tbuckley/cabot-search huggingface dataset:
Guillain-Barré Syndrome and the 1978–1979 Influenza Vaccine
Authors: Eugene S. Hurwitz, Lawrence B. Schonberger, David B. Nelson, Robert C. Holman
Journal: New England Journal of Medicine (1981)

An ongoing surveillance program was intensified to determine whether an increased risk of acquiring vaccine-related Guillain-Barré syndrome (GBS) (similar to that observed after vaccination with the A/New Jersey swine-influenza vaccine in 1976) existed for the approximately 12.5 million adults (≥18 years old) vaccinated in the 1978–1979 influenza campaign. In the contiguous United States (excluding Maryland) 544 cases of GBS with onset between September 1, 1978, and March 31, 1979, were reported, including 12 adults who had been vaccinated within eight weeks before the onset of GBS and 393 who had not. The relative risk of vaccine-associated GBS for adults reported in this surveillance was 1.4 (95 per cent confidence limits, 0.7 to 2.7) — significantly below the risk (6.2) associated with A/New Jersey vaccine for the equivalent eight-week period. In contrast to the A/New Jersey vaccine, the 1978–1979 influenza vaccine was not associated with a statistically significant excess risk of GBS. (N Engl J Med. 1981; 304:1557–61.)
"Organic brain syndromes": an empirical study and critical review
Authors: B Seltzer, I Sherwin
Journal: American Journal of Psychiatry (1978)

The authors found that all but 3 of 80 randomly chosen patients in a Veterans Administration hospital who had been given a primary nonspecific neuropsychiatric diagnosis (organic brain syndrome, organic psychosis, chronic brain syndrome, etc.) could be assigned to specific diagnostic categories. Diagnosis was based on chart review and thorough neurological and clinical evaluation. Senile and alcoholic dementia and Korsakoff's syndrome were seen most often, and 15% of the patients were diagnosed as having functional disorders of the mental state. The authors review the organic brain syndrome diagnosis in light of this and other evidence. They believe that fractionation into more specific diagnoses is essential to further understanding of this group of diseases. Use of the general term can result in inappropriate or no treatment; further, it hampers essential psychological, pharmacological, and biomedical research on these disorders.
Role of Endoscopic vs Percutaneous Biliary Drainage in the Treatment of Malignant Biliary Tract Obstruction
Authors: Zhongzhi Jia, David M. Sella, Weiping Wang
Journal: JAMA Oncology (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 Oncology 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 Oncology journal
Abstract 12925: The Neuro-Mechanical Unloading for Acute Myocardial Infarction Strikingly Reduces the Infarct Size and Prevents Heart Failure in the Long Term (Best of Basic Science Abstract)
Authors: Keita Saku, Takahiro Arimura, Takamori Kakino, Takeshi Tohyama, Takuya Nishikawa, Takuya Akashi, Yoshinori Murayama, Takafumi Sakamoto, Takuya Kishi, Tomomi Ide, Kenji Sunagawa
Journal: Circulation (2015)

Introduction: Although widespread practice of early coronary intervention has reduced the acute phase mortality in myocardial infarct (MI), the late development of heart failure remains increasing at an alarming rate. Left ventricular (LV) assist device (VAD) unloads the heart, thereby decreases oxygen consumption. Vagal nerve stimulation (VNS) exerts a powerful anti-infarct effects. Hypothesis: We hypothesized that the combination of short term VAD (mechanical unloading) and VNS (neural unloading) for the ischemia/reperfusion (IR) model would prevent the late development of heart failure. Methods: In 24 dogs, we occluded the left anterior descending coronary artery for 180min and then reperfused. We unloaded LV with transvascular VAD (Impella®). We administrated transvascular VNS with a pacing catheter in the superior vena cava (10Hz). The neuro-mechanical unloading started at 90min after the onset of ischemia and ended at 60min after reperfusion. We allocated dogs into 4 groups, IR (n=7), VAD (n=6), VNS...
S27 Predictive performance of STOPBANG questionnaire for diagnosis of sleep apnoea in a cardiac surgical cohort
Authors: M Mason, J Hernández-Sánchez, D Horton, A Clutterbuck-James, I Smith
Journal: Thorax (2015)

<h3>Introduction and objectives</h3> Questionnaires to assess the risk of obstructive sleep apnoea (OSA) prior to surgery could reduce the need for screening sleep studies. STOPBANG questionnaire is user friendly and was previously validated in a general surgical population. A high risk of OSA has been defined as a score of ≥3 and low risk as a score 0–2. We aimed to validate the STOPBANG against nocturnal oximetry in a population undergoing major cardiac surgery and assessed its prognostic value for postoperative outcomes. <h3>Methods</h3> Patients were screened for high risk of OSA with the STOPBANG questionnaire. The presence of sleep apnoea (SA), prior to surgery, was assessed with overnight oximetry. SA was defined as mild with a 4% oxygen desaturation index (ODI) of 5–14/hr, moderate with ODI of 15–29/hr and severe ODI ≥30/hr. Predictive performance of STOPBANG against nocturnal oximetry was assessed for diagnosis of mild and moderate SA by assessing the area under curve receiver operating characteristic (AUC-ROC) and sensitivity and specificity were calculated. A multiple-logistic regression model was used to assess association of STOPBANG and post-operative outcomes. <h3>Results</h3> The AUC-ROC for mild SA was low 0.57 (95% CI = 0.47–0.67). Good performance was observed for moderate SA with AUC-ROC 0.82 (95% CI = 0.69–0.95) (Figure 1) but specificity of STOPBANG at the conventional cut of value of ≥3 for moderate SA was very low at 5% whilst sensitivity was 100%. The best predictive STOPBANG cut-off value for moderate SA was ≥6 with sensitivity and specificity of 75% and 77% respectively. Assessing predictive value for severe SA was not possible due to the lack of severe SA cases in our cohort. STOPBANG was not found to be an independent predictor of worse post-operative outcomes. <h3>Conclusion</h3> Predictive performance of STOPBANG in our patient cohort at the conventional cut off value was poor. The probable explanation is that the cardiac surgical population is preselected as male, older and most suffer with hypertension. Thus the majority will score as high risk for OSA. STOPBANG had no prognostic value on worse postoperative outcomes in our study, which again contrasts with the findings in general surgical cohorts.
Cellular Adaptations in the Diaphragm in Chronic Obstructive Pulmonary Disease
Authors: Sanford Levine, Larry Kaiser, John Leferovich, Boris Tikunov
Journal: New England Journal of Medicine (1997)

In patients with severe chronic obstructive pulmonary disease, the diaphragm undergoes physiologic adaptations characterized by an increase in energy expenditure and relative resistance to fatigue. We hypothesized that these physiologic characteristics would be associated with structural adaptations consisting of an increased proportion of less-fatigable slow-twitch muscle fibers and slow isoforms of myofibrillar proteins.
Hypothyroidism after Treatment with Interleukin-2 and Lymphokine-Activated Killer Cells
Authors: Michael B. Atkins, James W. Mier, David R. Parkinson, Jody A. Gould, Eugene M. Berkman, Michael M. Kaplan
Journal: New England Journal of Medicine (1988)

The development of a goiter and hypothyroidism in a 28-year-old man in whom metastatic melanoma had been treated with interleukin-2 and lymphokine-activated killer cells (LAK cells) prompted us to assess thyroid function in patients undergoing this therapy. Thirty-four patients with advanced neoplasms who had received interleukin-2 and LAK cells were followed for at least four weeks after treatment. Seven patients (21 percent) had laboratory evidence of hypothyroidism, with a decline in the serum thyroxine concentration to below normal (≤35 nmol per liter; normal, 65 to 148), a decline in the serum free thyroxine index, and a rise in the serum thyrotropin concentration (peak values, 7.2 to 166 mU per liter; normal, 0.5 to 5.5) 6 to 11 weeks after treatment. Two patients had elevated serum thyrotropin levels before treatment, which increased further after treatment. In two patients, these abnormal values returned to normal within 10 months. All five symptomatic patients had borderline or elevated serum antimicrosomal antibody titers after treatment; two had serum antibodies to thyroglobulin. Five of the seven patients with hypothyroidism (71 percent) but only 5 of the 27 euthyroid patients (19 percent) had evidence of tumor regression (P<0.02). None of 11 patients treated with interleukin-2 but not LAK cells had hypothyroidism. We conclude that treatment with interleukin-2 and LAK cells can cause hypothyroidism, possibly by exacerbating preexisting autoimmune thyroiditis, and that it may be associated with a favorable tumor response. (N Engl J Med 1988; 318:1557–63.)
Intersecting Epidemics -- Crack Cocaine Use and HIV Infection among Inner-City Young Adults
Authors: Brian R. Edlin, Kathleen L. Irwin, Sairus Faruque, Clyde B. McCoy, Carl Word, Yolanda Serrano, James A. Inciardi, Benjamin P. Bowser, Robert F. Schilling, Scott D. Holmberg
Journal: New England Journal of Medicine (1994)

The smoking of "crack" cocaine is thought to be associated with high-risk sexual practices that accelerate the spread of infection with the human immunodeficiency virus (HIV). We studied 2323 young adults, 18 to 29 years of age, who smoked crack regularly or who had never smoked crack. The study participants, recruited from the streets of inner-city neighborhoods in New York, Miami, and San Francisco, were interviewed and tested for HIV. This report presents the findings for the 1967 participants (85 percent) who had never injected drugs.
A phase I dose escalation study of oral MK-2206 (allosteric Akt inhibitor) with oral selumetinib (AZD6244; ARRY-142866) (MEK 1/2 inhibitor) in patients with advanced or metastatic solid tumors.
Authors: Khurum Hayat Khan, Li Yan, Janusz Mezynski, Amita Patnaik, Victor Moreno, Kyriakos P. Papadopoulos, Chris R. Garrett, Michael Ong, Keith A. Shannon, Anne Morosky, Eric H. Rubin, Ernestina Tetteh, Jeffrey Skolnik, Ian C. Smith, Paul D. Smith, Johann Sebastian De Bono, Anthony W. Tolcher
Journal: Journal of Clinical Oncology (2012)

e13599 Background: Simultaneous inhibition of both the PI3K-Akt and RAF/MEK/ERK pathways may yield greater benefits than inhibiting either pathway alone. This phase I study (NCT01021748) examined the safety, pharmacokinetics (PK), pharmacodynamics (PD), maximal tolerated dose (MTD), and preliminary antitumor activity of the combination of a MEKi (selumetinib) and AKTi (MK-2206). Methods: Eligible patients (pts) with advanced solid tumors were treated with MK-2206 either every other day (QOD) or once weekly (QW), in combination with selumetinib administered either once daily (QD) or twice daily (BID). Results: 51 pts with advanced solid tumors (15 colon, 8 NSCLC, 6 ovarian, 5 pancreatic, 3 breast and 14 others) were treated across 9 dose levels. There were 2 confirmed partial response (PR) (1 NSCLC, ongoing &gt; 52 wks; 1 ovarian, on treatment for 47 weeks; both KRAS mutation positive), 1 unconfirmed PR (pancreatic, on treatment 20 wks), and 24 pts with stable disease (ranged from 6 to 47 wks). Preliminary assessment of PK data suggested no apparent drug-drug interactions with unaltered PK profiles of each drug when administered in combination. Conclusions: In combination the maximum tolerated doses of MK-2206 and selumetinib are 135 mg QW and 100 mg QD, respectively. This combination of investigational agents demonstrated preliminary antitumor activity in pts with advanced cancer. [Table: see text]
Circulatory Effects of Angiotensin, Levarterenol and Metaraminol in the Treatment of Shock
Authors: Vasant N. Udhoji, Max H. Weil
Journal: New England Journal of Medicine (1964)

THE rationale for the use of vasopressor agents in the treatment of shock is controversial. The principal objection to their use is that during shock, sympathetic and adrenergic activity is increased while the arterial vascular bed is already constricted. Hemodynamic measurements indicate that the arterial vascular resistance is usually high. Arteries and arterioles are constricted, particularly in splanchnic vascular beds.1 Since sympathomimetic drugs produce additional narrowing of the vessels it is postulated that their use results in further reduction of effective blood flow to vital organs, additional tissue ischemia and potentiation of shock. The search for nonadrenergic vasopressor agents led . . .
Salicylate Therapy of Recurrent Calcium Urolithiasis
Authors: Edwin L. Prien, Burnham S. Walker
Journal: New England Journal of Medicine (1955)

IT has been recognized for many years that the urine is a supersaturated solution so far as several relatively insoluble components are concerned when compared with a simple water solution of any one of them. The mutual increase of solubility that occurs in complex solutions, such as the urine, greatly reduces the degree of such supersaturation.1 Nevertheless, crystallization from normal urine is an everyday observation, and the formation of urinary-tract calculi indicates that the excretory load has exceeded the solubility of the stone components in the urinary mixture. Dilution of a complex solution may decrease the solubility of some of . . .
The Human Plasma Lipidome
Authors: Alberto Ortiz, Maria Sanchez-Niño, Oswald Quehenberger
Journal: New England Journal of Medicine (2012)

The Human Plasma LipidomeTo the Editor: In their review, Quehenberger and Dennis (Nov. 10 issue) 1 describe plasma lipids implicated in Gaucher's disease.Although they could not possibly mention every lipid, we believe it is worth commenting on the cationic amphiphilic glycolipid globotriaosylsphingosine (lyso-Gb3) and its contribution to a better understanding of the pathogenesis and monitoring of Fabry's disease.High plasma concentrations of lyso-Gb3 were observed in patients with this disease, 2 and these levels correlated with several of its manifestations 3 and decreased in response to enzyme-replacement therapy. 4,5Furthermore, lyso-Gb3 promoted vascular smooth-muscle cell proliferation 2 as well as transforming growth factor-β1-mediated synthesis of extracellular matrix components in cultured podocytes at concentrations found in the plasma. 6In Fabry's disease, vascular smooth-muscle cells and podocytes are cell targets, whereas fibrosis is a key feature of organ injury.The novelty, from a pathogenetic point of view, resides in the fact that a soluble mediator promotes cell injury in a disease long thought to be the result of intracel-
Reduction of Substance-P Mediated Neuronal Hyper-Reactivity By Dymista™ (Azelastine &amp; Fluticasone) Correlates with Decreased Cough-Frequency in Non-Allergic Rhinitis
Authors: Umesh Singh, Jonathan A. Bernstein, Holly Lorentz, Tara Sadoway, Victoria Nelson, Piyush Patel, Anne Marie Salapatek
Journal: Journal of Allergy and Clinical Immunology (2016)
A Genome-Wide Map of Acquired Uniparental Disomy in Acute Myeloid Leukemia.
Authors: Manu Gupta, Manoj Raghavan, Rosemary E. Gale, Claude Chelala, Christopher Allen, Gael Molloy, Tracy Chaplin, David C. Linch, Jean-Baptiste Cazier, Bryan Young
Journal: Blood (2007)
AB1042 A Comparison of Ultrasound Versus Nerve Conduction Studies for the Diagnosis of Carpal Tunnel Syndrome: Table 1.
Authors: C. McDonagh, M. Alexander, D. Kane
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Carpal tunnel syndrome (CTS) is the commonest entrapment neuropathy. (1, 2) Sensitivity and specificity of ultrasound (US) to diagnose carpal tunnel syndrome has been reported to be as high as 97.9% and 100% respectively using measurement of the cross-sectional area (CSA) of the median nerve (3), while nerve conduction studies (NCS) have a sensitivity and specificity of &gt;85% and &gt;95% respectively.(4) <h3>Objectives</h3> To document the sensitivity and specificity of US to diagnose CTS in comparison to NCS and to establish a new pathway for diagnosis of CTS using US. To assess the ability of US and NCS to assess the response to treatment with corticosteroid injection. <h3>Methods</h3> Patients with clinically confirmed idiopathic CTS were recruited from outpatient clinics. They were assessed clinically, by US including power Doppler (PD) and NCS. Clinical diagnosis was the reference standard. Patients received treatment with corticosteroid injection and outcome was assessed using the Levine Katz questionnaire (LKQ) and visual analogue score (VAS) for pain. <h3>Results</h3> There were 29 patients (40 wrists) and 12 controls (23 wrists) recruited into the study. Results of sensitivity and specificity of US and NCS to diagnose CTS are displayed in Table 1. Only PD showed a significant correlation with change in LKQ score and VAS at 6 weeks following injection but not at 6 months (p=0.047 and 0.008 for LKQ and 0.015 and 0.05 for VAS). <h3>Conclusions</h3> Sensitivity of US is the same as NCS in this study but NCS has a higher specificity. Increasing the cut-off for diagnosis of CTS using CSA increases the specificity of US but reduces the sensitivity. CSA≥10mm<sup>2</sup> and/or PD signal gave the best sensitivity for US. Greyscale US and NCS did not correlate with scores on LKQ, however PD correlated with subjective measures at 6 weeks only. A new paradigm for diagnosis of CTS incorporating US is proposed. <h3>References</h3> de krom M, Knipschild P, Kester A, Thijs C, Boekkooi P, Spaans F. Carpal tunnel syndrome: prevalence in the general population. J Clin Epidemiol. 1992;45:373-6. Bongers F, Schellevis F, van den Bosch W, van der Zee J. Carpal tunnel syndrome in general practice (1987 and 2001): Incidence and the role of occupational and non occupational factors. Br J Gen Pract. 2007;57:36-9. El Miedany Y, Aty S, Ashour S. Ultrasonography versus nerve conduction study in patients with carpal tunnel syndrome: substantive or complementary tests? Rheumatology. 2004;43(7):887-95. Jablecki C, Andary M, So Y, Wilkins D, Williams F. Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome. AAEM Quality Assurance Committee. Muscle and Nerve. 1993;16:1392-414. <h3>Disclosure of Interest</h3> None declared
Case 50-1992
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, J.O. Jacobson, N.L. Harris
Journal: New England Journal of Medicine (1992)

Presentation of CaseA 54-year-old man was admitted to the hospital because of lymphoma and fever of unknown origin.The patient was in stable health until four years earlier, when cervical and axillary lymphadenopathy developed, with slight peripheral lymphocytosis. Radiographs of the chest were normal. A computed tomographic (CT) scan of the abdomen showed multiple small paraaortic lymph nodes; the spleen appeared normal. Biopsy of a lymph node disclosed a diffuse small lymphocytic lymphoma of B-cell type, consistent with chronic lymphocytic leukemia (CLL). Surface markers on the circulating lymphocytes revealed a B-cell population with monotypic IgM kappa surface immunoglobulins; the . . .
Case 13-1996
Authors: J.L. Brusch, E.J. Mark
Journal: New England Journal of Medicine (1996)

Presentation of CaseA 51-year-old man was admitted to the hospital because of the adult respiratory distress syndrome.One week before admission, he began to have a dry cough, with myalgia and arthralgia. Three days later, he had shaking chills and coughed up yellow sputum. Two days before admission, the cough worsened, with the production of scanty sputum, a high temperature, and more chills. He sat upright because of dyspnea and had severe pain in the upper back. The day before admission to this hospital, he entered another hospital because of worsening dyspnea.The patient was a businessman. Thirty years . . .
Vitamin B Excretion Studies in Patients with Rheumatoid Arthritis
Authors: Theodore B. Bayles, Richard J. Palmer, Mary F. Massod, Elinor H. Judd
Journal: New England Journal of Medicine (1950)

THE problem of vitamin deficiency in rheumatoid arthritis has been debated for the past ten years since Steinberg1 found abnormal bowel roentgenograms in many arthritic patients and attributed the gastrointestinal symptoms to this deficiency. After increased vitamin B consumption, many of these symptoms subsided, and he ascribed this to a need for vitamin B in arthritic patients. Race2 was of the opinion that vitamin B deficiency produced thinning, atrophy and atonia of the gastric and intestinal membrane, leading to decreased food absorption with ultimate depletion of body reserves and increased susceptibility to secondary infection — possibly through the abnormal bowel . . .
Soundings: Stayin' alive with quantum physics
Authors: Kevin Barraclough
Journal: BMJ (2004)

Discos have always been rather an ordeal for me. I am musically dyslexic and, in the tribal society of adolescence, I should rightly have been considered disabled. Instead, at school I played rugby and read “nerdish” books. One was the incisive Chance and Necessity by Jacques Monod. Man is a machine, he asserted, and free will an illusion

Later, when I made the crossover from theoretical physics to medicine, I was surprised by the aggressive nihilism of the biologists' world view—for example, Richard Dawkins's pithy remark that “the world has precisely the properties one would expect if there is [at its root] nothing but blind, pitiless indifference.”

Consciousness, it seems, is a rather tragic Darwinian epiphenomenon. Free will is likewise illusory in a universe that is merely a game of Newtonian billiard balls—its outcome determined at that first, bleak, break of time. And its author is either long gone, or certainly currently uninvolved.

My surprise partly stemmed from the vehemence and certainty of those who propounded these views. Anyone who had the temerity to believe otherwise was “scientifically illiterate.”

Yet I had come from a discipline that had long since abandoned the model of the world as purely mechanistic. It was not possible to calculate the trajectory of even a simple electron without summing the wave function over the whole universe. Treat the problem as though all interactions must be local and you would simply get the answer wrong. The universe appeared interconnected in a way that left even my marijuana smoking, three lectures a month, arts student friends surprised. Biologists who knew anything about quantum mechanics maintained, not unreasonably, that quantum effects were averaged out long before reaching microscopic scales and therefore had no discernible consequences in biological systems. But this always seemed a little unlikely to me.

Maybe I am deluding myself that life has meaning and I have choice. But if so, I like the delusion, and have yet to come across a cogent argument that persuades me otherwise. I have, though, given up the belief that in a parallel universe I could dance like John Travolta. The universe is strange, but maybe not that strange.