tbuckley/cabot-search huggingface dataset:
Towards No Incisional Hernias: Lateral Paramedian versus Midline Incisions
Authors: P J Cox, J R Ausobsky, H Ellis, A V Pollock
Journal: Journal of the Royal Society of Medicine (1986)

A prospective randomized controlled clinical trial is reported which compares midline with lateral paramedian incisions in relation to the development of incisional hernias at one year. Of 431 patients randomized, 329 were available for assessment one year later. Two patients suffered burst abdomen, both being in the lateral paramedian group. Twenty-two incisional hernias occurred, 2 in the lateral paramedian group and 20 in the midline group ( P &lt; 0.001). Of the two types of incision, the lateral paramedian incision takes longer to perform, requires a longer incision, rarely results in dehiscence, and does confer protection against incisional hernia.
Effect of Sodium Bicarbonate and Pancreatin on the Absorption of Vitamin B<sub>12</sub>and Fat in Pancreatic Insufficiency
Authors: W. Veeger, J. Abels, N. Hellemans, H. O. Nieweg
Journal: New England Journal of Medicine (1962)

STEATORRHEA associated with a defective absorption of vitamin B12 is a common finding in intestinal insufficiency. The observation of a patient with pancreatic steatorrhea and impaired vitamin B12 absorption raised the question whether or not the acid-neutralizing power and the enzyme content of pancreatic juice might influence the absorption of vitamin B12. The decreased assimilation of this vitamin could not be explained by lack of Castle's intrinsic factor or by damage of the intestinal epithelium. We therefore decided to study the influence of sodium bicarbonate and an enzyme preparation, pancreatin, on the absorption of vitamin . . .
Chemotherapy plus radiotherapy (CT-RT) versus RT alone for patients with anaplastic oligodendroglioma: Long-term results of the RTOG 9402 phase III study.
Authors: J. Gregory Cairncross, Meihua Wang, Edward G. Shaw, Robert B. Jenkins, Bernd W. Scheithauer, David Brachman, Jan C. Buckner, Karen L. Fink, Luis Souhami, Normand Laperriere, Walter J. Curran, Minesh P. Mehta
Journal: Journal of Clinical Oncology (2012)

2008b Background: Anaplastic oligodendrogliomas, pure (AO) and mixed (AOA), are chemosensitive tumors, especially if co-deleted for chromosomes 1p and 19q, but whether addition of CT to RT prolongs overall survival (OS), is unknown. Methods: In the RTOG 9402 Phase III trial, patients (pts) with AO/AOA were randomly assigned to PCV [procarbazine, CCNU (lomustine) and vincristine] followed by immediate RT vs. immediate RT alone. Early analysis showed no OS benefit for the PCV+RT group but combined therapy was associated with a longer progression-free survival (PFS). It also showed that the finding of 1p/19q co-deletion was associated with a longer OS independent of treatment. The current analysis has a median follow up of 11.3 years (yrs). Results: Two hundred ninety-one patients were randomized, 148 to PCV+RT and 143 to RT. PCV+RT was associated with longer PFS [2.5 vs. 1.7 yrs, hazard ratio (HR) 0.68, 95% confidence interval (CI) (0.53, 0.88), P = 0.003] and the 1p/19q co-deletion with a longer Median Survival Time (MST) [8.7 vs. 2.7 yrs, HR 0.41, 95% CI (0.30, 0.55), P &lt; 0.001]. For the entire cohort, there was no difference in MST by treatment [4.6 yrs for PCV+RT vs. 4.7 yrs for RT, HR 0.79, 95% CI (0.60, 1.04), P = 0.1]. However, patients with 1p/19q co-deleted tumors lived much longer after PCV+RT (n = 59) than after RT (n = 67) [14.7 vs. 7.3 yrs, HR 0.59, 95% CI (0.37, 0.95), P = 0.03]. There was no difference in MST by treatment in pts without the 1p/19q co-deletion [n=137; 2.6 vs. 2.7 yrs, HR 0.85, 95% CI (0.58, 1.23), P = 0.39]. Re-operation rates upon progression were similar between treatment arms in co-deleted pts (43%, PCV+RT vs. 54%, RT) but salvage CT rates were higher in the RT arm [57% vs. 81% (P = 0.04)]. Conclusions: PCV followed by immediate RT was a highly effective therapy for patients with 1p/19q co-deleted AO/AOA. In this setting, 1p/19q co-deletion was both prognostic and predictive, and the early PFS benefit in co-deleted cases was a harbinger of their longer OS. [This work was supported by RTOG grants U10 CA21661 and U10 CA32115, NCCTG grant U10 CA25224, ECOG grants CA17145 and CA21115, SWOG grant CA32102, and CCOP grant U10 CA37422 from the National Cancer Institute (NCI)]
Xanthoma striatum palmare
Authors: Qiu-ju Tian, Xin-yan Zhao
Journal: Gut (2015)

A 31-year-old woman presented with a 7-month history of dark-colour urine, pruritus and xanthoma striatum palmare. Physical examination revealed diffuse yellowish and irregular plaques deposited over her fingers and palmar creases (figure 1). Skin biopsy was performed, which revealed accumulation of foam cells in the dermis (figure 2, arrow ). The patient's medical history and family history were unremarkable for other skin diseases or coronary heart disease but 3 years ago, the patient was diagnosed with drug-induced liver injury (DILI) after an episode of jaundice attributed to use of over-the-counter herbal medicine for a common cold. Laboratory biochemistry results were as follows: total cholesterol, …
High-Dose Intravenous Methylprednisolone Therapy for Pain in Children and Adolescents with Sickle Cell Disease
Authors: Timothy C. Griffin, Donald McIntire, George R. Buchanan
Journal: New England Journal of Medicine (1994)

The management of episodes of severe pain in patients with sickle cell disease is a difficult clinical problem. We studied 36 children and adolescents with sickle cell disease who had 56 acute episodes of severe pain (44 in 27 patients with sickle cell anemia, 8 in 7 patients with sickle cell-hemoglobin C disease, and 4 in 2 patients with sickle cell-β+-thalassemia). The patients were randomly assigned in double-blind fashion to receive an intravenous infusion of either saline placebo or high-dose methylprednisolone (15 mg per kilogram of body weight, to a maximum of 1000 mg) on their admission to the hospital and again 24 hours later. All the patients received intravenous morphine sulfate until severe pain abated and were then given acetaminophen with codeine.
Case 39-1963
Authors: Perry J. Culver, Benjamin Castleman
Journal: New England Journal of Medicine (1963)

Presentation of CaseA thirty-eight-year-old man was referred to the hospital because of intermittent abdominal pain.Eight months before entry the patient began to experience almost daily episodes of nonradiating pain in the middle portion of the abdomen that lasted for approximately fifteen minutes. The initial episode was of sudden onset, and the pain was associated with nausea, vomiting, diarrhea and elevation of the temperature to 103°F. Subsequently, he experienced five acute attacks, with pain across the upper portion of the abdomen, epigastric soreness, cramps, diarrhea and fever. The duration of the acute episodes was between thirty-six and forty-eight hours. . . .
Post-Traumatic Stress Disorder in the General Population
Authors: John E. Helzer, Lee N. Robins, Larry McEvoy
Journal: New England Journal of Medicine (1987)

There have been numerous studies of post-traumatic stress disorder in trauma victims, war veterans, and residents of communities exposed to disaster. Epidemiologic studies of this syndrome in the general population are rare but add an important perspective to our understanding of it. We report findings on the epidemiology of post-traumatic stress disorder in 2493 participants examined as part of a nationwide general-population survey of psychiatric disorders. The prevalence of a history of post-traumatic stress disorder was 1 percent in the total population, about 3.5 percent in civilians exposed to physical attack and in Vietnam veterans who were not wounded, and 20 percent in veterans wounded in Vietnam. Post-traumatic stress disorder was associated with a variety of other adult psychiatric disorders. Behavioral problems before the age of 15 predicted adult exposure to physical attack and (among Vietnam veterans) to combat, as well as the development of post-traumatic stress disorder among those so exposed. Although some symptoms of post-traumatic stress disorder, such as hyperalertness and sleep disturbances, occurred commonly in the general population, the full syndrome as defined by the Diagnostic and Statistical Manual of Mental Disorders, third edition, was common only among veterans wounded in Vietnam. (N Engl J Med 1987;317:1630–4.)
In Vitro Cell-Mediated Immunity of Cerebrospinal-Fluid Lymphocytes to Myelin Basic Protein in Primary Demyelinating Diseases
Authors: Robert P. Lisak, Burton Zweiman, Kathie Manthorne, Marilyn Ludwick
Journal: New England Journal of Medicine (1977)

In an attempt to characterize the immunologic reactivity of cerebrospinal-fluid lymphocytes in demyelinating diseases, we compared the myelin-basic-protein-induced in vitro responses of these cells to peripheral blood lymphocytes from the same subjects with a variety of neurologic diseases. Peripheral blood lymphocytes from patients with acute disseminated encephalomyelitis and progressive multiple sclerosis had increased reactivity as compared to those of normal volunteers (P less than 0.01 and P less than 0.05, respectively). Cerebrospinal-fluid lymphocytes from patients with acute disseminated encephalomyelitis and acute and progressive (but not stable) multiple sclerosis were more reactive than cells from subjects with other neurologic diseases (P less than 0.005, P less than 0.02 and P less than 0.05, respectively). Cerebrospinal-fluid lymphocytes manifested a greater reactivity than peripheral blood lymphocytes in acute and progressive multiple sclerosis but not in acute disseminated encephalomyelitis. These findings demonstrate that lymphocytic cells reactive to myelin basic protein are present in the spinal fluid during active demyelinating disease; and that these cells may be more reactive than peripheral blood lymphocytes.
Chronic Ulcerative Colitis and Pregnancy
Authors: Marcel Patterson, Ernest J. Eytinge
Journal: New England Journal of Medicine (1952)

THE physician who is caring for the female patient with chronic ulcerative colitis is occasionally asked about the advisability of child-bearing. Again, he may have the problem of treating a pregnant patient with colitis and must prognosticate concerning the effect on the mother and fetus. There is relatively little information on this subject, and the opinions expressed are conflicting.1 2 3 4 5 6 The purpose of this report has been to review those cases of ulcerative colitis and pregnancy that have been encountered at the Lahey Clinic. Only those cases have been considered in which adequate follow-up information and sufficient data concerning the effect . . .
Imaging Active Intracerebral Hemorrhage After Attempted Endovascular Thrombectomy
Authors: Saeed A. Alqahtani, Richard Leigh
Journal: JAMA Neurology (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 Neurology 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 Neurology journal
Prophylactic Sclerotherapy before the First Episode of Variceal Hemorrhage in Patients with Cirrhosis
Authors: Tilman Sauerbruch, Rudolf Wotzka, Wolfgang Köpcke, Michael Härlin, Walter Heldwein, Eckehard Bayerdörffer, Rainer Sander, Hassan Ansari, Irmgard Starz, Gustav Paumgartner
Journal: New England Journal of Medicine (1988)

The value of sclerotherapy as prophylaxis against the first episode of variceal hemorrhage has not been established. Therefore, we randomly assigned 133 patients with cirrhosis of the liver (of alcoholic origin in 66 percent), esophageal varices, and no previous intestinal bleeding to either prophylactic sclerotherapy (n = 68) or no prophylaxis (n = 65). The groups were comparable in hepatic function, endoscopic findings, and the pathogenesis of cirrhosis. All patients who subsequently had a first episode of variceal hemorrhage received sclerotherapy whenever possible. During a median follow-up of 22 months, variceal hemorrhage occurred in 28 percent of the patients receiving sclerotherapy and 37 percent of the controls (P = 0.3). Thirty-five percent of the sclerotherapy group and 46 percent of the control group died. The survival curves (Kaplan–Meier) of both groups were similar (P = 0.2). However, among patients with alcoholic and moderately decompensated cirrhosis (Child–Pugh group B), survival was significantly higher in those receiving sclerotherapy, although the risk of bleeding was only marginally reduced by this procedure. We conclude that prophylactic sclerotherapy does not significantly reduce the risk of bleeding from esophageal varices, but that a subgroup of patients with esophageal varices and moderately decompensated alcoholic cirrhosis may benefit from prophylactic sclerotherapy because of factors not solely attributable to prevention of an initial episode of variceal bleeding. (N Engl J Med 1988; 319:8–15.)
ATCT-22NRG ONCOLOGY/RTOG 1122: PHASE II DOUBLE-BLINDED, PLACEBO-CONTROLLED STUDY OF BEVACIZUMAB WITH OR WITHOUT AMG 386 IN PATIENTS WITH RECURRENT GLIOBLASTOMA OR GLIOSARCOMA
Authors: Eudocia Q. Lee, Peixin Zhang, Patrick Y. Wen, Elizabeth R. Gerstner, David A. Reardon, Ken Aldape, John F. de Groot, Kevin S. Choe, Jeffrey J. Raizer, Lyndon J. Kim, Steven J. Chmura, H. Ian Robins, Jennifer Connelly, James Battiste, John Villano, Naveed Wagle, Ryan T. Merrell, Merideth Wendland, Minesh P. Mehta
Journal: Neuro-Oncology (2015)
Autoimmunity in Thyroid Disease
Authors: Martin J. Cline, Herbert A. Selenkow, Marcus S. Brooke
Journal: New England Journal of Medicine (1959)

AUTOIMMUNE processes have been implicated in a variety of systemic disorders, including some primary hemolytic anemias, idiopathic thrombocytopenia, drug-induced neutropenias and collagenvascular diseases. The immunologic basis for such disorders has not been directly substantiated, and some investigators resist the concept that the body can develop antibodies against its own tissues. However, the results of recent studies of thyroiditis in animals1 , 2 and in human beings3 4 5 6 7 8 have more firmly established the idea that autoimmune processes may cause systemic disease.For many years physicians have been impressed by the finding of elevated serum levels of gamma globulin and abnormal serum flocculation in some . . .
US government is funding fewer trials as number of industry sponsored trials grows
Authors: Owen Dyer
Journal: BMJ (2015)

<h3>ABSTRACT</h3> Age-related macular degeneration (AMD) progresses through two phases: a non-exudative “dry” stage that compromises vision but does not involve angiogenesis, and an angiogenic “wet” phase characterized by choroidal neovascularization (CNV), in which neovessels from the choroid break through the Bruch’s membrane to form neovascular lesions in the macula. If left untreated, CNV leads to permanent central blindness, which the current standard of care (anti-VEGF therapy) arrests but does not reverse. In laser-induced CNV, a laser is used to rupture the Bruch’s membrane, prompting the outgrowth of choroidal blood vessels in a wound healing response. This model was used to develop currently available CNV therapeutics, such as intravitreal injection of anti-VEGF and corticosteroid therapies and is considered a gold standard model for CNV. Laser-induced CNV thus remains a highly clinically relevant model of CNV secondary to AMD and other pathologies, such as myopia. A rapidly growing body of research suggests that the pathogenesis of myriad diseases is highly dependent on biological sex, yet most studies use only male animals. This highlights the importance of determining whether the severity and pathogenesis of commonly used models of disease, for example laser-induced CNV, differ between sexes. In the present study, we tracked longitudinal progression and pathogenesis of laser-induced CNV in male and female animals, and found that CNV severity did not differ between sexes. This lack of difference recapitulates findings in human patients with CNV, which have also identified that both sexes are at equal risk of CNV development in the contexts of both age-related macular degeneration induced CNV and myopic CNV.
S101 Do those patients with a chronic respiratory disease that walk at a faster walking speed improve more post Pulmonary Rehabilitation?: Abstract S101 Table 1
Authors: EJL Chaplin, S Lohar, SJ Singh, SJ Singh
Journal: Thorax (2015)

<h3>Introduction</h3> Several baseline factors influence the response to Pulmonary Rehabilitation (PR). The Incremental and Endurance shuttle walk test is used to prescribe an exercise walking speed for patients with a chronic respiratory disease as part of a PR programme. We wished to explore the speed and duration of baseline endurance performance and observe how this impacted upon changes post rehabilitation particularly around the higher speeds of the endurance shuttle walk test (ESWT). <h3>Methods</h3> Patients completed a 7 week outpatient PR programme comprising of both endurance and strength training. The endurance training is based on the ESWT speed which is 85% of the individual maximal capacity derived from the incremental shuttle walk test (ISWT). The ISWT and subsequent ESWT were performed at baseline and discharge. Patients were categorised into low (&lt;3.6 km/hr) or high (&gt;3.6 km/hr) speed walkers based on their baseline ESWT performance. <h3>Results</h3> 990 patients completed the SWT: 567 low speed walkers (mean age 70.9 ± 9.7 years; FEV<sub>1 </sub>1.5 L ± 4.9; BMI 27.6 ± 9.0 kg/m<sup>2</sup>; MRC 4 (IQR 3–4); ISWT pre 128.4 ± 61.6 m; ESWT pre 166.3 ± 161.5 secs) and 423 high speed walkers (mean age 67.8 ± 9.2 years; FEV<sub>1</sub> 1.62 L ± 3.8; BMI 27.1 ± 14.0 kg/m<sup>2</sup>; MRC 3(IQR 2–3); ISWT pre 373.4 ± 103.3 m; ESWT pre 262.4 ± 147.6 secs). Those walking at a higher speed had a significantly higher pre ESWT (p ≤ 0.001). A statistically significant improvement was observed in the ESWT within each group (low: mean change 344.2 ± 401.5 p ≤ 0.001; high: mean change 369.3 secs p ≤ 0.001). However the change in ESWT was not significantly different between the groups (p = 0.3). <h3>Conclusion</h3> Interestingly, those patients who walk at a faster speed have a greater baseline ESWT performance compared to those patients who walk at a slower endurance speed. However both groups made comparable changes in the ESWT following PR.
Late renal allograft failure secondary to thrombotic microangiopathy-human immunodeficiency virus nephropathy.
Authors: G J Frem, H G Rennke, M H Sayegh
Journal: Journal of the American Society of Nephrology (1994)

The case of a renal transplant recipient with a known history of iv drug abuse but unknown human immunodeficiency virus (HIV) status who presents after having a stable renal allograft function for 4 yr, with acute/subacute advanced renal failure, nephrotic syndrome, and hypertension, as well as clinical and histologic findings of thrombotic microangiopathy, is reported. He was subsequently found to have a positive serology for HIV-1 with a low CD4 count but no clinical manifestations of the acquired immunodeficiency syndrome. He was treated conservatively with zidovudine (AZT). The patient never regained graft function and was ultimately discharged from the hospital on maintenance dialytic therapy. This is, to our knowledge, the first report of thrombotic microangiopathy in an HIV-1-infected patient presenting late in the course as acute/subacute renal allograft failure.
Early assessment of response to aromatase inhibitor (AI) therapy
Authors: H. M. Linden, B. F. Kurland, R. B. Livingston, G. K. Ellis, V. K. Gadi, J. M. Specht, J. R. Gralow, D. A. Mankoff, L. M. Peterson, E. K. Schubert
Journal: Journal of Clinical Oncology (2009)

11075 Background: Early decline in proliferative index (Ki-67) predicts response to endocrine therapy. For estrogen receptor positive (ER+) tumors, a low Ki-67 two weeks into endocrine therapy also predicts response (Dowsett JNCI 2007). FDG PET is promising for evaluating early response to systemic therapy and has the advantage of being non-invasive and of providing simultaneous quantitative measures at multiple tumor sites in vivo. We tested the association between FDG PET SUV and Ki-67 after two weeks of aromatase inhibitor (AI) therapy, and their prediction of response. Methods: Patients undergoing AI therapy were eligible for enrollment in the imaging study, and underwent a two week “run-in” of AI monotherapy prior to continued monotherapy or the addition of chemotherapy. Patients underwent baseline FDG PET, and Ki-67 was measured in tumor biopsy specimens. Following two weeks of therapy FDG PET and biopsy were again performed. Patients on AI therapy only were followed for clinical response. Results: A total of 21 patients enrolled in the study. 16/21 (76%) of patients had a greater than 20% decline in FDG SUV, including 11 with analyzable serial biopsy, all with 2-week Ki67 ≤5%. Of the 5 patients who did not show greater than 20% decline in FDG SUV, all 3 with serial biopsy had 2-week Ki67 of ≥20%. Subsequent response to AI was evaluable at 4–6 months in 8 patients who underwent AI monotherapy (5 R, 3 PD). All 5 responders showed decline of at least 20% in FDG SUV (30% - 60% decline), and 2/3 with PD did not (no change, 3% decline, 29% decline). Conclusions: We observed substantial changes in Ki-67 and FDG SUV following 2 W of targeted therapy. Decline in FDG SUV in patients on single agent AI predicted response in almost all cases. Serial FDG PET appears promising as an early indicator of response to AI therapy. No significant financial relationships to disclose.
The Jennerian Approach to Gram-Negative Bacillary Bacteremia?
Authors: Jay P. Sanford
Journal: New England Journal of Medicine (1972)

Although the terms gram-negative bacteremia, gram-negative shock and endotoxic shock have become idiomatic in the current medical literature, many physicians have forgotten that interest in and the bulk of knowledge concerning bacteremia due to gram-negative bacilli have developed during the past 20 years.1 The efforts directed at elucidation of the basic microbiology, epidemiology, clinical features and pathophysiologic events by both basic and clinical scientists have been spurred on by the increasing prevalence of infections caused by aerobic gram-negative bacilli.Despite, and perhaps in part as a consequence of, the advances in antimicrobial therapy that have followed the introduction of penicillin . . .
Dose-intensity in ovarian carcinoma: hold, enough?
Authors: J T Thigpen
Journal: Journal of Clinical Oncology (1997)

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.1997.15.4.1291 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 9193319 Dose-intensity in ovarian carcinoma: hold, enough? J T ThigpenxJ T ThigpenSearch for articles by this author https://doi.org/10.1200/JCO.1997.15.4.1291 First Page PDF © 1997 by American Society of Clinical Oncology