tbuckley/cabot-search huggingface dataset:
Effects of Varying Infusion Time in Maintenance Fluid Therapy
Authors: O. Neyzi, M. Bailey, N. B. Talbot, E. Yang, M. Terry
Journal: New England Journal of Medicine (1958)

A VAILABLE data indicate that patients entering the Massachusetts General Hospital are apt to receive about 3.8 liters of fluid parenterally during their stay, or about 1 liter every four hospital days.1 Of this a considerable, although unknown, portion is given for maintenance purposes during periods when they are unable to take food or fluids by mouth. These maintenance allotments are given in a widely variable fashion, ranging from a slow, continuous intravenous infusion to much more rapid infusions lasting for a few hours each day. The present study was undertaken to determine the effects of such variations in the . . .
Some scientists are exempted from government’s “gagging clause”
Authors: Anne Gulland
Journal: BMJ (2016)

Scientists have welcomed the government’s announcement that research councils and the national academies will not be bound by a controversial “gagging clause” but have called for more clarity about who will be exempt.

In February the Cabinet Office announced that a new clause would be inserted into all grant agreements from May, requiring that government money should not be spent on campaigns to influence parliament, government, or political parties or to “influence legislative or regulatory action.”1 Scientists were concerned that this would stop them speaking out against government policy.

In a statement released on 19 April the universities and …
Tissue factor, angiogenesis and thrombosis in pancreatic cancer
Authors: A. A. Khorana, C. W. Francis, C. K. Ryan, M. B. Taubman, Y. C. Hu, S. A. Ahrendt
Journal: Journal of Clinical Oncology (2006)

4001 Background: Coagulation proteins are commonly activated in pancreatic cancer and are closely linked to regulation of angiogenesis. We investigated tumor cell expression of tissue factor (TF), the prime initiator of coagulation, and its association with parameters of angiogenesis, venous thromboembolism (VTE) and survival. Methods: Tissue cores from a bi-institutional retrospective series of patients consecutively resected between January 1994 and February 2002 and followed for a median period of 16 months were used to build a pancreatic cancer tissue microarray. TF expression was graded semiquantitatively using immunohistochemistry (IHC)(grade 0:negative, grade 1: 1- 33% positive, grade 2: 34- 66% positive and grade 3: &gt; 66% cells positive) in pancreatic intraductal dysplasia (n=5) and resected pancreatic cancer (n=122). Study endpoints included correlation of TF with VEGF expression by IHC, microvessel density (MVD), clinical VTE and survival in resected patients. Patients with history of VTE, on anticoagulation or with inadequate follow-up were excluded from analysis of VTE outcomes (n=33). Results: TF expression was observed in all specimens with intraductal dysplasia and 108 resected pancreatic cancers (89%) but not in uninvolved pancreas. Sixty-six patients (54%) with resected pancreatic cancer were found to have high TF expression (defined as ≥ grade 2, the median score), and 56 patients (46%) had low or no TF expression. Tumors with high TF expression were more likely to also express VEGF (80% versus 27% with low TF expression, p&lt;0.0001). Tumors with high TF expression had a higher median MVD (8 versus 5/tissue core with low TF expression, p=0.01). Resected patients with high TF expression had a VTE rate of 20% compared to 5.5% in patients with low TF expression (p=0.04). Median survival in tumors with high TF was 17.9 months versus 12.6 months in those with low TF (p=0.16). Conclusions: TF expression appears to occur early in pancreatic cancer pathogenesis. This is the first report describing an association of TF expression with VEGF expression, increased MVD and clinical VTE in resected pancreatic cancer, confirming the linkage of thrombosis and angiogenesis. Targeting TF in pancreatic cancer could affect both neoplastic and thrombotic outcomes. No significant financial relationships to disclose.
Case 24-2003
Authors: Dawn M. McGee, Susan A. Connolly, Robert H. Young
Journal: New England Journal of Medicine (2003)

Presentation of CaseA 10-year-old girl was admitted to the hospital because of abdominal pain, vomiting, and fever.She had been in excellent health until about 18 months earlier, when she had the first of several bouts of severe pain in the right lower quadrant; each episode of pain persisted for an hour or two, was sometimes followed by nausea and vomiting, and then resolved. Six months before admission, she was taken to another hospital because of pain in the right flank. The results of an abdominal ultrasonographic study were unremarkable.One month later, after another episode of abdominal pain, . . .
Surgery in the Management of Small Cell Lung Cancer
Authors: Robert J. Downey, Lee M. Krug
Journal: Journal of the National Comprehensive Cancer Network (2004)

Because most patients with small cell cancer of the lung present with distant metastatic disease, the treatment is almost always medical therapies without surgery. However, a small number of patients present with resectable disease, and this review summarizes the available literature addressing the possible role for surgery in the treatment of these patients.
Gentamicin and CFTR
Authors: Yujiro Kida
Journal: New England Journal of Medicine (2003)

To the Editor: Wilschanski et al. (Oct. 9 issue)1 report that full-length cystic fibrosis transmembrane conductance regulator (CFTR) protein was expressed more effectively on the surface of nasal epithelial cells after gentamicin treatment than after placebo in patients with cystic fibrosis who had premature stop codons. Bedwell et al. observed that the expression of CFTR at the apical plasma membrane was restored after administration of the aminoglycoside antibiotic G-418 and that further mobilization of CFTR at this location was promoted by cyclic AMP (cAMP) stimulation.2 CFTR is normally recycled between the apical plasma membrane and an early endosomal compartment.3 The . . .
Prenatal Therapy of a Patient with Vitamin-B<sub>12</sub>-Responsive Methylmalonic Acidemia
Authors: Mary G. Ampola, Maurice J. Mahoney, Eiichi Nakamura, Kay Tanaka
Journal: New England Journal of Medicine (1975)

Methylmalonic acidemia due to deficient synthesis of 5'-deoxyadenosylcobalamin was discovered in a mid-term fetus by culture of amniotic-fluid cells. Elevated concentrations of methylmalonic acid were also found in amniotic fluid and maternal urine. Treatment during the last nine weeks of gestation with large doses of vitamin B12 given to the mother reversed the increasing maternal excretion of methylmalonic acid, which was 23 mug per milligram of creatinine at 31 weeks' gestation. Just before delivery, the mother was excreting 5 mug, two to three times normal. At birth the methylmalonic acid content of the baby's urine (67 mug per milligram of creatinine) and serum (2.0 mug per milliliter) was only moderately elevated, and serum vitamin B12 concentration was very high. Acid levels rose in serum and urine in response to oral protein loading, but subsided after vitamin B12 administration. The infant is developing normally on a restricted protein diet alone at present. Prenatal therapy of methylmalonic acidemia is possible with large amount of vitamin B12 administered to the mother.
Sex-Chromosome Mosaicism of Type XYY/XO
Authors: Herbert L. Cooper, Herbert S. Kupperman, Orlando R. Rendon, Kurt Hirschhorn
Journal: New England Journal of Medicine (1962)

STUDIES of human chromosomes have been greatly facilitated by the development of newer technics, particularly peripheral blood leukocyte culture.1 2 3 Many abnormalities have been described, most of them involving altered numbers of chromosomes. These have been the subject of a number of recent reviews.4 , 5 Most of these abnormalities have been attributed to meiotic nondisjunction, with the production of abnormal gametes. However, a class of abnormalities has been found in which a defect occurring after fertilization must be postulated. These are cases of mosaicism, in which cells of differing karyotypes are found in the same person.Such chromosomal mosaicism was first described . . .
Dihydrostreptomycin in the Treatment of Pulmonary Tuberculosis
Authors: Stanton T. Allison, Ralph Volk, Guy R. Vitagliano
Journal: New England Journal of Medicine (1949)

SINCE September 1946 the United States Veterans Administration Hospital, Rutland Heights, Massachusetts, a 600-bed hospital for the treatment of veterans with tuberculosis, has been engaged in the study of streptomycin and its effect in controlling various forms of the disease. It is not within the province of this paper to discuss the results of these studies, which have been presented in previous reports.1 2 3 4 5 6 In most cases streptomycin has not been considered to be definitive therapy, but rather a very helpful adjunct to other well established methods of treatment, such as bed rest and the various forms of collapse therapy, in . . .
Human Parvo Virus B19 Infection among Hospital Staff Members after Contact with Infected Patients
Authors: Louis M. Bell, Stanley J. Naides, Phyllis Stoffman, Richard L. Hodinka, Stanley A. Plotkin
Journal: New England Journal of Medicine (1989)

In the spring and summer of 1988, two separate outbreaks of an illness with a rash resembling erythema infectiosum occurred among members of the nursing staff of the Children's Hospital of Philadelphia. The sources were two adolescent patients with sickle cell disease and aplastic crisis who had unsuspected parvovirus infection. Tests for IgM and IgG antibodies to parvovirus B19 were positive in both patients, and electron microscopical examination showed parvovirus-like particles in the early serum samples. Of 40 health care workers exposed to infected patients, 12 (30 percent) were infected, 2 (5 percent) were possibly infected, 8 (20 percent) had evidence of a past infection with B19, and 18 (45 percent) remained seronegative. Attack rates among the susceptible contacts were 36 percent in the first outbreak and at least 38 percent in the second. Clinical symptoms began a mean of 12.6 days after exposure and included malaise, rash, and joint pain. We conclude that hospital workers are at risk of contracting nosocomial erythema infectiosum from patients with parvovirus-associated aplastic crisis. We recommend that all patients with hereditary hemolytic anemias who are admitted with a febrile illness be evaluated for aplasia and promptly placed in respiratory and contact isolation if aplastic crisis is suspected. (N Engl J Med 1989; 321: 485–91.)
P-307 Immunomodulatory switch maintenance therapy to improve overall survival in metastatic colorectal carcinoma: The phase 3 IMPALA study
Authors: D. Arnold, W. Scheithauer, A. Zurlo, R. Salazar, M. Ducreux, T. Waddell, A. Stein, C. Tournigand, A. Sobrero, E. Van Cutsem, D. Cunningham
Journal: Annals of Oncology (2015)
IMCT-04TOCA 5: PHASE 2/3 RANDOMIZED, OPEN-LABEL STUDY OF TOCA 511 WITH TOCA FC VERSUS STANDARD OF CARE IN PATIENTS UNDERGOING PLANNED RESECTION FOR RECURRENT HIGH GRADE GLIOMA (NCT02414165)
Authors: Gelareh Zadeh, Michael A. Vogelbaum, Derek Ostertag, Trinh Le, Alice Chu, Andreas Niethammer, Asha Das, Timothy Cloughesy
Journal: Neuro-Oncology (2015)

Recurrent glioblastoma and anaplastic astrocytoma have a dismal prognosis and a high unmet need for effective therapies. Toca 511 is a retroviral replicating vector derived from a cloned Moloney murine leukemia virus with the original ecotropic envelope gene replaced with an amphotropic envelope gene to enable the virus to infect human cells. A modified yeast cytosine deaminase (CD) gene has been inserted into this vector. The expressed CD enzyme catalyzes conversion of antifungal drug 5-flucytosine (administered as investigational extended-release formulation Toca FC) to antineoplastic drug 5-fluorouracil. Toca 5 is a multicenter, randomized, open-label Phase 2/3 trial of Toca 511 and Toca FC versus standard of care (Investigator's choice of single agent lomustine, temozolomide, or bevacizumab) administered to patients undergoing resection for first or second recurrence of glioblastoma or anaplastic astrocytoma. The trial will enroll approximately 370 patients (Phase 2-170 and Phase 3-200). Primary endpoint is overall survival (OS). Key secondary endpoints are safety, objective response rate, clinical benefit rate, progression-free survival, and landmark OS. Key inclusion criteria are age 18-75 years, histologically proven glioblastoma or anaplastic astrocytoma, measurable disease preoperatively of at least 1 cm, candidate for ≥ 80% resection of enhancing tumor based on pre-operative evaluation, KPS ≥ 70. Selected exclusion criteria are enhancing tumor > 5 cm, more than two prior recurrences and prior bevacizumab other than for newly diagnosed glioma. Assays will be performed to evaluate evidence for immunologic mechanisms of disease control, including tumor reactive PBMC measurement by stimulation via ex vivo glioma antigen presentation, flow cytometry based phenotyping of PBMCs with an effector, memory, Treg, and myeloid derived suppressor cell panel. Molecular profiling of resected tumor samples will be correlated with primary and secondary endpoints to identify potential biomarkers for treatment-related response. Toca 5 is expected to begin enrollment in 3Q 2015.
P157 Individual patterns of inhaler use and health outcomes in adolescents with asthma: Abstract P157 Table 1
Authors: S Howard, M Patel, AR Lang, C Youle, H Vyas, D Shaw, S Sharples
Journal: Thorax (2015)

<h3>Background</h3> Electronic monitoring devices with an audio-visual reminder function can significantly improve asthma inhaler adherence and control in children.<sup>1</sup> However, the relationship between attitudes, patterns of medication use and clinical outcomes are unknown. <h3>Aim</h3> To examine individual patterns of inhaled corticosteroid use, and their relationships with clinical outcomes and qualitative feedback in adolescents with asthma. <h3>Methods</h3> An exploratory study based on previous qualitative research investigating the attitudes of adolescents with asthma towards inhaler monitoring and data sharing. Patients from a specialist severe asthma clinic had their preventer inhaler use electronically monitored for one-month with a SmartTrack (Nexus6, Auckland, NZ) device. Adherence data was obtained and participants completed a questionnaire and interview at the beginning, middle and end of the trial on their attitudes. Ten months later, participants’ case notes were examined for information related to their health before and after the study. <h3>Results</h3> Spirometric data was captured on 4/7 participants and is presented alongside adherence data in Table 1. Daily adherence ranged from 67%–93% with the largest FEV1 change (+0.95) observed in P1 who had an average daily adherence of 73%, and the smallest FEV1 change (-0.18) observed in P3 who had an average daily adherence of 93%. All changes occurred without intensification of treatment. This fits with the previous qualitative findings that participants were enthusiastic about the reminders the SmartTrack device provided and felt more conscious of adhering to their treatment plan when they knew someone would be monitoring it. Participants spoke positively for utilising the data to demonstrate their adherence to their parents or doctor. <h3>Conclusions</h3> Through examining inhaled corticosteroid use, attitudes and clinical outcomes we gain an understanding of each patient’s condition including their habits with their inhaler (e.g. better adherence in the evenings), their attitudes to their asthma treatment and the potential effects of inhaler use on their health. Doing so helps us to identify patients who could benefit from intervention, to improve their inhaler taking behaviour and potentially improve their asthma control. <h3>Reference</h3> 1 Chan A, Stewart AW, Harrison J, <i>et al</i>. The effect of an electronic monitoring device (…). <i>Respir Med</i>. 2015;<b>3</b>:210–19
Financial Incentives and Cholesterol Levels—Reply
Authors: Andrea B. Troxel, David A. Asch, Kevin G. Volpp
Journal: JAMA (2016)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors 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
Serum IgE Concentrations and Skin Reactivity to Anti-IgE Antibody in IgA-Deficient Patients
Authors: Donald P. Schwartz, Rebecca H. Buckley
Journal: New England Journal of Medicine (1971)

Patients with IgA deficiency were examined to determine whether infection proneness is correlated with an associated deficit in IgE production, an association recently suggested by studies of patients with ataxia telangiectasia. IgE was detected in the skin of 24 of 26 IgA-deficient patients at dilutions of goat anti-IgE causing positive responses in controls, and in two of 26 with stronger concentrations of anti-IgE than required in controls. IgE concentrations ranged from 141 to 1987 ng per milliliter in 15 of 25 IgA-deficient serums examined; concentrations were less than 100 ng per milliliter in the remaining serums. A high correlation (p equal to 0.0136) was found between a serum IgE concentration of more than 100 ng per milliliter and a diagnosis of atopic disorders. No correlation was shown between infection proneness and serum or skin IgE concentration. The data obtained do not support a relation between infection proneness and a combined deficiency of IgA and IgE in the patients studied. Other explanations must be sought for the differential susceptibility to infection of IgA-deficient persons.
Dose escalation and pharmacokinetic (pk) study of E 7389, a microtubule-binding drug in patients (pts) with advanced solid tumors
Authors: K. K. Desai, S. Goel, A. Mita, S. Silberman, J. Sicam, S. Woeppel, M. Macapinlac, K. Berg, E. Rowinski, S. Mani
Journal: Journal of Clinical Oncology (2005)

3090 Background: E7389 is a synthetic analog of halichondrin B, which was isolated from the marine sponge Halichondria okadai.It has a unique profile of tubulin interactions and exhibits broad anti-proliferative activity at nanomolar concentrations. We performed a phase I study using a weekly infusional schedule for 3 weeks with a week rest. Methods: Patients (pts) at two centers were treated using an accelerated titration design with intra-patient dose escalation, and switched to a standard escalation upon observation of a dose limiting toxicity (DLT). E7389 was administered on days 1, 8 and 15 as a 1-hour intravenous infusion every 28 days (1 cycle) in 5 dose cohorts at doses ranging from 0.25–1.4 mg/m2. Pts underwent extensive PK sampling on days 1 and 15 of the first cycle. Results: 23 pts were enrolled: median (range) age was 56 (34–78) years and they received 50 (1–6) cycles. Overall performance status was ≥ 80% and diagnoses consisted of colon (5), lung (3), cervical (2), ovarian (2), or other (11). DLT (grade 3 fatigue) was observed in one patient at 0.5 mg/m2, resulting in expansion of the cohort. At the highest dose level tested (1.4 mg/m2), 3 patients developed grade 3/4 neutropenia, resulting in missed doses, and were considered DLTs based on protocol criteria (see table below). One pt died of interstitial pneumonitis after two cycles at 1 mg/m2. No other toxicity ≥ grade 3 was observed in this trial. Of the 12 pts evaluable for response, 1 (cervical cancer) had a partial response and another (uterine cancer) had stable disease for > 8 cycles. Conclusion: In this weekly regimen of E7389 every 4 weeks, neutropenia was the DLT at the 1.4 mg/m2 dose level. Alternative schedules of infusion to explore better hematological tolerability are planned. PK data and updated safety and efficacy will be presented. No significant financial relationships to disclose.
A phase I trial of muscadine grape skin in men with biochemically recurrent prostate cancer.
Authors: Channing Judith Paller, Michelle A. Rudek, Emmanuel S. Antonarakis, Mario A. Eisenberger, Hans J. Hammers, Xian Chong Zhou, Donna Dowling, Serina King, Susan Hudock, Samuel R. Denmeade, William D. Wagner, Gary L. Rosner, Tamaro Hudson, Michael Anthony Carducci
Journal: Journal of Clinical Oncology (2014)

263 Background: New therapies are being explored as an alternative to observation in men with biochemically recurrent prostate cancer (BRPC). Muscadine Grape Skin (MPX) is comprised of ellagic acid, quercetin, and resveratrol and demonstrates preclinical activity against prostate cancer cells in vitro. Here we summarize data from a phase I dose finding trial. Methods: This phase I study assigned non-metastatic BRPC patients to increasing doses of MPX (Muscadine Naturals) in cohorts of two patients, with six patients at the highest dose, using a modified continual reassessment method. Dose selection is based on preclinical data showing the equivalent of 500 to 4,000 mg of MPX to be safe in mouse models. Our primary end point was to determine the recommended phase II dosing. We calculated changes in prostate-specific antigen (PSA) doubling time (PSADT) from at least three measurements prior to trial initiation and PSA measurements on study. Results: The cohort (n=14, 71% white, 29% black) had a median follow-up of 14.7 (6.9 to 20.7) months, median age 61, median Gleason seven, and median PSA of 5.1 ng/mL (0.2 to 153.4). Four patients had possibly related gastrointestinal symptoms, including grade 1 flatulence, grade 1 soft stools, and grade 1 burping. No other related adverse events were reported and one patient reported improvement of chronic constipation. Two of 14 patients came off study for metastatic disease. Median within-patient PSADT increased from 9.4 to 12.3 months with a PSADT difference of 3.9 months. Conclusions: These data suggest that 4,000 mg of MPX is safe, and exploratory review of change in PSADT suggests there is enough data to proceed to a phase II trial. Both low dose (500 mg) and high dose (4,000 mg) MPX are being further investigated in a multicenter, placebo-controlled, dose evaluating phase II trial. Clinical trial information: NCT01317199.
Exacerbation of Pre-Existing Neurologic Disease after Spinal Anesthesia
Authors: Leroy D. Vandam, Robert D. Dripps
Journal: New England Journal of Medicine (1956)

THE chief dissatisfaction with spinal anesthesia centers about the neurologic complications that are probably indigenous to the method. In an attempt to clarify this problem we undertook a long-term study of this technic.1 The results were encouraging. In 89 per cent of 10,098 spinal anesthetics followed for six months to five years, there was no case of severe progressive neurologic disease. The major share of the lesser sequelae were related to lumbar puncture2 and are largely preventable by a careful technic. Certain minor neurologic defects were noted; none were progressive, and none of any consequence.3 These, too, it is believed, . . .