tbuckley/cabot-search huggingface dataset:
Case 8-1998
Authors: Henry W. Querfurth, Eugene J. Mark
Journal: New England Journal of Medicine (1998)

Presentation of CaseA 41-year-old man was admitted to the hospital because of leg weakness and mediastinal lymphadenopathy.The patient had been well until a month earlier, when he fell while walking and felt weakness in the left leg. On the next day, he had diffuse body pains, with numbness of the lateral aspect of the left thigh, calf, and foot. Conservative management was advised, but the symptoms worsened.Three weeks before admission, the patient lunged to catch a ball and fell because of leg weakness. He began to have difficulty emptying his bladder, with urinary frequency and oliguria; he . . .
Medicine and multimedia: The Third Way: New Politics for the New Century
Authors: Albert Weale
Journal: BMJ (1998)

Tony Blair







Fabian society, £3.50, pp 20

ISBN 0 71630588 7

———————

Rating: curiosity ★★★★, coherence ★

The plot is simple. Once upon a time, there was a world of secure jobs, large firms, low unemployment, relatively closed national economies, and strong communities underpinned by stable families. In that world social democratic governments could pursue their goals by simply using the instruments of state power. But that world has gone. Globalisation and other changes now mean that social democratic measures no longer work. Yet we should not give up on important centre left values—equal worth, opportunity, responsibility, and community. Governments will have to learn new skills, however. They must work in partnership with the private and voluntary sectors. They must devolve power. And they must avoid bloated central bureaucracies.

Taken literally, this diagnosis spells bad news for the NHS, which, along with the Civil Aviation Authority and the Church of England, is one of the few nationalised industries left in Britain. It would naturally imply something like the social insurance sickness funds for health care found in Germany, where the ideas of Christian democracy have sought to reconcile a commitment to social solidarity with a concern to limit the power of the state.

Yet, at this point, the argument bottles out. For Tony Blair, the NHS is a formidable achievement. That is why more money was found for it in the comprehensive spending review. The reduction of waiting lists is a priority, and there will be more rigorous monitoring of costs and quality. In other words the “third way” in health is a continuation of postwar policies by another name.

Such a paradox is not hard to understand. In the field of health services the story line of the third way is inconsistent with the high level of public support that the NHS enjoys. But the problem arguably goes deeper. In health care Tony Blair is a prime minister with a Christian democratic project working with a popular social democratic legacy.

Does this matter? After all, the world of politics rarely fits the neat categories of political ideology. And, of course, politicians can be forgiven many inconsistencies when they win landslide elections. Yet if we want an acid test of the third way it is mentioned in passing on page 14—long term care for elderly people. Only when we see how the Blair government handles this issue will we know whether the principles of the third way transcend the economic individualism to which it purports to be the successor.
Effect of Intracoronary Serotonin on Coronary Vessels in Patients with Stable Angina and Patients with Variant Angina
Authors: Eugene P. McFadden, John G. Clarke, Graham J. Davies, Juan Carlos Kaski, Agha W. Haider, Attilio Maseri
Journal: New England Journal of Medicine (1991)

Serotonin, a major product of platelet activation, has potent vasoactive effects in animal models, but its role in human coronary artery disease remains largely speculative.
Studies in Regional Heparinization
Authors: Leon A. Gordon, Ernest R. Simon, J. Max Rukes, Victor Richards, Herbert A. Perkins
Journal: New England Journal of Medicine (1956)

WHEN artificial-kidney hemodialysis is performed, the patient is ordinarily heparinized to prevent activation of the coagulation mechanism as the blood passes through the extracorporeal circuit. The use of this anticoagulant is largely responsible for the fact that active uncontrollable bleeding, particularly from the gastrointestinal tract, remains the only absolute contraindication to the use of the artificial kidney.1 2 3 4 In the first part of this report5 it was demonstrated that a very prolonged clotting time could be achieved in a part of the circulation without appreciably affecting the clotting time in the remainder of the circulation. One of us (E.R.S.) suggested that . . .
Cognitive deficits of patients with Alzheimer's disease with and without delusions
Authors: D V Jeste, R E Wragg, D P Salmon, M J Harris, L J Thal
Journal: American Journal of Psychiatry (1992)

The goal of this investigation was to study the prevalence of delusions in Alzheimer's disease and to compare the performance of the delusional and nondelusional groups on a neuropsychological test battery.The authors studied 107 patients with Alzheimer's disease and 51 age- and education-comparable normal subjects using a standardized psychiatric interview and a neuropsychological test battery.Thirty-seven patients with Alzheimer's disease had delusions with or without hallucinations. Patients with delusions were significantly more impaired than those without delusions (and the normal comparison group) on the Mini-Mental State examination; Blessed Information-Memory-Concentration Test; Dementia Rating Scale, especially its conceptualization and memory subtests; and a test of verbal fluency. The delusional group also tended to be somewhat more impaired than the nondelusional group on the modified Wisconsin Card Sorting Test and the similarities subtest of the Wechsler Adult Intelligence Scale-revised.Approximately one-third of patients with Alzheimer's disease had developed psychotic symptoms sometime after the onset of dementia. The presence of psychotic symptoms in Alzheimer's disease was associated with greater cognitive impairment, especially frontal/temporal dysfunction, and possibly with a more rapidly progressive dementia.
Cellular signalling in the diseased left ventricle influences cellular signalling in the non-diseased right ventricle of patients with aortic stenosis or ischaemic disease
Authors: Nasser Al-Shanti, Matthew Hancock, A Venturini, C Stewart, Raimondo Ascione, Gianni D Angelini, M.Saadeh Suleiman
Journal: Cardiovascular Research (2012)
Abstract 652: Antibody-drug conjugates (ADCs) of indolino-benzodiazepine DNA-alkylating agents
Authors: Michael L. Miller, Manami Shizuka, Nathan Fishkin, Emily Reid, Katie Archer, Erin Maloney, Chen Bai, Olga Ab, Nick C. Yoder, Rui Wu, Erica Hong, Megan Bogalhas, Alan Wilhelm, Kathleen Whiteman, Ravi Chari
Journal: Cancer Research (2015)

Abstract There are over thirty ADCs in the clinic today, reflecting the interest in ADCs for the treatment of cancer. Most of these ADCs utilize a tubulin-interacting small molecule as their cytotoxic payload. In order to continue to extend the utility of ADCs to more types of cancers, there is a strong interest in developing cytotoxic payloads with other mechanisms of action. Previously we have described the development of a class of indolino-benzodiazepine dimers (IGNs) with high potency and specificity. ADCs made with a mono-imine containing IGN, which only alkylate DNA, were found to display improved tolerability, along with the absence of delayed toxicity, compared to their DNA-cross-linking di-imine counterparts. Additional structure-activity relationship studies with mono-imine containing IGNs have resulted in two promising new leads, IGN-D1 and IGN-P1, which are conjugated to an antibody via either a disulfide or peptide linker, respectively. ADCs of IGN-D1 and IGN-P1 were prepared for evaluation using a folate receptor α (FRα)-binding antibody, anti-FRα, and EGFR-binding antibody, anti-EGFR. Anti-FRα-IGN-D1 and anti-FRα-IGN-P1 were found to be highly potent against the FRα-expressing KB cell line (IC50 values of 8 pM and 4 pM, respectively) and also demonstrated strong activity against nearby target-negative cancer cells. The addition of excess unconjugated antibody blocked the cytotoxic effect of these conjugates, thus demonstrating that their activity is antigen specific. In addition, both anti-FRα-IGN conjugates were found to be highly potent (IC50 values of 100 pM and 30 pM, respectively) against the breast ductal carcinoma cell line, T47D, despite only a moderate level of antigen expression on the target cells. Similarly, anti-EGFR-IGN-D1 and anti-EGFR-IGN-P1 were found to have IC50 values in the picomolar range against a panel of EGFR-expressing cell lines. In vivo, anti-FRα-IGN-D1 and anti-FRα-IGN-P1 were found to be effective against NCI-H2110 non-small cell lung cancer xenografts, with anti-tumor activity observed at single doses as low as 3 μg/kg (payload dose, equivalent to 0.15 mg/kg Ab dose). These data support evaluation of new ADC therapies with these two new IGNs for solid tumor indications as well as tumors with low antigen expression. Citation Format: Michael L. Miller, Manami Shizuka, Nathan Fishkin, Emily Reid, Katie Archer, Erin Maloney, Chen Bai, Olga Ab, Nick C. Yoder, Rui Wu, Erica Hong, Megan Bogalhas, Alan Wilhelm, Kathleen Whiteman, Ravi Chari. Antibody-drug conjugates (ADCs) of indolino-benzodiazepine DNA-alkylating agents. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 652. doi:10.1158/1538-7445.AM2015-652
Adherence to National Quality Forum (NQF) colorectal cancer indicators among members of the Florida Initiative for Quality Cancer Care (FIQCC) consortium
Authors: D. Shibata, E. Siegel, M. Malafa, J. Lee, W. Fulp, P. Jacobsen
Journal: Journal of Clinical Oncology (2009)

6563 Background: FIQCC is a consortium of 10 institutions participating in a comprehensive practice-based system of quality self-assessment across a number of cancer types. The NQF has endorsed several performance measures to assess the quality of care for colorectal cancer (CRC) patients. We have sought to identify adherence to NQF CRC indicators among members of FIQCC. Methods: Comprehensive chart reviews were conducted for all patients with CRC first seen in 2006 by a medical oncologist at one of the 10 FIQCC sites (2 academic/8 community). NQF quality measures included: 1) consideration or administration of chemotherapy to patients with stage III colon cancer (CC); 2) completeness of pathology reporting for CRC; 3) &gt;12 regional lymph nodes (LN) examined for resected CC. Statistical comparisons were performed using chi-squared analysis. Results: The population consisted of 475 patients (250 men and 225 women) with a median age of 65 years (range 27–92). Chemotherapy was considered/administered in 96.5% (136/141) of stage III CC patients. With respect to CRC pathologic reporting, there was strong compliance (&gt;90%) for reporting the number of LN examined and involved by tumor, proximal/distal margin status, depth of invasion, and histologic grade. However, only 225 of 295 (76.2%) reports documented lymphovascular invasion status. Radial margin status was included for 45% (27/60) of surgical rectal cancer specimens. Only 73.9% (173/234) of CC cases had &gt;12 LN examined. Of the NQF measures, significant differences across practice sites were noted for the reporting of histologic grade (p = 0.0002), proximal/distal margin status (p = 0.049), and lymphovascular invasion (p &lt; 0.0001). Conclusions: Although there was uniformly strong adherence to the application of adjuvant therapy for stage III CC across FIQCC sites, the adequacy of lymphadenectomy and LN examination for resected CC was lower and varied considerably across sites. There remains room for improvement of pathologic CRC reporting across the whole consortium as well as at individual sites. The FIQCC initiative allows for the identification of targets for global quality improvement as well as of specific measures for individual institutions. No significant financial relationships to disclose.
Afatinib versus methotrexate in older patients with second-line recurrent and/or metastatic head and neck squamous cell carcinoma: subgroup analysis of the LUX-Head &amp; Neck 1 trial
Authors: P.M. Clement, T. Gauler, J.P. Machiels, R.I. Haddad, J. Fayette, L.F. Licitra, M. Tahara, E.E.W. Cohen, D. Cupissol, J.J. Grau, J. Guigay, F. Caponigro, G. de Castro, L. de Souza Viana, U. Keilholz, J.M. del Campo, X.J. Cong, E. Ehrnrooth, J.B. Vermorken
Journal: Annals of Oncology (2016)

BackgroundIn the phase III LUX-Head & Neck 1 (LHN1) trial, afatinib significantly improved progression-free survival (PFS) versus methotrexate in recurrent and/or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) patients progressing on/after platinum-based therapy. This report evaluates afatinib efficacy and safety in prespecified subgroups of patients aged ≥65 and <65 years.Patients and methodsPatients were randomized (2:1) to 40 mg/day oral afatinib or 40 mg/m2/week intravenous methotrexate. PFS was the primary end point; overall survival (OS) was the key secondary end point. Other end points included: objective response rate (ORR), patient-reported outcomes, tumor shrinkage, and safety. Disease control rate (DCR) was also assessed.ResultsOf 483 randomized patients, 27% (83 afatinib; 45 methotrexate) were aged ≥65 years (older) and 73% (239 afatinib; 116 methotrexate) <65 years (younger) at study entry. Similar PFS benefit with afatinib versus methotrexate was observed in older {median 2.8 versus 2.3 months, hazard ratio (HR) = 0.68 [95% confidence interval (CI) 0.45–1.03], P = 0.061} and younger patients [2.6 versus 1.6 months, HR = 0.79 (0.62–1.01), P = 0.052]. In older and younger patients, the median OS with afatinib versus methotrexate was 7.3 versus 6.4 months [HR = 0.84 (0.54–1.31)] and 6.7 versus 6.2 months [HR = 0.98 (0.76–1.28)]. ORRs with afatinib versus methotrexate were 10.8% versus 6.7% and 10.0% versus 5.2%; DCRs were 53.0% versus 37.8% and 47.7% versus 38.8% in older and younger patients, respectively. In both subgroups, the most frequent treatment-related adverse events were rash/acne (73%–77%) and diarrhea (70%–80%) with afatinib, and stomatitis (43%) and fatigue (31%–34%) with methotrexate. Fewer treatment-related discontinuations were observed with afatinib (each subgroup 7% versus 16%). A trend toward improved time to deterioration of global health status, pain, and swallowing with afatinib was observed in both subgroups.ConclusionsAdvancing age (≥65 years) did not adversely affect clinical outcomes or safety with afatinib versus methotrexate in second-line R/M HNSCC patients.Clinical trial registrationNCT01345682 (ClinicalTrials.gov).
Long term use of proton pump inhibitors may increase risk of impaired kidney function
Authors: Susan Mayor
Journal: BMJ (2016)

Long term use of proton pump inhibitors (PPIs) for heartburn, acid reflux, or gastric ulcers is associated with a higher risk of new onset chronic kidney disease, progression of existing chronic kidney disease, and end stage renal disease, a large US study has shown.1

Reports have previously linked taking a PPI to acute kidney injury and acute interstitial nephritis. But it has been unclear whether exposure to these drugs is associated with the development or progression of chronic kidney disease.

Researchers studied the US Department …
Zinc Intake and Growth of a Transplanted Hepatoma Induced by 3′ -Methyl-4-dimethylaminoazobenzene in Rats 2
Authors: J.R. Duncan, I.E. Dreosti, C.F. Albrecht
Journal: JNCI Journal of the National Cancer Institute (1974)

Journal Article Zinc Intake and Growth of a Transplanted Hepatoma Induced by 3′ -Methyl-4-dimethylaminoazobenzene in Rats Get access J.R. Duncan, J.R. Duncan 3Department of Biochemistry, University of Natal, Pietermaritzburg, South Africa.. Search for other works by this author on: Oxford Academic PubMed Google Scholar I.E. Dreosti, I.E. Dreosti 3Department of Biochemistry, University of Natal, Pietermaritzburg, South Africa.. Search for other works by this author on: Oxford Academic PubMed Google Scholar C.F. Albrecht C.F. Albrecht 4National Chemical Research Laboratories, Council for Scientific and Industrial Research, Pretoria, South Africa.. Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 53, Issue 1, July 1974, Pages 277–278, https://doi.org/10.1093/jnci/53.1.277 Published: 01 July 1974 Article history Received: 05 February 1974 Accepted: 10 April 1974 Published: 01 July 1974
Recurrent Photodistributed Skin Eruptions in a Teenage Girl
Authors: Hannah Song, Kristina J. Liu, Jennifer T. Huang
Journal: JAMA Dermatology (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 Dermatology 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 Dermatology journal
Abstract 11036: Arrhythmia Risk Profiles in Patients with Coronary Artery Disease: The Influence of Diabetes
Authors: JuhaPerkiomaki, Olli-PekkaPiira, SamuliLepojärvi, JarkkoKarvonen, JuhaniJunttila, KatherineKavanagh, MarioTalajic, BenoitCoutu, IsmaileAbdalla, DerekExner, HeikkiHuikuri, Refine-Icd Investigators
Journal: Circulation (2012)

Background: Patients with diabetes (DM) are known to have a higher risk of sudden cardiac death. Recently, two non-invasive arrhythmia risk markers, heart rate turbulence (HRT) and T-wave alternans (TWA) measured from Holter recordings and/or exercise ECG, have emerged as powerful predictors of fatal or near-fatal arrhythmia events in patients with coronary artery disease (CAD). We assessed the relationship of DM with abnormal HRT+TWA in two independent CAD patient cohorts. Methods and Results: HRT & TWA were measured in the ARTEMIS risk stratification study that includes a broad group of CAD patients with (n=526) and without DM (n=475). Risk assessment was performed 3-12 months after coronary angiography. The REFINE-ICD study randomizes post-infarction (MI) patients with ejection fraction (EF) values between 36%-49% and abnormal HRT+TWA measured 2-12 months post-MI to ICD vs. conventional therapy. In the ARTEMIS cohort, abnormal HRT+TWA was more common in DM (125/526, 24%) vs. non-DM patients (63/475, 13...
Use of Triethylenethiophosphoramide (Thio-TEPA) in Treatment of Metastatic Carcinoma of the Breast
Authors: K KUWAYTI, J H HILTON
Journal: JAMA (1963)

Twenty-two patients with metastatic breast cancer were treated by a combination of testosterone and N,N',N'', triethylenethiophosphoramide (Thio-TEPA). All had undergone mastectomy and received radiation; six had had an oophorectomy and 12 had had oophorectomy and adrenalectomy. For its marrow-stimulating effect testosterone was given intramuscularly, 100 mg. daily for five days; then 100 mg. of depo-testosterone was given intramuscularly once a week. On the sixth day of treatment, 15 mg. of Thio-TEPA was given intramuscularly and repeated daily or every second day until a definite depression of the leukocyte and/or platelet counts occurred. To 15 patients a total dose of 200 mg. or more of triethylenethiophosphoramide was given. Thirteen patients improved subjectively and five of these improved objectively. The duration of improvement varied between one and 12 months. Treatment was most effective in patients with bony metastases.
Soundings: Souls in cages
Authors: Colin Douglas
Journal: BMJ (2006)

“Some are like souls in cages. Like, you can see they're there, but they look like they don't want to be.” He tries to elaborate, can't take it much further, but—for a 17 year old on work experience in a nursing home and wanting to be a doctor—perhaps he's done quite well already.

Where do they come from, these souls in cages? Not sure, but I see too many of them: too often and too easily we fail the souls and build the cages. In the rush and glamour of acute care, in the busy system that is designed to cure and doesn't like to lose, there are priorities that may take insufficient account of the worse-than-death outcome—the helpless, stabilised, damaged survival—that so many of us dread. And too often families are summoned for the grimly absurdist routine: “We've saved your father's life... But now he's blocking a bed.”

The sorrows can endure for months or years. The death averted is a bereavement suspended, the caged soul lingers, and people remain upset. Is it about regrets, or a strange injustice, or a wider and far more worrying dysfunction? Who knows, but it seems to happen quite a lot.

Yesterday my mother was well. This morning her neighbour rang me to say she was not: “She kent me, but she couldna talk, and she couldna get up.” I speak some Scots and know some neurology. It's very bad. Three hours later, in the emergency department of a decent district general hospital, I see her. Everyone has been kind and efficient, but she is now, in her grandson's words, a soul in a cage.

She was 90 in October and greatly enjoyed her birthday bash. Yesterday she logged yet another great grandchild into her fearsomely well organised birthday book, and had ordered but not yet collected her first walking stick. She had ticked all her boxes—two careers, bringing up her children, burying her husband—and since then has greatly enjoyed her bowling, her voluntary work, and a lively extended family. She cannot move her right side and cannot speak.

She is dying but she is lucky: no nasogastric tube or PEG (percutaneous endoscopic gastrostomy) feeding for her. A few months ago she tidied up her life, perhaps anticipating eternity, and made her wishes clear. I pass them on and a wonderful district general hospital team respects them, cares lovingly for her, and will not cage her soul.