tbuckley/cabot-search huggingface dataset:
A Prospective Study of Sudden Death in “High-Risk” Bundle-Branch Block
Authors: John H. McAnulty, Shahbudin H. Rahimtoola, Edward S. Murphy, Susan Kauffman, Leonard W. Ritzmann, Paula Kanarek, Henry DeMots
Journal: New England Journal of Medicine (1978)

We prospectively followed 257 patients with bifascicular and trifascicular conduction-system disease and intact atrioventricular conduction who had undergone His-bundle studies. Forty-seven per cent had associated coronary-artery disease, and 23 per cent primary conduction-system disease. His-ventricular interval was moderately prolonged in 43 per cent and markedly prolonged in 12 per cent. During an average follow-up period of 25 months 50 patients died. However, death was sudden in only 27, and 17 of the sudden deaths were not due to bradyarrhythias. Actuarial analysis showed an overall mortality rate (mean +/- S.E.) of 19 +/- 2.6 per cent at two years, mortality from sudden death being 10 +/- 2.6 per cent. Permanent heart block occurred in 12. No clinical symptoms (including syncope), electrocardiographic findings, electrophysiologic data or their combination identified patients at high risk of sudden death. Sudden death due to bradyarrhythmia is uncommon in patients with bundle-branch block and intact atrioventricular conduction. Therefore, routine prophylactic use of permanent pacemakers in all such patients is inappropriate. Pacemaker implantation should be reserved for those with documented symptomatic bradyarrhythmias.
Use of microRNAs expression profiles to classify the responsiveness of human osteosarcoma to doxorubicin, cisplatin, and ifosfamide
Authors: Y. Xi, S. Bruheim, K. Kudo, O. Fodstad, J. Ju
Journal: Journal of Clinical Oncology (2008)

10515 Background: Despite the increased survival rates of osteosarcoma patients attributed to adjuvant chemotherapy, at least one third of the patients still succumb to their disease. Furthermore, ultra-aggressive combination chemotherapy is associated with considerable acute and long term toxicity. Further improvements in the management of osteosarcoma seemingly depend on diagnostic and prognostic tools that may allow for a more risk adapted and individualized treatment. Non-coding microRNAs hold great promise as new prognostic biomarkers. In this study, we systematically investigated the miRNA expression in response to doxorubicin, cisplatin or ifosfamide using osteosarcoma tumor xenografts that are either sensitive or resistant to these compounds. Methods: High throughput Luminex FlexmiR MiRNA Human Panel was utilized to quantify miRNAs expression profiles from a panel of human osteosarcoma xenografts. The clustering analysis was performed using GeneSpring software to group xenografts based on their sensitivity to each of the three drug treatments with 2-fold cut off. Results: There are 22 miRNAs associated with doxorubicin sensitivity and 36 and 29 miRNAs to cisplatin and ifosfamide, respectively. Venn diagram analysis showed 3 overlapping miRNAs (miR-140, miR-217, and miR-431) among the three different drugs. There are 9 overlapping miRNAs between doxorubicin and cisplatin or cisplatin and ifosfamide. Doxorubicin and ifosfamide shared the other unique 5 miRNAs. It is interesting to note that miR-140 was highly overexpressed by an average of nearly 5.0 fold in the sensitive group vs. the resistance group to all three drugs. miR-140 is reported to be uniquely associated with bone development by targeting histone deacetylase 4, one of the critical targets for anti-cancer therapy due to its critical role in cell proliferation, differentiation and apoptosis. Conclusions: We have identified miRNAs as potential candidates to be classifiers of chemosensitivity to osteosarcoma treatment. Some of these miRNAs will be important to contribute our understanding of post-transcriptional control in drug resistance mechanism. No significant financial relationships to disclose.
Cetuximab Infusion Reactions in Japanese Head and Neck Cancer Patients
Authors: Shinya Suzuki, Nobuo Mochizuki, Yosuke Maki, Ai Irisawa, Masato Komuro, Hisanaga Nomura, Tomohiro Enokida, Tomoko Yamazaki, Makoto Tahara, Shinichiro Saito
Journal: Annals of Oncology (2014)
How Do House Officers Spend Their Nights?
Authors: Nicole Lurie, Brian Rank, Connie Parenti, Tony Woolley, William Snoke
Journal: New England Journal of Medicine (1989)

Abstract Recommendations to limit the working hours of house staff are forcing directors of training programs to reevaluate how house officers spend their time. We studied how 35 house officers in internal medicine spent their on-call time in three teaching hospitals: an urban county hospital, a university hospital, and a regional Veterans Administration medical center. Trained observers accompanied each member of different on-call teams for five nights and quantified how their time was spent. Teams consisting of residents and interns admitted three new patients per night at the Veterans Administration hospital, six at the university hospital, and eight at the county hospital. Each house officer received 16 to 25 calls per night. Up to 12 percent of their time was spent doing procedures (such as inserting intravenous catheters or drawing blood specimens) most of which could have been done by nonphysicians. From 87 to 175 minutes of on-call time was spent in direct patient evaluation, and the mean time spent on each new-patient evaluation ranged from 17 to 31 minutes. The mean time before the evaluation was interrupted ranged from 7 to 11 minutes. In contrast, 66 to 197 minutes per night was spent documenting new-patient evaluations in the hospital record. The average sleep time ranged from 122 to 273 minutes; however, the mean time before sleep was interrupted ranged from 40 to 86 minutes. We conclude that while on call, house officers spend relatively little time in direct patient contact, but they spend considerable time charting. They are frequently interrupted while working and trying to sleep. These data may be useful in finding administrative ways to improve patient care and the experience of the house staff while on call and in evaluating the effect of reforms. (N Engl J Med 1989;320:1673–7.)
Avoiding Magnetic Interference
Authors: Rebecca Voelker
Journal: JAMA (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 HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Addition of BIBW 2992, an irreversible inhibitor of EGFR/HER1 and HER2, to letrozole in estrogen receptor (ER)-positive metastatic breast cancer (mBC) progressing on letrozole monotherapy.
Authors: K. Gunzer, H. de Mont-Serrat, M. M. Uttenreuther-Fischer, J. Misset
Journal: Journal of Clinical Oncology (2010)

1072 Background: Inhibition of HER1/2 signaling via possible cross-talk between the ER and HER1/2 signaling pathways restores hormone sensitivity in animal models and may show clinical efficacy. BIBW 2992 is an oral, irreversible inhibitor of the EGFR/HER1 and HER2 with phase I and phase II activity in mBC. Methods: A multi-institutional, open-label, single-arm phase II study with BIBW 2992 added to letrozole upon disease progression on letrozole monotherapy was conducted. Eligible patients were post-menopausal, had ER-positive, hormone-sensitive mBC, and progressed on letrozole. Life expectancy had to be of ≥6 months and ECOG score 0–1. Chemotherapy was allowed prior to BIBW 2992 treatment following progression on letrozole. Patients received 50 mg BIBW 2992 once-daily in addition to letrozole. Tumor assessments were performed every two treatment courses (one course is 28 days) and safety data were collected. The primary endpoint was the rate of nonprogression at 16 weeks of therapy. Results: Of thirty patients enrolled, 28 were treated. Due to grade 3 skin and GI related AEs, the daily starting dose of BIBW 2992 was reduced from 50 mg to 30 mg. Preliminary data on BIBW 2992 and letrozole did not indicate any changes in the pharmacokinetics of either drug. Most frequently observed adverse events to date were diarrhea, nausea, acne, mucosal inflammation, and asthenia. 19/28 included patients were HER2-negative. Seven of 28 patients evaluable were treated with stable disease (SD) for more than 16 weeks (range to date: 113–449 days). Conclusions: Seven of 28 patients were under continuous therapy for 4 to 16 months on this trial. The majority of patients included were HER2-negative. The combination of 30 mg BIBW 2992 daily with letrozole was efficacious and well tolerated. We believe the approach deserves further testing with respect to reversal of acquired hormone resistance. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Boehringer Ingelheim Boehringer Ingelheim
Late Superior Vena Cava Syndrome after Superior Vena Cava–Right Pulmonary Artery Anastomosis
Authors: Irwin B. Boruchow, Thomas D. Bariley, Larry P. Elliott, Gerold L. Schiebler
Journal: New England Journal of Medicine (1969)

Cyanotic congenital heart disease and decreased pulmonary blood flow were palliated in four patients by superior vena cava—right pulmonary artery (SVC-RPA) shunts. Between four months and two years after SVC-RPA anastomosis, a late progressive form of SVC syndrome developed. Signs of the syndrome included facial edema, severe headaches and, in two patients, abnormal enlargement of head circumference, with increased intracranial pressure. These were associated with increasing cyanosis and hematocrit and decreasing exercise tolerance. In three patients prompt disappearance of signs of SVC syndrome and marked clinical improvement followed systemic—left pulmonary artery shunting or open-heart repair of the underlying malformation. The SVC-RPA shunt was left intact in each patient. Late, reversible SVC syndrome in patients with SVC-RPA shunts may be secondary to a progressive decrease in blood flow to the left lung. In the fourth case, a persistent left superior vena cava draining into the left atrium may also have been contributory.
A Randomized, Controlled Trial of Theophylline in Patients with Severe Chronic Obstructive Pulmonary Disease
Authors: Danièle Murciano, Marie-Hélène Auclair, René Pariente, Michel Aubier
Journal: New England Journal of Medicine (1989)

To assess the effects of theophylline in chronic obstructive pulmonary disease, we conducted a randomized, placebo-controlled, double-blind, crossover trial in 60 patients with severe but stable disease. The patients (mean age, 61 years) were studied before and after two months of placebo and two months of treatment with a sustained-release preparation of theophylline (10 mg per kilogram of body weight per day), administered orally. The two treatments were administered in a random order and separated by an eight-day washout period. After taking theophylline for two months (mean plasma concentration, 14.8 mg per liter), as compared with the two months of placebo, the patients had significant improvements in dyspnea, pulmonary gas exchange (partial pressure of arterial oxygen, 66 vs. 61 mm Hg [P less than 0.0001]; partial pressure of arterial carbon dioxide, 44 vs. 49 mm Hg [P less than 0.0001]), vital capacity (63 percent vs. 58 percent of the predicted value [P less than 0.0001]), and forced expiratory volume in one second (36 percent vs. 32 percent of the predicted value [P less than 0.0001]), with no significant change in airway resistance or functional residual capacity. Minute ventilation increased by a mean of 18 percent (P less than 0.0001) in the patients taking theophylline because of increased tidal volume, with no change in respiratory frequency. The respiratory-muscle performance of the patients taking theophylline improved by approximately 29 percent (P less than 0.0001), as indicated by a decline in the ratio of inspiratory pleural pressure during quiet breathing to maximal pleural pressure. We conclude that theophylline improves respiratory function and dyspnea in patients with severe chronic obstructive pulmonary disease and that these improvements are probably due to better respiratory-muscle performance.
Transformation of minds and souls
Authors: Vladimir J Simunovic
Journal: BMJ (2005)

A t a time of much transformation of health systems worldwide, I offer this story of transformation of health professionals' minds and souls in the former Yugoslavia. In socialist Yugoslavia the standards and skills of doctors conformed to worldwide standards, although few had an international reputation. The main health indicators in Yugoslavia were in line with most European countries, and in some clinical fields our results even exceeded those of major centres worldwide. Most doctors were paid enough by the government to live comfortably, and only minor, insignificant corruption existed in the hospitals. In short, medical doctors had secure jobs, were respected in their communities, and had a relatively privileged lifestyle.

When the 1992-5 war started many health professionals fled the country. In Bosnia-Herzegovina the number of people employed in the health sector fell from about 19 000 in 1991 to about 12 000 in 1996. It was not easy to become a wartime doctor overnight. My medical education focused on teaching me the skills to be a lifelong learner, clinician, educator, researcher, and manager. In just a few days I found myself having to perform in completely new roles: as hero, negotiator, expert in logistics, and guardian of …
Syphilitic Aortitis with Obstruction of Multiple Aortic Ostia
Authors: Wiley F. Barker
Journal: New England Journal of Medicine (1949)

UNTREATED or inadequately treated late syphilis is no longer so frequently seen by the average physician, and its exotic complications are becoming curiosities. The following case presents one of the more unusual cardiovascular complications.Case ReportS. L. (P.B.B.H. 7A85O), a 52-year-old shipping clerk, was admitted to the Peter Bent Brigham Hospital on March 15, 1948, complaining of severe pain in the anterior part of the chest radiating down the left arm. This symptom had been present, especially on exertion, for about 10 months. The initial episode of pain had occurred while he was walking one evening; a sense of . . .
PTU-276 What is the mortality rate following a colorectal 2ww clinic appointment
Authors: L Evans, R Wharton
Journal: Gut (2015)

<h3>Introduction</h3> The two week wait (2WW) scheme for urgent assessment and investigation of suspected colorectal cancer is well established in the UK. The pick up rate from patients with alarm symptoms referred in this way runs at around 10%. The recent publication of surgeon-specific mortality from patients undergoing surgery for colorectal cancer has quite rightly focussed attention on the process of counselling patients about their risk. Actuarial tables can be used to set the risk of dying from the disease or its treatment in context but may be misleading because they necessarily include the entire population rather than the typical patient sitting in the clinic. The aim of this study was to describe a mortality risk for the typical patient referred as a colorectal 2WW irrespective of whether they are found to have the disease. <h3>Method</h3> All 2WW referrals for the three months 01/03/13 to 31/05/13 were reviewed at one year from first clinic appointment. The hospital information (PAS) laboratory and electronic discharge systems were used to identify patients dying in this period. The records of those who died were searched to identify whether they had been diagnosed with a colorectal malignancy, if they had undergone surgery and whether the death was related to the underlying diagnosis. Actuarial tables were used to provide a comparison mortality rate for the similar age range. <h3>Results</h3> 611 patients were referred in the three month period studied. 30 (5%) patients died within a year of first clinic appointment following referral. Median time from referral to death of these patients was 183 days (IQR 124.5–253 days) Of the four (13%) patients found to have a colorectal malignancy two were operated, one with palliative intent and the other dying from cardiac causes post anastomotic leak. The average age of patients’ referred was 70 years (std dev 12 years). The average age of those subsequently dying was 81 years (std dev 10 years) From actuarial tables<sup>1</sup>the expected mortality rate at one year for men 70–74 is 0.0245% and for women is 0.016% <h3>Conclusion</h3> The mortality of patients referred as 2WW colorectal cancers is far higher than would be expected by age alone. 5% vs &lt;0.03%. Of those who go on to die in the year following a 2WW colorectal clinic 87% never had a colorectal cancer. Only 2 from 611 (0.3%) patients referred as 2WW died as a result of surgery for colorectal cancer. The findings from this work are important to set into context the discussions around patients’ fears of colorectal cancer. For the patient sitting in a 2WW colorectal clinic, the fact that the unit has an operative mortality of less than 2.5%<sup>2</sup>needs to be set against the underlying 5% mortality merely from having walked through the door. <h3>Disclosure of interest</h3> None Declared. <h3>References</h3> Office for National Statistics, Life Expectancy Tables. http://ons.gov.uk/ons/rel/lifetables/ ACPGBI outcome data. www.acpgbi.org.uk/surgeon-outcomes/
Demonstration of Cystine Crystals in Peripheral White Blood Cells in a Patient with Cystinosis
Authors: David Korn
Journal: New England Journal of Medicine (1960)

CYSTINE-STORAGE disease (cystinosis or Lignac-> Fanconi disease) is an uncommon but intriguing disorder, the etiology and pathogenesis of which are unknown. The cardinal pathological finding is the deposition of large quantities of crystalline cystine in the tissues, especially in the reticuloendothelial structures and in the cornea and conjunctiva of the eye.In the case reported below, a patient with proved cystine-storage disease presented cystine crystals within the white blood cells of the peripheral blood. A review of the literature indicates that this observation has not previously been reported. The potential value of this finding in the diagnosis and study of . . .
Renal Metastases to Pancreas: Do not Operate All and Always?
Authors: L. Burattini, M. Santoni, C. Porta, C.N. Sternberg, G. Procopio, U. Basso, U. De Giorgi, M. Rizzo, C. Ortega, F. Massari, C. Masini, M. Milella, G. Di Lorenzo, L. Cerbone, A. Conti, S. Buti, S. Partelli, M. Falconi, D. Santini, S. Cascinu
Journal: Annals of Oncology (2014)
HIF-1α regulates the interaction of chronic lymphocytic leukemia cells with the tumor microenvironment
Authors: Roberta Valsecchi, Nadia Coltella, Daniela Belloni, Manfredi Ponente, Elisa ten Hacken, Cristina Scielzo, Lydia Scarfò, Maria Teresa Sabrina Bertilaccio, Paola Brambilla, Elisa Lenti, Filippo Martinelli Boneschi, Andrea Brendolan, Elisabetta Ferrero, Marina Ferrarini, Paolo Ghia, Giovanni Tonon, Maurilio Ponzoni, Federico Caligaris-Cappio, Rosa Bernardi
Journal: Blood (2016)
Diltiazem and Subacute Cutaneous Lupus Erythematosus–Like Lesions
Authors: A.N. Crowson, C.M. Magro
Journal: New England Journal of Medicine (1995)

To the Editor: Calcium-channel blockers are associated with rashes, including light-induced and lichenoid eruptions. An association with lupus erythematosus has been reported, although the patient ...
Abstract 222: Intralipid-induced Cardioprotection In Late Pregnancy Is Fully Abolished By Inhibition Of Stat3, But Not Pi3k Signaling Pathway
Authors: Jingyuan li, Mansoureh Eghbali
Journal: Circulation Research (2014)

We have recently shown that the heart of late pregnant (LP) rodent is more prone to ischemia/reperfusion (I/R) injury compared to non-pregnant. Here we explored the therapeutic potential of Intralipid (ITLD) in the protection of LP hearts against I/R injury, and investigate the involvement of the signal transducer and activator of transcription-3 (STAT3) and phosphoinositide 3-kinase (PI3K) signaling pathways in ITLD-induced cardioprotetion. Isolated LP mouse hearts were subjected to 20 min ischemia followed by 40 min reperfusion with 1) Krebs Henseleit buffer (CTRL group), 2) 1% intralipid (ITLD group) or 3) ITLD+STAT3 inhibitor Stattic (20 μM, Stattic group), and 4) ITLD+PI3K inhibitor LY294002 (45 μM). The heart function and the infarct size were measured. The Intralipid-induced cardioprotection was fully abolished by Stattic, as RPP was significantly lower in the presence of Stattic (RPP=8881±1331 mmHg*beats/min vs. 1186±563 mmHg*beats/min in ITLD+Stattic, p&lt;0.01) at the end of reperfusion. In fact, all of the hemodynamic indexes in ITLD+Stattic were not significantly different from CTRL. The infarct size was also significantly larger in ITLD+Stattic group when compared to Intralipid alone (47.9±2.5% in ITLD+Stattic vs. 21.7±2.6 % in ITLD, p&lt;0.01). The Intralipid-induced cardioprotection was only partially abolished by LY294002, as at the end of 40 min reperfusion the RPP was significantly lower compared to the group treated with Intralipid alone, but still significantly higher than ITLD+Stattic ((RPP=8881±1331 mmHg*beats/min in ITLD vs. 5212±1955 mmHg*beats/min in ITLD+LY, p&lt;0.05; RPP=5212±1955 mmHg*beats/min in ITLD+LY vs.1186±563 mmHg*beats/min in ITLD+Stattic, p&lt;0.05). The infarct size was also larger when compared to Intralipid alone (32.8±3.1% in ITLD+LY vs. 21.7±2.6% in ITLD, p&lt;0.05), but lower than ITLD+Stattic group (32.8±3.1% in ITLD+LY vs 47.9±2.5%, p&lt;0.05). In conclusion, Intralipid protects the late pregnant heart against I/R injury via the STAT3 rather than the PI3K signaling pathway.