tbuckley/cabot-search huggingface dataset:
Excess of Ampicillin Rashes Associated with Allopurinol or Hyperuricemia
Journal: New England Journal of Medicine (1972)

In a comprehensive drug surveillance system, drug rashes were observed among 22.4 per cent of 67 hospitalized medical patients receiving allopurinol and ampicillin concomitantly, and among 7.5 per cent of 1257 patients receiving only ampicillin. The relative risk for allopurinol recipients, as compared with nonrecipients, was 3.0, with 95 per cent confidence limits of 1.8 and 4.6. Potentiation of ampicillin rashes by allopurinol (or hyperuricemia) seems a likely explanation, since only 2.1 per cent of 283 patients receiving allopurinol without ampicillin experienced drug rashes – a rate comparable with that observed among ampicillin nonrecipients in general. Data on uric acid levels were not available, and it is not clear whether the potentiation should be ascribed to allopurinol or to hyperuricemia.
Short-Term Treatment of Idiopathic Precocious Puberty with a Long-Acting Analogue of Luteinizing Hormone-Releasing Hormone
Authors: Florence Comite, Gordon B. Cutler, Jean Rivier, Wylie W. Vale, D. Lynn Loriaux, William F. Crowley
Journal: New England Journal of Medicine (1981)

The uncoupling of pituitary stimulation and response observed in adults during administration of the luteinizing hormone-releasing hormone analogue, D-Trp6-Pro9-NEt-LHRH (LHRHa) suggested that this drug might be useful in treating precocious puberty. We treated five girls with idiopathic precocious puberty (ages two to eight) for eight weeks with daily subcutaneous injections of LHRHa. The patients had Tanner II to IV pubertal development, advanced bone age, an estrogen effect on vaginal smear, measurable basal gonadotropin levels with pulsed nocturnal secretion, and a pubertal gonadotropin response to LHRH. Irregular vaginal bleeding was present in three patients. LHRHa significantly decreased basal (P less than 0.025) and LHRH-stimulated (P less than 0.01) gonadotropin levels as well as serum estradiol (P less than 0.05). The vaginal maturation-index score, which reflects the estrogen effect, fell by 25 per cent. Eight weeks after stopping treatment, all hormonal values and the vaginal maturation index had returned to pretreatment levels. These favorable short-term results will need further study before the benefits and risks of chronic treatment with LHRHa can be adequately assessed.
A national survey of resident assessment methods
Authors: W Procci, C Friedmann, G Prizant, S M Woods
Journal: American Journal of Psychiatry (1978)

The authors distributed a questionnaire regarding the assessment of psychiatric residents to 130 directors of residency training programs. Formal examinations were required by 37% of the programs and were being considered by an additional 49%, suggesting that formal examinations may be an integral part of residency training programs within five years. The authors believe that this trend toward utilization of objective measures reflects a growing national concern with accountability in medicine.
Treatment failure due to use of a ‘ramp’ option on pressure support home ventilators
Authors: Jesus Gonzalez-Bermejo, Claudio Rabec, Christophe Perrin, Bruno Langevin, Jean Louis Pepin, Daniel Rodenstein, Jean Paul Janssens
Journal: Thorax (2016)

Algorithms for monitoring home non-invasive ventilation (NIV) have been recently proposed.1–3 Following this strategy, we detected three cases of transient ineffective ventilation due to the use of a ‘ramp’ option on home pressure support (PS) ventilators. The ‘ramp’ option is a comfort setting initially made available on CPAP devices. This option exists in pressure-cycled ventilators, allowing a progressive increase of expiratory positive airway pressure (EPAP) only. A « ramp » option has also recently been made available for PS: to our knowledge, three home ventilators (Stellar, Resmed, Australia; Prisma, Weinmann, Germany; Dreamstar Duo, Sefam, France) now provide this feature, allowing a stepwise increase of PS from 2 cm H2O to the target PS within 5–45 min.

Patients whose data are entered in this work all signed a consent form authorising use of these data for research and teaching purposes.

Three patients previously treated for obstructive sleep apnoea (OSA) with CPAP devices, were switched to NIV because of uncontrolled hypoventilation due to obesity hypoventilation syndrome (OHS) (n=2) or diaphragmatic dysfunction (n=1) (table 1). NIV was introduced using a single circuit pressure-targeted ventilator (Stellar 100, Resmed, Australia) and a calibrated leak, in a ‘Spontaneous/Timed mode’ (assisted PS with a backup respiratory rate). Patients were monitored using a polygraph coupled to …
Fortnightly Review: Diffuse lung disease: an approach to management
Authors: R M D. Bois
Journal: BMJ (1994)

The term diffuse (interstitial) lung disease embraces a large number of disorders characterised by distinct cellular and extracellular infiltrates in the acinar regions of the lung (that is, distal to the terminal bronchiole). Some of these diseases present acutely whereas others have a subacute or chronic course: the infiltrate may result in tissue injury, as in cryptogenic fibrosing alveolitis, or cause little damage to the lung architecture, as in pulmonary eosinophilia. Because diffuse lung disease particularly affects the peripheral part of the lung, chest radiographs usually show widespread shadows of various types, and in clinical practice this is the commonest starting point for diagnostic evaluation: a clinician is consulted by a (usually breathless) patient with a chest radiograph that shows widespread pulmonary shadows.

About one in every 3000-4000 of the population in Britain has diffuse lung disease, and about 3000 people die each year from it.1 Cryptogenic fibrosing alveolitis is the most common diffuse lung disease and carries the worst prognosis: in all studies half of patients are dead within five years of presentation despite treatment, and only a quarter show an apparent response to treatment.*RF 1a4* In the United Kingdom mortality from fibrosing alveolitis is increasing and approaching 1500 a year.5

#### Diffuse (interstitial) lung disease

##### Cause known

##### Cause unknown

Despite these disturbing figures, a recent survey of the management of fibrosing alveolitis in three regions in Britain revealed that few patients underwent investigations to confirm the diagnosis.6 Transbronchial biopsy …
The Examination of Serous Fluids by the Cell-Block Technic
Authors: C. B. Chapman, E. J. Whalen
Journal: New England Journal of Medicine (1947)

THAT serous fluids from patients suspected of having malignant tumors may yield information of considerable diagnostic value has been established for many years, and in 1917 Mandelbaum1 devised a technic for the preparation of cell blocks that, with but few modifications, is generally employed at present.Evaluations of the procedure as employed in various laboratories have been published by a number of workers, including Zemansky,2 Schlesinger3 and Honigman,4 all of whom showed conclusively that, when properly carried out, the method is not only technically practical but also diagnostically useful. Zemansky has traced in some detail the development of the method, . . .
Preliminary Experience with Endoscopic Laser Surgery for Severe Twin–Twin Transfusion Syndrome
Authors: Yves Ville, Jon Hyett, Kurt Hecher, Kypros Nicolaides
Journal: New England Journal of Medicine (1995)

In monozygotic twin pregnancies, there are placental vascular communications between the two fetuses. In 15 percent of such pregnancies there is an imbalance in net blood flow between the twins, resulting in the twin-twin transfusion syndrome. The recipient twin may have severe hydramnios during the second trimester of pregnancy, and there is a high risk of perinatal death and cerebral palsy in survivors. This condition can now be treated by endoscopic coagulation of the vascular anastomoses responsible for fetofetal transfusion with a neodymium:yttrium-aluminum-garnet (Nd: YAG) laser.We performed intrauterine surgery in 45 pregnant women carrying twins at 15 to 28 weeks of gestation (median, 21); in each case there was severe hydramnios in one fetus due to the twin-twin transfusion syndrome. With the use of local anesthesia and continuous ultrasound visualization, a rigid fetoscope 2 mm in diameter, housed in a 2.7-mm cannula, was introduced transabdominally into the amniotic cavity of the recipient twin. A systematic search was made for all vessels approaching or crossing the membrane between the twins, and these were coagulated with an Nd:YAG laser by means of a fiber in the side arm of the cannula.Coagulation of the communicating vessels was successful in all cases. The total number of fetuses who survived to delivery was 48 (53 percent), and the number of pregnancies with at least 1 survivor was 32 (71 percent). Among the live-born infants, the median gestational age at delivery was 35 weeks (range, 25 to 40), and the median birth weight was 2098 g (range, 550 to 4252). The median interval between the endoscopic laser procedure and delivery was 14 weeks (range, 0 to 21). All the survivors were developing normally at a median age of 12 months (range, 2 to 24).Our preliminary experience suggests that the twin-twin transfusion syndrome can be treated effectively by endoscopic laser coagulation of the communicating placental vessels.
Building Learning Health Systems to Accelerate Research and Improve Outcomes of Clinical Care in Low- and Middle-Income Countries
Authors: Mike English, Grace Irimu, Ambrose Agweyu, David Gathara, Jacquie Oliwa, Philip Ayieko, Fred Were, Chris Paton, Sean Tunis, Christopher B. Forrest
Journal: PLoS Medicine (2016)

Mike English and colleagues argue that as efforts are made towards achieving universal health coverage it is also important to build capacity to develop regionally relevant evidence to improve healthcare.
B.C.G. Tuberculin as a Testing Material
Authors: Eli Friedman, Irving Silverman
Journal: New England Journal of Medicine (1949)

WITHOUT going into a lengthy discussion on the significance of a positive skin reaction to tuberculin and its limitations, it is fair to state that few laboratory tests are as satisfactory and as widely used by the medical profession. Any additional contribution to the safety and efficiency of the test should be of value.It is well known that the allergic response to tuberculoprotein, as indicated by the intensity of the reaction to tuberculin, varies in different persons. Thus, a given amount of tuberculin may elicit a mildly positive reaction in one subject and yet, in a more sensitive person, . . .
Altered Cardiac Function in the Prenecrotic Phase of Adrenal-Regeneration Hypertension: Observations with a Rat Heart/Lung Preparation
Authors: D L GARDNER, J GUISE, J FERGUSON, J PARBOOSINGH
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
Long-term neurocognitive outcomes in adult survivors of childhood medulloblastoma.
Authors: K. Edelstein, B. J. Spiegler, S. Fung, T. Panzarella, D. C. Hodgson, D. J. Mabbott, N. Laperriere, U. Tabori, E. Bouffet, W. P. Mason
Journal: Journal of Clinical Oncology (2010)

9554 Background: Medulloblastomas are malignant tumors of the posterior fossa that occur in childhood. With the advent of craniospinal radiation (CSI) treatment survival rates improved. However, CSI is associated with progressive decline in neurocognitive function, particularly in younger children. Accelerated aging due to treatment late effects has been suggested, but little is known about the first generation of survivors as they approach middle age. Methods: In this retrospective cohort study, we assessed 17 adults, 8 to 42 years (median 20 years) after diagnosis of medulloblastoma in childhood, treated with surgery, radiation (CSI + post fossa boost: median dose, 35+18 Gy, n=14; CSI only: 45 Gy, n=1; post fossa only: 50 Gy, n=2). Six patients also received chemotherapy. We conducted a cross sectional analysis of their current neurocognitive and physical status. Data from prior neuropsychological assessments conducted 1 to 31 years (median 6.6 years) after diagnosis were available for 15, and we used growth curve analyses to model individual change over time for those 15 participants. Results: All participants exhibited physical and neurocognitive late effects of their disease and treatment. The most common health complications included hearing impairment, second cancers, diabetes, hypertension, and endocrine deficiencies. The group was well below average across multiple neurocognitive domains (e.g., mean full scale IQ = 87.13, SD = 15.03) and 88% required accommodations at school for learning disorders. Longitudinal analyses revealed that verbal abilities and processing speed remained stable decades after treatment was complete, but working memory (β ± SE: -0.5 ± 0.2, p=0.02) and mathematics (β ± SE: -0.96 ± 0.18, p<0.0001) continued to decline. Conclusions: Medulloblastoma survivors face ongoing physical and neurocognitive challenges in adulthood, including progressively impaired working memory and persistently slow processing speed. They have limited resources with which to confront the challenge of aging, given diminished physical, cognitive, and neural reserve. These survivors will require social and economic support when their aging parents are no longer able to care for them. No significant financial relationships to disclose.
Breast Cancer, Version 4.2017, NCCN Clinical Practice Guidelines in Oncology
Authors: William J. Gradishar, Benjamin O. Anderson, Ron Balassanian, Sarah L. Blair, Harold J. Burstein, Amy Cyr, Anthony D. Elias, William B. Farrar, Andres Forero, Sharon H. Giordano, Matthew P. Goetz, Lori J. Goldstein, Steven J. Isakoff, Janice Lyons, P. Kelly Marcom, Ingrid A. Mayer, Beryl McCormick, Meena S. Moran, Ruth M. O'Regan, Sameer A. Patel, Lori J. Pierce, Elizabeth C. Reed, Kilian E. Salerno, Lee S. Schwartzberg, Amy Sitapati, Karen Lisa Smith, Mary Lou Smith, Hatem Soliman, George Somlo, Melinda L. Telli, John H. Ward, Rashmi Kumar, Dorothy A. Shead
Journal: Journal of the National Comprehensive Cancer Network (2018)

Ductal carcinoma in situ (DCIS) of the breast represents a heterogeneous group of neoplastic lesions in the breast ducts. The goal for management of DCIS is to prevent the development of invasive breast cancer. This manuscript focuses on the NCCN Guidelines Panel recommendations for the workup, primary treatment, risk reduction strategies, and surveillance specific to DCIS.
Correction of the Anemia of Malabsorption Syndrome (Nontropical Sprue?) by Oral Administration of Cortisone and Iron
Authors: Maurice L. Kelley, Victor W. Logan, Lane M. Christ
Journal: New England Journal of Medicine (1955)

THE use of ACTH and cortisone in the treatment of nontropical sprue was prompted by evidence that adrenocortical insufficiency may be implicated as a factor in the etiology of the disease.1 2 3 4 5 Although the role of adrenocortical hormones in intestinal absorption and in the etiology of sprue has not been established, the clinical response to corticosteroids of patients refractory to all other types of therapy has been excellent. Adlersberg et al.6 suggest that "a functional insufficiency of the adrenal gland in patients with intractable sprue may explain the observed therapeutic effects of cortisone, hydrocortisone, and corticotrophin, while patients with Addison's disease . . .
P243 A Retrospective Observational Study Of 20 Year Lung Transplant Survivors - A Single Centre Experience
Authors: S. Sithamparanathan, L. Thirugnanasothy, A. Fisher, J. Lordan, G. Meachery, J. Dark, A. Hasan, S. Clark, K. Gould, G. MacGowan, G. Parry, P. Corris
Journal: Thorax (2014)

<h3>Introduction and objectives</h3> Lung transplant patients have a reduced survival rate compared to other solid organ recipients. Chronic lung allograft dysfunction (CLAD) remains the main factor in limiting longevity in lung transplant patients, with 50% of recipients developing Bronchiolitis Obliterans Syndrome (BOS) by 5.6 years. There is a lack of published data on the course and history of long term survivors and we describe characteristics and outcomes of all lung transplant recipients who have survived greater than 20 years at our centre. <h3>Results</h3> Twenty-one (16.2%) out of a possible total of 121 transplant patients survived at least 20 years with an overall median survival of 21.3 (range 20.1–24.9) years. The mean age at transplantation was 31.8 ± 9.9 years and 13 (61.9%) were male. The most common indication for transplantation in the group was Cystic Fibrosis (33.3%); heart-lung and bilateral lung transplant operations were equally the most commonly performed. The median six-minute walk distance (6MWD) was 600m (range 419–785m). The median time to the development of BOS was 9.7 years. At time of evaluation, 2 (10%) patients had BOS score 0, 3 (14%) BOS 1, 6 (29%) BOS 2 and 10 (48%) BOS 3. The total number of rejections requiring augmentation with corticosteroids was 30 episodes in 21 patients with an average of 1.4 (range 0–3) episodes per patient. Eighteen patients had at least one episode of rejection needing corticosteroids. No patient developed symptomatic ischaemic heart disease; systemic hypertension was found in 19 (90.5%) patients. Two (9.5%) patients developed post-transplant lymphoproliferative disease. Four patients developed other malignancies, 3 of which were skin cancers and 1 renal cancer. All 4 cases of diabetes post transplantation occurred in patients with Cystic Fibrosis. Eight patients required renal replacement therapy as a result of ciclosporin toxicity and four underwent renal transplantation. <h3>Conclusion</h3> Twenty-one (16.2%) patients in our cohort survived 20 years. Although nearly all patients developed an element of CLAD, exercise tolerance was preserved as judged by 6MWD. Hypertension was common and renal failure remained the most problematic complication of immunosuppression.
Correlation of Pharmacokinetics of 6Mp and Its Metabolites with Haematological Toxicity: Step Towards Development of Pharmacokinetics Based Model for Optimal 6 Mp Dosing in Adult All
Authors: M. Sengar, V. Gota, S. Rath, H. Jain, H. Menon, U. Dangi, M. Gurjar, K. Jadhav
Journal: Annals of Oncology (2014)
Evolving Landscape of Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors
Authors: Steven C. Kao, Michael J. Boyer
Journal: Journal of Clinical Oncology (2016)

Recognition of the role and importance of driver mutations in malignancy has had a major impact on the management approach for many cancers. In the case of non–small-cell lung cancer, our understanding of molecular alterations has resulted in significant advances in the treatment of subgroups of patients, such as those whose tumors have an EFGR mutation or ALK or ROS-1 gene rearrangements. For tumors with sensitizing EGFR mutations, there is strong clinical evidence that epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) such as gefitinib, erlotinib, or afatinib significantly prolong progression-free survival (PFS) compared with platinum doublet chemotherapy. 1-4 Therefore, an EGFRTKIisconsideredthestandardofcareinthe first-linetreatment of EGFR-mutant lung cancer. However, it has been unclear whether there are important differences between the two first-generation EGFR inhibitors erlotinib and gefitinib because of a lack of direct comparative data. In the absence of data, the choice of agent has been largely a matter of physician or patient preference. The study by Urata et al 5 helps make the choice more rational. Initial evaluation of the first-generation EGFR TKIs erlotinib
Shoe-fitting X-ray Fluoroscopes
Authors: E. D. Dyson
Journal: BMJ (1956)

The question of radiation hazards is a topical one, and some newspaper publicity has recently been given to a type ol x-ray equipment whlch may be seen in shoe-shops in this country-the x-ray fluoroscope for demonstrating the fit of shoes.As long ago as September 2, 1950, the British Medical Journal, under the title " Radiation in the Shoe-Shop," drew attention to the potential hazards of such machines.Since then, measurements have been made on typical British machines, both in shoe-shops and on a recent type of machine which was loaned to A.E.R.E., Harwell, for testing.Before giving the results obtained, it is appropriate to describe some features of these machines.The terminology follows that in the Recommendations of the International Commission on Radiological Protection (1954), so, for example, r= roentgen and mr=milliroentgen (I / 1000 roentgen). Description and Use of FluoroscopesAll the machines examined were British-made, and they are known by the trade name " pedoscope."The company which manufactures these machines gave every facility to enable measurements to be made.The x-ray equipment is contained in the wooden base of the machine.There is a high-tension transformer rated at 42 kV (R.M.S.), with the mid-point of the high-tension