tbuckley/cabot-search huggingface dataset:
Metabolism of Isotopically Labeled Uracil and Uridine in Man
Authors: S M WEISSMAN, M LEWIS, M KARON
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 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
Coexpression of MYC and BCL-2 Predicts Inferior Survival in Pgi-DLBCL Treated with CHOP-like Regimen/Rituximab
Authors: Le Zhang, Bing Xia, Shanqi Guo, Xiaowu Li, Fulian Qu, Haifeng Zhao, Lianyu Zhang, Baocun Sun, Liang Zhang, Yizhuo Zhang
Journal: Blood (2014)
RTRB-22HYPOFRACTIONATED RADIOTHERAPY VERSUS STANDARD FRACTIONATED RADIOTHERAPY WITH CONCURRENT TEMOZOLOMIDE IN ELDERLY PATIENTS WITH NEWLY DIAGNOSED GLIOBLASTOMA
Authors: Tony Wang, Cheng-Chia Wu, Ashish Jani, Juan Estrada, Timothy Ung, Daniel Chow, Jennifer Soun, Shumaila Saad, Yasir Qureshi, Robyn Gartrell, Heva Saadatmand, Anurag Saraf, Steven Isaacson, Simon Cheng, Michael Sisti, Jeffrey Bruce, Sameer Sheth, Andrew Lassman, Fabio Iwamoto, Guy McKhann
Journal: Neuro-Oncology (2015)

BACKGROUND: Adjuvant hypofractionated radiotherapy (HRT) for elderly patients with newly diagnosed glioblastoma (GBM) is reasonable compared to standard fractionation radiotherapy (SRT).Comparison of HRT in the presence of temozolomide (TMZ) vs SRT with TMZ is unclear.We examined HRT for GBM with TMZ in comparison to SRT with TMZ.METHODS: Retrospective analysis of patients .60 years-old who received SRT or HRT of newly diagnosed GBM in the post-operative setting from 1994 to 2014.Inclusion criteria included SRT (60 Gy/30 fractions or 59.4 Gy/33 fractions) vs HRT of 40 Gy/15 fractions.RESULTS: 158 patients received SRT vs 26 with HRT.Median survival receiving SRT versus HRT was 430 and 475 days (p ¼ 0.550).95% of the SRT patients received TMZ vs 100% with HRT.Patients receiving HRT were older (median: 72 vs 66 years).All HRT patients were treated with IMRT technique vs SRT.Multivariate Cox regression showed decreased survival in age .70 (Hazard ratio [HR] 1.84; 95% confidence interval [CI] 1.23-2.75),lower Karnofsky performance status (HR 5.25; 95% CI 1.73-15.99),biopsy vs. surgical resection (HR 4.18;, RT planning technique 3D-or 2D-planning vs. IMRT (HR 1.91; respectively).IMRT based planning showed no difference between HRT vs SRT.For patients receiving TMZ, there was no survival difference between HRT and SRT.CONCLUSIONS: Elderly GBM patients receiving HRT or SRT had similar overall survival.Subset analysis patients receiving concurrent TMZ showed no difference in survival between HRT and SRT.
Abstract 17300: Acute Kidney Injury is Associated With High Mortality in Patients With Atrial Fibrillation
Authors: Siva Harsha Yedlapati, Usman Younus, Scott H Stewart
Journal: Circulation (2015)

Introduction: The prevalence of atrial fibrillation (AF) is high in patients with chronic kidney disease (CKD). The mortality risk of AF in the presence of CKD is also significantly high. Multiple theories of which importantly, the renin-angiotensin-aldosterone system activation causing increased ventricular remodeling and heart failure, explain the increased incidence of AF in CKD. However, there are no data available on the effects of acute kidney injury (AKI) on mortality in patients with AF. We sought to investigate the prevalence and association of AKI with in-hospital mortality in patients presenting with AF. Methods: We performed a cross-sectional analysis of the 2011 Nationwide Inpatient Sample (NIS). Using logistic regression methods appropriate for the NIS sample design, we estimated the mortality risk associated with AKI in AF patients and evaluated factors that might modify this association. Results: In 2011, AF accounted for 457662 (1.4%) of overall adult admissions in the United States with an in-hospital mortality rate of 1%. Among these hospitalizations 30894 (6.8%) had a concomitant AKI diagnosis. The prevalence of AKI was higher (38%) in patients who died during these AF hospitalizations. The mortality risk in AF hospitalizations with an AKI diagnosis remained high even after adjusting for factors associated with AKI including age, sex, CKD, sepsis, hypertension, diabetes, congestive heart failure (CHF), smoking and heavy alcohol use (odds ratio 5.6; 95% CI (4.7 - 6.6); P&lt;0.0001), relative to patients hospitalized with a non-AF diagnoses (odds ratio 3.3; 95% CI (3.2 - 3.4). The factors that interacted with AKI in predicting mortality risk in AF hospitalizations were underlying CKD, CHF, diabetes and alcoholism. Conclusion: Among hospitalized patients with AF, AKI is associated with significantly high mortality. This mortality was higher when compared to patients hospitalized with a non-AF diagnosis. Interpretation of our results must be conservative given the study design and data limitations. Future research using primary data sources might help identify factors associated with increased mortality in AKI patients presenting with AF.
Case 52-1972
Authors: Richard C. Cabot, Benjamin Castleman, Robert E. Scully, Betty U. McNeely, Sheldon Kaufman, James J. Galdabini
Journal: New England Journal of Medicine (1972)

Presentation of Case First admission. A 58-year-old man was admitted to the hospital because of abdominal pain.There was a long standing history of rheumatoid spondylitis, and he had undergone bilateral cup arthroplasty of the hips in his twenties. Three months before admission he began to experience an increase in his chronic back pain accompanied by diffuse, fleeting abdominal pains that were unrelated to food or activity, and he occasionally passed maroon stools. Six weeks before entry severe pain developed in the left upper quadrant of the abdomen, with radiation to the back, and he was admitted to the hospital. . . .
Outbreak of invasive pneumococcal disease at a Belfast shipyard in men exposed to welding fumes, Northern Ireland, April–May 2015: preliminary report
Authors: L Patterson, N Irvine, A Wilson, L Doherty, A Loughrey, L Jessop
Journal: Eurosurveillance (2015)

We report an outbreak of four confirmed cases of invasive pneumococcal disease (IPD) in individuals occupationally exposed to welding fumes, at a Belfast shipyard (Northern Ireland). All cases were hospitalised. A high-risk sub-group of 679 workers has been targeted for antibiotic prophylaxis and pneumococcal vaccination. Physicians and public health institutions outside Northern Ireland should be alert to individuals presenting with pneumonia or IPD and recent links to the shipyard, to facilitate early assessment and treatment.
Digitalis
Authors: Thomas W. Smith, Edgar Haber
Journal: New England Journal of Medicine (1973)

Pharmacokinetics and BioavailabilityPharmacokineticsThe broad outlines of pharmacokinetic patterns of commonly used cardiac glycosides were carefully sketched by the studies of Gold and Modell and their co-workers in the 1940's.149 150 151 Doherty has reviewed in detail the further contributions of studies with isotopically labeled cardiac glycosides to the current understanding of digitalis pharmacokinetics.152 , 153 Table 1 summarizes current information related to absorption, onset of action, and excretion times and patterns for cardiac glycosides commonly used in the United States. It cannot be overemphasized that the values given are averages, and substantial individual variation is to be expected.As recently discussed in the Journal . . .
AB0588 Systemic Lupus Erythematosus in Men from a Mexican Cohort
Authors: L.D. Fajardo Hermosillo
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disorder that disproportionally affects women and is known to occur rarely in men. This difference may be explained by estrogenic effect and ethnicity. Clinical outcomes including renal involvement, disease activity, damage accrual and mortality seem to be more severe in males (1,2). These factors associated with adverse outcomes in males vary among patients from different ethnic backgrounds (1,2,3). Few studies have been performed in Mexican population (4). <h3>Objectives</h3> To examine the differences and associated factors of clinical outcomes in males with SLE from a Mexican cohort. <h3>Methods</h3> 131 SLE patients (≥16 years) from a Mexican cohort from 2011 to 2014 were examined. SLE cases fulfilled 4 of SLICC 2012 criteria. Demographic factors, Disease Activity Index (SLEDAI), Systemic Lupus International Collaborating Clinics Damage Index (SLICC), mortality, comorbidities and pharmacologic treatments were examined for SLE patients by gender. Variables were examined by univariable and multivariable analyses. <h3>Results</h3> Of 131 SLE patients, 11 (8.4%) were men. The ratio of female to male patients was 11:1. The mean age [standard deviation (SD)] for women was 38.9 (1.26) years and for men was 40.6 (6.24) years. The mean of time at onset of SLE in women was 7.08 (0.75) and in men 6.55 (1.75) years, respectively. In univariable analyses male SLE patients compared with women were more likely to had lower levels of education, more frequently to present renal involvement, disease activity, damage accrual and mortality; further comorbidities as peripheral vascular disease and arterial hypertension; to use more commonly maximum doses of glucocorticoids, mycophenolate mofetil, cyclophosphamide and rituximab; also more probably to show anti-Ro and lupus anticoagulant antibody. In the multivariable analyses to have less renal involvement (OR 0.33, 95% CI 0.12-0.85, p=0.05), less accrual damage (OR 0.46, 95% CI 0.25-0.82, p=0.008), and less arterial hypertension (OR 0.06, 95% CI 0.06-0.68, p=0.023) remained significant as protective factors. <h3>Conclusions</h3> This study as other previous reports suggests that in Mexican population with SLE exist differences in clinical outcomes as renal involvement, activity disease damage accrual and mortality between males and females. However, these observations must be confirmed in larger and prospective studies with more rigorous methodology. <h3>References</h3> J Rheumatol. 2012 Apr;39(4):759-69. Clin Exp Rheumatol. 2010 May-Jun;28(3):297-9. Lupus. 2005;14(12):938-46. Clin Exp Rheumatol. 2004 Nov-Dec;22(6):713-21. <h3>Disclosure of Interest</h3> None declared
Psychology and Medicine
Authors: M NEME
Journal: BMJ (1957)

A TTEMPTS to explain certain phenomena in medicine by psychological conceptions are found far back in history, but with the advent of scientific method these attempts were shouldered off the field, because it was thought that psy- chology was unable to satisfy the requirements which science demanded.This objection was later removed, partly by a better understanding of the real nature of science, and partly by a reform in psychological procedure, which freed it from the alien influences which had long crippled its development and allowed it to conform whole-heartedly to the rules of scientific method.Psychological conceptions then began to be systematically applied to medical problems, and encouraging results were almost at once achieved.During the past half century the attack along these lines has been vigorously pushed forward, and in certain spheres of medicine, notably in the psychoneuroses, psychological conceptions have enabled us to attain a degree of understanding and of therapeutic control incomparably greater than that before possessed.Psychology has therefore unquestionably succeeded in establishing a place for itself in medicine, but the validity of its methods, the limits of its sphere, and its relations to other modes of dealing with the problems of disorder are still subjects of dispute and confusion.The question is debated, for example, whether the psychoneuroses are essentially psychogenic or physiogenic, and there would seem to lie behind this the implication that one theory must necessarily be valid and the other invalid.The question in itself has a definite meaning, but the implication behind it is false and due to a confusion of thought.The aim of science is to construct conceptions which will enable us to explain and to predict the sequences of observable phenomena.We are at liberty to construct these conceptions either in physical or psychological terms, provided in either case that the method of science is rigidly followed, and that the test of utility is satisfied.By utility is meant precisely that E PITORIA .
Unusual Manifestations of Acute Leukemia
Authors: W.Y. Au, S.K. Ma, C. Ooi, R. Liang, Y.L. Kwong
Journal: Journal of Clinical Oncology (2000)

Article Tools Unusual Manifestations of Acute Leukemia Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2000.18.19.3435 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 11013284 Unusual Manifestations of Acute Leukemia W.Y. AuxW.Y. AuSearch for articles by this author , S.K. MaxS.K. MaSearch for articles by this author , C. OoixC. OoiSearch for articles by this author , R. LiangxR. LiangSearch for articles by this author , Y.L. KwongxY.L. KwongSearch for articles by this author Show More Queen Mary Hospital, Hong Kong https://doi.org/10.1200/JCO.2000.18.19.3435 First Page Full Text PDF Figures and Tables © 2000 by American Society of Clinical Oncology
Kidney Cancer
Authors: Robert J. Motzer, Neeraj Agarwal, Clair Beard, Graeme B. Bolger, Barry Boston, Michael A. Carducci, Toni K. Choueiri, Robert A. Figlin, Mayer Fishman, Steven L. Hancock, Gary R. Hudes, Eric Jonasch, Anne Kessinger, Timothy M. Kuzel, Paul H. Lange, Ellis G. Levine, Kim A. Margolin, M. Dror Michaelson, Thomas Olencki, Roberto Pili, Bruce G. Redman, Cary N. Robertson, Lawrence H. Schwartz, Joel Sheinfeld, Jue Wang
Journal: Journal of the National Comprehensive Cancer Network (2009)

In 2008, an estimated 54,390 Americans were diagnosed with kidney cancer and 13,010 died of the disease in the United States. 1 Renal cell carcinoma (RCC) comprises approximately 2% of all malignancies, with a median age at diagnosis of 65 years.The rate of RCC has increased 2% per year for the past 65 years.The reason for this increase is unknown.Approximately 90% of renal tumors are RCC, and 85% of these are clear cell tumors. 2Other, less-common cell types include papillary, chromophobe, and Bellini (collecting) duct tumors.Collecting duct carcinoma comprises fewer than 1% of all cases.Medullary renal carcinoma is a variant of collecting duct renal carcinoma and was initially described as occurring in patients who are sickle cell-trait positive.Smoking and obesity are among the risk fac-
The Clinical Utility Of Bone Turnover Markers In The Evaluation Of Bone Disease In Patients With Haemophilia A and B
Authors: Panagiotis Anagnostis, Sofia Vakalopoulou, Vyzantiadis Timoleon-Achilleas, Maria Charizopoulou, Eudokia M. Mandala, Alexandra Agapidou, Violaki Vassiliki, Garipidou Vasilia
Journal: Blood (2013)
Thrombosis and Anticoagulants
Authors: O O MEYER
Journal: BMJ (1960)

Keepingthe Heart Going" (19 June, p. 1566) we believe that incorrect emphasis has been placed upon the risks of the production of ventricular fibrillation by pacing on the T wave in patients who have returned to sinus rhythm.All proved instances of ventricular fibrilla- tion, in our experience, have occurred only with the epicardial system of pacing, and only in the immediate post-thoracotomy period.'It seems that the risk of ventricular fibrillation is highest when the threshold for the production of ventricular fibrillation is lowered from superficial myocardial damage caused by stitching the electrode on to the epicardium and from alterations in pul- monary ventilation due to the thoracotomy.Another facotor was probably the unnecessarily high power of the earlier units.Now that we use endocardial jugular sys- tems for long-term pacing, thereby avoiding a thoracotomy, the risk of ventricular fibrillation must be greatly reduced, and we have never seen it in our experience of over 100 patients treated by endocardial pacing.-We
An alternative clinical trial design for early cancer vaccine development to phase 3+3 design.
Authors: Emily Gammoh, Osama E. Rahma, Richard Simon, Samir Khleif
Journal: Journal of Clinical Oncology (2012)

2578 Background: Traditional phase I, “3+3 dose escalation” design, is conducted to identify the MTD and in some cases the optimal biologic dose. Given their unique mechanism of action and the profile of their clinical outcome, this design may not apply to cancer vaccines. The therapeutic cancer vaccine FDA guidance calls for an alternative early development design. Nevertheless, whether an alternative design should be based on “dose escalation” is still an opened question. Methods: We analyzed the toxicity profile in 241 phase 1, 1/2 and pilot therapeutic cancer vaccine trials conducted between 1990 and 2011. Results: Sixty-two grade 3/4 vaccine related systemic toxicities were reported in 4952 treated patients (1.25 events/100 patients). Interestingly, only 2 out of 127 trials that used dose escalation reported vaccine related DLTs, both trials used bacterial vectors. Furthermore, correlation of immunological response with dose level showed no consistent trend. Conclusions: Our analysis suggests that in cancer vaccines neither toxicity nor cellular immune response correlates with dose levels. Accordingly, dose escalation is not suitable for most cancer vaccine studies. Here, we propose a two-step alternative design for early development of cancer vaccines. The first step is to determine and confirm the minimum Immune-Active Dose (IAD). If a vaccine class has been used in humans, IAD dose is chosen based on previous experience if the class is non-toxic (eg. Peptide), otherwise, a traditional dose escalation will be used. For a vaccine class that has not been tested or has undetermined toxicity we recommend “One Patient Escalation Design” (OPSD): one patient is treated per tested dose until an immune response is induced. To confirm this activity, an expanded cohort of 7 patients will be tested until demonstrating an additional response. This will then be used in phase II combination therapy trial. Alternatively, IAD can be directly tested in combination with an immune modulator in a phase II clinical trial using a two-stage design. The first stage of the phase 2 trial can be set at 4-5 patients for a target response rate of over 50%. If no response is seen, then the immune modulator will be escalated in the second stage.
PWE-018 Trends in endoscopic stenting and clinical outcome for oesophageal malignancy over the last decade in north east scotland
Authors: JD Sterne, JC MacDonald, PS Phull, JS Leeds
Journal: Gut (2015)

<h3>Introduction</h3> Management of dysphagia due to oesophageal cancer can be challenging and self-expanding metal stents (SEMS) have an important role in this. SEMS have been placed under direct vision in our institution since 2004 and a previous audit showed a significant rise in numbers particularly repeat stenting. A new referral protocol was implemented from 2011 to better aid assessment and appropriate insertion of SEMS and so the aim of this study was to assess changes in trends of SEMS insertion following this. <h3>Method</h3> Retrospective analysis of all oesophageal SEMS inserted in our institution from 2004 to 2014 was performed. Patient demographics, tumour pathology and location, repeat stenting and 30 day mortality were recorded. Emerging trends were analysed by examining changes on a yearly basis and proportional analysis before and after the change in referral protocol. <h3>Results</h3> 393 patients with a mean age 72.9 years (242 males) were included with 510 SEMS being inserted overall (117 repeat stents) and Figure 1shows this graphically. Median age was 77 in 2004 which dropped steadily over the decade to 71 in 2010 and then remained between 73–75. SEMS insertion increased significantly from 6 in 2004 to 74 in 2011 and then dropped to 52 over the next 3 years. Repeat stenting rose until 2012 (1 in 2004 to 18 in 2011) and then fell following the change in protocol. The majority of tumours were adenocarcinomas (&gt;60%) and were in the distal oesophagus or gastro-oesophageal junction. 30 day mortality peaked in 2010 and then steadily declined following the change in protocol but has increased again in the last year. <h3>Conclusion</h3> There has been a significant increase in the number of SEMS inserted in our institution over the last decade. The previous audit revealed that patients were likely being stented too soon and the change in protocol has reduced overall numbers but more importantly repeated stenting. The recent rise in mortality may represent SEMS being inserted closer to the end of a patients life and therefore a true palliative intervention. <h3>Disclosure of interest</h3> None Declared.
PET/CT Fusion Scan Prevents Futile Laparotomy in Early Stage Pancreatic Cancer
Authors: Richard Kim, Gopi Prithviraj, Nishi Kothari, Greg Springett, Mokenge Malafa, Pamela Hodul, Jongphil Kim, Binglin Yue, Brian Morse, Amit Mahipal
Journal: Clinical Nuclear Medicine (2015)

Surgical resection with negative margins is the only curative approach for pancreatic cancer. A paucity of data exists in using PET/CT scan as staging workup in resectable pancreatic cancer. The aim of this study is to determine if PET/CT prevents futile laparotomy by detecting occult metastatic disease in patients with resectable or borderline resectable pancreatic cancer.Patients were included using institutional PET/CT data base incorporating National Oncologic PET Registry with diagnosis of resectable or borderline resectable pancreatic cancer from 2005 to 2012. Clinical, radiographic, and pathologic characteristics were evaluated. The impact of PET/CT on patient management was estimated by calculating the percentage of patients whose treatment plan was altered secondary to PET/CT.We identified 285 patients with early stage pancreatic cancer who received PET/CT as part of initial staging workup. Upon initial workup (CT + EUS), 62% of patients were considered resectable, and 38% were borderline resectable. Addition of PET/CT scan changed the management in 10.9% (n = 31) of the patients (95% CI, 8%-15%). Metastatic lesions were confirmed with biopsy in 19 patients (61%). The proportion of change in treatment plan was significantly higher in patients who were initially considered to have borderline resectable compared with resectable malignancy (17% vs 7%, P = 0.019). In 199 patients who underwent surgery, 18.1% (n = 36) were found to have metastatic disease intraoperatively.PET/CT helped improve detection of occult metastases, ultimately sparing these patients a potentially unnecessary surgery. The role of PET/CT scan should be validated in prospective study.
Liver Biopsy Guided by Laparoscopic Sonography
Authors: J.A. Bönhof, P. Linhart, U. Bettendorf, H. Holper
Journal: Endoscopy (1984)

Laparoscopy sonography combined with a new puncture technique permits the performance of sonographically guided Menghini needle biopsy of focal lesions in the liver. The indications, procedure, and advantages of this biopsy method are demonstrated on the basis of a case report.