tbuckley/cabot-search huggingface dataset:
A prospective multicenter, single blinded, randomized phase III trial to compare the efficacy of ramosetron, aprepitant and dexamethasone with ondansetron, aprepitant, and dexamethasone for preventing chemotherapy-induced nausea and vomiting: KCSG PC10-21.
Authors: Hyo Jung Kim, Eun-Kee Song, Jun Suk Kim, Jin Seok Ahn, Hwan Jung Yun, Yo Han Cho, Keon Uk Park, Si-Young Kim, JoungSoon Jang, Sang-We Kim, Hyun Woo Lee, Se Ryeon Lee, Yang Soo Kim, Soon-Nam Lee, Yoon-Ho Ko, Hwa Jung Kim, Jin Hyoung Kang, Sang Won Shin
Journal: Journal of Clinical Oncology (2013)

9633 Background: Combination of aprepitant, 5-HT 3 receptor antagonist and steroid improve complete response (CR) of chemotherapy induced nausea and vomiting (CINV). But until now, there was no information whether ramosetron is as effective as other 5-HT 3 receptor antagonists for the combination regimen. Therefore, we compared a ramosetron, aprepitant and dexamethasone (RAD) with ondansetron, aprepitant and dexamethasone (OAD) to establish the non-inferiority of RAD in controlling highly emetogenic chemotherapy induced nausea and vomiting. Methods: A total of 334 patients with malignant disease who were scheduled to receive highly emetogenic chemotherapy were randomized to RAD or OAD. Aprepitant (125 mg day 1; 80 mg day 2, 3) and dexamethasone (12 mg day 1; 8 mg day 2-4) were administered to both group. Intravenous ramosetron (0.3mg day 1) or ondansetron (16mg day1) was given to RAD or OAD, respectively. Patients recorded vomiting and nausea (VAS score) on the diary. The primary end point was CR (no vomiting or retching and no rescue medication) rate in the acute period (chemotherapy day 1). The non-inferiority margin was defined as -15% differences. Results: 299 patients (RAD 143, OAD 156) were eligible for the efficacy analyses of modified intention-to-treat. Median age and sex were 60 (IQR 52 – 66) and 61 (51.5 – 68, p=0.54), 90 Male/66 Female and 114 Male/29 Female (p&lt;0.0001) in RAD and OAD, respectively. There were no significant differences between two groups on the other baseline characteristics. The CR rates of RAD vs OAD were 84.6% vs 77.6% (95% C.I. -0.4 – 14.5%) at acute period, 69.5% vs 62.6% (-2.1 – 16.0%) at delayed period (days 2-5), and 66.7% vs 58.1% (-0.6 – 17.8%) at overall period. Median nausea score at acute period were 4 (IQR 2 – 5) and 3 (2-5, p=0.14) in RAD and OAD, respectively. There were no grade 3 or 4 toxicities. Conclusions: RAD regimen is as effective and tolerable as OAD antiemetic combination for the prevention of CINV in patients receiving highly emetogenic chemotherapy. Ramosetron could be considered as one of the best partners for aprepitant. Clinical trial information: NCT01536691.
Risk of individual malignant neoplasms in patients with sickle cell disease: English national record linkage study
Authors: Olena O Seminog, Oyindamola I Ogunlaja, David Yeates, Michael J Goldacre
Journal: Journal of the Royal Society of Medicine (2016)

Objective Case reports suggest that there may be an increased risk of some cancers associated with sickle cell disease. However, population-based studies are scarce and there is no comprehensive enumeration of the risks across the whole range of site-specific cancers. Our aim was to provide this. Design We used an English national dataset of linked statistical records of hospital admissions and deaths from 1999 to 2011 to undertake a retrospective cohort study. Setting England. Participants Records of all hospital admissions in England with SCD or with conditions included in the control cohort. Main outcome measures Rate ratios were calculated comparing rates of cancer in a sickle cell disease cohort and a control cohort, confining the analyses to people whose ethnicity was recorded as Black. Results Comparing the sickle cell disease cohort with the cohort without sickle cell disease, the rate ratio for all cancers combined was 2.1 (95% confidence interval 1.7–2.5). There were significantly high rate ratios for haematological malignancies, including Hodgkin’s lymphoma (rate ratio 3.7, 1.5–8.4), non-Hodgkin’s lymphoma (2.6, 1.3–4.8), multiple myeloma (5.5, 2.8–10.1), lymphoid leukaemia (3.3, 1.3–8.0) and myeloid leukaemia (10.0, 4.6–21.5). Four solid tumours showed elevated rate ratios: colon cancer (2.8, 1.2–5.5), non-melanoma skin cancer (4.4, 1.3–12.2), kidney cancer (5.4, 2.3–11.5) and thyroid cancer (5.1, 1.3–15.4). Conclusions The risk of some malignancies may be raised in patients with sickle cell disease. However, this study was based on administrative data without the scope to validate these against patients’ full clinical records. Our findings need confirmation or refutation. If confirmed, work to elucidate, at the genetic and molecular level, why people with sickle cell disease have elevated risks of individual cancers might make contributions to the fundamental understanding of carcinogenesis.
Efficacy Of The Polo-Like Kinase Inhibitor, Rigosertib Alone Or In Combination With ABL Tyrosine Kinase Inhibitor Against BCR-ABL-Positive Leukemia Cells
Authors: Seiichi Okabe, Tetsuzo Tauchi, Yuko Tanaka, Toshihiko Kitahara, Kazuma Ohyashiki
Journal: Blood (2013)
Safety of everolimus plus exemestane in patients with hormone-receptor–positive, HER2–negative locally advanced or metastatic breast cancer progressing on prior non-steroidal aromatase inhibitors: primary results of a phase IIIb, open-label, single-arm, expanded-access multicenter trial (BALLET)
Authors: G. Jerusalem, G. Mariani, E.M. Ciruelos, M. Martin, V.C.G. Tjan-Heijnen, P. Neven, J.G. Gavila, A. Michelotti, F. Montemurro, D. Generali, E. Simoncini, I. Lang, J. Mardiak, B. Naume, M. Camozzi, K. Lorizzo, S. Bianchetti, P. Conte
Journal: Annals of Oncology (2016)
Final Results of a Multicenter Phase II Trial with Bendamustine and Rituximab As First Line Treatment for Patients with MALT Lymphoma (MALT-2008–01)
Authors: Antonio Salar, Eva Domingo-Domenech, Carlos Panizo, Concepción Nicolás, Joan Bargay, Ana Muntanola, Miguel Canales, Jose Luis Bello, juan Manuel Sancho, Jose Francisco Tomas, María José Rodriguez, Francisco-Javier Penalver, Luis Palomera, Carlos Grande, José J Sánchez-Blanco, Reyes Arranz, Eulogio Conde, Dolores Caballero, Carlos Montalban
Journal: Blood (2012)
Painful sensory symptoms in neuroleptic-induced extrapyramidal syndromes
Authors: P Decina, S Mukherjee, G Caracci, K Harrison
Journal: American Journal of Psychiatry (1992)

The authors tested the hypothesis that neuroleptic-induced extrapyramidal syndromes are associated with painful sensations objectively conforming to the characteristics of primary sensory symptoms as reported in idiopathic and postencephalitic parkinsonism.The frequency of subjective painful sensory symptoms and their relation to neuroleptic-induced extrapyramidal syndromes were examined in a consecutive series of 107 psychiatric patients newly admitted to acute care units at a teaching hospital. Patients without illnesses or conditions likely to be associated with pain were included in the study if they had a diagnosis other than organic mental syndromes and were receiving psychotropic medications as prescribed by their treating physicians. Structured interviews with a modified version of the McGill Pain Questionnaire to assess sensory complaints and neurological examinations for neuroleptic-induced extrapyramidal syndromes (parkinsonism and akathisia) were conducted independently by two raters blind to each other's findings and patients' medication status.Fourteen (23%) of 60 patients receiving neuroleptics reported experiences of spontaneous pain subjectively attributed to pharmacological treatment, compared with only one (2%) of 47 patients receiving psychotropic medications other than neuroleptics. There was no difference between these two groups in subjective complaints of paresthesia (8% versus 9%). Twelve (55%) of the 22 patients with neuroleptic-induced extrapyramidal syndromes reported pain, compared with only two (5%) of the 38 patients who received neuroleptics but did not experience extrapyramidal syndromes.Although consonant with the study hypothesis, these results should be regarded as preliminary and interpreted conservatively in the light of the methodological limitations of the study.
JEVTCC: Phase II trial of cabazitaxel (Cbz) in patients (pt) with advanced or metastatic transitional-cell carcinoma (mTCC), who progressed before 12 months after cisplatin-based chemotherapy—A Spanish Oncologic Genitourinary Group (SOGUG) study.
Authors: Jose Angel Arranz Arija, Xavier Garcia del Muro, Begoña Perez-Valderrama, Sergio Vazquez-Estevez, Nuria Sala, María José Juan Fita, Nuria Laínez, Esther Noguerón, Albert Font, M Isabel Sáez, Pablo Maroto, Enrique Gallardo Diaz, María José Méndez-Vidal, M. Pilar Lopez Criado, Alvaro Pinto, Martin Lázaro Quintela, Aránzazu Gonzalez del Alba, Raquel Luque, Marta Lopez Brea, Ignacio Duran
Journal: Journal of Clinical Oncology (2015)

4525 Background: Treatment of mTCC progressing to cisplatin is an unmet need. Prognostic factors (PF) for worse overall survival (OS) are ECOG >0, Hb <10 g/dL and liver metastases (Bellmunt, JCO 2010). Taxanes are active as 2nd-line in mUC. Cbz, a semi-synthetic taxane, is a poor substrate for the multidrug resistance system. Methods: Phase II study of Cbz 25 mg/m2/3w until progression, death or unacceptable toxicity, in each of the 3 subgroups of mTCC: very good, good or poor prognosis (VGP, GP, PP), defined by 0, 1 or > 1 of the above PF respectively. Primary endpoint of response rate ≥ 20% (RR, RECIST 1.1), required 35 pt in each group. Multinomial response and early progressions method (MREP, α = 0.05, β = 0.2), and 2-stage Simon’s optimal design (SOD, π0 = 10%, π1 = 30% α = 0.05, β = 0.1), were used for early stopping rules in an intermediate analysis (IA) in each group, after 15 and 18 evaluable pt respectively. Secondary endpoints: PFS, OS, and toxicity. Recruitment was not stopped until IA were available. Results: 71 pt were included (ITT population), 59 eligible and evaluable: 16/21 VGP, 28/34 GP, 15/16 PP. Mean age 65 y, 85% male, 94% ECOG 0-1, 77% bladder mTCC. Metastatic sites: 69% lymph nodes, 41% lung, 32% bone, 24% liver, 30% others. Toxicity is described in a separate abstract. Response (R), stable disease (SD), progression (PD), % RR, PFS and OS (months, with CI 95%) are summarized in the table below. Conclusions: In the IA, a RR ≥20% of Cbz after cisplatin in mTCC could be excluded in all prognostic subgroups, and the study was stopped. However, PFS and OS seem to be similar to those obtained with other active drugs in 2nd-line mTCC. EUDRACT 2011003498-27. Funding: Sanofi. Clinical trial information: 2011003498-27. Group N # R # SD # PD % RR (CI 95%) Median PFS (CI 95%) Median OS (CI 95%) VGP 16 1 6 8 6.25 (1.1 – 28.3) 2.3 (1.9 - 3.9) 11.6 (4.5 - 20.1) GP 28 0 11 17 0% 2.1 (1.9 - 4) 7.1 (3.6 - 8.3) PP 15 1 2 12 6.7 (0.3 – 34) 2 (1.8 - 2.3) 3.7 (2.3 – 5.2) ITT 71 4.9 [1.7 - 13.5] 2.1 (1.9 - 2.4) 5.3 (4.1 - 8.3)
Treatment of Non-Obese Diabetic (NOD)/Severe-Combined Immunodeficient Mice (SCID) With flt3 Ligand and Interleukin-7 Impairs the B-Lineage Commitment of Repopulating Cells After Transplantation of Human Hematopoietic Cells
Authors: Ursula Kapp, Mickie Bhatia, Dominique Bonnet, Barbara Murdoch, John E. Dick
Journal: Blood (1998)
Intervals Between PCV13 and PPSV23 Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP)
Authors: Miwako Kobayashi, Nancy M Bennett, Ryan Gierke, Olivia Almendares, Matthew R Moore, Cynthia G Whitney, Tamara Pilishvili
Journal: MMWR Morbidity and Mortality Weekly Report (2015)

Two pneumococcal vaccines are currently licensed for use in the United States: the 13-valent pneumococcal conjugate vaccine (PCV13 [Prevnar 13, Wyeth Pharmaceuticals, Inc., a subsidiary of Pfizer Inc.]) and the 23-valent pneumococcal polysaccharide vaccine (PPSV23 [Pneumovax 23, Merck and Co., Inc.]). The Advisory Committee on Immunization Practices (ACIP) currently recommends that a dose of PCV13 be followed by a dose of PPSV23 in all adults aged ≥65 years who have not previously received pneumococcal vaccine and in persons aged ≥2 years who are at high risk for pneumococcal disease because of underlying medical conditions (Table) (1-4). The recommended intervals between PCV13 and PPSV23 given in series differ by age and risk group and the order in which the two vaccines are given (1-4).
Bcr-Abl Mutations in Chronic Myeloid Leukemia - Impact on Survival and Treatment with Second Generation Inhibitors– A Study on Behalf of Latin American Leukemia Net (Lalnet)
Authors: Katia B. Pagnano, Israel Bendit, Carla Boquimpani, Carmino Antonio De Souza, Eliana C M Miranda, Rosana A Silveira, Vaneuza A M Funke, Ricardo Pasquini, Vania Hungria, Nelma Clementino, Monika Conchon, Elena B Moiraghi, Jose L. Lopez, Carolina Pavlovsky, Eduardo Cervera, Belinda Pinto Simoes, Luis A Meillon, Nelson Spector, Nelson Hamerschlak, Miguel Pavlovsky, Alicia Magarinos, Vagner O Duarte, Ernesto M Fanilla, Jorge E. Cortes, Raquel Bengió
Journal: Blood (2011)
Allergy in Japan.
Authors: Alford Ri
Journal: Allergy (1948)

Abstract  These observations indicate that allergy in Japan is in striking contrast to allergy in the United States. The climate and general topography of the country are such that grasses and ragweed are not important factors in causing allergic symptoms. Physicians in practice outside of medical schools do not use, as a rule, specific methods of hyposensitization. Nonspecific therapy is more generally available and more widely practiced. Urticaria is the most prevalent allergic condition. No records of seasonal hay fever were noted. House dust is not an important cause of allergic symptoms. Eggs, milk, wheat, and chocolate are not commonly eaten, while fish and rice are the staple articles of diet among the greatest number of Japanese. Adequate medical literature on allergy is available but the clinical application of this knowledge is limited.
PD-032 Is there an impact of the number of metastases in the outcome of potentially resectable metastatic colorectal cancer patients receiving bevacizumab-based regimen in 1st line? Results of the PICASSO study
Authors: J.-P. Metges, J. Bennouna, M. Rivoire, D. Elias, F. Bonnetain, L. Dourthe, M. Ben Abdelghani, R. Radji, P. Laplaige, F. Petit Laurent, K. Sébastien, J. Telliez, D. Malka
Journal: Annals of Oncology (2016)
Traction Device Eases Pain of Travel
Authors: H KLEINMAN, M K COONEY, C B NELSON, R R OWEN, L BOYD, G SWANDA
Journal: JAMA (1964)

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
Final Results of a Phase 2 Open-Label, Monotherapy Efficacy and Safety Study of Quizartinib (AC220) in Patients ≥ 60 Years of Age with FLT3 ITD Positive or Negative Relapsed/Refractory Acute Myeloid Leukemia
Authors: Jorge E. Cortes, Alexander E Perl, Hervé Dombret, Sabine Kayser, Björn Steffen, Philippe Rousselot, Giovanni Martinelli, Elihu H. Estey, Alan K Burnett, Guy Gammon, Denise Trone, Eugen Leo, Mark J. Levis
Journal: Blood (2012)
Phase I trial of docetaxel/prednisone plus fractionated dose radiolabeled anti-prostate-specific membrane antigen (PSMA) monoclonal antibody <sup>177</sup>lu-J591 in patients with metastatic, castration-resistant prostate cancer (mCRPC).
Authors: Scott T. Tagawa, Young E. Whang, Gurveen Kaur, Shankar Vallabhajosula, Paul J. Christos, Anastasia Nikolopoulou, Yuliya Jhanwar, Arif Sheikh, Adam Ireland, Carmen Garcias-Espana, Stanley J. Goldsmith, Himisha Beltran, Neil Harrison Bander, David M. Nanus
Journal: Journal of Clinical Oncology (2014)

5064 Background: Docetaxel remains a standard agent for mCRPC and has radiosensitizing properties. 177Lu-J591 delivered with fractionated dosing leads to less myelosuppression while maintaining efficacy in mCRPC. This study was designed to determine the safety, dose limiting toxicity (DLT) and maximum tolerated dose (MTD) of fractionated 177Lu-J591 administered concurrently with standard docetaxel. Methods: Men with progressivemCRPC received docetaxel 75 mg/m2 every 3 weeks with escalating 2 fractionated doses of 177Lu-J591 (initial dose 20 mCi/m2 x2 up to max of 40 mCi/m2 x2) with cycle 3. Cycle 4 of docetaxel was planned 6 weeks after cycle 3 to allow for recovery from 177Lu-J591-associated hematologic toxicity. DLT was defined as delay in docetaxel >3 weeks, prolonged myelosuppression or need for >2 platelet (plt) transfusions, febrile neutropenia, or grade >2 non-heme toxicity following 177Lu-J591. PSA was assessed prior to each cycle and CTC count (CellSearch) was assessed at baseline and after 177Lu-J591. Results: 15 men with median age 67.3 (range 49.2-80.8), PSA 84.3 (17-776), 73.3% with elevated LDH, 71.4% unfavorable CTC counts received up to the highest anticipated dose (40 mCi/m2 x2). No DLT was seen at any dose level. Significant toxicity was limited to reversible myelosuppression. Gr 4 neutropenia without fever occurred in 3 (20%) and Gr 4 plts in 2 (13.3%), with 2 receiving prophylactic plt transfusion. No Gr >2 non-heme toxicity was observed. 13 had PSA decline, with 11 (73.3%) and 12 (80%) having >50% and >30% PSA decline respectively. All 14 evaluable men had decline (85.7%) or persistently undetectable (14.3%) CTC counts, with 78.6% having CTC counts decline by >50% and 78.6% having favorable counts after 177Lu-J591. Of 10 analyzed to date, all had targeting of known sites of disease by planar 177Lu-J591 imaging. Conclusions: The combination offractionated dose 177Lu-J591 and docetaxel/prednisone is well tolerated in patients with mCRPC. Without pre-selection, accurate targeting of known sites of disease and a strong preliminary efficacy signal was observed. Clinical trial information: NCT00916123.
Neovaginal diverticula: pathophysiology of colonic diverticulosis revisited
Authors: Floor Bakker, Wouter van der Sluis, Mark-Bram Bouman, Nanne de Boer
Journal: Endoscopy (2015)

A 56-year-old transgender woman who had a history of intestinal neovaginoplasty with the use of a sigmoid segment visited our outpatient clinic for neovaginoscopy and colonoscopy as part of regular postoperative follow-up 31 years after sex reassignment surgery. She had been sexually active with one male partner for 25 years. The patient reported feeling frequent peristaltic movements of the neovagina during and after sexual intercourse. She had used estradiol as hormonal replacement treatment for 34 years, starting 3 years before sex reassignment surgery. Because of recurrent symptoms of neovaginal discharge and abdominal pain, multiple colonoscopic and neovaginoscopic procedures had been performed in the past, the last one 6 years before the current presentation. Only colonic diverticula had been observed.
Risk factors for predicting severe neutropenia induced by pemetrexed plus carboplatin therapy in patients with NSCLC
Authors: Hiroaki Ikesue, Hiroyuki Watanabe, Megumi Hirano, Ayako Chikamori, Kimitaka Suetsugu, Yuriko Ryokai, Nobuaki Egashira, Takayama Koichi, Nakanishi Yoichi, Satohiro Masuda
Journal: Annals of Oncology (2015)
Elevations in the Fasting Serum Proinsulin–to–C-Peptide Ratio Precede the Onset of Type 1 Diabetes
Authors: Emily K. Sims, Zunaira Chaudhry, Renecia Watkins, Farooq Syed, Janice Blum, Fangqian Ouyang, Susan M. Perkins, Raghavendra G. Mirmira, Jay Sosenko, Linda A. DiMeglio, Carmella Evans-Molina
Journal: Diabetes Care (2016)

OBJECTIVE We tested whether an elevation in the serum proinsulin–to–C-peptide ratio (PI:C), a biomarker of β-cell endoplasmic reticulum (ER) dysfunction, was associated with progression to type 1 diabetes. RESEARCH DESIGN AND METHODS Fasting total PI and C levels were measured in banked serum samples obtained from TrialNet Pathway to Prevention (PTP) participants, a cohort of autoantibody-positive relatives without diabetes of individuals with type 1 diabetes. Samples were obtained ∼12 months before diabetes onset from PTP progressors in whom diabetes developed (n = 60), and were compared with age-, sex-, and BMI-matched nonprogressors who remained normoglycemic (n = 58). PI:C ratios were calculated as molar ratios and were multiplied by 100% to obtain PI levels as a percentage of C levels. RESULTS Although absolute PI levels did not differ between groups, PI:C ratios were significantly increased in antibody-positive subjects in whom there was progression to diabetes compared with nonprogressors (median 1.81% vs. 1.17%, P = 0.03). The difference between groups was most pronounced in subjects who were ≤10 years old, where the median progressor PI:C ratio was nearly triple that of nonprogressors; 90.0% of subjects in this age group within the upper PI:C quartile progressed to the development of diabetes. Logistic regression analysis, adjusted for age and BMI, demonstrated increased odds of progression for higher natural log PI:C ratio values (odds ratio 1.44, 95% CI 1.02, 2.05). CONCLUSIONS These data suggest that β-cell ER dysfunction precedes type 1 diabetes onset, especially in younger children. Elevations in the serum PI:C ratio may have utility in predicting the onset of type 1 diabetes in the presymptomatic phase.
Tricyclic antidepressants in obsessive-compulsive disorder: antiobsessional or antidepressant agents? II
Authors: M Mavissakalian, S M Turner, L Michelson, R Jacob
Journal: American Journal of Psychiatry (1985)

The authors explored the relationship between the antiobsessional and antidepressant effects of tricyclic drugs in primary obsessive-compulsive disorders. Study 1 consisted of a controlled 12-week trial with clomipramine (N = 7) and placebo (N = 5); study 2 analyzed the pooled data from 15 patients uniformly selected and treated with either clomipramine or imipramine. Although the antiobsessional and antidepressant effects of the drugs covaried, their antidepressant action was not a prerequisite for their antiobsessional effect. The findings suggest that clomipramine and probably imipramine possess specific antiobsessive effects that are at least partially independent of their antidepressant effects.
Case 5-1979
Authors: Richard C. Cabot, Robert E. Scully, James J. Galdabini, Betty U. McNeely
Journal: New England Journal of Medicine (1979)

Presentation of Case A 64-year-old man was admitted to the hospital because of fever. There was a long history of excessive use of alcohol and tobacco and of chronic obstructive pulmonary disease. Five months before admission he entered another hospital because of severe dyspnea. Bronchodilator medication and adrenocorticosteroids were administered, and he was discharged on the 16th hospital day with the diagnoses of status asthmaticus and chronic obstructive pulmonary disease. Three months before admission the patient began to have abdominal pain and diarrhea, with occasional vomiting. One month later he returned to his physician, and cimetidine was begun. An upper . . .