tbuckley/cabot-search huggingface dataset:
Survival with Dialysis and Transplantation in Patients with End-Stage Renal Disease
Authors: William M. Vollmer, Patricia W. Wahl, Christopher R. Blagg
Journal: New England Journal of Medicine (1983)

We examined the survival experience of 1038 white patients with end-stage renal disease to compare transplantation with maintenance dialysis. A mathematical model was used that permitted adjustment for the confounding effects of age and morbidity at the start of treatment as well as for the year in which treatment began. For patients with all kinds of renal disease, survival was related to age and morbidity but not to the year of starting treatment. Transplantation with a graft from a living related donor was associated with significantly better survival than either transplantation with a cadaveric graft (relative risk, 0.54) or dialysis (relative risk, 0.55). No significant difference in survival was found between treatment by dialysis and by cadaveric transplantation (relative risk, 1.01). In view of this experience, the decision about whether a patient on dialysis should receive a cadaveric transplant should be based on evaluation of the differences in complications associated with the two treatments and the potential effects of these on the patient's general life style, opportunity for rehabilitation, and family and social responsibilities. Whether the use of cyclosporine will change this assessment in the future remains to be seen.
Association of β-Blocker Treatment With Adverse Outcomes in Hypertensive Patients Undergoing Noncardiac Surgery
Authors: Paolo Palatini
Journal: JAMA Internal Medicine (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 Internal Medicine 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 Internal Medicine journal
Case 17-1998
Authors: John A. Jarcho, Eugene J. Mark
Journal: New England Journal of Medicine (1998)

Presentation of CaseA 53-year-old man was admitted to the hospital with left ventricular dysfunction four years after receiving a cardiac transplant.The patient had been well until 5 1/2 years earlier, when he had a severe “viral” illness with marked cardiac enlargement followed by congestive heart failure. Four years before admission, a cardiac transplantation was performed. The donor was positive for cytomegalovirus; the patient was negative for cytomegalovirus and received cytomegalovirus hyperimmune globulin and cyclosporine. Examination of the excised heart revealed hypertrophy and fibrosis of the left ventricle, without active inflammation, and minimal coronary artery disease. One month after . . .
PWE-014 Flat and sessile colonic neoplasia, is it feasible and safe to remove them in UK practice?: Abstract PWE-014
Authors: R J Mead, M Duku, G Longcroft-Wheaton, P Bhandari
Journal: Gut (2010)

<h3>Introduction</h3> Traditional endoscopy removes pedunculated polyps and some sessile polyps, with flat lesions requiring surgery due to safety concerns and technical difficulties. With modern approaches flat lesions can now be resected throughout the colon, but lesions &gt;20 mm still remain difficult to remove with little literature to help in assessing the upper size limit for safe resection. We aim to assess the feasibility, safety and medium term outcomes of endoscopic resection of large and very large flat colonic polyps in expert hands. <h3>Methods</h3> The majority of patients included in this study were tertiary referrals from Consultant Gastroenterologists or Surgeons. Patients are referred due to difficult endoscopic access, lesion size, concerns of cancer risk, or concerns with other endoscopic complication. A review of a prospective Endoscopic Mucosal Resection (EMR) database, endoscopy records and pathology reports was performed. All lesions were removed by a single expert endoscopist, using advanced EMR techniques introduced at the start of this study. These include submucosal injection of colloids, multipiece EMR, endoscopic submucosal dissection (ESD), a combination of the two techniques, and Argon Plasma Coagulation ablation when indicated. <h3>Result</h3> 117 patients (52 female, 55 male, mean age 70 years) with 117 polyps, of a mean size 44 mm. (range: 20–150 mm) Follow-up is over a mean 1.54 years (0.1–4.7 years). In those undergoing endoscopic treatment, with follow-up, disease is resected in 82%. 7/117patients had procedure associated complication, 5/117 (4%) delayed bleeds managed endoscopically, 1/117 (0.8%) post-polypectomy syndrome managed conservatively, and 1/117 (0.8%) perforation requiring surgery. In the patients with carcinoma: 5/15 had &lt;submucosal 1 (SM-1) disease with four resected endoscopically and cured, one having surgery with no residual disease. In 10/15 patients depth of invasion was uncertain or had &gt;SM-1 invasion: one declined surgery and nine had surgery with residual local disease found in five patients (4%) (Abstract 014).
What Do We Gain from the Sixth Stool Guaiac?
Authors: Duncan Neuhauser, Ann M. Lewicki
Journal: New England Journal of Medicine (1975)

The six sequential stool guaiac protocol has been advocated for screening of colonic cancer. Analysis of the expenditures involved in such a program shows that the cost of detecting cancer rises exponentially so that the marginal cost of the sixth test may be 20,000 times the average cost. The marginal cost is decreased with lower test sensitivity and increased with lower prevalence of colonic cancer. This result shows that even an inexpensive test can become quite costly in terms of cases detected. The marginal cost per case detected depends on the prevalence of the condition in the population screened and the sensitivity of the test applied.
Interference in the Measurement of Plasma 11-Hydroxycorticosteroids Caused by Spironolactone Administration
Authors: Lawrence C. Wood, Rolf Richards, Sidney H. Ingbar
Journal: New England Journal of Medicine (1970)

The Mattingly method for estimating plasma "cortisol" concentration involves measurement of the fluorescence in strong sulfuric acid of materials extracted from plasma by methylene chloride. In three patients without adrenocortical disease and in one normal volunteer, administration of spironolactone was shown to be associated with a prompt, striking and sustained increase in plasma Mattingly fluorogens. Similar increases followed administration of spironolactone to a patient with Addison's disease, indicating that the response was not due to an alteration in endogenous steroid metabolism. Furthermore, direct in vitro addition of spironolactone to plasma yielded increased values in the Mattingly assay. Hence, artifactual elevations in the concentrations of plasma "cortisol," as measured by the Mattingly method, are to be expected in patients receiving spironolactone.
Multidisciplinary Management of Pancreatic Cancer
Authors: Margaret A. Tempero
Journal: Journal of the National Comprehensive Cancer Network (2015)

Pancreatic cancer remains a vexing treatment challenge, with a cure rate that remains just 7%. Two effective regimens--gemcitabine/nab-paclitaxel and FOLFIRINOX--have improved outcomes and are being used earlier in the disease. However, meaningful differences in outcomes may not be realized without novel strategies. Targeting of the immune system is an active area of research.
Targeting The Mitochondrial ClpP As a Novel Therapeutic Strategy For Acute Myeloid Leukemia
Authors: Alicia Cole, Zezhou Wang, Rachel Mattson, Etienne Coyaud, Rose Hurren, Marcela Gronda, Fengshu Lin, Neil Maclean, Elisa Leung, Yihua Qiu, Nianxiang Zhang, Kevin R. Coombes, Mark D. Minden, Walid A. Houry, Zenyaho Hao, Steven M. Kornblau, Brian Raught, Aaron Schimmer
Journal: Blood (2013)
Elevation of Plasma Glutamate in Gout
Authors: Anthony S. Pagliara, A. David Goodman
Journal: New England Journal of Medicine (1969)

Fasting plasma glutamate concentration in 36 patients with gout was 65 ± 4 mμmoles per milliliter (± SE), and in 26 normal subjects it was 40 ± 3 (p less than 0.001). In 16 of the 36 patients fasting plasma glutamate was more than two standard deviations above the normal mean. After the ingestion of casein (0.5 gm per kilogram of body weight) plasma glutamate reached excessively high levels in the group with gout. Plasma glutamine and α-amino nitrogen were normal, both in the fasting state and after casein ingestion. The increase in glutamate may be causally related to the overproduction of purines in gout.
Moschcowitz, Multimers, and Metalloprotease
Authors: Joel L. Moake
Journal: New England Journal of Medicine (1998)

In 1924, Dr. Eli Moschcowitz described the abrupt onset of petechiae and pallor, followed rapidly by paralysis, coma, and death, in a 16-year-old girl.1 Terminal arterioles and capillaries in the doomed teenager were occluded by hyaline thrombi, later determined to consist mostly of platelets without perivascular inflammation or endothelial desquamation. Moschcowitz suspected a “powerful poison which had both agglutinative and hemolytic properties”1 as the cause of this frightening new disease, now known as thrombotic thrombocytopenic purpura.In 1982, unusually large multimers of von Willebrand factor found in the plasma of patients with chronic relapsing thrombotic thrombocytopenic purpura were proposed as . . .
The Pathogenesis and Treatment of Kidney Stones
Authors: Fredric L. Coe, Joan H. Parks, John R. Asplin
Journal: New England Journal of Medicine (1992)

ABOUT three fourths of all kidney stones are composed of calcium oxalate1; most calcium oxalate stones also contain a small amount of hydroxyapatite, and 10 to 12 percent contain some uric acid.2 Ten to 20 percent of stones contain struvite (magnesium ammonium phosphate) produced by a urinary tract infection with bacteria that express the enzyme urease.3 Five percent of stones are pure uric acid, 5 percent contain more than 50 percent hydroxyapatite or calcium monohydrogen phosphate (brushite), and less than 1 percent are composed of cystine. Whereas most calcium oxalate stones are less than 2 cm in diameter, struvite, . . .
Gallstone Migration as a Cause of Acute Pancreatitis
Authors: Juan Miguel Acosta, Carlos Luis Ledesma
Journal: New England Journal of Medicine (1974)

Stools were screened for gallstones in 36 patients with acute pancreatitis associated with gallstones. These patients had typical clinical evidence of pancreatitis with transiently elevated serum amylase and bilirubin concentrations. Another 36 patients with gallstones but without acute pancreatitis served as controls. Gallstones were found in the feces of 34 out of 36 patients with pancreatitis, but in only three out of the 36 control cases. In the former group, the finding was usually preceded by a relief of the symptoms and a rapid decrease of serum amylase and bilirubin concentrations. The calculi found in the stools and those found in the biliary tracts of the patients at operation were identical as determined by gross inspection and chemical analysis. These findings suggest that acute pancreatitis associated with gallstone disease is frequently caused by transient blockage of the ampulla of Vater by migrating gallstones. (N Engl J Med 290:484–487, 1974)
Multiple Peritoneal Autotransplantation of Splenic Tissue Following Traumatic Rupture of the Spleen
Authors: Richey l. Waugh
Journal: New England Journal of Medicine (1946)

THE purpose of this paper is to discuss multiple peritoneal autotransplantation of splenic tissue following traumatic rupture of the spleen and to present a summary of reported cases, together with the first report of a case occurring in an adult.In the cases hitherto reported, all patients had in youth survived traumatic rupture of the spleen and later, either at reoperation or autopsy, numerous spleenlike nodules were found scattered over the various peritoneal surfaces, including the omentum, small and large intestine, diaphragm and pelvic cavity. Buchbinder and Lipkoff1 consider the condition a clinical entity and suggest the use of the . . .
Pathological Complete Response and Changes Related to T Infiltrating Lymphocytes and Regulatory T Cells in Tissue and Peripheral Blood After Neoadjuvant Chemotherapy in Breast Carcinoma
Authors: L. De La Cruz Merino, A. Barco Sánchez, J. Ibáñez Martínez, A. Nieto García, A. Vallejo Benítez, F. Henao Carrasco, V. Sánchez Margalet
Journal: Annals of Oncology (2014)

ABSTRACT   Aim: Some clinical trials in breast cancer have reported imppressive outcomes related to laboratory immune findings in the neoadjuvant setting. In this context, tumor infiltrating lymphocytes (TILs) and regulatory Tcells (Tregs) in tissue specimens and in peripheral blood are being tested as two emerging prognostic and predictive factors. We designed a protocol to analyze immune profile before, during and after neoadjuvant chemotherapy (CT) in breast cancer in blood and tissue, and their eventual relation with pathological complete response (pCR).  Methods: From March 2011 to february 2014, 47 patients (18 her2 + /29 her2-) with T2-4 N0-3 breast carcinoma treated wih neoadjuvant CT in the Breast Cancer Unit of the Hospital Universitario Virgen Macarena (Seville, Spain) were included in the study. CD3 + , CD8 + , CD8-16-56+ and FOXP3+ cell infiltrates were detected by immunohistochemistry before and after CT in tissue specimens. Blood samples were collected in EDTA-K3 tubes before every cycle to determine the immunophenotype profile. Cell populations were determined by flow cytometry analysis of whole blood, including the study of CD3-CD4-CD25low and CD3-CD4-C25high (regulatory) T cells.  Results: By February 2014, 47 patients were operated. pCR or near pCR (grade 4/5 Miller&Payne) was attained in 20 patients (42,6%). pCR was achieved in 66,6% (12/18) of tumors overexpressing her2 and treated with CT plus trastuzumab, and in only a 27,5% (8/29) of the her2- population. Absence and /or disappearance of Tregs in tissue (Black grading system = 0) was more frequent after neoadjuvant CT (11,11 vs 62,2%). Furthermore, average whole blood CD3-CD4-CD25high (regulatory) T cells were 126,36 before and 91,19 after neoadjuvant CT (p 0,010). Overall Tregs diminished in the pCR and non pCR groups without statistically significant differences.  Conclusions: Neoadjuvant CT decreases Tregs immunosuppressive infiltrates in tissue and CD3-CD4-CD25high (regulatory) T cells in peripheral blood in all the population. Although differences among subgroups (pCR/non-pCR and her-/her2+) were not statistically significant, these data support the role of Tregs as an interesting biomarker with eventual therapeutic implications in breast carcinoma.  Disclosure: All authors have declared no conflicts of interest.
Aortic Stenosis — Listen to the Patient, Look at the Valve
Authors: Catherine M. Otto
Journal: New England Journal of Medicine (2000)

Over the past 15 years, the increasing use of echocardiography has dramatically changed our understanding of the prevalence and progression of aortic-valve stenosis. Aortic stenosis may be due to rheumatic disease or to calcification of a congenitally bicuspid or normal trileaflet valve. However, in the United States and Europe, calcific valvular disease is by far the most common cause of aortic stenosis.We now recognize that calcific valvular disease is not simply a degenerative condition associated with aging but, instead, represents the end stage of an active disease process. In the early stages, the aortic side of the valve contains . . .
NIMG-33CORRELATING A PATIENT-SPECIFIC MATHEMATICAL MODEL OF GLIOBLASTOMA PROLIFERATION-INVASION WITH IMAGE-GUIDED BIOPSIES
Authors: Andrea Hawkins-Daarud, Hani Malone, Timothy Ung, Anthony Rosenberg, Joshua Jacobs, Jeff Bruce, Peter Canoll, Kristin R. Swanson
Journal: Neuro-Oncology (2015)

Glioblastoma is an invasive disease with cancerous cells extending well beyond the margin of the imaging abnormalities. The degree of invasiveness, however, is heterogeneous amongst the patient population. Previous work with a patient-specific mathematical model has shown that a mathematically intuitive understanding of individual invasiveness based on matching patients' T1Gd and T2 abnormalities with 80% and 16% tumor cell density respectively is predictive of IDH1 mutation status, degree of hypoxia, and overall survival benefit due to resection. Direct validation of the tumor cell density prediction has not been possible due to insufficient data availability. Over the last few years, a cohort of patients at Columbia University have been recruited to have MRI guided biopsies just prior to their tumor resections allowing for a known correspondence between tissue and MRI characteristics. Seven of these patients have been analyzed in both contexts of the mathematical model and biopsy cell counts. Their images were analyzed with the model to create individualized predictions of the patients' tumor cell density. In parallel, biopsy specimens were prepared with H&E stains and total cell counts were obtained from representative portions of the prepared slide when viewed at 400x magnification. Cell counts were compared to density predictions corresponding to the biopsy location's distance from the edge of the measured T1Gd abnormality. The median number of biopsies used for comparison from each patient was 2 (range 1-4). In total, cell counts from 16 biopsies were obtained. Allowing for sources of error in both the model prediction and the biopsy acquisition location, all 16 cell counts were consistent with the model's prediction of tumor cell density. While this is certainly not enough evidence to conclusively determine the validity of the model, these results support a direct interpretation of individualized cell density model predictions beyond the T1Gd imaging abnormality.
Phase II trial of continuous/metronomic 5-fluorouracil infusion plus long acting Octreotide in advanced neuroendocrine carcinoma
Authors: L. Dogliotti, M. P. Brizzi, A. Ferrero, E. Milanesi, L. Ciuffreda, F. Castiglione, S. Bombaci, D. Perroni, O. Alabiso, A. Berruti
Journal: Journal of Clinical Oncology (2007)

15003 Background: The administration of cytotoxic drugs on a metronomic schedule has shown antiangiogenetic properties. Well differentiated neuroendocrine carcinomas are notoriously highly vascularized and may be responsive to metronomic chemotherapy. A phase II study was designed to test the activity of protracted 5-fluorouracil (5FU) infusion in association with and long-acting release (LAR) octreotide in patients with advanced/metastatic neuroendocrine carcinoma. Patients and Methods: Twenty-nine patients (pts), with metastatic or locally advanced well differentiated neuroendocrine carcinoma not amenable to surgery with radical intent and not previously submitted to systemic treatments were enrolled. Treatment consisted of 5FU intravenous continuous infusion (200 mg/m2 daily) in association with Octreotide LAR (20 mg once every 4 weeks). 5FU treatment was administered until progression or for a maximum of 9 months. Octreotide LAR was administered until progression. Patients were followed for toxicity, objective response, symptomatic response, biochemical response, time to progression and survival. Results: According to RECIST criteria a partial response was observed in 7 patients (24.1%), a stable disease in 20 pts (69.0%) and a progression disease in only 2 pts (6.9%). A biochemical (chromogranin A) response was observed in 11/25 assessable patients (44.0%), 9/15 symptomatic patients (60.0%) obtained symptom relief. Post-treatment surgery was attempted in three patients, one of them was radically resected. The median time to disease progression was 25 months (range 2–69 months), median overall survival was not reached. Hematologic toxicity was rare and mild [grade 2 neutropenia in 2 pts (6.9%)]. Six cases (20.7%) suffered from grade 2–3 hand-foot syndrome. No patient withdrew from the study because of adverse events. Conclusions: Continuous/metronomic 5FU infusion plus octreotide LAR is well tolerated and shows promising activity in patients with advanced well differentiated neuroendocrine carcinoma. Additional studies with this combination are warranted. No significant financial relationships to disclose.
340 T CELLS REDIRECTED BY A CHIMERIC ANTIGEN RECEPTOR RECOGNIZING HBsAg EFFICIENTLY CONTROL HBV IN VIVO IN TRANSGENIC MICE
Authors: K. Krebs, N. Böttinger, L.-R. Huang, M. Chmielewski, S. Arzberger, G. Gasteiger, E. Schmitt, F. Bohne, M. Aichler, W. Uckert, H. Abken, M. Heikenwälder, P. Knolle, U. Protzer
Journal: Journal of Hepatology (2013)
PWE-089 Oesophageal stents for benign refractory oesophageal strictures: meta-analysis and systematic review: Abstract PWE-089
Authors: T Thomas, V Subramanian, J Mannath, K Ragunath
Journal: Gut (2010)

<h3>Introduction</h3> The management of benign refractory oesophageal strictures is challenging. Insertion of self-expanding removable plastic stents (SEPS) have been considered a viable alternative to serial dilatations. Since the incidence of benign refractory strictures is low a randomised clinical trial of SEPS vs serial dilatations appears impractical <h3>Methods</h3> The Primary aim was to determine the efficacy of SEPS in the treatment of refractory oesophageal strictures. Established guidelines for the reporting of meta-analysis were followed. MEDLINE (1966-2009), EMBASE and PubMed databases were searched using keywords, “oesophageal stricture”, “oesophageal stents”, (American and British spelling used) “benign strictures” and “dysphagia”. Relevant abstracts were selected and reviewed based on a pre-defined inclusion criteria (agreed by internal consensus). The articles were independently reviewed by two authors (TT and JM). Data were collected (TT) and independently verified by a second author (JM). A meta-analysis of proportions was done and since there was significant heterogeneity in the studies the random effects model was used. <h3>Results</h3> Of the 56 relevant abstracts 37 were excluded as they did not fit the inclusion criteria. Ten further articles were excluded after analysing the full article. Overall 295 patients from nine studies were included in the final analysis (178 males, average age 54 years, range 49–68). The aetiology of the strictures (8 studies) were as follows: post-surgical: 48, Radiation: 24, Peptic: 14, Corrosive: 87, Others: 122. The average length of the stricture (5 studies) was 4.1 cm (range 3–7). Of the 151 strictures (5 studies) 73/151 (48%) were located in the mid-oesophagus. Overall 57.7% (95% CI 40 to 74.4%) of patients were dysphagia free and 64.8% (95% CI 47.3% to 80.4%) of patients were stent free at a follow-up of 619 person years duration. The outcomes were compared based on duration of stent placement, type of stent and no: of patients in the study (see Abstract 007). In 57/295 (19%) cases stents migrated after an average duration of 17.2 days (range 2–38). There were three (1%) perforations and two (0.6%) deaths. <h3>Conclusion</h3> SEPS for benign refractory strictures seems to have a modest benefit for long-term symptom relief. Stents migrate in 19% of cases and is associated with a mortality of &lt;1%. A large multicentre study is needed to determine the efficacy of SEPS in these cohort of patients.