tbuckley/cabot-search huggingface dataset:
Trastuzumab in Combination with Different First-Line Chemotherapies for Treatment of Her2-Positive Metastatic Gastric Cancer: Updated Findings from the German Non-Interventional Study Hermes
Authors: S. Al-Batran, H. Kroening, C.V. Hannig, T. Hamm, E. Moorahrend, V. Petersen, E. Eggers, D. Hempel, K. Zielke, T. Wohlfarth, P.C. Thuss-Patience, M. Moehler, S. Hegewisch-Becker
Journal: Annals of Oncology (2014)
PTU-027 Is water assisted colonoscopy superior to carbon dioxide assisted standard colonoscopy: results of an observational study:
Authors: AK Kurup, B Disney, S Shetty, S Ishaq
Journal: Gut (2015)

<h3>Introduction</h3> Water assisted colonoscopy [WAC] is known to reduce patient discomfort and improve the adenoma detection rate [ADR].<sup>1</sup>In this retrospective observational study, we compared water assisted colonoscopy against standard colonoscopy[SC] using CO<sub>2</sub>in a bowel cancer screening positive population. <h3>Method</h3> This was a retrospective review of prospectively collected data. The population studied was undergoing colonoscopies following a positive faecal occult blood test as part of the bowel cancer screening programme [BCSP]. Endoscopist A preferred to intubate the caecum using the water exchange method and endoscopist B would insufflate the bowel using carbon dioxide. Sedation and analgesic use was at the discretion of the endoscopist. The primary outcome was the adenoma detection rate and the comfort scores in the two groups. Secondary outcomes included caecal intubation rate, mean withdrawal time, sedation use and polyp retrieval rate. <h3>Results</h3> Data from two hundred and seven colonoscopies performed from April 2014 to December 2014 [9 months] were analysed. 102 colonoscopies were performed using the water exchange method [group A] and 105 colonoscopies were performed using CO<sub>2</sub>[group B]. Primary outcomes: Adenoma detection rate [ADR] in group A was 53% compared to of 36% in group B. This was statistically significant [difference in rate = -0.1868 [95% CI 0.0052–0.3685 p = 0.0438]. The proportion of patients experiencing none [score 1] or minimal [score2] discomfort [based on modified Gloucester comfort score] were more in group A [n = 74] compared to group B [n = 62]. This was found to be statistically significant [Z = 2.046, p = 0.0408] Secondary outcomes: <h3>Conclusion</h3> Our finding of a significant improvement in ADR and better tolerability in the WAC group supports similar conclusions by Hsieh e t al. This may have potential implications for the bowel cancer screening programme since the perception of colonoscopy can influence public participation and improve uptake in the BCSP. Improved ADR may be due to combination of factors like improved bowel preparation, flattening of mucosal folds and floating effect of polyps with water irrigation. We hope our findings are validated in the future through randomised trials. <h3>Disclosure of interest</h3> None Declared. <h3>Reference</h3> Hsieh YH, Koo M, Leung FW. A patient blinded randomized, controlled trial comparing air insufflation, water immersion and water exchange during minimally sedated colonoscopy. Am J Gastroenterol. 2014;109(9):1390–400
First of All Do No Harm
Authors: Richard J. Duma
Journal: New England Journal of Medicine (1971)

IN the arena of therapeutics "Primum non nocere" is a familiar quotation whose origin is unclear but whose meaning is not. It probably dates back to Hippocrates: "As to diseases, make a habit of two things — to help, or at least to do no harm."* In this era of increasing nosocomial and iatrogenic diseases, the study by Curry and Quie in this issue of the Journal is of considerable import, for the authors' observations of frequent fungemia (in retrospective studies 67 per cent) or septicemia (in prospective studies 27 per cent) associated with or resulting from intravenous hyperalimentation disturbs . . .
Holistic-medical foundations of American psychiatry: a bicentennial
Authors: Z J Lipowski
Journal: American Journal of Psychiatry (1981)

American psychiatry has reached its bicentennial. Holistic-medical foundations have been its hallmark, inspiration, and source of preeminence. Incorporated by psychobiology, the American school, they enabled the growth of psychiatry as a medical specialty and scientific discipline and stimulated unparalleled growth of general hospital psychiatry, psychiatric research and teaching, and psychosomatic medicine and liaison psychiatry. Holistic conceptions, a product of a democratic system and the liberal mind, continue to provide the best framework for psychiatry and an antidote to dogma and fanaticism.
Fatal Amebiasis Complicating Corticosteroid Management of Pemphigus Vulgaris
Authors: Jack Eisert, John E. Hannibal, Saul L. Sanders
Journal: New England Journal of Medicine (1959)

A NUMBER of papers dealing with the use of ACTH and adrenocorticosteroids in infectious diseases have appeared in recent years. In a review of the subject in this journal Spink1 concluded that these hormones, when given for brief periods to patients critically ill with infectious diseases, often produce dramatic improvement, without harmful effects. He also warns, however, that the drugs are potentially dangerous and must be used judiciously.Thomas2 states that cortisone has the property of completely disorganizing the natural host-parasite relation, with enhancement of the infection and the outcome overwhelmingly in favor of the parasite. Deaths due to Staphylococcus . . .
Safety of crizotinib in 892 Japanese ALK-positive advanced NSCLC patients: Interim report of post-marketing surveillance
Authors: Isamu Okamoto, Kazuhiko Nakagawa, Yuichiro Ohe, Naomi Ueno, Shigeo Banno, Yutaka Endo, Emiko Ohki, Akihiko Gemma
Journal: Annals of Oncology (2015)
Aneurysm of a Saphenous-Vein Bypass Graft
Authors: D Sutherland, P C Block
Journal: New England Journal of Medicine (2001)

Figure 1. A 75-year-old man who was taking 8 mg of prednisone per day for systemic lupus erythematosus was admitted for the evaluation of an enlarging chest mass. Seventeen years earlier he had undergone aortocoronary saphenous-vein grafting. Two years before presentation, he had coronary angiography for recurrent chest pain. A chest x-ray film showed a small, rounded irregularity of the right lateral aspect of the cardiac silhouette (arrows in Panel A). A calcified 90 percent stenosis of the proximal native right coronary artery was found. The right saphenous-vein graft was patent and had an aneurysm measuring 8 by 10 mm . . .
Facing Our Mistakes
Authors: David Hilfiker
Journal: New England Journal of Medicine (1984)

Looking at the appointment book for July 12, 1978, I notice that Barb Daily will be in today for her first prenatal examination. "Wonderful," I think, remembering my joy as I helped her deliver her first child two years ago. Barb and her husband Russ are friends, and our relationship became much closer with the shared experience of that birth. With so much exposure to disease every day in my rural family practice, I look forward to today's appointment with Barb and to the continuing relationship over the next months.Barb seems to be in good health with all the . . .
PWE-380 Safety and efficacy of laparoscopic ventral mesh rectopexy and sacrocolpopexy for rectal prolapse and obstructed defecation: analysis of first 20 cases at a uk district general hospital
Authors: A Tennakoon, G Farook
Journal: Gut (2015)

<h3>Introduction</h3> Laparoscopic ventral mesh rectopexy (LVMR) is gaining wider acceptance. The aim of this study is to present that LVMR can be learnt and safely performed with short term results similar to that of establish centres <h3>Method</h3> All patients presented with obstructed defecation (ODS) and rectal prolapse from January 2011 to January 2015 underwent anorectal physiology, defecation proctography, colon transit studies, colonoscopy or sigmoidoscopy as appropriate, pelvic floor MDT and biofeedback. Patients with high grade intussusception who did not respond to laxatives and biofeedback were offered LVMR. Surgical technique was as described by A. D’Hoore <i><i>et al</i></i>. and was performed by both authors who are experienced laparoscopic surgeons. We initially used lightweight monofilament polyester mesh (Parietex™) 4 × 20 cm. This was later changed to Titanium coated lightweight polypropylene mesh (TiLENE®) 4 × 20 cm or 4 cm × 18 cm × 1 mm biological mesh (Permacol™) in young patients. Suturing was Intracorporeal and Ethibond Excel®2/0 was used to attach the mesh to the rectum. Vicryl® 2/0 was used for Colpopexy and ProTack™ 5mm for attaching the mesh to the sacral promontory. Data concerning demographics, operative data, complications, length of stay, recurrence and patient reported outcome were gathered from a prospective data base. Data are presented as median, range and proportions. <h3>Results</h3> Median age, ASA and BMI were 60.5 (34–78), 2 (1–3), 26.1 (20.4–33.1). Previous pelvic surgery included hysterectomy (35%), Vaginal wall repair (15%) and rectal prolapse surgery (20%). 2 patients had undergone Delorme’s procedure whereas 2 patients had previous laparoscopic suture rectopexy. 60% had Oxford prolapse grades 3/4 and rest were grade 5. Enterocele (25%), Rectocele (40%) and Middle compartment prolapse (5%) were associated. Median operative time was 229 min (175–330). Synthetic mesh was used in 16 patients (Parietex 30%, TiLENE 50%) and Permacol in 4(20%). Colpopexy was performed in 90%. 30 day mortality was zero. There were no conversions and overall complication rate was 10% (1 wound infection and 1 port site hernia). No intraoperative complications, mesh related complications or sexual dysfunction were reported. Median length of stay was 3(2–6). 17 patients (85%) had 6 months or more follow up. Median patient reported outcome for satisfaction was 9.5 on a scale of 1 to 10(2–10). One patient developed recurrence of ODS after 1 year. One patient (Permacol) developed recurrent prolapse as well as anterior and posterior vaginal prolapse after 6 months. <h3>Conclusion</h3> We suggest that experienced laparoscopic surgeons can learn and safely perform laparoscopic ventral mesh rectopexy <h3>Disclosure of interest</h3> None Declared.
The Behavior and Biology Behind Bariatric Surgery Outcomes
Authors: Amir A. Ghaferi, Marilyn Woodruff, Jenna Arnould
Journal: JAMA Surgery (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 Surgery 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 Surgery journal
IMPS-23RETROSPECTIVE ANALYSIS CLINICAL RESULTS OF AUTOLOGOUS FORMALIN-FIXED TUMOR VACCINE FOR NEWLY DIAGNOSED GLIOBLASTOMA
Authors: Takashi Maruyama, Yoshihiro Muragaki, Masayuki Nitta, Hiroshi Iseki, Tadao Ohno, Takakazu Kawamata
Journal: Neuro-Oncology (2015)

There has been a growing interest in therapeutic modalities based on tumor-specific immune reactions for glioblastoma (GBM). Autologous formalin-fixed tumor vaccine (AFTV) for GBM is an emerging innovative treatment approach, which aims at stimulating patient's own immune system. We retrospectively analyzed clinical results of vaccine treatment patients. 63 cases of newly diagnosed GBM cases with concomitant AFTV treatment on the 1st line therapy were analyzed comparing with 100 cases of control group without AFTV during 2000 ∼ 2013. Newly diagnosed GBM with KPS > 60, 16-75yo, more than 80% removal were enrolled for the analysis. Three courses of AFTV was administered after initial treatment of chemo- and radiation. Overall survival (OS) and progression free survival (PFS) were analyzed. mOS of AFTV group and control group were 31.3 months and 20.6 months (p = 0.01). mPFS were 14.0 months and 9.8 moths (p = 0.037). OS of delayed-type hypersensitivity(DTH) positive group was 31.6 months comparing with 15.4 months in negative group(p = 0.063). multivariate analysis showed significant association in KPS (HR 1.84). The results of this study demonstrate the feasibility of AFTV as concomitant treatment of 1st line therapy. We are ongoing multicenter double-blind prospective randomized phase II/III trial.
S63 Human Mesenchymal Stromal Cell (hMSC) regulation of human macrophages in<i>in vitro</i>models of the Acute Respiratory Distress Syndrome (ARDS)
Authors: T Morrison, M Jackson, A Kissenpfennig, C O’Kane, D McAuley, A Krasnodembskaya
Journal: Thorax (2015)

<h3>Background</h3> Currently there is no effective therapy which targets the mechanisms underlying the development of ARDS. MSCs present a promising candidate therapy and are being tested in clinical trials for ARDS however their mechanisms of effect in ARDS are not fully understood. Since the alveolar macrophage is key to orchestrating the alveolar inflammatory response, it was hypothesised that hMSCs induce an anti-inflammatory M2-like phenotype in human macrophages. The aim of this study therefore was to determine the effect of MSCs on macrophage phenotype and function and to elucidate the mechanisms of these effects. <h3>Methods</h3> Using an <i>in vitro</i> non-contact co-culture system, human MSCs and human monocyte-derived-macrophages (MDMs) were stimulated with <i>E.coli</i> lipopolysaccharide (LPS). Cytokine and marker expression profiles were examined using ELISAs, multiplex and flow cytometry. Phagocytic capacity of MDMs was measured using fluorescent <i>E.coli</i> bioparticles by flow cytometry. For additional clinical relevance, the ARDS microenvironment was mimicked by using bronchoalveolar lavage fluid (BALF) obtained from patients with ARDS to examine the effect of MSCs. <h3>Results</h3> MSCs suppress the production of both pro-inflammatory and anti-inflammatory cytokines by MDMs stimulated with LPS. MSCs increase expression of M2 markers CD163 and CD206 and have no effect on M1 markers CD80 and ICAM-1. Importantly, in spite of the immunosuppressive effect on macrophages, MSCs increase their phagocytic capacity. MSC effects on cytokine secretion and marker expression were maintained in the presence of BALF from patients with ARDS (Figure 1). <h3>Conclusions</h3> Human bone marrow-derived MSCs induce an M2-like phenotype and suppress cytokine secretion in primary human MDMs stimulated with LPS or ARDS patient BALF. Importantly, these effects are coupled with augmentation of macrophage phagocytosis which may be important in the clearance of bacteria and apoptotic cells. Uncovering the paracrine mechanisms responsible for the MSC effects on human macrophages remain the focus of ongoing work. <h3>Supported by</h3> MRC MR/L017229/1, Department of Employment and Learning. <i>Some of the materials employed in this work were provided by the Texas A&amp;M Health Science Centre College of Medicine Institute for Regenerative Medicine at Scott and White through a grant from NCRR of the NIH, Grant # P40RR017447.</i>
Percutaneous Aspiration Biopsy of the Pancreas under Ultrasonic Guidance
Authors: Edward H. Smith, Royal J. Bartrum, Young C. Chang, Carl J. D'Orsi, Jacob Lokich, Americo Abbruzzese, John Dantono
Journal: New England Journal of Medicine (1975)

Fine-needle aspiration biopsy for cytologic diagnosis was performed on seven patients suspected of having pancreatic tumors. A 23-gauge biopsy needle was accurately placed in the suspicious lesion under ultrasonic guidance. Six patients had tumors; of these, five had a definite cytologic diagnosis, and the sixth was suspicious of tumor. There was no morbidity associated with the procedure in these patients. Although fine-needle biopsy is not expected to prolong life in patients with pancreatic tumors, it does eliminate the need for more complicated, expensive, uncomfortable and hazardous diagnostic procedures. In many cases exploratory surgery may be obviated.
The lived experience with idiopathic pulmonary fibrosis: a qualitative study
Authors: Dorthe Overgaard, Gudrun Kaldan, Kristoffer Marsaa, Thyge Lynghøj Nielsen, Saher Burhan Shaker, Ingrid Egerod
Journal: European Respiratory Journal (2016)

The disease course in idiopathic pulmonary fibrosis (IPF) is variable, but patients experience a progressive decline in lung function and increased symptom burden leading to death. Little is known about the patients' experience and their needs during the disease course or about the burden on family caregivers. Both patients and family caregivers face an altered life as the disease progresses. The aim of our study was to increase knowledge of life with IPF for patients and family caregivers. This study had a qualitative descriptive design using in-depth dyadic interviews with IPF patients (n=25) and family caregivers (n=24). We used the five-step analysis from the framework method and analysed the data on three levels: the patient, the family caregivers and couple level. The following six themes emerged as the main results: information and disclosure, reactional dyssynchrony, perpetual vigilance, emotional ambivalence, gradual and tacit role shift, and adapted coping strategies. Our findings suggest that IPF patients need information at the time of diagnosis, but some issues should be paced as the disease progresses. A palliation plan was demanded by patients and their caregivers. Further efforts are required to provide palliative care to IPF patients starting at the time of diagnosis.
Evidence for a Genetic Etiology of Temporal-Central Abnormalities in Focal Epilepsy
Authors: Patrick F. Bray, W. C. Wiser, M. Carol Wood, Shirley B. Pusey
Journal: New England Journal of Medicine (1964)

IT has been known for many years that genetic factors play some part in the etiology of idiopathic epilepsy. Some studies have considered only the incidence of clinical epilepsy, and others have reported the incidence of electroencephalographic abnormalities in symptom-free near relatives. Few carefully controlled electroencephalographic studies of epilepsy have been carried out with the use of the methods of population genetics. Workers who have employed their own control groups have reached the unanimous conclusion that the evidence of epilepsy among near relatives of index cases is significantly higher than one would expect in a control population. In 1940 Lennox, . . .
Hypomethylation induction in MDS after treatment with decitabine at three different doses
Authors: Y. Oki, H. Kantarjian, J. Davis, F. Ravandi-Kashani, S. Verstovsek, J. E. Cortes, G. Garcia Manero, J.-P. Issa
Journal: Journal of Clinical Oncology (2005)

6546 Background: DNA methyltransferase inhibitors have shown efficacy in patients with MDS. We are conducting a randomized phase II trial of decitabine in MDS at three doses (Group 1: 20 mg/m2 IV daily for 5 days, Group 2: 10 mg/m2 IV daily for 10 days, Group 3: 10 mg/m2 subcutaneously twice a day for 5 days). It remains unclear whether hypomethylation of critical genes and/or global DNA hypomethylation mediate responses to the agent. Methods: Mononuclear cell DNA was obtained from 54 patients at different times (pre-treatment, day 5, 12, and day 26). Using bisulfite/pyrosequencing method, we quantified the methylation status at seven CpG sites in the repetitive element LINE as a surrogate for global methylation, and three CpG sites in the p15 promoter. Results: The overall response rate was 85% (CR 33%, PR 7%, and hematological improvement 44%). CR rate was highest in Group1 (42%) followed by group 3 (29%) and group 2 (25%). Relative LINE hypomethylation (decrease/baseline) averaged 5.5%, 14.0% and 6.9% on days 5, 12, and 26, respectively. Hypomethylation was least pronounced in group 2 (day5; 3.5% vs. 6.3%, p=0.32, Day10; 10.0% vs. 16.3%, p=0.05), which also had the lowest CR rate. There were only 8 patients with no evidence of response, and they had a trend towards lower degree of hypomethylation than responders on day 5 (2.1% vs. 6.1%, p=0.26) and day 10 (10.9% vs. 14.8%, p=0.32). P15 promoter methylation (>10%) was observed in 17/47 patients (36%) before treatment. Significant hypomethylation induction (>20% of baseline) was observed in 12 of these (71%) after decitabine. Baseline p15 methylation trended slightly higher in non-responders than in responders (13.6% vs. 8.2%, p=0.13), but clinical response was observed in patients both with and without baseline p15 methylation, and p15 hypomethylation induction did not correlate with response. Conclusions: Decitabine is very active in MDS. Clinical and laboratory correlates suggest that increasing dose-intensity results in greater hypomethylation and greater clinical efficacy in this disease. P15 promoter methylation at baseline or after therapy was not a predictor of response, and further studies into genes critical for responses to this hypomethylating agent are needed. No significant financial relationships to disclose.
Insulin resistance modifies the association between obesity and current asthma in adults
Authors: Juan Carlos Cardet, Samuel Ash, Tope Kusa, Carlos A. Camargo, Elliot Israel
Journal: European Respiratory Journal (2016)

Insulin resistance potentiates the association between obesity and childhood asthma, but this relationship appears inconsistent in relatively small studies of adults. We investigated effect modification in adults using the National Health and Nutrition Examination Survey 2003–2012, a large, nationally representative database. Insulin resistance and a history of physician-diagnosed current asthma were obtained from 12 421 adults, ages 18–85 years. We used logistic regression to determine associations between obesity and current asthma, adjusting for age, sex, race/ethnicity, poverty income ratio and smoking status. An interaction term evaluated effect modification by insulin resistance of the obesity–asthma association. As expected, obesity was positively associated with current asthma. Insulin resistance modified this association, with obesity measured as body mass index, waist circumference or waist-to-height ratio. The relationship between obesity and current asthma was stronger with increasing insulin resistance tertiles (OR 2.05, 95% CI 2.76–3.00; p-value for interaction 0.03). This association was robust to adjustments for other components of the metabolic syndrome (hypertriglyceridaemia, hypertension, hyperglycaemia and systemic inflammation). None of these components were themselves effect modifiers of the obesity–asthma association. In this large, nationally representative sample, insulin resistance modified the association between obesity and current asthma in adults. Targeting insulin resistance may represent a novel therapeutic strategy for obese patients with asthma.