tbuckley/cabot-search huggingface dataset:
Chemotherapy of Tuberculosis
Authors: William S. Schwartz
Journal: New England Journal of Medicine (1953)

MANY substances have been used in the treatment of tuberculosis with the supposition that the resistance of the patient to the disease might be enhanced. Of these, gold salts and tuberculin were the most widely employed. A direct effect on the tubercle bacillus was not even hoped for in most cases. A direct effect of the sulfone and sulfonamide derivatives (Diasone, Promine and Promizole) was expected but was probably seldom attained.The era of effective chemotherapy began with the discovery of the action of streptomycin against the tubercle bacillus in 1944 and 1945.1 , 2 Several extensive Cooperative studies, begun in 1946, . . .
Neurologic Disorders after Asian Influenza
Authors: Frederick A. Horner
Journal: New England Journal of Medicine (1958)

DURING the recent epidemic of Asian influenza, certain neurologic syndromes have arisen in patients convalescing from this disease. The purpose of this paper is to describe 5 such cases in detail and to present laboratory evidence supporting the diagnosis of Asian influenza in these patients.Case ReportsCase 1. R.D., a 16-year-old boy, was admitted to the Colorado General Hospital on October 15, 1957. Seven days previously he experienced an illness characterized by a temperature of 104°F., an unproductive cough, malaise, headache and weakness. He improved considerably during the following day and within 3 days seemed perfectly well. Two days . . .
Durable responses with the antiangiogenic metronomic regimen RT-PEPC in elderly patients with recurrent mantle cell lymphoma (MCL)
Authors: J. Ruan, P. Martin, M. Coleman, R. Furman, P. Glynn, M. Joyce, K. Cheung, T. Shore, M. Schuster, J. Leonard
Journal: Journal of Clinical Oncology (2009)

8525 Background: Targeting tumor microenvironment and angiogenesis is a novel therapeutic strategy in lymphoma. Two putative anti-angiogenic regimens, RT (rituximab with thalidomide) and PEPC oral metronomic chemotherapy (prednisone, etoposide, procarbazine and cyclophosphamide) are clinically active. We report phase II safety, activity, and angiogenic profiling data with the novel combination RT-PEPC in elderly patients with recurrent MCL. Methods: RT-PEPC includes an induction phase (mo 1–3) of daily thalidomide (50 mg) and PEPC with weekly rituximab x 4. A maintenance phase (mo 4 until progression) continues with daily thalidomide (100 mg), PEPC dosing titrated to ANC &gt; 1K/ul, and rituximab q 4 months. Endpoints included safety, efficacy, and FACT-G quality of life (QoL) assessment. Translational studies assessed the angiogenic phenotypes of tumor cells, and dynamic levels of circulating endothelial and hematopoietic progenitors in response to treatment. Results: Twenty-five pts (19 males) were enrolled, with 22 evaluable (3 never received rx). At study entry, median age (N=25) was 68 yrs (range 52–81), 24 (96%) had stage ≥ III, 16 (64%) had LDH &gt; nl, and 18 (72%) IPI 3–5. The median number of prior therapies was two (range 1 to 7), and 15 pts (60%) progressed on bortezomib. At a median followup of 30 months, overall response rate was 73% (32% CR/CRu, 41% PR, N=22). Median PFS was 12 months, and median OS 22 months. Four CRs of 4+, 28+, 46+ and 48+ months are ongoing. Toxicities included gr 1–2 fatigue, rash and neuropathy as well as cytopenias (by design) including gr 1–2 thrombocytopenia (56%) and gr 3/4 neutropenia (56%). Two thrombotic events and 5 episodes of gr 3–4 infection were observed. QoL was maintained or improved on treatment. Correlative studies demonstrated pre-therapy autocrine angiogenic loop in tumor cells evidenced by expression of VEGFA and VEGFR1. Circulating levels of hematopoietic and endothelial progenitor cells decreased on rx in responders. Conclusions: RT-PEPC has significant and durable clinical activity in MCL, with manageable toxicity and maintained QoL. Novel low-intensity anti-angiogenic approaches warrant further evaluation in MCL and other NHL subtypes, potentially as initial therapy in elderly patients. [Table: see text]
Precocious Puberty in Boys
Authors: Han G. Brunner, Barto J. Otten
Journal: New England Journal of Medicine (1999)

Normal puberty starts when pulsatile release of gonadotropin-releasing hormone (GnRH) from the hypothalamus begins. This triggers the release of luteinizing hormone and follicle-stimulating hormone from the pituitary. In both sexes, these pituitary hormones then activate gonadal function. Sexual precocity is the appearance of any sign of secondary sexual maturation before the age of eight years in girls and before the age of nine years in boys,1 and precocity due to early activation of the pulse generator of hypothalamic GnRH is known as central, or GnRH-dependent, precocious puberty.In most girls with central precocious puberty, no cause can be identified, whereas . . .
Transforming Growth Factors β1 and α in Chronic Liver Disease
Authors: A Castilla, J Prieto, N Fausto
Journal: New England Journal of Medicine (1991)

Cirrhosis is a diffuse process of hepatic fibrosis and regenerative nodule formation of unknown pathogenesis. Transforming growth factor (TGF) β1 induces the production of extracellular matrix proteins by liver cells and has been implicated in the pathogenesis of hepatic fibrosis in laboratory animals. TGFα is a hepatocyte mitogen that participates in liver regeneration.
Volume and Outcome — It Is Time to Move Ahead
Authors: Arnold M. Epstein
Journal: New England Journal of Medicine (2002)

The volume–outcome hypothesis has created a policymaker's dilemma. In 1979, Luft and colleagues1 reported in the Journal that the number of procedures performed at a hospital (hospital volume) and mortality rates for many surgical procedures were inversely related. Since then, this relation has been documented many times,2 fueling a persistent debate about whether health care should be regionalized and certain sorts of complex, elective care restricted to high-volume medical centers.35 Two studies reported in this issue of the Journal will undoubtedly fuel this controversy. In the first, Birkmeyer and colleagues6 used Medicare claims data from 1994 through 1999 to . . .
Management of Acute Appendicitis, Comparative Effectiveness Research, and the Nuances of Study Design—Reply
Authors: Peter C. Minneci, Katherine J. Deans
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
P288 Prevalence of non-pulmonary embolism diagnoses on CT Pulmonary Angiography. One year experience in a district general hospital
Authors: S Barnes, C Ingham, A Pryce, R Russell
Journal: Thorax (2015)

<h3>Introduction and objectives</h3> CT pulmonary angiography (CTPA) is recommended as the investigation of choice for suspected pulmonary embolism (PE). Even in appropriately risk-assessed groups, CTPA often proves negative for PE, but additional diagnostic information is still provided by technically adequate scans. We reviewed our CTPAs to assess technical quality and final diagnosis. <h3>Methods</h3> Retrospective review of CTPAs performed in 2013 in a 588 bed district general hospital. All patients selected were considered either intermediate or high probability for PE based on Wells PE clinical risk scoring. Only imaging performed on patients presenting as acute admissions was reviewed. Patients under the age of 16 were excluded, but no upper age limit was applied in order to be fully representative of our patient population and clinical practice. Scans were assessed for their diagnostic and technical quality by the reporting radiologist. <h3>Results</h3> 720 CTPAs were selected for review. Patient mean age 66.4 (range 17–103). PE was demonstrated in 135 studies (18.8%). 111 CTPAs (15%) excluded PE and were otherwise normal. 355 CTPA (49%) excluded PE but revealed an alternative diagnosis. Of these, cardiac failure (26%), emphysema (19%), pneumonia (16%), interstitial lung disease (10%), bronchiectasis (9%) and pleural disease (8%) were the most frequently reported clinically significant diagnoses. 119 CTPAs were considered technically inadequate to exclude PE based on insufficient contrast opacification, however an alternative explanatory diagnosis was seen in 76 (64%) of these. In the remaining 43 cases no diagnosis was reported, and only 2 patients had repeat CTPA performed during the same admission. Four patients from the non-diagnostic group represented within a 3 month follow up period and were subsequently proven to have PE on repeat CTPA. <h3>Conclusions</h3> CTPA can provide an alternative diagnosis in the majority of cases even if PE is excluded. Of these, cardiac failure and emphysema were the most common diagnoses. Physicians must be vigilant for non-diagnostic scans and arrange further tests as appropriate, as in our series 4/43 patients with technically inadequate imaging on initial presentation subsequently represented with PE.
Lifting Up the HAT: Synthetic Lethal Screening Reveals a Novel Vulnerability at the CBP–p300 Axis
Authors: Cigall Kadoch
Journal: Cancer Discovery (2016)

Abstract Summary: Cancer genotype–specific synthetic lethal vulnerabilities represent promising therapeutic targets. In this issue of Cancer Discovery, Ogiwara and colleagues uncover a synthetic lethal relationship between two histone acetyl transferase paralogs, CBP and p300, highlighting that cancer cells deficient in CBP are uniquely sensitized to genetic and chemical inhibition of p300. Cancer Discov; 6(4); 350–2. ©2016 AACR. See related article by Ogiwara et al., p. 430.
Dipyridamole for Renal Phosphate Leak?
Authors: Patrick Michaut, Dominique Prie, Claude Amiel, Gerard Friedlander
Journal: New England Journal of Medicine (1994)

To the Editor: Dipyridamole, a widely used vasodilatory drug, enhances renal tubular reabsorption of phosphate by decreasing adenosine uptake by tubular cells.1 In rats, dipyridamole prevents phosphate excretion induced by cyclic AMP and decreases the phosphaturic effect of parathyroid hormone.1 This demonstrates that adenosine, a local product of the degradation of nephrogenous cyclic AMP, is associated with phosphaturia. We sought to determine whether dipyridamole might decrease urinary phosphate excretion in humans. We evaluated the short-term effect of dipyridamole in 48 people (22 men and 26 women) with a mean age of 52 years (range, 26 to 74). Twelve were normal . . .
The Case for the Use of Animals in Biomedical Research
Authors: Carl Cohen
Journal: New England Journal of Medicine (1986)

USING animals as research subjects in medical investigations is widely condemned on two grounds: first, because it wrongly violates the rights of animals,1 and second, because it wrongly imposes on sentient creatures much avoidable suffering.2 Neither of these arguments is sound. The first relies on a mistaken understanding of rights; the second relies on a mistaken calculation of consequences. Both deserve definitive dismissal.Why Animals Have No RightsA right, properly understood, is a claim, or potential claim, that one party may exercise against another. The target against whom such a claim may be registered can be a single . . .
Case 22-1991
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, Daniel K. Podolsky, Kent B. Lewandrowski
Journal: New England Journal of Medicine (1991)

Presentation of CaseA 15-year-old boy was admitted to the hospital because of fever of unknown origin, anemia, and weight loss.The boy was well until 40 days earlier, when he experienced the sudden onset of pain in the right upper abdominal quadrant, without nausea, vomiting, or diarrhea. He was examined on the same day by his pediatrician, who found no abnormality; the urine was reported to be normal. Three days later the temperature rose to 40.6°C, with persistent right-sided abdominal pain and cough. On physical examination the pharynx was red. The urine was normal. The hematocrit was 45 percent, . . .
Regression of Liver Fibrosis after Biliary Drainage in Patients with Chronic Pancreatitis and Stenosis of the Common Bile Duct
Authors: Pascal Hammel, Anne Couvelard, Dermot O'Toole, Anne Ratouis, Alain Sauvanet, Jean François Fléjou, Claude Degott, Jacques Belghiti, Pierre Bernades, Dominique Valla, Philippe Ruszniewski, Philippe Lévy
Journal: New England Journal of Medicine (2001)

Chronic obstruction of the common bile duct may cause hepatic fibrosis and secondary biliary cirrhosis.
Small‐fibre neuropathy in a patient with dermatomyositis and severe scalp pruritus
Authors: E. Hurliman, D. Groth, G. Wendelschafer‐Crabb, W. Kennedy, S. Kavand, M. Ericson, M. Hordinsky
Journal: British Journal of Dermatology (2016)

Dermatomyositis (DM) is commonly associated with scalp pruritus that can be severe. In addition, significant crawling and burning sensations have been reported in these cases. The aetiology of these scalp sensations in the context of DM is not fully understood. We report a 42-year-old female with treatment-resistant DM and structural changes in scalp epidermal and dermal nerve fibres. The patient presented with characteristic skin manifestations (Gottron's papules and poikiloderma), severely pruritic scalp, intermittent muscle weakness on neurological exam with electrodiagnostically confirmed myositis, and joint pain. Structural changes in scalp epidermal and dermal nerve fibres were discovered in a skin biopsy, suggesting that small-fibre neuropathy associated with scalp pruritus may be a manifestation of the DM syndrome. Further clinical experience combined with selective skin biopsy in patients with DM and symptomatic scalp will help determine the frequency of coexistent small nerve fibre involvement. Based on our limited findings, we suggest that pruritus in DM may be associated with abnormal epidermal and dermal nerve fibre structure.
Methods to Estimate Acclimatization to Urban Heat Island Effects on Heat- and Cold-Related Mortality
Authors: Ai Milojevic, Ben G. Armstrong, Antonio Gasparrini, Sylvia I. Bohnenstengel, Benjamin Barratt, Paul Wilkinson
Journal: Environmental Health Perspectives (2016)

Background:Investigators have examined whether heat mortality risk is increased in neighborhoods subject to the urban heat island (UHI) effect but have not identified degrees of difference in susceptibility to heat and cold between cool and hot areas, which we call acclimatization to the UHI.Objectives:We developed methods to examine and quantify the degree of acclimatization to heat- and cold-related mortality in relation to UHI anomalies and applied these methods to London, UK.Methods:Case–crossover analyses were undertaken on 1993–2006 mortality data from London UHI decile groups defined by anomalies from the London average of modeled air temperature at a 1-km grid resolution. We estimated how UHI anomalies modified excess mortality on cold and hot days for London overall and displaced a fixed-shape temperature-mortality function ("shifted spline" model). We also compared the observed associations with those expected under no or full acclimatization to the UHI.Results:The relative risk of death on hot versus normal days differed very little across UHI decile groups. A 1°C UHI anomaly multiplied the risk of heat death by 1.004 (95% CI: 0.950, 1.061) (interaction rate ratio) compared with the expected value of 1.070 (1.057, 1.082) if there were no acclimatization. The corresponding UHI interaction for cold was 1.020 (0.979, 1.063) versus 1.030 (1.026, 1.034) (actual versus expected under no acclimatization, respectively). Fitted splines for heat shifted little across UHI decile groups, again suggesting acclimatization. For cold, the splines shifted somewhat in the direction of no acclimatization, but did not exclude acclimatization.Conclusions:We have proposed two analytical methods for estimating the degree of acclimatization to the heat- and cold-related mortality burdens associated with UHIs. The results for London suggest relatively complete acclimatization to the UHI effect on summer heat–related mortality, but less clear evidence for cold–related mortality.Citation:Milojevic A, Armstrong BG, Gasparrini A, Bohnenstengel SI, Barratt B, Wilkinson P. 2016. Methods to estimate acclimatization to urban heat island effects on heat- and cold-related mortality. Environ Health Perspect 124:1016–1022; http://dx.doi.org/10.1289/ehp.1510109
Patient tolerance of palliative chemotherapy for recurrent hepatocellular carcinoma following orthotopic liver transplant
Authors: A. L. Sobol, P. Kuriakose, G. Colon-Otero
Journal: Journal of Clinical Oncology (2006)

14034 Background: While orthostatic liver transplant (OLT) is an accepted treatment for localized hepatocellular carcinoma (HCC), little data exists as to the appropriate treatment of recurrent disease. Consensus opinion favors avoiding systemic chemotherapy on the grounds that toxicity would be poorly tolerated by patients medically immunosuppressed to prevent allograft rejection. Methods: Study design: retrospective chart review. The medical records of all patients who underwent OLT at the Mayo Clinic in Jacksonville, Florida, from February 1998 to April 2005 were reviewed. Those patients who developed recurrent HCC treated with systemic chemotherapy and were followed for at least 5 weeks with documented side effects were identified as the study population. Tolerance of treatment was assessed through review of side effects and Eastern Co-operative Oncology Group (ECOG) performance status scores. Disease progression was identified as increasing size of lesions on computed tomography (CT) scans and increasing serum alpha fetoprotein (AFP) levels. The primary endpoint was defined as discontinuation of chemotherapy due to severe side effects. Results: Of 1133 patients undergoing OLT, 179 were diagnosed with HCC. Thirty developed recurrent disease. Of these, 8 did not receive chemotherapy (2 observation only, 2 Hospice care, 2 radiation therapy, 1 surgical resection, 1 chemoembolization), 10 were lost to follow-up, and 2 died of rapidly progressive disease. The remaining 10 patients underwent systemic chemotherapy with six patients receiving multiple regimens. Seven patients received from 2 to 15 cycles of gemcitabine and cisplatin. Cytopenias were the most common side effect. One patient discontinued the regimen after developing neutropenic fever following 2 cycles of treatment. Five patients received from 1 to 12 cycles of capecitabine. Diarrhea was the most common side effect. Three patients received from 3 to 6 cycles of doxorubicin. Stomatitis and cytopenias were the most common side effects. No treatment related mortalities were observed. Conclusions: Palliative systemic chemotherapy is not usually associated with life threatening side effects and therefore is a viable option for patients with recurrent HCC following OLT. No significant financial relationships to disclose.
Abstract MP59: Orthostatic Hypotension and Risk of Falls in the Atherosclerosis Risk in Communities (ARIC) Study
Authors: Stephen P Juraschek, Natalie Daya, Lawrence J Appel, Edgar R Miller, B G Windham, Lisa Pompeii, Michael Griswold, Gerardo Heiss, Anna Kucharska-Newton, Elizabeth Selvin
Journal: Circulation (2016)

Background: Orthostatic hypotension (OH) is considered an important risk factor for falls, but prospective studies have been small and inconsistent. Methods: We examined the association between OH assessed at baseline in 12,661 middle-aged participants of the ARIC Study (1987-1989). OH was considered present if there was a drop in blood pressure (systolic ≥20 mm Hg or diastolic blood pressure ≥10 mm Hg) when moving from the supine to standing position after three minutes. Changes in systolic or diastolic blood pressures were also examined as continuous variables. The outcome of interest was any fall identified from ICD9 discharge codes from hospitalization records or Centers for Medicare &amp; Medicaid Services claims data. The association of OH and risk of fall was characterized using Cox proportional hazard models. Results: At baseline, the mean age was 54 years; participants were 55% women and 47% black; 5% (N = 651) had OH. During a median follow-up of 23 years, there were 2,274 new falls. The incidence rate, using age as the time axis, was 2.8 per 1,000 person-years among participants with OH versus 2.3 per 1,000 person-years among those without OH (P = 0.03). OH was significantly associated with long-term risk of fall even after adjustment for demographics and other risk factors (Figure legend) (HR 1.25, 95% CI 1.04-1.49). Furthermore, postural change in diastolic blood pressure was more strongly associated with risk of falls (HR 1.07 per -5 mm Hg in diastolic blood pressure; P &lt; 0.001) than postural change in systolic blood pressure (HR 1.02 per -5 mm Hg in systolic blood pressure; P = 0.01). This association appeared linear without evidence of a threshold effect (Figure). Conclusions: In an ambulatory population, OH, and in particular, postural change in diastolic blood pressure, were significant, independent risk factors for falls over a long period of time. Future studies should determine whether targeted therapies can reduce falls in persons with OH.
Elevation of Factor VIII (Antihemophilic Factor) during Pregnancy in Normal Persons and in a Patient with von Willebrand's Disease
Authors: Herbert S. Strauss, Louis K. Diamond
Journal: New England Journal of Medicine (1963)

DURING pregnancy increased blood levels of fibrinogen,1 , 2 factor VII (SPCA, proconvertin) and factor X (Stuart–Prower factor),3 4 5 6 as well as increased platelet adhesiveness,7 have been observed. This has been linked with a hypercoagulable state existing during pregnancy. It has been stated that factor VIII (antihemophilic factor) levels were not altered during this period.6 , 8 Recent experience in our laboratory, however, has demonstrated significant elevations of factor VIII levels gradually taking place during the course of pregnancy in all subjects thus far studied. Of interest in this connection is a recent report describing elevations of factor VII and VIII in women under hormonal . . .
Metastatic Renal Cell Carcinoma (Mrcc) Treated with Targeted Therapies (Tt) in the Community Setting: an Italian Survey on 1238 Pts
Authors: F. Pasini, A.P. Fraccon, F. Zustovich, C. Sacco, F. Valcamonico, D. Donati, E. Durante, M. Sorarù, M. Nicodemo, R. Cengarle, P. Randisi, C. Ogliosi, D. Bernardi, C. Ciccarese, S. Zanon, I. Martellucci, I. Falco, C. Mucciarini, M. Mandarà, G. Santabarbara
Journal: Annals of Oncology (2014)
147P: Level of concordance between EGFR mutation status obtained from tissue/cytology and blood (plasma) for advanced non-small-cell lung cancer in Spain: ASSESS study
Authors: E. Arriola, A. Paredes, R. García Gomez, P. Diz, M. Constenla, C. García Girón, M. Amador, M. Reck, G. López Vivanco
Journal: Journal of Thoracic Oncology (2016)