tbuckley/cabot-search huggingface dataset:
Практические подходы к ведению больных с диспепсией
Authors: S.M. Tkach
Journal: GASTROENTEROLOGY (2016)

Статья посвящена проблемам лечения синдрома диспепсии. Поскольку в последнее время у большинства больных функциональной диспепсией отмечается сочетание симптомов эпигастрального болевого синдрома и постпрандиального дистресс-синдрома, на практике значительно чаще в качестве первой линии эмпирического лечения применяется комбинированная терапия ингибиторами протонной помпы (ИПП) и прокинетиками. В этом отношении очень удобен прием готовых комбинированных препаратов, таких как Омез Д или Омез ДСР, содержащих ИПП и безопасную дозу домперидона.
Folinic acid, 5-fluorouracil, irinotecan (FOLFIRI) plus chemoradiation (CRT) with 5-fluorouracil (5FU) as adjuvant treatment for patients with operable gastric cancer (OGC): A feasibility study with pharmacogenetic analysis.
Authors: A. Athanasiadis, I. Boukovinas, M. Sfakianaki, Z. Saridaki, C. Papadaki, M. Tzardi, N. E. Androulakis, A. Polyzos, V. Georgoulias, I. Sougklakos
Journal: Journal of Clinical Oncology (2011)

44 Background: To evaluate the efficacy and safety of FOLFIRI plus CRT with 5FU as adjuvant treatment for patients with OGC. Methods: Patients received treatment with FOLFIRI (irinotrecan 150 mg/m 2 , d1, LV 200 mg/m 2 , d1+2 and 5FU [400 mg/m 2 /d bolus and 600 mg/m 2 /d, 22 h infusion, d1+2]) for 2 15-day cycles followed by RT (45Gy) with 5FU continuous infusion (325 mg/m 2 /d in the 1 st and 5 th week) administration. Eight additional cycles of FOLFIRI were administered after the completion of CRT. BRCA1, ERCC1, XPD, TOPO-I, TOPO-IIA and B and TS mRNA expression was determined in the primary tumor where available. Results: The median age of the 171 enrolled patients was 62 years, 114 (66%) were males, 136 (79%) had R0 resections and 152 (89%) had at least a D1 resection. Treatment was completed as per protocol in 107 (63%) of the patients. CRT was completed in all but 5 (3%) patients. The median rate of drug exposure was 93% for irinotecan, 87% for 5FU and 91% for LV. The most common grade 3/4 adverse events were neutropenia (32%), febrile neutropenia (3.5%) and diarrhea (7%). After a median follow-up of 45.7 months 84 had relapsed and 70 were deceased. The median disease-free survival (DFS) was 30 months (95% CI: 18-41 months), while the projected median overall survival (mOS) was 53.7 months (95% CI: 30-77 months). The recurrence free probability at 5 years was 44% while the probability of survival at 5 years was 46%. From the studied pharmacogenetic markers only TS low expression was correlated with a trend towards improved DFS and OS in patients with R0 resections. Conclusions: These results show that the administration of FOLFIRI plus CRT with 5FU as adjuvant treatment in OGC is a feasible approach with acceptable toxicity and challenging efficacy which merits further evaluation in a randomized trial. No significant financial relationships to disclose.
Effects of continuation, frequency, and type of cannabis use on relapse in the first 2 years after onset of psychosis: an observational study
Authors: Tabea Schoeler, Natalia Petros, Marta Di Forti, Ewa Klamerus, Enrico Foglia, Olesya Ajnakina, Charlotte Gayer-Anderson, Marco Colizzi, Diego Quattrone, Irena Behlke, Sachin Shetty, Philip McGuire, Anthony S David, Robin Murray, Sagnik Bhattacharyya
Journal: The Lancet Psychiatry (2016)

BackgroundAlthough cannabis use after a first episode of psychosis has been associated with relapse, little is known about the determinants of this most preventable risk factor for relapse of psychosis. Here we aimed to study whether the effects on outcome vary depending on the type of cannabis consumed and usage pattern.MethodsIn this observational study, we prospectively recruited and followed up patients aged 18–65 years who presented with their first episode of psychosis to psychiatric services in south London, London, UK. Relapse of psychosis within 2 years after onset of psychosis was defined as risk of subsequent admission to hospital. We classified patients into different patterns of cannabis use based on continuity of use after onset of psychosis, potency of cannabis consumed, and frequency of use after the onset of their illness. We used multiple regression analyses (logistic or binominal) to compare the different cannabis use groups and propensity score analysis to validate the results.FindingsBetween April 12, 2002, and July 26, 2013, 256 patients presented with a first episode of psychosis. We did follow-up assessments for these patients until September, 2015. Simple analyses showed that former regular users of cannabis who stopped after the onset of psychosis had the most favourable illness course with regards to relapse. In multiple analysis, continued high-frequency users (ie, daily use in all 24 months) of high-potency (skunk-like) cannabis had the worst outcome, indexed as an increased risk for a subsequent relapse (odds ratio [OR] 3·28; 95% CI 1·22–9·18), more relapses (incidence rate ratio 1·77; 95% CI 0·96–3·25), fewer months until a relapse occurred (b −0·22; 95% CI −0·40 to −0·04), and more intense psychiatric care (OR 3·16; 95% CI 1·26–8·09) after the onset of psychosis.InterpretationAdverse effects associated with continued use of cannabis after the onset of a first episode of psychosis depend on the specific patterns of use. Possible interventions could focus on persuading cannabis-using patients with psychosis to reduce use or shift to less potent forms of cannabis.FundingNational Institute for Health Research (NIHR).
Association of early changes in<sup>1</sup>H MRSI parameters with survival for patients with newly diagnosed glioblastoma receiving a multimodality treatment regimen
Authors: Sarah J. Nelson, Achuta K. Kadambi, Ilwoo Park, Yan Li, Jason Crane, Marram Olson, Annette Molinaro, Ritu Roy, Nicholas Butowski, Soonmee Cha, Susan Chang
Journal: Neuro-Oncology (2016)

The heterogeneous biology of glioblastoma (GBM) emphasizes the need for imaging methods to assess tumor burden and assist in evaluating individual patients. The purpose of this study was to investigate early changes in metrics from 3D 1H magnetic resonance spectroscopic imaging (MRSI) data, compare them with anatomic lesion volumes, and determine whether they were associated with survival for patients with newly diagnosed GBM receiving a multimodality treatment regimen.Serial MRI and MRSI scans provided estimates of anatomic lesion volumes and levels of choline, creatine, N-acetylaspartate, lactate, and lipid. The association of metrics derived from these data with survival was assessed using Cox proportional hazards models with adjustments for age, Karnofsky performance score, and extent of resection. Temporal changes in parameters were evaluated using a Wilcoxon signed rank test.Anatomic lesion volumes at the post-radiotherapy (RT) scan, metabolic lesion volume at mid-RT and post-RT scans, as well as metrics describing levels of choline, lactate, and lipid were associated with overall survival. There was a significant reduction in the enhancing lesion volume, increase in T2 lesion volume from mid-RT to post-RT, and decrease in parameters describing metabolite levels during these early time points.The MRSI data provided metrics that described the effects of treatment on the metabolic lesion burden and were associated with overall survival. This suggests that adding these parameters to standard assessments of changes in anatomic lesion volumes could contribute to making early decisions about the efficacy of such combination therapies.
Self-injury Mortality in the United States in the Early 21st Century
Authors: Ian R. H. Rockett, Christa L. Lilly, Haomiao Jia, Gregory L. Larkin, Ted R. Miller, Lewis S. Nelson, Kurt B. Nolte, Sandra L. Putnam, Gordon S. Smith, Eric D. Caine
Journal: JAMA Psychiatry (2016)

Fatal self-injury in the United States associated with deliberate behaviors is seriously underestimated owing to misclassification of poisoning suicides and mischaracterization of most drug poisoning deaths as "accidents" on death certificates.
Bevacizumab after bevacizumab in platinum-sensitive recurrent ovarian cancer: A subgroup analysis of GOG0213.
Authors: Robert L. Coleman, Mark F. Brady, Thomas J Herzog, Deborah Kay Armstrong, Paul Sabbatini, Joan L. Walker, Byoung Kim, Keiichi Fujiwara, Krishnansu Sujata Tewari, David M. O'Malley
Journal: Journal of Clinical Oncology (2016)

5523 Background: In GOG 213, a phase III randomized trial designed to determine the impact of secondary cytoreduction and/or incorporation of anti-angiogenesis therapy on overall survival (OS) in recurrent platinum-sensitive EOC, we recently reported that the integration of bevacizumab (B, 15 mg/kg) with paclitaxel (P, 175 mg/m2 BSA) and carboplatin (C, AUC 5) was associated with a hazard of death of 0.829;(95% CI 0.83-1.006); p = 0.056. We sought to characterize the clinical efficacy and safety of B re-treatment in this population. Methods: This is a subset analysis of patients who had previously received B as part of primary and/or maintenance therapy for newly diagnosed EOC prior to recurrence and subsequent enrollment onto GOG213. Measurable/evaluable, platinum sensitive disease (platinum-free interval > 6 months) was among the eligibility criteria stipulated in the original protocol, with treatment-free interval listed among the pre-specified stratification variables. Impact of prior B treatment on OS was a pre-specified supplemental analysis. Results: Of the 674 women enrolled and randomized, 69 (10.3%, n = 34, PC, n = 35 PCB) had previously received B. In this subpopulation, the median OS of adding B to chemotherapy did not differ from that of chemotherapy alone (PCB: 36.8 mos vs PC: 32.0 mos, HR: 0.76, 95% CI: 0.44-1.34). Median OS in B-naïve patients randomized to PCB was 42.1 mos. The median PFS for PCB and PC were similar (median PFS 10.7 mos vs 9.8 mos, HR: 0.84, 95%CI: 0.52-1.37, respectively). 56 patients (n = 28 each arm) had assessable measurable disease. Response was significantly higher in the PCB cohort (82% vs 54%, P = 0.044); the rate of complete response was 3 fold higher (32% vs 11%). B increased the rate of grade 3-4 hypertension from 0% to 6%. All grade proteinuria, non-CNS bleeding and neutropenia were higher in the PCB arm, however, the rate of GI perforation/abscess was not significantly increased (0% in both arms). Conclusions: Re-treatment with B was not associated with a negative rebound effect in GOG0213. Re-introduction of B was associated with a higher objective response rate and did not significantly impact toxicity. Results were consistent with those in the overall trial. Clinical trial information: NCT00565851.
Case 37-1974
Authors: Richard C. Cabot, Robert E. Scully, Betty U. McNeely, Edwin P. Maynard, Gerald Nash
Journal: New England Journal of Medicine (1974)

Presentation of CaseA 53-year-old woman was admitted to the hospital because of fever.She was well until six months previously, when she had a respiratory-tract infection that gradually cleared but left her feeling vaguely unwell. Two months before admission pain developed in the left side of the neck and left shoulder, with radiation to the left arm. Injections into the shoulder joint and a cervical collar gave no relief.One month before entry she came to the Orthopedic Service of this hospital, where examination disclosed that she was afebrile. There was tenderness over the cervical spine, with pain on . . .
Polarization of Tissue-Resident TFH-Like Cells in Human Hepatoma Bridges Innate Monocyte Inflammation and M2b Macrophage Polarization
Authors: Min-Min Chen, Xiao Xiao, Xiang-Ming Lao, Yuan Wei, Rui-Xian Liu, Qiu-Hui Zeng, Jun-Cheng Wang, Fang-Zhu Ouyang, Dong-Ping Chen, Ka-Wo Chan, Dai-Chao Shi, Limin Zheng, Dong-Ming Kuang
Journal: Cancer Discovery (2016)

The existence, regulation, and functions of IL21+ immune cells are poorly defined in human cancers. Here, we identified a subset of protumorigenic IL21+ TFH-like cells in human hepatocellular carcinoma. These cells were the major source of IL21 in tumors and represented about 10% of the CD4+ T-cell population at levels comparable with the TFH cells present in lymph nodes. However, these TFH-like cells displayed a unique CXCR5-PD-1lo/-BTLA-CD69hi tissue-resident phenotype with substantial IFNγ production, which differed from the phenotype of TFH cells. Toll-like receptor 4 (TLR4)-elicited innate monocyte inflammation was important for IL21+ TFH-like cell induction in tumors, and activation of STAT1 and STAT3 was critical for TFH-like cell polarization in this process. Importantly, the TFH-like cells operated in IL21-IFNγ-dependent pathways to induce plasma cell differentiation and thereby create conditions for protumorigenic M2b macrophage polarization and cancer progression. Thus, induction of TFH-like cells links innate inflammation to immune privilege in tumors.We identified a novel protumorigenic IL21+ TFH-like cell subset with a CXCR5-PD-1- BTLA-CD69hi tissue-resident phenotype in hepatoma. TLR4-mediated monocyte inflammation and subsequent T-cell STAT1 and STAT3 activation are critical for TFH-like cell induction. TFH-like cells operate via IL21-IFNγ pathways to induce plasma cells and create conditions for M2b macrophage polarization. Cancer Discov; 6(10); 1182-95. ©2016 AACR.This article is highlighted in the In This Issue feature, p. 1069.
Placebo controls in clinical trials: concerns about use in relapse prevention studies in schizophrenia
Authors: Robin Emsley, W Wolfgang Fleischhacker, Silvana Galderisi, Lisa J Halpern, Joseph P McEvoy, Nina R Schooler
Journal: BMJ (2016)

Robin Emsley and colleagues  question the use of placebos when established treatment is effective and lack of harm has not been proved
Phenotypic programming as a distal cause of resilience
Authors: Esther Nederhof
Journal: Behavioral and Brain Sciences (2015)

Abstract During early childhood, individuals with high sensitivity to early programming adjust their phenotype in a way that is expected to be adaptive in their later environment. These adaptations are hypothesized to result in resilience in environments that match the early environment. As appraisal style is a putative target of adaptive programming, early experiences could be a distal cause of resilience.
Promoter Methylation of Multiple Genes in Diffuse Large Cell Lymphoma (DLCL), Follicular Lymphoma (FL) and Bening Follicular Hyperplasia (BFH).
Authors: Jose M. Paz-Carreira, Raquel Losada, Arantxa Garcia-Rivero, Augusto Alvarez, Fernando Bal, Guillermo Deben, Jesus Alba-Losada
Journal: Blood (2007)
Impact of Provider Incentives on Quality and Value of Health Care
Authors: Tim Doran, Kristin A. Maurer, Andrew M. Ryan
Journal: Annual Review of Public Health (2015)

The use of financial incentives to improve quality in health care has become widespread. Yet evidence on the effectiveness of incentives suggests that they have generally had limited impact on the value of care and have not led to better patient outcomes. Lessons from social psychology and behavioral economics indicate that incentive programs in health care have not been effectively designed to achieve their intended impact. In the United States, Medicare's Hospital Readmission Reduction Program and Hospital Value-Based Purchasing Program, created under the Affordable Care Act (ACA), provide evidence on how variations in the design of incentive programs correspond with differences in effect. As financial incentives continue to be used as a tool to increase the value and quality of health care, improving the design of programs will be crucial to ensure their success.
Intramuscular versus ultrasound-guided intratenosynovial glucocorticoid injection for tenosynovitis in patients with rheumatoid arthritis: a randomised, double-blind, controlled study
Authors: Mads Ammitzbøll-Danielsen, Mikkel Østergaard, Viktoria Fana, Daniel Glinatsi, Uffe Møller Døhn, Lykke Midtbøll Ørnbjerg, Esperanza Naredo, Lene Terslev
Journal: Annals of the Rheumatic Diseases (2016)

The aim of this study was to compare the efficacy of intramuscular versus ultrasound (US)-guided intratenosynovial glucocorticoid injection in providing disease control after 2, 4 and 12 weeks in patients with rheumatoid arthritis(RA) with tenosynovitis.Fifty patients with RA and tenosynovitis were randomised into two double-blind groups: (A) 'intramuscular group', receiving intramuscular injection of betamethasone and US-guided intratenosynovial isotonic saline injection and (B) 'intratenosynovial group' receiving saline intramuscularly and US-guided intratenosynovial betamethasone injection. All patients were in stable disease-modifying anti-rheumatic drug treatment prior to and during the study. Patients were excluded, and considered non-responders, if any treatments were altered during the follow-up period. 'US tenosynovitis remission', defined as US tenosynovitis grey-scale score ≤1 and colour Doppler score=0, was assessed at week 4 (primary outcome), and weeks 2 and 12, using non-responder imputation for missing data.US tenosynovitis remission at week 4 was achieved in 25% (6/24) in the 'intramuscular group' versus 64% (16/25) in the 'intratenosynovial group', that is, a difference of -39 percentage point (pp) (CI -65pp to -13pp), Fisher exact test p=0.001. Corresponding values for the 'intramuscular group' versus the 'intratenosynovial group' at 2 and 12 weeks were 21% (5/24) versus 48% (13/25), that is, a difference of -27pp (CI -53pp to -2pp), p=0.072 and 8% (2/24) versus 44% (11/25), that is, difference of -36pp (-58pp to -13pp), p=0.003. Most US, clinical and patient-reported scores improved more in the 'intratenosynovial group' at all follow-up visits.In this randomised double-blind clinical trial, patients with RA and tenosynovitis responded significantly better to US-guided intratenosynovial glucocorticoid injection than to intramuscular glucocorticoid injection, both at 4 and 12 weeks follow-up.EudraCT nr: 2013-003486-34.
Cerebral Oxygenation and Transfusion for Severe Anemia
Authors: John J. Strouse
Journal: JAMA Pediatrics (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 Pediatrics 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 Pediatrics journal
A Risk-Prediction Model For Identifying Venous Thromboembolism In Hospitalized Pediatric Patients: A Single Institution Retrospective Case-Control Analysis
Authors: Ruchika Goel, Jessy Dhillon, Craig Malli, Kishen Sahota, Prabhjot Seehra, Michael B. Streiff, John J. Strouse, Neil A Goldenberg, Clifford M. Takemoto
Journal: Blood (2013)
Occupational and Environmental Medicine
Authors: S Deitchman
Journal: JAMA (1994)

Specialists in occupational and environmental medicine focus on recognizing, treating, and, most important, preventing illness and injury caused by workplace and environmental hazards. Only 1501 practicing specialists are board certified in occupational medicine (Ron Cornick, MALS, oral communication, December 7, 1993). However, annually there are an estimated 6 345 700 cases of work-related illness and injury among the 90 million Americans who work in private industry, and there are no comprehensive estimates of the prevalence of environmental illness.<sup>1</sup>Patients may therefore present to physicians of any specialty. Yet, too few physicians are adequately trained to recognize these illnesses. Brancati et al<sup>2</sup>studied 94 patients admitted to the general medical wards of a university-affiliated veterans' hospital. They found that 62% of the patients had at least one probable occupational disease; of that subgroup, 68% had a history of an occupational exposure that was relevant to their disease. In contrast,
Effects of the Dietary Approaches to Stop Hypertension (DASH) Diet and Sodium Intake on Serum Uric Acid
Authors: Stephen P. Juraschek, Allan C. Gelber, Hyon K. Choi, Lawrence J. Appel, Edgar R. Miller
Journal: Arthritis & Rheumatology (2016)

Randomized trial data guiding dietary recommendations to lower serum uric acid (UA), the etiologic precursor of gout, are scarce. We undertook this study to examine the effects of the Dietary Approaches to Stop Hypertension (DASH) diet (a well-established diet that lowers blood pressure) and levels of sodium intake on serum UA.We conducted an ancillary study of a randomized, crossover feeding trial in 103 adults with prehypertension or stage I hypertension. Participants were randomly assigned to receive either the DASH diet or a control diet (typical of the average American diet) and were further fed low, medium, and high levels of sodium for 30 days, each in random order. Body weight was kept constant. Serum UA levels were measured at baseline and following each feeding period.Trial participants were 55% women and 75% black with a mean ± SD age of 51.5 ± 9.7 years and a mean ± SD serum UA level of 5.0 ± 1.3 mg/dl. The DASH diet reduced serum UA (-0.35 mg/dl [95% confidence interval (95% CI) -0.65, -0.05], P = 0.02), with a higher effect (-1.29 mg/dl [95% CI -2.50, -0.08]) among participants (n = 8) with a baseline serum UA level of ≥7 mg/dl. Increasing sodium intake from the low level decreased serum UA during the medium sodium intake period (-0.3 mg/dl [95% CI -0.5, -0.2], P < 0.001) and during the high sodium intake period (-0.4 mg/dl [95% CI -0.6, -0.3], P < 0.001).The DASH diet lowered serum UA, and this effect was greater among participants with hyperuricemia. Moreover, we found that higher sodium intake decreased serum UA, which enhances our knowledge of urate pathophysiology and risk factors for hyperuricemia.