tbuckley/cabot-search huggingface dataset:
Clinical and Immunologic Effects of Monthly Administration of Intravenous Cyclophosphamide in Severe Systemic Lupus Erythematosus
Authors: W. Joseph McCune, Joseph Golbus, Wendy Zeldes, Patricia Bohlke, Robert Dunne, David A. Fox
Journal: New England Journal of Medicine (1988)

Severe systemic lupus erythematosus affecting the kidney or central nervous system may lead to organ failure or death despite treatment with high doses of corticosteroids. To evaluate the clinical and immunologic effects of intravenous cyclophosphamide in this setting, we treated nine patients with monthly intravenous infusions of cyclophosphamide for six months. A comparison of characteristics at entry and follow-up revealed improvements (by paired t-test) in creatinine clearance (66 vs. 96 ml per minute, P less than 0.001); 24-hour urinary protein level (4.11 vs. 0.90 g, P less than 0.05), Farr anti-DNA titer (43 vs. 8.5 percent, P less than 0.01); complement components C3 (894 vs. 1150 mg per liter, P less than 0.05), C4 (154 vs. 222 mg per liter, P less than 0.05), and total complement activity (CH50) (88.7 vs. 113.4 IU, P less than 0.05); and Westergren erythrocyte sedimentation rate (60.2 vs. 34.4 mm per hour, P less than 0.0005). Other manifestations of lupus improved markedly in most cases, despite a reduction in the mean daily dose of prednisone, from 45 mg at entry to 17 mg at follow-up (P less than 0.01). The numbers of lymphocytes positive for T3, T4, T8, and B1 declined progressively during treatment. At follow-up, persistent decreases were observed in the T-lymphocyte subsets, whereas the absolute number of B lymphocytes had returned to levels near base line. T-cell proliferative responses at follow-up were not significantly different from entry values, except that the response to mitogenic anti-T11 (CD2) antibodies was decreased (P less than 0.01). Our data indicate that monthly intravenous administration of cyclophosphamide was associated with a substantial amelioration of severe systemic lupus, in conjunction with discrete changes in T-lymphocyte markers and T-cell function. This was a preliminary, uncontrolled study, but the results warrant further investigation of this form of treatment.
Effects of Central-Nervous-System Irradiation on Neuropsychologic Functioning of Children with Acute Lymphocytic Leukemia
Authors: Sileen S. Soni, George W. Marten, Samuel E. Pitner, Danilo A. Duenas, Morris Powazek
Journal: New England Journal of Medicine (1975)

Two neuropsychologic studies were performed to determine the long-term effects of "prophylactic" cranial or craniospinal irradiation on the psychologic and neurologic functions of children with acute lymphocytic leukemia. In a prospective study, 34 patients with leukemia who received either craniospinal irradiation or cranial irradiation combined with intrathecal methotrexate were evaluated by standardized neurologic and psychologic examinations before and after irradiation. Their performance was compared with that of 27 controls who received irradiation to parts of the body other than the cranium. In a retrospective study, 11 patients with leukemia receiving prophylactic craniospinal irradiation and 12 controls with the disease not receiving such therapy were followed from the second year after either irradiation or the initial hematologic remission. Eighteen months after irradiation in the prospective study and four years after irradiation in the retrospective study, no noteworthy neurologic or psychologic differences were found between subjects and controls.
Multiple Sclerosis in Rural Norway
Authors: Roy L. Swank, Ola Lerstad, Axel Strøm, Julie Backer
Journal: New England Journal of Medicine (1952)

THE investigation of the distribution of cases of multiple sclerosis in Switzerland between the years 1918 and 1922 seems to have established that the frequency of this disease can vary greatly in different geographic locations.1 The subsequent studies by Gram2 in Denmark and more recent investigations in the United States3 , 4 leave little doubt that these variations may be real and not due to technical errors in diagnosis, methods of collecting the data and so forth.In another study, Swank5 has suggested the possibility that these variations are related directly to the amount (and possibly the nature) of the fat consumption. . . .
Covariate Adjustment and Propensity Score
Authors: Melissa M. Garrido
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
Blood Glucose Measurements during Symptomatic Episodes in Patients with Suspected Postprandial Hypoglycemia
Authors: Jean Palardy, Jana Havrankova, Raymond Lepage, Ronald Matte, Raphaël Bélanger, Pierre D'Amour, Louis-Georges Ste.-Marie
Journal: New England Journal of Medicine (1989)

Postprandial (reactive) hypoglycemia is a controversial disorder because its symptoms are not specific, the presence of symptoms often correlates weakly with blood glucose concentrations measured after oral glucose administration, and glucose levels have rarely been measured when symptoms have developed spontaneously. In this study, we measured blood glucose in 28 patients with suspected postprandial hypoglycemia while they were experiencing their typical symptoms, in capillary blood collected on filter paper. Five patients (18 percent) had symptoms of "hypoglycemia" that were associated with blood glucose levels of 2.8 mmol per liter (50 mg per deciliter) or less, and eight other patients (29 percent) had symptoms associated with glucose levels of 2.9 to 3.3 mmol per liter on at least one occasion. Six (5 percent) of 132 reported symptomatic episodes that were associated with blood glucose levels of 2.8 mmol per liter or less, and 16 (12 percent) with levels of 2.9 to 3.3 mmol per liter. In 140 measurements made in 17 normal subjects, blood glucose levels were never found to be less than 2.8 mmol per liter, and levels of 2.9 to 3.3 mmol per liter were found only twice. No specific symptom was associated with low glucose levels in the patients with suspected hypoglycemia. The relief of symptoms by ingesting food was more often associated with low than with normal blood glucose levels: 86 percent of episodes in which blood glucose values were less than or equal to 3.3 mmol per liter were relieved by eating, as compared with 53 percent of episodes in which values were more than 3.3 mmol per liter (P less than 0.007). No correlation was found between plasma glucose levels measured after oral glucose administration and blood glucose levels measured during symptoms. We conclude that postprandial hypoglycemia is infrequent, even in a referral population, and that recording blood glucose measurements during spontaneously occurring symptomatic episodes is necessary to establish the diagnosis since symptoms are not specific and oral glucose-tolerance testing is not helpful.
Overtube-assisted placement of a capsule endoscope in a patient with a swallowing disorder
Authors: Sayo Ito, Kinichi Hotta, Kenichiro Imai, Hiroyuki Ono
Journal: Endoscopy (2016)

Small-bowel video capsule endoscopy (VCE) is generally contraindicated in patients with swallowing disorders. However, it is difficult to judge the ability of patients to swallow a capsule endoscope before examination and accidental aspiration of capsule endoscopes has been reported [1] [2] [3]. Previously, it was reported that overtube-assisted VCE placement was useful [4] [5].
Clinical Features of Patients with Hereditary Angioedema with Normal C1 Inhibitor: A Study of Seventy-Four Brazilian Individuals Belonging to Nine Unrelated Families
Authors: Juliana A. Sella, Luana Delcaro, Janaina M.L. Melo, Thais M. Nociti, Marina M. Dias, Solange R. Valle, Alfeu T. França, Soloni Levy, Faradiba Sarquis Serpa, Mariana P.L. Ferriani, Adriana S. Moreno, Luisa Karla P. Arruda
Journal: Journal of Allergy and Clinical Immunology (2016)
Role of thymidine phosphorylase in angiogenesis and its prognostic significance in esophageal carcinoma
Authors: Takuma Nomiya, Kenji Nemoto, Eiko Nakata, Hideo Miyachi, Yoshihiro Takai, Shogo Yamada
Journal: Cancer Research (2005)

Proc Amer Assoc Cancer Res, Volume 46, 2005

4647 

Purpose: Thymidine phosphorylase (dThdPase) is identical to platelet-derived endothelial cell growth factor (PD-ECGF) and has angiogenetic activity in tumor tissue. The purpose of this study was to determine the role of dThdPase in angiogenesis and its clinical significance in prognosis of patients with esophageal carcinoma. Materials and methods: Forty resected esophageal carcinoma tissues were immunohistochemically stained for dThdPase, VEGF, CD34 and Ki67. Expressions of dThdPase and VEGF, microvascular density and cell proliferation activity of each specimen were evaluated and patients’ survival rates were analyzed. Results: Microvascular density was significantly higher in the high dThdPase expression group than in the lower dThdPase expression group (vessel counts (mean ±S.D.): 138 ±75 vs. 93 ±49, p=0.03). Significant positive correlation and regression were found between the level of dThdPase expression and microvascular density (r=0.383: p=0.017, R2=0.788: p<0.0001). No significant relationships were found between dThdPase expression and VEGF expression, clinical stage, cell proliferation activity and the size of tumor. Survival analysis according to dThdPase and VEGF expressions showed that the prognosis of the patients in the dThdPase(+)/VEGF(+) group was significantly poorer than that of the patients in the dThdPase(-)/VEGF(-) group (5-year survival rate: dThdPase(-)/VEGF(-) vs. dThdPase(-)/VEGF(+) or dThdPase(+)/VEGF(-) vs. dThdPase(+)/VEGF(+): 68% vs. 46% vs. 0%, p=0.0003) Conclusion: dThdPase expression seems to have a close relationships with tumor angiogenesis and to be one of the unfavorable prognostic factors. Angiogenesis due to dThdPase overexpression seemed to enhance tumor progression and hematogenous metastases. Evaluation of dThdPase expression seems to be useful for estimating the prognosis of patients and for selecting the optimal anticancer drug for treatment of patients with esophageal carcinoma.
Recurrence of Ph′-Positive Leukemia in Donor Cells after Marrow Transplantation for Chronic Granulocytic Leukemia
Authors: Alberto Marmont, Francesco Frassoni, Andrea Bacigalupo, Marina Podestá, Giovanna Piaggio, Maria T. Van Lint, Attilio Caimo, Sandor de Filippi
Journal: New England Journal of Medicine (1984)

THE recurrence of leukemia in donor cells is a rare type of relapse after bone-marrow transplantation for acute leukemia, whether lymphoblastic or nonlymphoblastic. This phenomenon was first described in 1971,1 and since then additional cases have been reported — two of nonlymphoblastic2,3 and five of lymphoblastic leukemia.1,4 5 6 7 Disease recurred in the original cell line in five cases, and in morphologically different lines in two; all the patients were either in relapse or in an advanced stage of disease at the time of transplantation.We report a case of Ph′(Philadelphia chromosome)-positive leukemic relapse in donor cells after allogeneic marrow transplantation for . . .
Ghost writers need to be more visible
Authors: Keith Dawes
Journal: BMJ (2007)

What is a medical writer? A medical writer is a professional writer who is hired to write scientific or medical documents, including manuscripts for publication in peer reviewed journals. Most medical writers are employed by drug companies, contract research organisations, or medical communication agencies, but there are also freelance medical writers and consultants. 

Currently medical writers contribute extensively to medical journals, mostly as unheralded “ghost writers.” Medical writers also have an important role in medical education, drug development, and drug marketing. Though mostly unseen, unappreciated, and misunderstood, they nevertheless add quite a bit of grease to the wheels of science publishing. It has been claimed that at least 50% of all publications on treatments in the BMJ , Lancet , and New England Journal of Medicine have been written by an unacknowledged ghost writer ( BMJ 2004;329:937; 2004;329:1345). 

Not surprisingly, given the negativity associated with publications sponsored by the drug industry, the hidden role of the medical writer has attracted much criticism. The preconception that medical writers are all unscrupulous—employed by Machiavellian drug companies to distort and promote scientific data in an unethical manner—is untrue. Most medical writers would welcome more recognition; and in an effort to increase transparency a number …
Acquired Circulating Anticoagulants in Hemophilia A
Authors: Herbert S. Strauss
Journal: New England Journal of Medicine (1969)

Factor VIII inhibitor was found in 16 of 77 patients (21 per cent) with severe hemophilia A. In 12 cases with marked inhibition, this became manifest after as few as 20, but no more than 90, accumulated days of exposure to transfusions, and usually before 10 years of age. Four to five days after antigenic stimulation from the infusion of factor VIII, the inhibitor level rose sharply, reached a peak at 10 to 14 days and then declined slowly. Peak inhibitor levels varied greatly in individual patients. On the basis of a patient's inhibitor level, the quantity of factor VIII needed to neutralize his inhibitor could be calculated. Thus, newer and more potent preparations could be rationally used. Eight episodes of life-threatening, enclosed soft-tissue bleeding in these patients required management by exchange transfusion. Sensitive methods for measurements of serum levels of inhibitor are imperative for the management of patients with hemophilia.
NIMG-59PREDICTING THE RESPONSE TO TREATMENT IN GBM: MACHINE LEARNING ON CLINICAL IMAGES
Authors: Corbin Rayfield, Kristin Swanson
Journal: Neuro-Oncology (2015)

NIMG-59. PREDICTING THE RESPONSE TO TREATMENT IN GBM: MACHINE LEARNING ON CLINICAL IMAGES Corbin Rayfield and Kristin Swanson; Mayo Clinic, Scottsdale, AZ, USA Patients suffering from glioblastoma exhibit a wide response to therapy. Studies relying on genetic/phenotypic markers to predict treatment response struggle to deliver clinically useful information in an actionable timeframe which underscores the need for a predictive measure produced by pretreatment clinical information. Our group has previously described the Days Gained (DG) metric of response which is capable of stratifying patients by overall and progression free survival (Neal 2013). We sought to explore whether a predictive algorithm could be used to predict patients’ response to therapy as measured by the DG metric. We studied 52 patients with newly diagnosed glioblastoma who had at least 2 pre-treatment and 1 post radiation therapy MRIs. The group was divided into a training (n 1⁄4 31) and a test set (n 1⁄4 21). A decision tree calculated through multiple iterations of linear regressions was used to generate variables that were correlated with the DG score and cluster the training patients according to clinically available variables. A random forest algorithm was used to search for the optimal model that would differentiate those patients who had a significant response to treatment (DG . 73), previously shown to be predictive of better overall survival (Neal 2013). The variables that clustered patients by treatment response were age, gender, Karnofsky Performance Score, tumors size on MRI (T1Gd and T2) at diagnosis, extent of resection, pre-treatment velocity, and the ratio of the net rates of diffusion to proliferation. A test performed on the test cohort showed 95% accuracy in predicting their response to treatment. This tool, utilizing nothing more than information available at the time of surgery, patients can be stratified according to expected response to adjuvant therapy. By targeting those patients that are predicted not to respond, clinicians can begin to consider more aggressive radiation schemes, faster implementation of salvage therapy or clinical trials. Neuro-Oncology 17:v153–v171, 2015. doi:10.1093/neuonc/nov225.59 Published by Oxford University Press on behalf of the Society for Neuro-Oncology 2015.
The Tonic Effects of Insulin in Acute Alcoholism
Authors: Etem G. Vassaf, Volta R. Hall
Journal: New England Journal of Medicine (1946)

IN all toxic states, the prompt removal of the toxic agent must be the prime consideration in therapy, with the counteracting of its toxic effects and the restoration of impaired organs and their functions as secondary although vital factors. In the treatment of acute alcoholism, rapid elimination of alcohol is important, not only from the point of view of the patient's physical well-being but also for the psychologic implications, in getting him as quickly as possible through the difficult period in which he has not enough alcohol to render him emotionally analgesic, yet too much to permit clear intellectual functioning . . .
Epidemiology of Acute Lower Respiratory Disease in Children
Authors: W. Paul Glezen, Floyd W. Denny
Journal: New England Journal of Medicine (1973)

RESPIRATORY infections are the major cause of morbidity due to acute illnesses in the United States.1 Children may experience six to eight acute respiratory illnesses per year,2 3 4 many of which, particularly in infancy, will involve the lower respiratory tract.4 , 5 Mortality resulting from acute lower respiratory disease is a serious problem in children under five years of age.6 7 8 A large proportion of these illnesses have been ascribed to specific respiratory viruses and Mycoplasma pneumoniae.9 , 10 Despite this information and the scientific knowledge and technical advances that have led to control of diseases such as poliomyelitis and measles, little progress has been . . .
Response of Ankle Systolic Pressure to Leg Exercise in Mild or Questionable Arterial Disease
Authors: Stefan A. Carter
Journal: New England Journal of Medicine (1972)

Measurement of ankle systolic pressure at rest is a valuable method for evaluation of patients with arterial disease. However, when disease is mild, pressure at rest may be normal. We measured ankle pressure, using a pneumatic cuff and an ultrasonic flow detector, before and after 2.5 minutes of flexion extension of the ankle at the rate of one per second. In 37 normal limbs ankle pressure after exercise either remained above or fell only a few millimeters of mercury below the brachial systolic pressure. In 14 limbs with mild disease, ankle pressure fell more than 16 mm Hg below brachial. Among 18 limbs with questionable disease, three responses were normal, four borderline (ankle pressure, 9 to 16 mm Hg below brachial), and 11 abnormal. Measurement of ankle systolic pressure after exercise is thus useful in the assessment of patients with mild or questionable arterial disease.
Case 34-2006
Authors: Paula A. Johnson, Farouc A. Jaffer, Tomas G. Neilan, Jo-Anne O. Shepard, James R. Stone
Journal: New England Journal of Medicine (2006)

A 72-year-old woman awoke from sleep with nausea that worsened during a 24-hour period. Evaluation disclosed pulmonary infiltrates, an elevated granulocyte count, hypoxemia, and hypotension; antibiotics were administered. Blood drawn later showed elevated levels of cardiac enzymes, and an electrocardiogram showed ST-segment elevation. Hypoxemia and hypotension worsened. A diagnostic procedure was performed.
Development of a risk model to identity prognostic ‘outliers’ underwent surgery for early-stage invasive lobular breast carcinoma (ILBC) according to clinical and pathological factors
Authors: L. Carbognin, I. Sperduti, J. Furlanetto, C. Vicentini, R. Nortilli, M. Brunelli, E. Manfrin, A. Nottegar, F. Pellini, G.P. Pollini, F. Bonetti, E. Bria, G. Tortora
Journal: Annals of Oncology (2015)
Case 22-1998
Authors: H. Royden Jones, Suzanne M. de la Monte
Journal: New England Journal of Medicine (1998)

Presentation of CaseA 22-year-old man was seen in the neurology clinic because of an unexplained creatine kinase elevation.He had been well until the age of 17 years, when congestive heart failure developed; microscopical examination of a specimen from a left ventricular endomyocardial biopsy revealed myocarditis (Figure 1). Immunosuppressive therapy, digoxin, and diuretic and vasodilator medications caused no improvement in the patient's condition. One year later, the heart failure had worsened, and during the next 20 months, a series of left ventricular–biopsy specimens showed healed myocarditis, with focal fibrosis and hypertrophy (Figure 2). An orthotopic cardiac transplantation was performed. . . .
Response of a Nonmalignant Pleural Effusion to Bevacizumab
Authors: Oskar Pichelmayer, Christoph Zielinski, Markus Raderer
Journal: New England Journal of Medicine (2005)

To the Editor: The potential role of vascular endothelial growth factor in malignant as well as nonmalignant pleural effusion1,2 prompted us to use bevacizumab, a monoclonal antibody against vascul...
Secular Trends in Coronary Atherosclerosis — Analysis in Patients with Valvular Regurgitation
Authors: Maurice Enriquez-Sarano, Elizabeth Klodas, Kirk N. Garratt, Kent R. Bailey, A. Jamil Tajik, David R. Holmes
Journal: New England Journal of Medicine (1996)

Between 1980 and 1989, mortality due to coronary artery disease decreased considerably in the United States, suggesting a possible decrease in the prevalence of coronary atherosclerosis. We examined this possibility in patients with valvular regurgitation who, often in the absence of angina, underwent coronary angiography before valve-replacement surgery.
Case 14-1982
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, Betty U. McNeely
Journal: New England Journal of Medicine (1982)

Presentation of Case An 81-year-old woman was admitted to the hospital because of severe lumbar pain. There was a long history of hypertension, which was treated with hydrochlorothiazide, triamterene, and propranolol. There was an eight-year history of chronic low-back pain and intermittent right sciatica, treated with salicylates and a corset. Six weeks before admission a severe cough and wheezing developed, and propranolol was discontinued; her symptoms improved slowly during the next four weeks. During the day before entry she was intermittently incontinent of small volumes of urine and had no sensation of bladder distention. In the evening she arose from . . .