tbuckley/cabot-search huggingface dataset:
Clinical Outcome From Oxaliplatin Treatment in Stage II/III Colon Cancer According to Intrinsic Subtypes
Authors: Nan Song, Katherine L. Pogue-Geile, Patrick G. Gavin, Greg Yothers, S. Rim Kim, Nicole L. Johnson, Corey Lipchik, Carmen J. Allegra, Nicholas J. Petrelli, Michael J. O’Connell, Norman Wolmark, Soonmyung Paik
Journal: JAMA Oncology (2016)

Oxaliplatin added to fluorouracil plus leucovorin therapy for patients with colon cancer has been shown to provide significant but modest absolute benefit for disease-free survival. However, acute and chronic neurotoxic effects from this regimen underscore the need for markers that predict oxaliplatin benefit.To test our hypothesis that molecular subtypes of colon cancer would be associated with differential prognosis and benefit from oxaliplatin added to fluorouracil plus leucovorin therapy.Participants in the NSABP C-07 trial were divided into discovery (n = 848) and validation (n = 881) cohorts based on the order of tissue block submission. A reestimated centroid using 72 genes was used to determine Colorectal Cancer Assigner subtypes and their association with oxaliplatin benefit in the discovery cohort. The validation cohort was examined with a locked-down algorithm for subtype classification and statistical analysis plan. Post hoc analysis included examination of the entire cohort with Colorectal Cancer Assigner, Colorectal Cancer Subtype (CCS), and Consensus Molecular Subtype (CMS) methods.Fluorouracil plus leucovorin with or without oxaliplatin.Percent recurrence-free survival.Among 1729 patients, 744 (43%) were female and mean (SD) age was 58 (11) years. Although C-07 participants with stage III disease with an enterocyte subtype showed a statistically significant benefit from oxaliplatin in the discovery cohort (hazard ratio, 0.22 [95% CI, 0.09-0.56]; P = .001 [N = 65]), no statistically significant benefit was observed in the validation cohort (hazard ratio, 0.53 [95% CI, 0.22-1.24]; P = .14 [N = 70]). The stemlike subtype was associated with poor prognosis and lack of benefit from oxaliplatin treatment (HR, 0.99 [95% CI, 0.73-1.34]; P = .96 [N = 367]). Examination of the different subtyping methods shows that all 3 methods robustly identified patients with poor prognosis (stemlike, CCS-3, and CMS-4) in both stage II and III.Patients with stemlike tumors may be appropriate for clinical trials testing experimental therapies because stemlike tumors were robustly identified and associated with a poor prognosis regardless of stage or chemotherapy regimen. The clinical utility of using subtyping for the identification of patients for treatment with oxaliplatin requires validation in independent clinical trial cohorts.clinicaltrials.gov Identifier: NCT00004931.
Penicillamine in the treatment of rheumatoid arthritis.
Authors: A V Camp
Journal: BMJ (1973)

of vision so caused may be wrongly attributed to papilloedema.24Monro's and George Kellie'.s (1779-1829)concern with the "circulation within the head" was due to a prevailing preoccupation with the congested brain, then considered to be at the root of many cerebral disorders.Kellie's reassuring conclusion that "to whatever extent the one set of vessels is becoming overcharged to the same extent, it seems prob- able, is the other set voided" had a profound impact upon medical thought of the day.31Correctly interpreted, the Monro-Kellie theorem is still a valuable adjunct to a con- sideration of the swollen brain.
Oncologic Emergencies: The Anesthesiologist's Perspective
Authors: Michael W. Lew, Andres Falabella, Earl Moore-Jeffries, Russell J. Gray, Michael J. Sullivan
Journal: Journal of the National Comprehensive Cancer Network (2007)

Cancer is the second leading cause of death in the United States. During the course of treatment, a cancer patient may present emergently to the hospital because of either the cancer itself or a manifestation of cancer therapy. Rarely, patients with cancer can present to the operating room with several emergent conditions that require the services of an anesthesiologist. The main oncologic emergencies affecting anesthesiologists relate to airway obstruction and cardiac-, neurologic-, gastrointestinal-, and endocrine-related conditions. Mismanagement of these crises can increase morbidity and mortality. This article addresses emergencies in patients with cancer and how they relate to anesthetic care.
The cardiovascular safety of methylphenidate
Authors: John W Jackson
Journal: BMJ (2016)

In the United States alone, 6.4 million children received a diagnosis of attention-deficit/hyperactivity disorder (ADHD) in 2011.Of these, 3.5 million received a stimulant drug, typically methylphenidate. 1 In addition, there is off label use of stimulants for milder attention problems.The cardiac safety of stimulants, which are known to slightly raise blood pressure and accelerate the heart rate, has been hotly debated as case reports, 2 and conflicting evidence has emerged over time. 3linked paper by Shin and colleagues (doi:10.1136/bmj.i2550)reports on data from the first case only study of cardiovascular risk with methylphenidate. 4Using the South Korea National Health Insurance Database, the authors extracted data on 1224 cases of adverse cardiac events from a population of 114 647 children and young people aged 17 or younger and newly treated with methylphenidate at any time in 2008-11.There were 864 patients with arrhythmias, 396 with hypertension, 52 with myocardial infarctions, 67 with stroke, and 44 with heart failure.The authors asked whether these events were more likely to occur in the first two months (and even smaller intervals) of methylphenidate use than in periods of non-use.
Herpes simplex encephalitis
Authors: T Morishima
Journal: JAMA (1968)

Herpes simplex encephalitis (HSE) is a severe disease with high mortality and morbidity. As effective antiviral therapy improves the outcome of younger patients, the early diagnosis of the disease has become important, especially in children. The annual incidence of HSE in Japan among children is estimated to be about 100-200 cases, and the mortality is 10-20%. Instead of brain biopsy, we applied the polymerase chain reaction (PCR) assay to the early diagnosis. The DNA of herpes simplex virus was detectable in CSF of all HSE patients in the acute phase. Serial quantitation of viral genome by PCR also revealed that the amount of DNA decreased gradually corresponding to antiviral therapy, and it turned to be negative 3 to 18 days after the onset of neurological signs and symptoms (mean 10.1 days). These results show the PCR assay is a useful diagnostic tool for the early and non-invasive diagnosis of HSE.
Ablation of Adenosine Monophosphate-Activated Protein Kinase α1 in Vascular Smooth Muscle Cells Promotes Diet-Induced Atherosclerotic Calcification In Vivo
Authors: Zhejun Cai, Ye Ding, Miao Zhang, Qiulun Lu, Shengnan Wu, Huaiping Zhu, Ping Song, Ming-Hui Zou
Journal: Circulation Research (2016)

Atherosclerotic calcification is highly linked with plaque rapture. How calcification is regulated is poorly characterized.We sought to determine the contributions of AMP-activated protein kinase (AMPK) in atherosclerotic calcification.Aortic calcification was evaluated in aortic roots and brachiocephalic arteries of atherosclerotic prone ApoE(-/-) mice or in mice with dual deficiencies of ApoE and AMPKα isoforms in whole body (ApoE(-/-)/AMPKα1(-/-) and ApoE(-/-)/AMPKα2(-/-)) or vascular smooth muscle cell (VSMC)-specific or macrophage-specific knockout of AMPKα1 fed with Western diet for 24 weeks. Genetic deficiency of AMPKα1 but not of AMPKα2 promoted atherosclerotic calcification and the expression of Runx2 (Runt-related transcription factor). Conversely, chronic administration of metformin, which activated AMPK, markedly reduced atherosclerotic calcification and Runx2 expression in ApoE(-/-) mice but had less effects in ApoE(-/-)/AMPKα1(-/-) mice. Furthermore, VSMC-specific but not macrophage-specific ablation of AMPKα1 promoted aortic calcification in vivo. Ablation of AMPKα1 in VSMC prevented Runx2 from proteasome degradation in parallel with aberrant osteoblastic differentiation of VSMC, whereas AMPK activation promoted Runx2 post-translational modification by small ubiquitin-like modifier (SUMO, SUMOylation), which is associated with its instability. Mechanically, we found that AMPKα1 directly phosphorylated protein inhibitor of activated STAT-1 (PIAS1), the SUMO E3-ligase of Runx2, at serine 510, to promote its SUMO E3-ligase activity. Finally, mutation of protein inhibitor of activated STAT-1 at serine 510 suppressed metformin-induced Runx2 SUMOylation and subsequently prevented metformin's effect on reducing oxidized low-density lipoprotein-triggered Runx2 expression in VSMC.AMPKα1 phosphorylated protein inhibitor of activated STAT-1 to promote Runx2 SUMOylation and subsequently lead to its instability. AMPKα1 deficiency in VSMC increased Runx2 expression and promoted atherosclerotic calcification in vivo.
Recent Events of Special Interest to Medical Education
Authors: C. H. William Ruhe
Journal: JAMA (1977)

This section includes information about special studies, reports, legislation, and other events and activities that currently have an influence on, or relation to, medical education, and that might be expected to influence the future course of events in medical education. Most of the items listed are extensions of reports given in earlier years and are still in development or in transition. Some of these items are also considered in other sections of the EDUCATION NUMBER. <h3>Coordinating Council on Medical Education</h3> The Coordinating Council on Medical Education (CCME) has been described in several previous issues of the EDUCATION NUMBER. Since its establishment late in 1972, it has been involved in studying and developing reports on a number of important issues affecting medical education. Major reports were prepared and were published previously in<i>JAMA</i>on the subjects of "The Primary Care Physician" and "The Role of the Foreign Medical Graduate," both of
Louse-borne relapsing fever (Borrelia recurrentis) in an Eritrean refugee arriving in Switzerland, August 2015
Authors: D Goldenberger, G J Claas, C Bloch-Infanger, T Breidthardt, B Suter, M Martínez, A Neumayr, A Blaich, A Egli, M Osthoff
Journal: Eurosurveillance (2015)

We report an imported case of louse-borne relapsing fever in a young adult Eritrean refugee who presented with fever shortly after arriving in Switzerland. Analysis of blood smears revealed spirochetes identified as Borrelia recurrentis by 16S rRNA gene sequencing. We believe that louse-borne relapsing fever may be seen more frequently in Europe as a consequence of a recent increase in refugees from East Africa travelling to Europe under poor hygienic conditions in confined spaces.
PTH-036 Effectiveness of endoscopic retrograde cholangiopancreatography for palliative biliary drainage in patients with inoperable hilar cholangiocarcinoma and its impact on survival
Authors: UI Aujla, N Ladep, HL Lee, O Noorullah, L Dwyer, N Stern, S Hood, R Sturgess
Journal: Gut (2015)

<h3>Introduction</h3> Cholangiocarcinoma (CCA) has a poor prognosis and is often unresectable at presentation. Palliative stenting is the goal in unresectable disease followed by chemotherapy in suitable patients. In our unit endoscopic retrograde cholangiopancreatography (ERCP) is preferred initial approach for biliary drainage and tissue acquisition. To optimise drainage in some patients this is combined with percutaneous bile duct drainage (PTC). Meticulous pre-procedural work up is required to select suitable sector for drainage and to minimise subsequent cholangitis in complex hilar lesions. The aim of this study was to determine the effectiveness of ERCP in unresectable hilar CCA and survival advantage related to bile duct drainage. <h3>Method</h3> A single large volume tertiary referral centre study looking at ERCP records of patients with hilar CCA using a prospectively collected procedural database together with an electronic hospital clinical record over a period of six years from Jan 2009 to Dec 2014. <h3>Results</h3> ERCP was performed for palliative biliary stenting in 207 patients with hilar CCA (99 males and 108 females) with median age of 73 years (range 34–95 y). Median number of ERCPs performed was 2 (range 1–12). 190 (92%) patients had self-expandable metal stents (16 covered and 174 uncovered) for biliary drainage while remaining 17(8%) had plastic stents. Median serum bilirubin pre and post-stenting was 238 (95% CI: 225–264) umol/l and 39 (95% CI: 31–49) umol/l, respectively (p &lt; 0.001). 154 (74%) patients had unilateral stenting for biliary drainage, while 53(26%) patients required bilateral stenting for complex strictures. 45 (22%) patients with hilar CCA required additional PTC for optimal drainage. Median survival of patients with hilar CCA who had bilateral stents was 8 (95% CI: 4–13) months, while those who had unilateral stenting was 5 (95% CI: 4–8) months (p = 0.22). 55 (36%) patients with unilateral stenting and 18(34%) with bilateral stenting had repeat procedures due to episodes of stent blockage and cholangitis. There was no direct procedure related mortality. <h3>Conclusion</h3> Endoscopic bile duct drainage provides effective and rapid decompression in patients with advanced hilar CCA. We aim to drain more than 50% of biliary tree, which was achieved with either unilateral or bilateral stenting. Choice of unilateral or bilateral stenting is dependent on pathological biliary tree anatomy. In our experience there was no statistically significant survival advantage among patients with unilateral and bilateral stenting of complex hilar lesions. <h3>Disclosure of interest</h3> None Declared.
Multiple Myeloma, Hemolytic Anemia, and Protein Phagocytosis
Authors: M G BOHROD, E J BOTTCHER
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
SP0199 How To Treat / Manage: Vasculitis
Authors: P. Lamprecht
Journal: Annals of the Rheumatic Diseases (2015)

Vasculitides comprise a heterogeneous group of inflammatory diseases of the blood vessels, which are characterized both by their diversity and an overlap of clinical and pathological findings and manifestations. The etiology of most vasculitides is unknown. Based on pathological and immunological features, vasculitides are subdivided into major categories affecting large, medium-sized and small vessels. Early diagnosis and prompt institution of immunosuppressive therapy may be delayed due to the rarity of vasculitides and their complex clinical presentation, rapid and unpredictable courses, and lack of unambiguous diagnostic laboratory tests. Moreover, access to an appropriate tissue for histological examination may not always be feasible and distinctive clinical features therefore serve as surrogate criterions. Prior to the introduction of immunosuppressive therapy, systemic vasculitis used to be an inevitably fatal condition. With the advent of corticosteroids and establishment of immunosuppressive treatment protocols through randomized trials, outcomes and survival rates have improved. Studies using biologicals have been shown to further improve therapy, e.g. rituximab for the maintenance of remission in ANCA-associated vasculitis. Based on trials and other reports, national and international recommendations for the treatment of the different categories of vasculitides have been compiled. Modern immunosuppressive treatment options have considerably improved the prognosis of vascultides, so that the major challenges are now chronicity, relapses and complicating comorbidities. Thus, a need for safer and more effective targeted therapies remains. <h3>Disclosure of Interest</h3> None declared
P0089 : Plasma betatrophin levels in patients with liver cirrhosis
Authors: M.T. Arias, M. García-Unzueta, S. Llerena, P. Iruzubieta, A. Puente, J. Cabezas, C. Alonso, A. Cuadrado, J.A. Amado, J. Crespo, E. Fabrega
Journal: Journal of Hepatology (2015)
ECT in metropolitan New York hospitals: a survey of practice, 1975-1976
Authors: G M Asnis, M Fink, S Saferstein
Journal: American Journal of Psychiatry (1978)

Of New York psychiatric facilities surveyed, 83% used ECT. Five percent of patients in university and private nonprofit hospitals, less than 1% in public hospitals, and 21% in private for-profit hospitals received ECT. Practices and procedures were remarkably uniform, except that less than 17% of units used unilateral ECT. Training programs were minimal and unplanned. Differences in incidence of use result from staff training, public antipathy, and economic factors.
Endoscopic ultrasound-guided choledochojejunostomy with a forward-viewing echoendoscope for severe benign bilioenteric stricture in a patient with Child’s resection
Authors: Mitsuhiro Kida, Hiroshi Yamauchi, Kosuke Okuwaki, Shiro Miyazawa, Hiroshi Imaizumi, Tomohisa Iwai, Wasaburo Koizumi
Journal: Endoscopy (2015)

Anastomotic strictures occurring after choledochojejunostomy have generally been treated by a percutaneous approach. A recent study reported that good outcomes were obtained after balloon enteroscope-assisted endoscopic retrograde cholangiopancreatography [1]. A number of procedures have been reported to be useful, including endoscopic ultrasound (EUS)-guided hepaticojejunostomy combined with antegrade stent placement [2], EUS-guided trans-hepatic antegrade balloon dilation [3], and EUS-guided choledochojejunostomy [4].
CD34-deficient mice have reduced eosinophil accumulation after allergen exposure and show a novel crossreactive 90-kD protein
Authors: A Suzuki, DP Andrew, JA Gonzalo, M Fukumoto, J Spellberg, M Hashiyama, H Takimoto, N Gerwin, I Webb, G Molineux, R Amakawa, Y Tada, A Wakeham, J Brown, I McNiece, K Ley, EC Butcher, T Suda, JC Gutierrez-Ramos, TW Mak
Journal: Blood (1996)
Cognition in survivors of high-grade glioma.
Authors: J G Cairncross
Journal: Journal of Clinical Oncology (1998)

Article Tools Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1998.16.9.3210 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 9738601 Cognition in survivors of high-grade glioma. J G CairncrossxJ G CairncrossSearch for articles by this author https://doi.org/10.1200/JCO.1998.16.9.3210 PDF "Cognition in survivors of high-grade glioma.." Journal of Clinical Oncology, 16(9), pp. 3210–3211© 1998 by American Society of Clinical Oncology
PTU-328 Colonic evaluation after acute diverticulitis – is it time for a change in practice?
Authors: S Shahid, G Nana, A Huang, D Gorard
Journal: Gut (2015)

<h3>Introduction</h3> UK commissioning guidelines recommend colonic evaluation after an attack of acute diverticulitis to exclude colorectal malignancy. However, recent studies demonstrate increased accuracy of Computed Tomography (CT) in diagnosing acute diverticulitis and suggest a selective approach to further colonic evaluation in cases of complicated acute diverticulitis. Therefore, the role of routine colonic luminal imaging following CT proven acute diverticulitis is debatable. Our aim was to audit colonic evaluation following CT diagnosis of acute diverticulitis over a 12 month period and review the requirement for this as a routine follow-up investigation. <h3>Method</h3> A two part audit in a district hospital. Firstly, all patients admitted with CT-proven acute diverticulitis from 1<sup>st</sup>Jan 2013 to 31<sup>st</sup>Dec 2013 were followed up for the results of colonic evaluation by endoscopy, CT colonography or CT Long prep. Secondly all patients discussed in the lower gastro-intestinal tract multi-disciplinary meeting (LGI MDT) over the same 12 month period had a retrospective review of imaging for a CT diagnosis of acute diverticulitis in the preceding 12 months. <h3>Results</h3> 101 patients (mean age 67 yrs) had acute diverticulitis (57 uncomplicated and 34 complicated) confirmed on CT. 43 patients underwent further colonic evaluation (30 in uncomplicated diverticulitis yielding one cancer). No cancers were found in the complicated diverticulitis group. Of 191 patient discussed in the LGI MDT, 63 had a CT scan preceding a lower GI endoscopy (33%). 2 of these had an in-patient CT scan for clinically suspected acute diverticulitis. One patient had sigmoid diverticulosis (but no inflammation) and an incidental finding of a caecal tumour. The second had acute uncomplicated sigmoid diverticulitis but a co-existent malignancy could not be excluded (further investigation confirmed a sigmoid tumour). <h3>Conclusion</h3> Less than half the patients admitted with acute diverticulitis at our centre underwent subsequent investigation of the colonic lumen and only one cancer was detected. Despite the low referral rate for follow-up colonic imaging, cross referencing with our cancer data base shows our radiologists are accurate in diagnosing acute diverticulitis on CT and that masquerading cancers are rare. <h3>Disclosure of interest</h3> None Declared.