tbuckley/cabot-search huggingface dataset:
NS-04A CASE REPORT OF A GIANT CONGENITAL TERATOMA MANAGED THROUGH EX UTERO INTRAPARTUM TREATMENT PROCEDURE AND MULTIPLE STAGED SURGERIES
Authors: Ulrika Sandvik, Caroline Gahm, Georgios Papatziamos, Andreas Ekborn, Erik Neovius, Yinghua Li, Bengt Gustavsson
Journal: Neuro-Oncology (2016)

NS-04. A CASE REPORT OF A GIANT CONGENITAL TERATOMA MANAGED THROUGH EX UTERO INTRAPARTUM TREATMENT PROCEDURE AND MULTIPLE STAGED SURGERIES Ulrika Sandvik1, Caroline Gahm2, Georgios Papatziamos2, Andreas Ekborn2, Erik Neovius3, Yinghua Li4, and Bengt Gustavsson1; Section for Neurosurgery, Department of Clinical Neuroscience. Karolinska University Hospital, Stockholm, Sweden; Department of Otorhinolaryngology, Head and Neck Surgery, Karolinska University Hospital, Stockholm, Sweden; Stockholm Craniofacial Center, Department of Reconstructive Plastic Surgery, Karolinska University Hospital, Stockholm, Sweden; Departmentof Neonatology, Astrid Lindgrens Childrens Hospital, Karolinska University Hospital, Stockholm, Sweden Our patient was prenatally diagnosed with a giant teratoma. The delivery was performed in gestational week 32 + 5 with birth weight 2.3kg through an EXIT (ex utero intrapartum treatment) procedure including caesarean section and an immediate tracheostomy followed by neonatal intensive care. MRI revealed a multicystic, contrast enhancing tumor extending from the left shoulder area up to the face including the left orbita. The tumor extended also intracranially to the left posteriorand middle fossa dislocating both brainstem and temporal lobe. After thorough the ethical discussions and planning, the child was operated by staged surgeries. At four days of age the child was operated for the cervical part of the teratoma by a team of ENT-surgeons. A second surgery performed by a team of ENT-surgeons, plastic surgeons and neurosurgeons was done five days later. A residual mass in the epipharynx was removed one month later. The histopathological evaluation was consistent with congenital immature teratoma WHO grade III. The tracheostoma was successfully removed two months later and the patient was discharged after three month neonatal intensive care without infection or intracranial hemorrhage. The patient is currently 21 months and displays normal mental, motor, and physical development and has so far been relapse-free with low levels of alpha fetoprotein. Congenital giant teratomas are associated with significant surgical risks mainly due to blood loss and difficulties in maintaining a patent airway. Here we present a strategy where a highly specialized delivery process and multiple staged surgeries have been essential for successful management. Neuro-Oncology 18:iii127–iii134, 2016. doi:10.1093/neuonc/now078.4 #The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
LMI-10TEN YEARS SURVEY OF PEDIATRIC BRAIN TUMOURS IN ALEXANDRIA
Authors: Shady Fadel, Moatasem Elayadi, Wael Kedr
Journal: Neuro-Oncology (2016)

LMI-10. TEN YEARS SURVEY OF PEDIATRIC BRAIN TUMOURS IN ALEXANDRIA Shady Fadel1, Moatasem Elayadi3, and Wael Kedr2; Pediatric Oncology, Alexandria University, Alexandria, Egypt; Neurosurgery, Alexandria University, Alexandria, Egypt; Pediatric Oncology, NCI, Cairo, Egypt BACKGROUND: Brain tumors form the second most common cancer in children, accounting for a quarter of all childhood cancers. Alexandria the second largest province of Egypt with a population of 8 million and 3.6 millions child. Data on childhood brain tumors in Alexandria is scarce. The multidisciplinary (MDC) was first implemented in January 2011. Our objectives were to identify characteristics, outcome data and challenges for children with brain tumors in Alexandria. In addition we wanted to measure the impact of MDC approach. METHODS: All children less than 19 years old who presented to the neurosurgery department at Alexandria University between January 2003 and January 2013 with a brain tumor. RESULTS: 161 children (91 boys) eligible for inclusion, The mean age was 7.8 years. Most of the tumors were infratentorial (55%), the pathology showed Astrocytic tumors (22.3 %), Medulloblastomas (18.6 %), Ependymoma (12.4 %), Brain stem glioma (11.1 %), Pineoblastoma (0.04 %), Craniopharyngiomas (0.03 %), Supratentorial PNETs (0.03 %). GTR in 62%, STR was done in 31 % (11% for biopsy of brain stem gliomas) and 7% the operations were aborted. 6/37 cases with CSF tested were found positive for metastatic disease; MB1⁄4 2 cases, Ependymoma1⁄4 2 cases, ATRT1⁄4 1 and Pineoblastoma1⁄4 1. Recurrence 24% of children. 18% incomplete data, 40% died, 42% are alive. CONCLUSIONS: Establishment of data registry for pediatric brain tumors gives a basic backup for, which reveals an increasing rate of detection and a more application of surgical treatment, which will improve the surgical outcome and survival. Neuro-Oncology 18:iii123–iii126, 2016. doi:10.1093/neuonc/now077.9 #The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
LG-59MORTALITY IN CHILDREN WITH LOW-GRADE GLIOMA: A SINGLE-INSTITUTION STUDY
Authors: Santhosh Upadhyaya, Yahya Ghazwani, Shengjie Wu, Alberto Broniscer, David Ellison, Amar Gajjar, Ibrahim Qaddoumi
Journal: Neuro-Oncology (2016)

LG-59. MORTALITY IN CHILDREN WITH LOW-GRADE GLIOMA: A SINGLE-INSTITUTION STUDY Santhosh Upadhyaya, Yahya Ghazwani, Shengjie Wu, Alberto Broniscer, David Ellison, Amar Gajjar, and Ibrahim Qaddoumi; St. Jude Children’s Research Hospital, Memphis, TN, USA PURPOSE: Few studies address cause of death in children with low-grade glioma (LGG). METHODS: We conducted a retrospective review of clinical, pathologic, and radiologic data from children (,21 years old) with LGG who died, at St. Jude Children’s Research Hospital between 1983 and 2015. RESULTS: For the 86 eligible patients, median age of diagnosis was 7.6 years (range, 0.1-21 years), median age of death was 14 years (range, 0.6-32 years), and median duration to death from diagnosis was 3.5 years (range, 0.2-32 years). Thalamus/midbrain was the most common tumor location (n 1⁄4 35), followed by suprasellar/hypothalamic (n 1⁄4 19) and hemispherical (n 1⁄4 13). Astrocytoma, not otherwise specified (n 1⁄4 23) was the most common histologic diagnosis, followed by pilocytic astrocytoma (n 1⁄4 22), fibrillary astrocytoma (n 1⁄4 12), and pleomorphic xanthoastrocytoma (n 1⁄4 6). The cause of death was progression (PD) of primary tumor (n 1⁄4 40), malignant transformation (MT) to a highgrade tumor (n 1⁄4 17), sepsis (n 1⁄4 4), second cancer (n 1⁄4 3), suicide (n 1⁄4 2), accident (n 1⁄4 2), respiratory compromise (n 1⁄4 4), and miscellaneous causes (n 1⁄4 6). Cause of death was unknown in 8 patients. Among those with MT, 8/17 had received radiotherapy prior to transformation. Three patients had a diagnosis of neurofibromatosis type 1, 2 of whom died from a second malignancy and 1 from MT. Four patients had metastatic disease at diagnosis, and 29 developed metastasis during the clinical course. CONCLUSIONS: PD and MT contributed to 66% of the mortality in our patient cohort. Understanding the molecular basis of PD and MT is vital to plan optimal therapy for children with LGG and reduce mortality. Neuro-Oncology 18:iii78–iii96, 2016. doi:10.1093/neuonc/now075.59 #The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Expand non-medical roles to give doctors training time, royal college says
Authors: Matthew Limb
Journal: BMJ (2016)

Non-medical staff in England should be given fully developed roles in extended surgical teams to let junior doctors have more time for training, the Royal College of Surgeons has said.

More patients could be treated by the growing numbers of non-medical practitioners, such as advanced nurse practitioners, physician associates, and surgical first assistants, the college said.

This could enhance patient care, surgical training, and consultant teams—but the roles of non-medical practitioners must be properly developed, “better aligned with the surgical profession,” and made part of the NHS’s workforce planning, it argued. The college said that its report on the issue “challenged the status quo that doctors in training should be the default providers of frontline medical …
GRAM-NEGATIVE BACTEREMIA
Authors: J Lewis, F R Fekety
Journal: JAMA (1963)

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
Infectious Mononucleosis
Authors: Mark H. Ebell
Journal: JAMA (2016)

Infectious mononucleosis ("mono") is an infection that causes sore throat, fever, swollen glands, and tiredness or fatigue. Causes of Infectious MononucleosisInfectious mononucleosis is transmitted by exposure to saliva, so it can be spread by kissing, by sharing glasses or cutlery, and by droplets spread by coughing.Mono is usually caused by the Epstein-Barr virus.It most often affects children, teenagers, and young adults.Other diseases that cause similar symptoms include infection with other viruses that cause sore throat, streptococcal bacteria ("strep throat"), or cytomegalovirus.
Characteristics, Treatments, and Outcomes of Hospitalized Heart Failure Patients Stratified by Etiologies of Cardiomyopathy
Authors: Supriya Shore, Maria V. Grau-Sepulveda, Deepak L. Bhatt, Paul A. Heidenreich, Zubin J. Eapen, Adrian F. Hernandez, Clyde W. Yancy, Gregg C. Fonarow
Journal: JACC Heart Failure (2015)
Response to 35% CO2 as a marker of panic in severe anxiety
Authors: E Griez, J Zandbergen, H Pols, C de Loof
Journal: American Journal of Psychiatry (1990)

One inhalation of 35% CO2 was administered to each of 32 patients with high anxiety ratings. Only patients with panic disorder had increases in reported anxiety upon CO2 intake. CO2-triggered anxiety appears specific for panic disorder and independent of baseline anxiety.
HG-116ONCOGENIC ACTIVITY OF HISTONE MUTATIONS IN THE MAMMALIAN BRAIN
Authors: Jon Larson, Lawryn Kasper, Gang Wu, Yiping Fan, Xiaoyan Zhu, Barbara Paugh, Chunxu Qu, Helen Russell, Peter McKinnon, David Ellison, Jinghui Zhang, Suzanne Baker
Journal: Neuro-Oncology (2016)
Anxiogenic effects of CO2 and hyperventilation in patients with panic disorder
Authors: J M Gorman, L A Papp, J D Coplan, J M Martinez, S Lennon, R R Goetz, D Ross, D F Klein
Journal: American Journal of Psychiatry (1994)

Previous studies have indicated that patients with panic disorder are more likely than normal subjects to have acute panic attacks during inhalation of CO2, but methodological objections have been raised. In this study the authors attempted to address three of these methodological problems by ensuring that raters who assessed whether panic attacks occurred were blind to subjects' diagnoses, by randomizing the order of administration of 5% CO2 and hyperventilation, and by challenging a greater number of subjects with 7% CO2.Patients with panic disorder and normal subjects underwent 20-minute inhalations of 5% CO2 and 7% CO2 and 15 minutes of room-air hyperventilation. Ratings of panic/no panic during each condition were made separately by an assessor blind to diagnosis and by the subject. Scores on four panic rating scales were also recorded before and after each intervention.Room-air hyperventilation caused panic attacks in a small number of patients; the difference in panic rate between patients and comparison subjects was statistically significant by the subjects' but not by the raters' assessment. Panic rates during 5% CO2 and 7% CO2 were significantly greater among the patients by both assessments; the panic rate was greatest during 7% CO2. Order of administration did not significantly affect panic rates for hyperventilation and 5% CO2.Panic patients were clearly more sensitive to the anxiogenic effects of CO2 than comparison subjects, and CO2 was a more potent anxiogenic stimulus than room-air hyperventilation. Seven percent CO2 discriminated best between patients and comparison subjects and should be the focus of further research.
Drug-Resistant<i>Streptococcus pneumoniae</i>
Authors: N E Clynes
Journal: New England Journal of Medicine (1996)

To the Editor: Since the first description of infection caused by b -lactam-resistant Streptococcus pneumoniae, the optimal empirical antibiotic therapy for patients with suspected meningitis caused by this microorganism has remained unknown.Hofmann et al. (Aug.24 issue) 1 reported a 25 percent prevalence of penicillin-resistant S. pneumoniae isolates and a 9 percent prevalence of cephalosporin-resistant isolates among 431 patients with invasive pneumococcal infections in Atlanta.The authors recommended adding vancomycin to the initial therapeutic regimen of patients with suspected pneumococcal meningitis.Their suggestion appears questionable because they did not present the susceptibility patterns of the meningeal strains or discuss morbidity and mortality, there are insufficient published data to support their recommendation, and the adjunctive use of dexamethasone may reduce the penetration of vancomycin into the cerebrospinal fluid.In addition, there have been reports in the literature on the failure of vancomycin monotherapy for S. pneumoniae meningitis. 2 Finally, it has recently been shown that the clinical outcome of patients with meningitis due to S. pneumoniae that is relatively resistant to broad-spectrum cephalosporins (minimal inhibitory concentration [MIC] of cefotaxime, Ͻ 2 m g per milliliter) is similar to that of patients infected with susceptible strains and that treatment with high doses of cefotaxime could be appropriate in this setting. 3,4 Before recommending the routine addition of vancomycin to the regimen used to treat suspected cases of S. pneumoniae meningitis, one should first demonstrate that its use is associated with a significant survival benefit.Another approach would be to reserve the use of vancomycin for infections that do not respond to b -lactam antibiotics, which would help delay the emergence of vancomycin-resistant strains of S. pneumoniae, such as we are now seeing with the strains resistant to broad-spectrum cephalosporins.
Hidden extras
Authors: Ike Iheanacho
Journal: BMJ (2007)

Last weekend The Food Magazine published research on over-the-counter medicines for young children (www.foodcomm.org.uk/latest_medicines_Mar07.htm). Its conclusion that some of these treatments contain inappropriate additives has caused understandable anxiety among parents and healthcare professionals. But this has overshadowed wider issues about the content of medicines, particularly those less safe than over-the-counter treatments.

Every working day, a doctor may unknowingly prescribe dozens of substances. This represents neither incompetence nor carelessness. Far from it: each prescription might be wholly appropriate and accurately documented. Nevertheless, it may still obscure exactly what the patient is being invited to take.

This is because of the ragbag of other substances incorporated in a prescribed medicine with the so-called active ingredient. Possibilities include coatings, colourants, printing inks, preservatives, sweeteners, flavourings, fillers, agents to facilitate binding or disintegration, lubricants and flow-enhancers—a non-exhaustive list. These excipients (and even this umbrella term may be unfamiliar to some prescribers) are typically an under-recognised part of treatment. Until something goes wrong, that is.

A common misconception is that excipents are completely inert substances not worth worrying about. In reality, these supposedly innocent bystanders can cause significant casualties. Such effects may well be highlighted in a medicine's product literature or other guidance; but, even so, a lack of awareness may prevent the prescriber from averting or promptly spotting them. Clinical reactions are not the only problem. People with specific religious or lifestyle principles can feel justifiably aggrieved if not forewarned of, or offered alternatives to, medicines that contain animal derivatives such as pork or beef gelatin.

None of this should undermine the importance of excipients. After all, they may be crucial in making, stabilising, distinguishing, storing, and taking medicines. And there is clearly a balance to be struck between avoiding unjustified paranoia in the prescriber and patient, while ensuring both are well informed about the therapies they use. But achieving this compromise is difficult, not least because doctors are usually taught little or nothing about excipients. This knowledge gap can leave them hamstrung to critically appraise a medicine's content, as they would clinical data about the treatment, for instance.

Oddly enough, another type of prescriber is better placed to make this sort of assessment. The development of prescribing by pharmacists in the UK has been greeted rather sniffily in certain quarters. Yet here is an area where the training and experience of these individuals may confer advantages over doctors in some prescribing decisions. It is hard to believe this differential expertise will not have tangible benefits for patients. It might do something for the sniffing, too.
Effect of Lifetime Exposure to Aflatoxin B 1 in Rats 2
Authors: Jerrold M. Ward, James M. Sontag, Elizabeth K. Weisburger, Carolyn A. Brown
Journal: JNCI Journal of the National Cancer Institute (1975)

Aflatoxin B1 was feci at 2 ppm in the diet to a group of pregnant F344 rats from the time of conception; it was then fed to their offspring until death. This diet was also given to another group of rats 6-7 weeks old for comparison. The survival time of male rats was significantly shorter than that of the female rats of both groups. However, the survival times of rats of the same sex in both groups did not differ significantly. The major causes of death were hepatic neoplasms with metastases, although some early deaths occurred before neoplasms developed. Most deaths were from a malignant hemorrhagic liver tumor, histologically diagnosed as a hemangiosarcoma, which caused rupture and hemorrhage into the peritoneal cavity or metastases to the lungs. These hemangiosarcomas were readily transplantable and did not produce α-fetoprotein. Ultrastructurally, they were composed of poorly differentiated cells resembling endothelial cells. Nodules of hyperplasia induced by aflatoxin B1 sometimes grew large (>1.5 em), and 2 were transplanted. Approximately 20% of the rats had colon tumors; a few rats had tumors of the kidney, oral cavity, and hematopoietic system.
Interventional Nanotheranostics of Pancreatic Ductal Adenocarcinoma
Authors: Junjie Li, Fengyong Liu, Sanjay Gupta, Chun Li
Journal: Theranostics (2016)

Pancreatic ductal adenocarcinoma (PDAC) accounts for over 90% of all pancreatic cancer.Nanoparticles (NPs) offer new opportunities for image-guided therapy owing to the unique physicochemical properties of the nanoscale effect and the multifunctional capabilities of NPs.However, major obstacles exist for NP-mediated cancer theranostics, especially in PDAC.The hypovascular nature of PDAC may impede the deposition of NPs into the tumor after systemic administration, and most NPs localize predominantly in the mononuclear phagocytic system, leading to a relatively poor tumor-to-surrounding-organ uptake ratio.Image guidance combined with minimally invasive interventional procedures may help circumvent these barriers to poor drug delivery of NPs in PDAC.Interventional treatments allow regional drug delivery, targeted vascular embolization, direct tumor ablation, and the possibility of disrupting the stromal barrier of PDAC.Interventional treatments also have potentially fewer complications, faster recovery, and lower cost compared with conventional therapies.This work is an overview of current image-guided interventional cancer nanotheranostics with specific attention given to their applications for the management of PDAC.
Radiofrequency Renal Denervation Protects the Ischemic Heart via Inhibition of GRK2 and Increased Nitric Oxide Signaling
Authors: David J. Polhemus, Juan Gao, Amy L. Scarborough, Rishi Trivedi, Kathleen H. McDonough, Traci T. Goodchild, Frank Smart, Daniel R. Kapusta, David J. Lefer
Journal: Circulation Research (2016)

Catheter-based renal denervation (RDN) is currently under development for the treatment of resistant hypertension and is thought to reduce blood pressure via interruption of sympathetic pathways that modulate cardiovascular function. The sympathetic nervous system also plays a critical role in the pathogenesis of acute myocardial infarction and heart failure.We examined whether treatment with radiofrequency (RF)-RDN would protect the heart against subsequent myocardial ischemia/reperfusion injury via direct effects on the myocardium.Spontaneously hypertensive rats received either bilateral RF-RDN or sham-RDN. At 4 weeks after RF-RDN (n=14) or sham-RDN (n=14) treatment, spontaneously hypertensive rats were subjected to 30 minutes of transient coronary artery occlusion and 24 hours -7 days reperfusion. Four weeks after RF-RDN, myocardial oxidative stress was markedly attenuated, and transcription and translation of antioxidants, superoxide dismutase 1 and glutathione peroxidase-1, were significantly upregulated compared with sham-RDN spontaneously hypertensive rats. RF-RDN also inhibited myocardial G protein-coupled receptor kinase 2 pathological signaling and enhanced myocardial endothelial nitric oxide synthase function and nitric oxide signaling. RF-RDN therapy resulted in a significant reduction in myocardial infarct size per area at risk compared with sham-RDN (26.8 versus 43.9%; P<0.01) at 24 hours postreperfusion and significantly improved left ventricular function at 7 days after myocardial ischemia/reperfusion.RF-RDN reduced oxidative stress, inhibited G protein-coupled receptor kinase 2 signaling, increased nitric oxide bioavailability, and ameliorated myocardial reperfusion injury in the setting of severe hypertension. These findings provide new insights into the remote cardioprotective effects of RF-RDN acting directly on cardiac myocytes to attenuate cell death and protect against ischemic injury.
Nitric Oxide Deficiency Triggering Strokelike Episodes
Authors: Josef Finsterer, Sinda Zarrouk-Mahjoub
Journal: JAMA Neurology (2016)

To the Editor With interest we read the article by Koenig et al1 about the management of strokelike episodes (SLEs) by early administration of the nitric oxide precursors l-arginine or citrulline. We have the following comments and concerns.
Accelerated T-cell activation and differentiation of polar subsets characterizes early atopic dermatitis development
Authors: Hitokazu Esaki, Tali Czarnowicki, Juana Gonzalez, Margeaux Oliva, Sreya Talasila, Isabel Haugh, Giselle Rodriguez, Lauren Becker, James G. Krueger, Emma Guttman-Yassky, Amy S. Paller
Journal: Journal of Allergy and Clinical Immunology (2016)