tbuckley/cabot-search huggingface dataset:
Normal Growth with Subnormal Growth-Hormone Levels
Authors: Lewis B. Holmes, Andrew G. Frantz, Mitchell T. Rabkin, J. Stuart Soeldner, John D. Crawford
Journal: New England Journal of Medicine (1968)

Nine patients had normal or superior rates of statural growth after the removal of tumors impinging upon the pituitary gland and hypothalamus (craniopharyngioma in eight and third-ventricle cyst in one). After operation hyperphagia and obesity, as well as deficiencies of vasopressin, thyroxine and cortisol, were observed. Four patients over 15 years of age remained sexually immature, with no measurable gonadotropin excretion. Immunoassay of plasma showed barely detectable growth hormone during fasting and after Stimulation by hypoglycemia in nine of the patients and after exercise in six. The patients were free of hypoglycemic symptoms, and fasting blood sugar levels were normal; the serum immunoreactive insulin levels were in the low-normal range, except in the presence of obesity. The endocrine data indicate that in these unusual patients, normal or accelerated growth can occur when growth-hormone secretion is so low as to be only barely detectable by presently available technics.
Abstract 2780: Mammographic density and breast cancer tumor characteristics in the Multiethnic Cohort Study
Authors: Shannon M. Conroy, Ian Pagano, Laurence N. Kolonel, Gertraud Maskarinec
Journal: Cancer Research (2010)

Abstract Mammographic density (MD), a strong risk factor for breast cancer, may reflect proliferation of breast epithelial and stromal cells in response to cumulative exposure to endogenous and exogenous hormones. Whether MD predicts subtypes of breast cancer defined by expression of the estrogen (ER+) and/or progesterone (PR+) receptor is unclear. Because factors associated with higher MD are associated with ER+PR+ breast cancers, we hypothesized that women with higher percent MD (dense breast tissue area to total breast area) would have a higher risk for ER+PR+ and a lower risk for ER-PR- breast cancers as compared to women with lower percent MD. In a nested case-control study, we compared the MD of 667 controls and 607 breast cancer cases among women of Caucasian, Japanese and Native Hawaiian ancestry in the Hawaii component of the Multiethnic Cohort Study. A reader blinded to disease status performed computer assisted density assessment on prediagnostic mammograms. Receptor status for breast cancers was obtained from the statewide Hawaii Tumor Registry. Tumors were classified into ER+PR+ (n=341), ER-PR- (n=50), ER+PR-/ER-PR+ (n=64) and unstaged/unknown (n=152). Mean density values were computed for women with more than one mammogram and modeled using polytomous logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) while adjusting for confounders. Mean percent MD was significantly greater for ER+PR+, but not for ER-PR- breast cancers compared to controls after adjusting for age: 37.3%, 28.9%, versus 29.4%, respectively. The overall ORs for a 10% increase in percent MD were similar for all breast cancer cases and for ER+PR+ and ER+PR-/ER-PR+ cancer subtypes: 1.22 (95% CI, 1.14-1.30), 1.25 (95% CI, 1.16-1.35) and 1.23 (95% CI, 1.07-1.42), respectively. Percent MD was not found to be a predictor for ER-PR- subtypes (OR for a 10% increase = 1.00, 95% CI, 0.84, 1.18). Our findings indicate that within a multiethnic population, women with higher MD have an increased risk for ER+PR+, but not ER-PR- breast cancer. Breast cancer subtypes are suspected to have diverse etiologies that respond to different treatments. Our findings support specific models of hormone-related triggers for the increased breast cancer risk associated with MD. Research supported by NCI grants: R37CA54281, R01CA85265 and R25CA90956. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2780.
AB0774 Comparative clinical characteristics of cyclosporine-related and cyclosporine-unrelated acute neurological events in behcet’s disease
Authors: S. Hirohata, H. Kikuchi, T. Sawada, H. Nagafuchi, M. Kuwana, M. Takeno, Y. Ishigatsubo
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Central nervous system (CNS) involvement in Behcet's disease (BD) is one of its most serious complications (neuro-Behcet's disease [NBD]). It is unclear and still under debate whether cyclosporine-induced neurological manifestations might be different from acute neurological events of NBD. <h3>Objectives</h3> The current studies therefore compared the clinical characteristics of cyclosporine-related acute neurological events with cyclosporine-unrelated acute manifestations of NBD. <h3>Methods</h3> A multicenter retrospective survey was performed on BD patients who fulfilled the diagnostic criteria of the international study group and presented neurological manifestations between 1987 and 2008. The diagnosis of NBD, including cyclosporine-related and cyclosporine-unrelated acute neurological events, was confirmed by retrospective review of the clinical records. Kaplan-Meier analysis was performed to compare the relapse ratio. <h3>Results</h3> A total of 144 BD patients were studied, including 76 with NBD, who showed acute neurological events. Twenty-six of the 76 patients had been taking cyclosporin at the onset of the acute neurological events. All the 26 patients with cyclosporin and 43 of the 50 patients without cyclosporin had eye involvement. There were no significant differences in demographic features, clinical symptoms, MRI findings, laboratory findings (serum CRP, cerebrospinal fluid cell counts and IL-6) between patients with cyclosporin and those without cyclosporin. On analysis of 66 acute neurological events (21 cyclosporin-related, 45 cyclosporin-unrelated), there were no significant differences in the need for steroid therapy including pulse therapy and in the responses to the treatment. Of note, patients with cyclosporin -unrelated events showed significantly higher relapse-ratio than those with cyclosporine-related events (HR 8.452, 95% CI: 1.330-10.89, p=0.0127). <h3>Conclusions</h3> These results therefore indicate that cyclosporin-related acute neurological manifestations are almost identical with cyclosporin-unrelated acute events of NBD, except for the paucity of relapse on withdrawal of cyclosporin. The data also suggest that cyclosporin should be regarded as one of the risk factors for NBD. <h3>Disclosure of Interest</h3> None Declared
Transient Improvement of Spinocerebellar Ataxia with Zolpidem
Authors: Ralf Clauss, Mike Sathekge, Wally Nel
Journal: New England Journal of Medicine (2004)

To the Editor: There is currently no effective pharmacologic treatment for spinocerebellar ataxia. We describe a family of five patients, four of whom had clinical improvement within one hour after the ingestion of zolpidem (10 mg). The diagnosis of spinocerebellar ataxia type 2 was confirmed by molecular analysis. Analysis of DNA for CAG repeat expansions in the SCA1, 2, 3, 6, and 7 genes revealed expansion of CAG repeats at the SCA2 locus. Patient 1, a 49-year-old man with titubation, dizziness, and loss of balance from the age of 34 years, had deteriorating speech and handwriting. Cerebellar signs included moderate . . .
Abstract P353: Survival after Acute Coronary Syndrome in the Community
Authors: Sheila M McNallan, Yariv Gerber, Susan A Weston, Jill Killian, Shannon M Dunlay, Alanna M Chamberlain, Malcolm R Bell, Allan S Jaffe, Jan Kors, Veronique L Roger
Journal: Circulation (2013)

Background: Contemporary data on survival after incident acute coronary syndrome (ACS), including both myocardial infarction (MI) and unstable angina (UA), are limited. Objective: To describe survival after incident ACS, to determine if it differs by ACS type (MI or UA) and to determine whether it has improved over time. Methods: Olmsted County, MN residents hospitalized between 1/1/2005-12/31/2010 were screened for incident ACS. ACS was defined as either MI validated by standard epidemiological criteria or UA validated by the Braunwald classification. Patients were followed for death from any cause. Cox proportional hazards regression was used to determine whether survival differed by ACS type, while adjusting for year of diagnosis, age, sex and comorbidities. Results: Among 1,160 incident ACS cases (mean±SD age 66.9±14.8, 60% male), 35% were UA and 65% were MI. After a mean (SD) follow up of 3.7 (2.1) years, 274 deaths occurred. The 3-year Kaplan-Meier survival estimate for MI was 79.6% (95% CI: 76.7%-82.6%) and for UA was 84.9% (95% CI: 81.3%-88.6%) (log-rank p=0.011). The association of ACS type with survival differed by age (p=0.056). After adjustment for year of diagnosis, sex and comorbidities, no difference in survival was observed between ACS types among those aged &lt;60 (HR for MI vs. UA: 0.64, 95% 0.29-1.42). By contrast, among patients aged 60-79, those with an MI had 2 times the risk of death compared to those with UA (HR: 2.04, 95% CI: 1.24-3.37). Patients aged 80 or older who had an MI had a 40% increased risk of death compared to patients of the same age who had UA (HR: 1.42, 95% CI: 1.02-1.98). There was no difference in survival over time (HR for 2010 vs. 2005: 0.91, 95% CI: 0.61-1.36). Conclusions: Survival did not differ between UA and MI patients younger than 60, however among patients 60 or older, survival was worse among those with an MI. Survival after ACS did not change over the study period.
A3.11 Selective deletion of cells expressing fibroblast activation protein attenuates synovial inflammation
Authors: AP Croft, J Campos, M MacKenzie, A Filer, DT Fearon, F Barone, CD Buckley
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background and objectives</h3> Fibroblasts are key effector cells of synovial inflammation and joint damage. Fibroblast activation protein (FAP) is a cell surface serine protease, expressed at a low level by synovial fibroblasts but which is significantly up-regulated during inflammation. Furthermore the levels of FAP expression in the human synovium correlate with disease persistence in patients with early synovitis and in mice FAP has been shown to protect against inflammation induced cartilage damage1. However, it remains unclear whether it is FAP itself, or specific cellular populations expressing FAP that play a major role in these processes. <h3>Materials and methods</h3> To determine the role of FAP+ fibroblasts in arthritis, we utilised a transgenic mouse in which FAP expressing cells were ablated (FAP-DTR2) by administration of diphtheria toxin in either in a prophylactic or therapeutic regime. Inflammatory polyarthritis was induced by the passive transfer of K/BxN serum into naïve mice. Mice were scored for clinical signs of arthritis and flow cytometry of digested synovial tissue was performed to determine the expression of fibroblast subsets. <h3>Results</h3> FAP was dynamically expressed by fibroblasts, with up-regulated expression observed during inflammation. In wild type mice, FAP was predominately expressed by lining layer synovial fibroblasts compared to sub-lining fibroblasts, and a subpopulation of FAP expressing cells also expressed Podoplanin. Prophylactic deletion of FAP+ cells before the transfer of serum resulted in delayed onset of inflammatory arthritis but with similar severity to control mice. In contrast, therapeutic deletion of FAP+ cells significantly attenuated both the clinical signs and severity of synovial inflammation. <h3>Conclusion</h3> These data suggest a pathogenic role for FAP expressing fibroblasts in synovial inflammation. <h3>References</h3> Wäldele S. Arthritis Res Ther. 2015;<b>20:</b>17–12 Kraman M. Science. 2010;330(6005):827–830
Abstract P2-19-05: Inhibitor Screening Utilizing Human Kinase Multiplex Arrays
Authors: N Sahli, D Finkel, M Lindberg, C Buehl, S Stoesz, R Campos-Gonzalez, K. Brumbaugh
Journal: Cancer Research (2010)

Abstract Protein kinase pathways show dysregulation in cancer, usually displaying increased activation. Kinases are typically influenced by extracellular signals, and many kinases are now considered to be therapeutic targets. Upon phosphorylation, kinases regulate signaling pathways that effect cellular processes. Individual cell lines, including cancer cells, express different kinase activation patterns. Previously, we have shown the phospho-tyrosine kinase profile of MDA-MB-453 cells, most notably the Erb family of Receptor Tyrosine Kinases, to be hyperactivated in this breast cancer cell line. Using a new kinase multiplex plate-based array, we have seen similar activation of multiple intracellular kinases, such as Akt and Erk. As a result, the MDA-MB-453 cells were selected for treatment with a kinase inhibitor library (Enzo, Catalog # BML-2832-0100). While several of the inhibitors block kinase activation, other inhibitors block proteins that are upstream from their kinase target. After incubation with the inhibitor library, a multiplex kinase array was utilized to screen the effects of the inhibitors on the MDA-MB-453 cells. In contrast with MCF-7 cells, MDA-MB-453 breast cancer cells showed a basal hyperactivation of the Akt and GSK-3β kinases. The activation of Akt could be selectively inhibited by SB-203580, SB-202190, ML-7, and BML-265 inhibitors. The results obtained in the multiplex assay were verified by singleplex ELISA for Akt. Hence, the data collected with the multiplex assay provide a rapid analysis of the inhibitors’ effects on defined signaling pathways. This allows for a faster identification of kinase inhibitors that may affect cancer cells. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-19-05.
Diurnal Rhythm of Urinary Electrolyte Excretion. I. Observations in Normal Subjects
Authors: J B DOSSETOR, H M GORMAN, J C BECK
Journal: JAMA (1963)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Variant Angina Pectoris
Authors: Richard B. Whiting, Michael D. Klein, Joseph Vander Veer, Bernard Lown
Journal: New England Journal of Medicine (1970)

Variant angina pectoris occurred with normal coronary angiograms in a 52-year-old woman. She had the anginal type of discomfort spontaneously at rest or during sleep, but not with exertion; neither was the pain initially provoked by exercise testing. Marked ST-segment elevations accompanied the pain. Ventricular premature beats, ventricular tachycardia and one episode of ventricular fibrillation were recorded. Syncope due to complete heart block associated with the pain required insertion of a transvenous demand pacemaker. No abnormalities of hemoglobin-oxygen dissociation were found. The basis for the variant angina in this patient remains unexplained.
After the False Start — What Can We Expect from the New Health Insurance Marketplaces?
Authors: Jon Kingsdale
Journal: New England Journal of Medicine (2014)

Interview with Dr. Jon Kingsdale on the rollout of the ACA's health insurance marketplaces and expectations for their benefits. (16:21)Download Despite their troubled rollout, the health insurance exchanges should eventually promote enrollment and rational consumer choice, reduce the cost of distributing insurance, enhance competition, and improve cost and quality by helping to transform care delivery.
FRI0385 Long term follow-up after systemic sclerosis patients treated with intravenous cyclophosphamide pulse therapy for interstitial lung disease: a single eustar center (042) experience.
Authors: A. Balbir-Gurman, L. Guralnik, M. Yigla, E. Hardak, A. Solomonov, A. P. Rozin, K. Toledano, A. Dagan, R. Bishara, M. A. Nahir, D. Markovits, Y. Braun-Moscovici
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Two RCT and several open-labeled studies demonstrated various efficacy of cyclophosphamide (CYC) for treatment of Systemic sclerosis-associated interstitial lung disease (SSc-ILD) with follow up for 1-4 years. <h3>Objectives</h3> To analyze the changes in pulmonary function tests, pulmonary artery pressure (PAP) estimated by Doppler echocardiography, and skin involvement measured by modified Rodnan' skin score (mRSS) at 4-years, and 7-years follow-up after completion of at list 6 monthly treatments intravenous (IV) CYC of SSc-ILD. <h3>Methods</h3> The data on pts with active SSc-ILD (ground glass opacities and/or pulmonary fibrosis (PF) on chest HRCT and reduction in FVC and/or DLCO for more than 10% during 2 consecutive visits) who started IV CYC before year 2007 were analyzed. Student T-test, Mann-Whitney U-test and Wilcoxon Signed Ranks tests were used for statistical analysis with significance measured by p&lt;0.05. <h3>Results</h3> A total of 225 SSc pts were registered in the EUSTAR database at our site, 41pts were had an active ILD, data on 28 pts started CYC before year 2007 (17/28- before year 2004) were eligible. Age, disease duration, and follow-up period were (mean +/- SD) 50.7 +/- 12.7 years (yrs), 16.3 +/- 17.9 months, 6.5 +/- 6 yrs respectively. Eight pts died (6 pts due to SSc). Mean cumulative CYC dose was 8.96 +/- 3.8 G; in 12 pts the treatment was followed by another non-biological DMARD. Three pts developed adverse events: 2-pneumonia, 1-hepatitis B reactivation and ankle Kaposi sarcoma, 1-premature menopause. Main changes in FVC, DLCO, PAP and mRSS were observed in first 4 yrs after CYC treatment with mild additional reduction in the next three yrs. Annual changes rate in FVC, DLCO, mRSS, and PAP are presented in Table 1. Among presenting features only elevated CK correlated with FVC, DLCO and PAP (p=0.04, p=0.026 and p=0.028 respectively). Reduction in mRSS was significant (p=0.023) at any cumulative CYC dose, but not changes in FVC, DLCO and PAP. <h3>Conclusions</h3> Course of CYC IV infusions did not prevent FVC and DLCO reduction as well as PASP elevation in the next 4 yrs of follow-up. CYC rapidly and significantly improved mRSS. Cumulative doses of CYC above 6G had not additional influence on FVC and DLCO. In SSc-ILD follow-up longer than 4 years indicates a need for maintenance therapy after stabilization of pulmonary function tests with CYC. <b>Disclosure of Interest</b>: None Declared
PWE-148 Bouveret's syndrome: leaving no stone unturned: Abstract PWE-148 Figure 1
Authors: S Fong, E Oderuth, F Langlands, A Riding, J Rademaker
Journal: Gut (2012)

<h3>Introduction</h3> Bouveret9s syndrome is a clinically distinct form of gallstone ileus caused by the formation of a fistula between the biliary tract and duodenum. Early recognition and treatment can significantly improve morbidity and mortality. We present two cases that have been successfully treated at our hospital. <h3>Methods</h3> Patient A is 71-year-old lady who was referred for gastroscopy after a CT abdomen that was performed to investigate her weight loss showed deformity of the duodenal cap. The gastroscopy showed a large gallstone obstructing the pyloric opening (Abstract PWE-148 figure 1A). Endoscopic removal was unsuccessful. She then developed vomiting and abdominal pain. Blood tests showed raised inflammatory markers and liver function tests. Repeat gastroscopy showed that the gallstone had passed down the pylorus, revealing a fistula opening in the duodenum (Abstract PWE-148 figure 1B). Diagnosis was confirmed on repeat CT abdomen which showed pneumobilia and two large gallstones that had migrated to the ileum (Abstract PWE-148 figure 1C). Patient B is 87-year-old lady who presented with a 1-week history of vomiting and haematemesis. Her blood tests on admission showed raised inflammatory markers with normal liver function tests. Gastroscopy showed oesophagitis, a duodenal ulcer and obstructing gallstone. Gastrograffin studies then showed that the gallstone had migrated to the proximal jejunum (Abstract PWE-148 figure 1D) and this was confirmed on CT abdomen. <h3>Results</h3> Patient A was treated with a Ryle9s tube insertion for stomach decompression, intravenous fluids, antibiotics and peripheral parenteral nutrition. She underwent a laparotomy, which showed distended fluid filled small bowel, with a large 5×3 cm gallstone lodged in the ileum. An ileal enterotomy was performed and the gall stone excised. Patient B was treated with a Ryle9s tube insertion, intravenous fluids and peripheral parenteral nutrition. She underwent a laparotomy, in which a gallstone was found lodged in the proximal jejunum and surgically removed. Both patients made a full recovery and were discharged home. <h3>Conclusion</h3> Bouveret9s syndrome is rare and accounts for 1–3% of gallstone ileus. We have now encountered two cases in our hospital recently. This may reflect the rise in our ageing population, as a major risk factor for developing this syndrome is age &gt;70 years. Establishing the diagnosis early requires an awareness of this syndrome and prompt recognition of the signs. Contrast enhanced CT is the investigation of choice. In addition to this, a combined care approach between the gastroenterologists, surgeons and nutrition team is crucial to a successful outcome, hence our wish to present these cases. <h3>Competing interests</h3> None declared. <h3>Reference</h3> 1. <b>Cappell MS</b>, Davis M. Characterization of Bouveret9s syndrome: a comprehensive review of 128 cases. <i>Am J Gastroenterology</i> 2006;<b>101</b>:2139–46.
Differentiation of Aortic-Valve Stenosis from Subaortic Muscular Stenosis by Means of Arterial-Sound Recordings
Authors: Simon Rodbard, Albert J. Libanoff
Journal: New England Journal of Medicine (1965)

THE clinical methods of history and physical examination and laboratory findings such as x-ray study and electrocardiography often prove inadequate for the differentiation of stenosis of the aortic valve from subaortic muscular stenosis. For example, in both conditions the blood pressures may be within normal limits, the murmurs similar, and the heart shadows small. Before the diagnosis is sufficiently secure to warrant surgical intervention, further evidence such as that obtained by cardiac catheterization and angiocardiography is commonly required. Although these are usually benign procedures, they demand special training and equipment, and carry a minimal but definite risk.Intra-arterial recordings have . . .