison, Deepti Radia, Pablo Muxi, Norman Maldonado, Carlos Besses, Francisco Cervantes, Peter L. Johansson, Tiziano Barbui, Giovanni Barosi, Alessandro M. Vannucchi, Francesco Passamonti, Bjorn Andreasson, Maria L. Ferarri, Alessandro Rambaldi, Jan Samuelsson, Gunnar Birgegard, Ayalew Tefferi, Ruben A. Mesa
Journal: Journal of Clinical Oncology (2012)

Myeloproliferative neoplasm (MPN) symptoms are troublesome to patients, and alleviation of this burden represents a paramount treatment objective in the development of MPN-directed therapies. We aimed to assess the utility of an abbreviated symptom score for the most pertinent and representative MPN symptoms for subsequent serial use in assessing response to therapy.The Myeloproliferative Neoplasm Symptom Assessment Form total symptom score (MPN-SAF TSS) was calculated as the mean score for 10 items from two previously validated scoring systems. Questions focus on fatigue, concentration, early satiety, inactivity, night sweats, itching, bone pain, abdominal discomfort, weight loss, and fevers.MPN-SAF TSS was calculable for 1,408 of 1,433 patients with MPNs who had a mean score of 21.2 (standard deviation [SD], 16.3). MPN-SAF TSS results significantly differed among MPN disease subtypes (P<.001), with a mean of 18.7 (SD, 15.3), 21.8 (SD, 16.3), and 25.3 (SD, 17.2) for patients with essential thrombocythemia, polycythemia vera, and myelofibrosis, respectively. The MPN-SAF TSS strongly correlated with overall quality of life (QOL; r=0.59; P<.001) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) functional scales (all P<.001 and absolute r≥0.50 except social functioning r=0.48). No significant trends were present when comparing therapy subgroups. The MPN-SAF TSS had excellent internal consistency (Cronbach's α=.83). Factor analysis identified a single underlying construct, indicating that the MPN-SAF TSS is an appropriate, unified scoring method.The MPN-SAF TSS is a concise, valid, and accurate assessment of MPN symptom burden with demonstrated clinical utility in the largest prospective MPN symptom study to date. This new prospective scoring method may be used to assess MPN symptom burden in both clinical practice and trial settings.
Familial spontaneous pneumothorax and lung cysts due to a Folliculin exon 10 mutation
Authors: S. Sundaram, A. D. Tasker, N. W. Morrell
Journal: European Respiratory Journal (2009)

Approximately 10% of patients who have a spontaneous pneumothorax have a positive family history. In 1977, Birt, Hogg and Dube (BHD) described a genodermatosis characterised by benign tumours of the hair follicle that has been associated with renal neoplasms and spontaneous pneumothorax. The BHD locus is located on chromosome 17p11.2 and is now known to be due to heterozygous germline mutations in the Folliculin gene. We report three generations of an English family who suffered spontaneous pneumothoraces in the absence of other features of the BHD syndrome and were found to have lung cysts. In addition, we report an antenatal diagnosis (34 weeks gestation) of lung cysts in one affected family member. Genetic analysis in the family has revealed a unique deletion mutation (c. 1537 del-C) involving exon 10. To our knowledge, this mutation has not been previously described and there is no previous report of antenatal detection of the pulmonary abnormality in BHD syndrome.
A Difficult Case: Treat the most unstable vascular distribution identified by carotid and cardiac angiography
Authors: E M. Ohman
Journal: BMJ (1995)

Randomised clinical trials have helped to define the best approach to patients with isolated unstable angina and multivessel coronary artery disease or symptomatic carotid artery disease. However, the benefit to risk ratio of carotid endarterectomy, coronary artery bypass grafting, or a combined procedure in patients with combined symptomatic carotid and coronary artery disease can be assessed based only on retrospective clinical observations with their inherent limitations. In this case it may therefore be appropriate initially to approach management as if the stroke and unstable angina had occurred in isolation. After the prognosis and need for revascularisation have been clarified for both conditions independently the priority of management and procedures will be simplified.

The patient has symptoms and signs of intermittent transient ischaemic attack …
Purified hematopoietic stem cell engraftment of rare niches corrects severe lymphoid deficiencies without host conditioning
Authors: Deepta Bhattacharya, Derrick J. Rossi, David Bryder, Irving L. Weissman
Journal: The Journal of Experimental Medicine (2005)

In the absence of irradiation or other cytoreductive conditioning, endogenous hematopoietic stem cells (HSCs) are thought to fill the unique niches within the bone marrow that allow maintenance of full hematopoietic potential and thus prevent productive engraftment of transplanted donor HSCs. By transplantation of purified exogenous HSCs into unconditioned congenic histocompatible strains of mice, we show that ∼0.1–1.0% of these HSC niches are available for engraftment at any given point and find no evidence that endogenous HSCs can be displaced from the niches they occupy. We demonstrate that productive engraftment of HSCs within these empty niches is inhibited by host CD4+ T cells that recognize very subtle minor histocompatibility differences. Strikingly, transplantation of purified HSCs into a panel of severe combined immunodeficient (SCID) mice leads to a rapid and complete rescue of lymphoid deficiencies through engraftment of these very rare niches and expansion of donor lymphoid progenitors. We further demonstrate that transient antibody-mediated depletion of CD4+ T cells allows short-term HSC engraftment and regeneration of B cells in a mouse model of B(-) non-SCID. These experiments provide a general mechanism by which transplanted HSCs can correct hematopoietic deficiencies without any host conditioning or with only highly specific and transient lymphoablation.
Use of peripheral blood instead of bone marrow to monitor residual disease in children with acute lymphoblastic leukemia
Authors: Elaine Coustan-Smith, Jose Sancho, Michael L. Hancock, Bassem I. Razzouk, Raul C. Ribeiro, Gaston K. Rivera, Jeffrey E. Rubnitz, John T. Sandlund, Ching-Hon Pui, Dario Campana
Journal: Blood (2002)
THE SPIROCHETAL FLORA OF THE NORMAL MALE GENITALIA
Authors: Hideyo Noguchi
Journal: The Journal of Experimental Medicine (1918)

The spirochetal flora of normal female genitalia is similar to that of the male and consists of Treponema calligyrum, Treponema minutum, and Spironema refringens. The types are present in varying proportions, but the calligyrum usually predominates, and the refringens is the least frequent. The female genitalia are much richer generally in the number of spirochetes than the male.
18F-Fluoroethylcholine (18F-Cho) PET/MRI Functional Parameters in Pediatric Astrocytic Brain Tumors
Authors: Francesco Fraioli, Ananth Shankar, Darren Hargrave, Harpreet Hyare, Mark N. Gaze, Ashley M. Groves, Pierpaolo Alongi, Sara Stoneham, Sofia Michopoulou, Rizwan Syed, Jamshed B. Bomanji
Journal: Clinical Nuclear Medicine (2014)

To examine the feasibility of simultaneous acquisition of F-fluoroethylcholine (F-choline) PET and functional MRI (standardized uptake value [SUV]max/mean and apparent diffusion coefficient [ADC]mean), using a hybrid PET/MRI scanner, for diagnosis and response assessment in a cohort of children with astrocytic brain tumors.F-choline PET/MRI scans were performed in 12 patients with proven astrocytic tumors.Eight patients simultaneously underwent F-choline PET/MR follow-up scans after treatment. Uptake in the lesion above the normal brain activity was considered indicative of a positive scan. Maximum and mean SUVs (SUVmax and SUVmean) and mean ADC (ADCmean) of the whole tumor region of interest were assessed. Lesion size and contrast enhancement were recorded. For all tumors, the association between ADCmean and SUVmean/SUVmax values were assessed using the Spearman correlation coefficient.At baseline, the areas of F-choline uptake matched areas of contrast enhancement and restricted diffusion. There was a negative correlation trend between SUVmax and ADCmean and a positive correlation trend between SUVmax and tumor size. There was concordance between reduction in tumor size and reductions in SUVmax and SUVmean in 4 children, in three of whom ADCmean values were increased. In 2 patients, tumor size remained stable whereas SUVmax and SUVmean values were increased with reduction in the ADCmean values. Additionally, in 2 children, cross-sectional MRI showed an increase both in tumor size and SUVmax but a reduction in ADC values.Simultaneous F-choline PET/MRI is a promising and reliable imaging tool for children with astrocytic tumors, as it permits monitoring of morphological and metabolic response and changes during therapy.
Development and validation of the WASP classification system for optical diagnosis of adenomas, hyperplastic polyps and sessile serrated adenomas/polyps
Authors: Joep E G IJspeert, Barbara A J Bastiaansen, Monique E van Leerdam, Gerrit A Meijer, Susanne van Eeden, Silvia Sanduleanu, Erik J Schoon, Tanya M Bisseling, Manon CW Spaander, Niels van Lelyveld, Marloes Bargeman, Junfeng Wang, Evelien Dekker
Journal: Gut (2015)

<h3>Objective</h3> Accurate endoscopic differentiation would enable to resect and discard small and diminutive colonic lesions, thereby increasing cost-efficiency. Current classification systems based on narrow band imaging (NBI), however, do not include neoplastic sessile serrated adenomas/polyps (SSA/Ps). We aimed to develop and validate a new classification system for endoscopic differentiation of adenomas, hyperplastic polyps and SSA/Ps &lt;10 mm. <h3>Design</h3> We developed the Workgroup serrAted polypS and Polyposis (WASP) classification, combining the NBI International Colorectal Endoscopic classification and criteria for differentiation of SSA/Ps in a stepwise approach. Ten consultant gastroenterologists predicted polyp histology, including levels of confidence, based on the endoscopic aspect of 45 polyps, before and after participation in training in the WASP classification. After 6 months, the same endoscopists predicted polyp histology of a new set of 50 polyps, with a ratio of lesions comparable to daily practice. <h3>Results</h3> The accuracy of optical diagnosis was 0.63 (95% CI 0.54 to 0.71) at baseline, which improved to 0.79 (95% CI 0.72 to 0.86, p&lt;0.001) after training. For polyps diagnosed with high confidence the accuracy was 0.73 (95% CI 0.64 to 0.82), which improved to 0.87 (95% CI 0.80 to 0.95, p&lt;0.01). The accuracy of optical diagnosis after 6 months was 0.76 (95% CI 0.72 to 0.80), increasing to 0.84 (95% CI 0.81 to 0.88) considering high confidence diagnosis. The combined negative predictive value with high confidence of diminutive neoplastic lesions (adenomas and SSA/Ps together) was 0.91 (95% CI 0.83 to 0.96). <h3>Conclusions</h3> We developed and validated the first integrative classification method for endoscopic differentiation of small and diminutive adenomas, hyperplastic polyps and SSA/Ps. In a still image evaluation setting, introduction of the WASP classification significantly improved the accuracy of optical diagnosis overall as well as SSA/P in particular, which proved to be sustainable after 6 months.
Determinants of bone mineral density in the lumbar spine instable patients with COPD
Authors: Yoshifumi Yamamoto, Masanori Yoshikawa, Koichi Tomoda, Yukio Fujita, Motoo Yamauchi, Noriko Koyama, Hiroshi Kimura
Journal: European Respiratory Journal (2014)

Background 

Osteoporosis is known as a major systemic effect of COPD. Recent studies demonstrated high prevalence of vertebral fractures in patients with COPD. We aim to investigate the determinants of bone mineral density in the lumbar spine (L-BMD) in stable patients with COPD.

Methods 

L-BMD was determined by dual energy X-ray absorptiometry and serum levels of undercarboxylated osteocalcin (ucOC) and tartrate-resistant acid phosphatase type 5b (TRAP- 5b) were measured in 38 outpatients with COPD (mean age:71 yr, mean %FEV1:46.4%). The extent of pulmonary emphysema was evaluated by chest CT scan on the basis of Goddard classification and 6 min walk test was assessed. Nutritional status was evaluated by body mass index (BMI) and fat-free mass index (FFMI) measured by bioelectrical impedance analysis.

Results 

L-BMD was decreased in 12 patients (32%). Serum levels of ucOC and TRAP- 5b were significantly elevated in underweight patients with COPD compared with control subjects. L-BMD was significantly correlated with serum ucOC levels, FFMI, %DLco/VA and Goddard scores. By stepwise regression analysis, variables significantly contributing to L-BMD were FFMI and serum ucOC levels. Total variance explained in this model was 65% for L-BMD.

Conclusion 

FFMI and serum ucOC levels were important predictor of osteoporosis.