tbuckley/cabot-search huggingface dataset:
Stimulation of Myelopoiesis in Patients with Aplastic Anemia by Recombinant Human Granulocyte-Macrophage Colony-Stimulating Factor
Authors: S Vadhan-Raj, S Buescher, H E Broxmeyer, A LeMaistre, J L Lepe-Zuniga, G Ventura, S Jeha, L J Horwitz, J M Trujillo, S Gillis
Journal: New England Journal of Medicine (1988)

Aplastic anemia is a syndrome in which pancytopenia occurs in the presence of hypocellularity of the bone marrow. To assess the biologic activities of recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF) in aplastic anemia, we gave GM-CSF (60 to 500 micrograms per square meter of body-surface area) to 10 patients with moderate or severe disease, by continuous intravenous infusion daily for two weeks, and repeated the treatment after a two-week rest period. The treatment increased the white-cell count (1.6- to 10-fold) in all patients, primarily because of an increase in the numbers of neutrophils (1.5 to 20-fold), eosinophils (12- to greater than 70-fold), and monocytes (2- to 32-fold). Rates of hydrogen peroxide production in purified granulocyte fractions increased during GM-CSF treatment. Increases in bone marrow cellularity, myeloid precursor cells, and myeloid:erythroid cell ratios accompanied the white-cell response. Despite the in vivo response of the white-cells, the concentration of colony-forming cells remained the same. Measurable concentrations of interleukin-2 (2 to 15 units per milliliter) were found in the serum of 8 patients, and high levels of erythropoietin (81 to 1200 IU per liter) were found in 10 patients. The predominant side effects were constitutional symptoms. These results indicate that recombinant human GM-CSF is effective in stimulating myelopoiesis in patients with severe aplastic anemia and may benefit some patients in whom the disorder is refractory to standard forms of therapy.
My most unfortunate mistake: Sociable medicine
Authors: T L Chambers
Journal: BMJ (2003)

Umpteen years ago, I worked as a locum for an unwell general practitioner in another part of the country. Ahead of his times, he traded on equal terms with his patients—neither kept a record of consultations. To add to the challenge, the labels on medicine bottles did not specify their content. I spent many happy hours writing repeat prescriptions for elderly patients: they all asked that, in addition to the specific drugs for their condition, I should replenish their supply of Dr A's “green and yellow pills.” None had any idea what these were, or what they did. Not wanting to undermine the existing doctor-patient relationship, I complied, albeit hesitantly, by prescribing Librium 5 mg, the green and yellow capsule familiar to me in hospital practice. I continued for a few months with patients who seemed content with me and my treatment.

Much later, I worked for a distinguished but temperamental surgeon. Fortunately our paths rarely crossed in the NHS wards or clinics, but I became a skilled flak catcher when caring for his private patients. One of them asked me for a supply of “Mr B's green and yellow bombs,” but was I sure I knew what they were?

“Of course,” I said, and wrote the familiar prescription. Shortly after I was summoned urgently to the private patients' wing. Sister was smirking, and Mr B was apoplectic. “What do you mean by prescribing tranquillisers for the duchess?” he demanded.

“She asked me to, Sir.”

“What? She asked you for Librium?”

“No, Sir, your green and yellow capsules.”

He boiled over: “Stupid boy—they're vitamin B supplements.”

(Inaudible) “Oh shit.”

Anxious inquiry with the now recovered general practitioner settled my mind: no harm had befallen his patients. He thought the story hilarious and thought he might even follow my practice since, in his view, neither preparation added materially to the sum of human happiness. Respect and tact prevented me from suggesting that he prescribed neither.

Not only did this episode subvert my youthful faith in the effectiveness of medicines: more importantly, it was an early and sharp lesson on the sins of medical presumption and omniscience, but, regrettably, one that my patients continue to teach me.
CASE REPORTS
Authors: J. A. CUMMINS
Journal: American Journal of Psychiatry (1944)

A case of atypical status epilepticus is reported in which convulsive spasms were slight and tended selectively to affect muscles associated with respiration with the result that cyanosis was deeper than the degree observed in ordinary status epilepticus. Status epilepticus occurs infrequently, it may be atypical and difficult to recognize. Fatal cases have been reported. On this occasion it was amenable to treatment. Its occurrence bears no relation to the size of the dose of metrazol used. In the cases reported it has followed the first administration of the convulsive agent.
Discussing Long-term Prognosis in Primary Care
Authors: Mara A. Schonberg, Alexander K. Smith
Journal: JAMA Internal Medicine (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 Internal Medicine 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 Internal Medicine journal
Distinct Reactivity of Burkitt's Lymphoma Cell Lines With Eight Monoclonal Antibodies Correlated With the Ethnic Origin
Authors: M C Favrot, I Philip, T Philip, J Portoukalian, J F Doré, G M Lenoir
Journal: JNCI Journal of the National Cancer Institute (1984)

Journal Article Distinct Reactivity of Burkitt's Lymphoma Cell Lines With Eight Monoclonal Antibodies Correlated With the Ethnic Origin Get access M. C. Favrot, M. C. Favrot Search for other works by this author on: Oxford Academic PubMed Google Scholar I. Philip, I. Philip Search for other works by this author on: Oxford Academic PubMed Google Scholar T. Philip, T. Philip Search for other works by this author on: Oxford Academic PubMed Google Scholar J. Portoukalian, J. Portoukalian Search for other works by this author on: Oxford Academic PubMed Google Scholar J. F. Doré, J. F. Doré Search for other works by this author on: Oxford Academic PubMed Google Scholar G. M. Lenoir G. M. Lenoir Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 73, Issue 4, October 1984, Pages 841–847, https://doi.org/10.1093/jnci/73.4.841 Published: 01 October 1984 Article history Received: 24 February 1984 Accepted: 25 May 1984 Published: 01 October 1984
Trichinosis with Neurologic and Mental Manifestations
Authors: Robert A. Scott, Robert E. Johnson, Daniel Holzman
Journal: New England Journal of Medicine (1952)

DESPITE the frequent occurrence of trichinosis in man, its neurologic manifestations have been less commonly recognized. In 1906 Frothingham1 first demonstrated areas of cellular infiltration containing trichina embryos in the brain of a patient dead of trichinosis. In 1914 van Cott and Lintz2 first reported the presence of these larvae in the cerebrospinal fluid.Neurologic manifestations in this disease are often nonspecific, and headache, apathy and drowsiness have frequently been reported. In addition, focal neurologic signs such as loss of deep tendon reflexes,3 polyneuritis,4 hemiplegia,3 , 5 6 7 and both generalized and Jacksonian convulsions8 have been described. Epileptic seizures have occurred four weeks . . .
ENDOSCOPIC TRANSANAL VACUUM-ASSISTED CLOSURE OF LOW PELVIC CAVITIES FOLLOWING ANASTOMOTIC AND STUMP LEAKAGE
Authors: G Martel, K McElvanna, K McCallion, I McAllister
Journal: Gut (2013)

<h3>Introduction</h3> Endoscopic transanal vacuum-assisted closure is a minimally invasive method used in the treatment of low pelvic anastomotic leaks and symptomatic cavities. <h3>Aims/Background</h3> We report our experience with this technique using Endo-Sponge therapy in a series of 10 patients. <h3>Method</h3> All patients treated with Endo-Sponge therapy between November 2008 and January 2013 in our hospital were identified. Data collected retrospectively from clinical and endoscopic notes included indication, duration of therapy, number of sponge changes, complications and outcome. <h3>Results</h3> Ten patients (8 male, median age 59 years) underwent Endo-Sponge therapy. Seven were treated for anastomotic leaks following low anterior resection. Two patients had symptomatic low pelvic cavities following ileal pouch excision and 1 was treated for a pelvic cavity following a perforated low Hartmann9s stump. Seven patients were treated within 17 days (0-17 days) of diagnosis of pelvic sepsis. The remaining 3 patients were treated for chronic low pelvic cavities at intervals ranging from 5 months following index surgery. Median duration of treatment was 28.5 days (8–40 days) with a median number of sponge changes of 7 (2–11 changes). One patient developed a transient inflammatory response and pneumoperitoneum which settled with antibiotic therapy but there were no other complications. All patients had clinical resolution of pelvic sepsis and four patients had definitive cavity closure. <h3>Conclusion</h3> Endoscopic transanal vacuum-assisted closure is an effective low-risk method of controlling pelvic sepsis following anastomotic leak and can be used in the management of symptomatic cavities following pouch excision and low rectal stump leakage.
FRI0124 Increased risk of diastolic heart failure in RA – what should we screening for?:
Authors: T. Schau, M. Gottwald, M. Neuss, D. Ridjab, I. Fischer, C. Butter, M. Zaenker
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Patients with rheumatoid arthritis (RA) share an increased risk of diastolic heart failure with normal ejection fraction (HFNEF), which is often underrecognized. Age, female gender and history of hypertension are important risk factors. Also, persistant disease activity and disease duration have been shown to be significant contributors. Therefore, effective screening for heart failure should be part of follow-up evaluation in RA-patients. However, not all patients with HFNEF are symptomatic. In contrast, RA-related fatigue and functional impairment may influence symptoms of heart failure and interfere with exercise testing. <h3>Objectives</h3> To determine diagnostic value of symptoms, laboratory results, and technical findings for classification of HFNEF in RA-patients. <h3>Methods</h3> We analyzed data of our prospective heart failure study of consecutively recruited RA-patients showing up in our community based outpatient-clinic. All patients were interviewed using a standardized questionnaire. Clinical signs were evaluated based upon Framingham criteria. Laboratory tests included NT-proBNP. Echocardiography contained tissue doppler and global longitudinal strain (GLS) imaging. <h3>Results</h3> 162 pat., n=110 (68%) female, mean (SD) age 61.3 (±13.1) years, mean disease duration 12.5 (±11.4) years, mean DAS<sub>28</sub> 2.8 (±1.0) were enrolled. Appropriate echocardiographic data was available in 155 pat. LVEF&lt;50% was found in 6 pat. (3.7%), 3 (2%) pat. had additional symptoms of NYHA class&gt;1 and were classified having systolic heart failure. Of the remaining 149 pat. with normal EF, 62 (41,6%) had symptoms of NYHA-class&gt;1, and HFNEF according to ESC criteria was finally classified in 31 (21%) pat. In the group with normal EF, hypertension was found in 83 (56%), diabetes in 21 (14%), GFR&lt;60 ml/min in 22 (15%), PAOD in 14 (9%), CAD in 25 (17%), prior MI in 8 (5%), stroke/TIA in 3 (2%) pat. <h3>Conclusions</h3> When screening RA-patients, peripheral edema, dyspnea on exertion, nocturia, increased NTproBNP, high grade diastolic dysfunction, and abnormal GLS are main indicators of HFNEF. There is low diagnostic value of other symptoms and clinical findings. <h3>Disclosure of Interest</h3> None Declared
PTU-268 The impact of EWTD on gastroenterology training and the inpatient GI referral service at a district general hospital
Authors: V Chhaya, C Alexakis, M Mendall, S Gupta
Journal: Gut (2012)

Introduction A Specialist Registrar's (SpR) weekly duties include two Consultant and one SpR ward round, two clinics, 1–2 endoscopy training lists along with on-calls for General Medicine (GIM). Ward referrals are not included in the timetable. Since the implementation of the European Working Time Directive (EWTD), it has become increasingly difficult to get Gastroenterology (GI) training within the specified working hours. We aim to quantify the impact of EWTD on endoscopy training and the GI referral service at our hospital which serves 350 000 people. Methods Data for GI referrals (excluding GI bleeds and endoscopy requests) was collected by two SpRs from November 2010 to September 2011. All ward referrals were seen within 24 h. An average duration of 20 min was used to see each referral which included a history, examination, review of medical records and documenting a proposed management plan. The average number of weekly referrals and standard rota details were used to analyse the impact of this activity for the year. Results 515 referrals were seen over a period of 11 months with a mean age of 60 years (range 14–98). 22% were over 80 years and 54% were female. On average, 12 referrals were seen per week resulting in a total of 4 h and 57% were reviewed by a Consultant. Reasons for referral included liver disease (21%), inflammatory bowel disease (15%), hepatobiliary and pancreatic disease (13%), ERCP (13%), upper GI conditions (12%), lower GI conditions (9%), PEG (8%) and other miscellaneous conditions (9%). Conclusion In a year of 260 working days, 35 days were spent on-call for GIM and 21 for night on-calls (1 in 5 rota). Due to EWTD restrictions, a further 28 days were lost on compensatory leave and 32 on annual leave leaving 144 working days. Only 2.8 days (number of working days remaining/260 working days x number of working days in the week) or 6 sessions per week are spent as a GI trainee. Clinics and ward rounds are fixed commitments leaving trainees to attend endoscopy lists within the remaining time. Due to shift patterns, SpRs are spending more time on the wards. Prospective cover for colleagues produces further challenges. This hinders endoscopy training and leaves referrals to be seen after working hours. We calculate that only 43% of training lists are attended in the year according to electronic records with endoscopy time recovered on non-training lists. Referrals add 4 h to the average week and although this is invaluable experience, the time is largely unaccounted for. This survey demonstrates the strains of modern rotas on endoscopy training and ability to see referrals. We suggest appropriate resourcing of the inpatient GI referral service with greater integration between GI and GIM rotas. Competing interests None declared.
Health Care Reform — What Went Wrong on the Way to the Courthouse
Authors: Mark A. Hall
Journal: New England Journal of Medicine (2010)

Before health care reform was enacted, Democratic lawmakers and most legal scholars were confident of its constitutionality. Under long-established Supreme Court precedent, Congress would have authority, if it wanted, to enact a single-payer socialized insurance system, using its powers to tax and spend "for the general welfare." Far short of such a system, the complex blend of regulation, subsidies, and an individual mandate included in the Affordable Care Act (ACA) is vastly more protective of insurance markets and individual freedoms. Congress has nearly unbridled authority to regulate products sold in or affecting interstate commerce, and health insurance is one such . . .
Abstract LB-164: B lymphocytes inhibit anti-tumor response in a murine EMT6 tumor model by facilitating expansion of T regulatory cells
Authors: Yu Zhang, Tamar Tadmor, Yair Eliav, Taylor H. Schreiber, Eckhard R. Podack, Robert Levy, Seung-uon Shin, Joseph D. Rosenblatt
Journal: Cancer Research (2011)

Abstract B lymphocytes play a central role in inhibiting the immune response against certain tumors, but the underlying mechanisms by which B cells facilitate tumor growth are still poorly understood. Murine EMT6 mammary tumors grow readily in immune competent mice (ICM) but poorly in B-cell deficient μ−/− BALB/c mice (BCDM). Both decreased T regulatory cell (Treg) expansion and impaired Treg function were observed in BCDM compared to ICM. In this study, we investigated how the presence or absence of B cells affects expansion of Tregs in response to tumor implantation. We compared tumor growth, and the number of Treg cells, T cell function, number and character of tumor infiltrating cells, immune effector molecule, chemokine and cytokine expression in tumor tissue in ICM, compared to BCDM and B cell reconstituted BCDM (BCDM+B). Partial reconstitution of BCDM with adoptively transferred B cells restored tumor growth. Transfer of both normal and IL-10−/− B cells restored tumor growth in BCDM. Restored tumor growth correlated with an increase in CD4+FoxP3+ Treg cells in the spleen and draining lymph nodes and a decrease in interferon-γ secretion and cytotoxic T cell activity against EMT6 targets, in BCDM+B to BCDM. Tumor growth was completely inhibited in BCDM+B by depletion of Treg using PC61 antibody. Markedly increased levels of NK and CD8+ T cell infiltration into the tumor bed were seen in BCDM or BCDM+B treated with Treg depletion, compared to levels of infiltration seen in ICM or BCDM+B mice. PCR array analysis of mRNA expression in tumor tissue in BCDM, BCDM+B treated with PC61 antibody, or ICM following PC61 treatment, revealed down regulation of IL-17A, IL-17F, TGF-β and IL-23, CD73, VEGF-C, Rorγt and CCR4, when compared to either BCDM+B or BALB/c control mice. We observed similar changes in immune effector molecules/cytokines mRNA in all scenarios in which Treg levels were decreased. In conclusion, our studies indicate that the T cell anti-tumor response is enhanced in the absence of B cells, in part due to effects on Treg cell expansion and changes in immune effector molecule and cytokine profile in the tumor micro-environment. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr LB-164. doi:10.1158/1538-7445.AM2011-LB-164
Abstract 2160: Critical BRCA1 role as a transcriptional regulator in prostate cancer DNA damage response
Authors: Paola De Luca, Cristian Moiola, Florencia Zalazar, Geraldine Gueron, Javier Cotignola, Elba Vazquez, Kevin Gardner, Adriana De Siervi
Journal: Cancer Research (2011)

Abstract Loss or mutation of the BRCA1 gene is associated with nearly 5% of all breast cancers. Since many cases of sporadic cancers that also show decreased BRCA1 expression are often associated with higher grade tumors, significant interest has developed in defining mechanisms of BRCA1 regulation at the level of transcription. BRCA1 plays numerous roles in regulating genome integrity. It interacts with crucial proteins and is considered a gene-specific transcriptional co-regulator; however, BRCA1's role in the transcriptional response to DNA damage is poorly understood. In this study we show that BRCA1 plays a central role in the transcriptional response to genotoxic stress in prostate cancer. Using BRCA1-depleted or BRCA1-overexpressing human prostate cancer cell lines, we found that BRCA1 mediates apoptosis, cell cycle arrest and decreased viability in response to doxorubicin treatment. Furthermore, xenograft studies using human prostate carcinoma PC3 cells demonstrate that BRCA1 depletion results in increased tumor growth. In addition, genome-wide screens using the combined application of chromatin immunoprecipitation and microarray technology (ChIP-chip) reveals that BRCA1 is highly enriched at the promoters of greater than 1300 genes. Gene Ontology (GO) analysis of this “BRCA1 ChIP signature” reveals a significant enrichment in genes that function in cell cycle regulation and the response to DNA damage including “M phase”’ and “Mitotic checkpoint” terms, suggesting a specific role for BRCA1 in controlling mitotic events following genotoxic stress. We have validated multiple members of this BRCA1 ChIP signature including: BLM, FEN1, DDB2, H3F3B, BRCA2, CCNB2, MAD2L1, GADD153 and ATM. Further focused analysis reveals that BRCA1 occupancy at the ATM promoter increases its transcription and H2AX phosphorylation. Notably, following doxorubicin exposure, BRCA1 is released from the ATM promoter and redistributed to other genes like GADD153 where it induces expression, apoptosis and cell cycle arrest. RNAi depletion of GADD153 blocks BRCA1-dependent apoptosis and cell cycle arrest in response to doxorubicin, suggesting that GADD153 is required for BRCA1 mediated drug sensitivity. These findings define a novel mechanism through which BRCA1 influences cell fate decisions in response to genotoxic insult through direct transcriptional control of genes, including GADD153 and ATM. Thus, tumors with absent or reduced expression of BRCA1 are likely to show a marked resistance to chemotherapy for prostate cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 2160. doi:10.1158/1538-7445.AM2011-2160
18F-Choline PET/CT-Positive Lytic Bone Lesions in Prostate Cancer and Accidental Myeloma Detection
Authors: Luigia Florimonte, Eva Orunesu, Massimo Castellani, Virgilio Longari, Agostino Cortelezzi
Journal: Clinical Nuclear Medicine (2016)

F-choline PET/CT was performed for suspected prostate cancer relapse in a 67-year-old man with hip pain and a rapid rise in prostate-specific antigen values (1.1 ng/mL). PET imaging showed an area of increased F-choline bone uptake in the right ischium. Coregistered CT images showed a lytic bone lesion. The infrequent CT appearance of a possible prostate carcinoma metastasis led to additional laboratory testing that showed a monoclonal γ-peak and to subsequent biopsy, which revealed a solitary plasmocytoma.
Bone Scan Alterations in Aromatase Inhibitor–Treated Patients
Authors: Frank De Geeter, Annick Van den Bruel, Eveline De Cuypere, Michel Langlois
Journal: Clinical Nuclear Medicine (2014)

We report bone scan changes in 3 patients receiving aromatase inhibitors as adjuvant treatment for postmenopausal hormone receptor–positive breast cancer. Compared with bone scans before treatment, repeated scans after at least 10 months of aromatase inhibitor treatment showed increased activity in the peripheral skeleton and the skull. In 2 patients, these alterations could be correlated with increased markers of bone turnover. They probably result from high bone turnover induced by estrogen depletion caused by aromatase inhibitors. This effect should be taken into account in the differential diagnosis of a bone scan pattern suggestive of hyperparathyroidism, which was ruled out.