tbuckley/cabot-search huggingface dataset:
Improved organ preservation with dose escalation using contact X-ray brachytherapy for good responders following external beam chemoradiotherapy: Long-term outcomes from a single institution.
Authors: Arthur Sun Myint, Christopher Rao, Amandeep Singh Dhadda, Helen Wong, Michael Hershman, Rajaram Sripadam, Mark Pritchard
Journal: Journal of Clinical Oncology (2022)

131 Background: We previously reported the benefit of Contact X-ray Brachytherapy boost (CXB) in achieving a higher clinical complete response (cCR) following partial response to external beam chemoradiotherapy (EBCRT). We now update our report on the organ preservation rate and long-term durability of the cCR in this cohort. Methods: Outcome data for rectal cancer patients referred to our institution from 2003 to 2012 were retrieved from an institutional database after an audit approval. These patients were referred after initial local multidisciplinary team discussion. All patients had EBCRT 45Gy/25/5 weeks with capecitabine 825mg/m2 (Mon-Fri). Those who respond well but has a small residual tumour were offered CXB boost of 90Gy in 3 fractions over 4-6 weeks as they were not suitable or unwilling to undergo completion surgery. Following treatment, patients had close 3 monthly follow-ups with DRE, endoscopy, and MRI in the first 2 years, then 6 monthly up to 5 years. Results: Of 345 consecutive patients with rectal cancer referred to us, 83 patients who responded well to EBCRT but with small suspicious residual disease (≤3 cm) were offered CXB boost. Median age was 72 years (range 36–87) and 58 (69.9%) were males. Initial MRI tumor stages were cT2 (n = 28), cT3 (n = 55) and 54.2% were node positive. The median follow up of surviving patients was 6.4 years (range 2-11 years). cCR was achieved after CXB boost in 53/83 (64%). After achieving cCR, 8/53 (15%) developed local regrowth. However, all patients successfully underwent curative surgery with R(0) resection rate of 24/30 (80%) and only 21/83 (25%) had stoma. Organ preservation was achieved in 62/83 (75%). 12/53 (14%) patients developed metastatic disease. At the end of the study period, 64/83(77%) were cancer free. Conclusions: Our long-term data suggests dose escalation with CXB boost following EBCRT can achieved high organ preservation rate with excellent long-term durable cCR. This approach can provide an alternative treatment option for elderly or comorbid patient patients who are not suitable for surgery. This can also be an option for some patients who wish to avoid surgery upfront after initial diagnosis. Those who needed surgery later for treatment failure can be salvage successfully. A phase 3 European randomised trial OPERA (Organ Preservation in Early Rectal Adenocarcinoma) was set up to evaluate this concept further.
Into Africa
Authors: Davey Smith
Journal: Annals of Internal Medicine (2003)

Ad Libitum21 October 2003Into AfricaDavey Smith, MDDavey Smith, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-8-200310210-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Back whenthe sun was closerto the groundBefore my plane descendedinto AfricaBack whendawn did not signify a new dayIt was the sameas the day beforeand the day before thatand the day before Back whenthere was one continentone word, one prayer, one musicThat same dayShalawho is Meko's motherwoke up coughing upspit, sputter, spatbloody spatShala coughed up deaththat daybut did not take it with herDeath moved ona thousand timesthat day, this day, every daybeside the ... Author, Article, and Disclosure InformationAffiliations: Dedicated to Dr. Leland Rickman.Current Author Address: Davey Smith, MD, University of California, San Diego, 9500 Gilman Drive 0679, La Jolla, CA 92093. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 21 October 2003Volume 139, Issue 8Page: 701KeywordsChildrenCoughingDustHeartRiversSneezing ePublished: 21 October 2003 Issue Published: 21 October 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Recent Progress in Microneedles‐Mediated Diagnosis, Therapy, and Theranostic Systems
Authors: Jian Yang, Jingbo Yang, Xia Gong, Ying Zheng, Shengzhu Yi, Yanxiang Cheng, Yanjun Li, Bin Liu, Xi Xie, Changqing Yi, Lelun Jiang
Journal: Advanced Healthcare Materials (2022)

Abstract Theranostic system combined diagnostic and therapeutic modalities is critical for the real‐time monitoring of disease‐related biomarkers and personalized therapy. Microneedles, as a multifunctional platform, are promising for transdermal diagnostics and drug delivery. They have shown attractive properties including painless skin penetration, easy self‐administration, prominent therapeutic effects, and good biosafety. Herein, an overview of the microneedles‐based diagnosis, therapies, and theranostic systems is given. Four microneedles‐based detection methods are concluded based on the sensing mechanism: i) electrochemistry, ii) fluorometric, iii) colorimetric, and iv) Raman methods. Additionally, robust microneedles are suitable for implantable drug delivery. Microneedles‐assisted transdermal drug delivery can be primarily classified as passive, active, and responsive drug release, based on the release mechanisms. Microneedles‐assisted oral and implantable drug delivery mechanisms are also presented in this review. Furthermore, the key frontier developments in microneedles‐mediated theranostic systems as the major selling points are emphasized in this review. These systems are classified into open‐loop and closed‐loop theranostic systems based on the indirectness and directness of feedback between the transdermal diagnosis and therapy, respectively. Finally, conclusions and future perspectives for next‐generation microneedles‐mediated theranostic systems are also discussed. Taken together, microneedle‐based systems are promising as the new avenue for diagnosis, therapy, and disease‐specific closed‐loop theranostic applications.
Radiology, Detroit
Journal: JAMA (1962)

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 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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
Book Review Plastic Surgery of the Breast and Abdominal Wall . By Max Thorek, M.D., LL.D. With an introduction by Rudolf Nissen, M.D., and a foreword by J. Eastman Sheehan, M.D. 4°, cloth, 446 pp., with 458 illustrations. Springfield, Illinois: Charles C Thomas, 1942. $6.00.
Journal: New England Journal of Medicine (1944)
Editorial: Vaginal candidosis.
Journal: BMJ (1976)

Whither scabies?Scabies occurs in epidemics, and, though it is still seen fairly often in Britain, there is reason to hope that the condition may soon become much less common.At the start of the second world war the mode of transmission of scabies was not fully understood, and in 1941 there were, according to Mellanby,l over one million people in Britain with scabies.Mellanby's
Pertussis vaccines: trials (and tribulations)
Authors: C. Marwick
Journal: JAMA (1988)

THE LARGE SWEDISH field trial of two acellular pertussis vaccines has not shown levels of efficacy high enough to make either vaccine a likely candidate for immediate licensure in the United States. At the same time, the trial produced evidence from follow-up studies of the disease among both vaccinees and the placebo controls that the vaccines do offer some protection against the disease. These are the essential findings from first analysis of data becoming available from this much-discussed trial. They were reported in recent weeks at the National Institutes of Health, Bethesda, Md. There was an earlier review in Stockholm, and a preliminary report will appear in<i>The Lancet</i>. The trial was an international collaborative effort between the National Bacteriological Laboratory, Stockholm; Research Foundation for Microbial Diseases, Osaka University, Japan; Japanese National Institute of Health; National Institute of Allergy and Infectious Diseases, Bethesda, Md; Center for Biologics Evaluation and Research,
Circulating microRNA: Searching for new players in assessment of therapy response in colorectal cancer patients.
Authors: Veronika Vymetalkova, Klara Cervena, Pavel Vodicka, Stanislav Filip
Journal: Journal of Clinical Oncology (2022)

183 Background: The identification of clinicopathological and molecular predictive and/or prognostic factors represents currently one the most challenging tasks in oncology. Significant efforts are currently being dedicated to identify patients who will or will not benefit from chemotherapy. In fact, drug resistance is a limiting factor of the efficacy of chemotherapy in colorectal cancer (CRC) treatment. However, despite modern surgical techniques and adjuvant systemic therapy, only 20% of patients with distant metastasis achieve long-term remission, while 60–70% of patients develop local or distant recurrence. Methods: Recently, we have identified by high-throughput approach that circulating microRNAs (miRNAs), namely, miR-122-5p and miR-142-5p show a high potential for CRC screening and early detection as well as for the assessment of patients’ outcomes and the effectiveness of treatment schedule. Results: In detail, the expression levels of these miRNAs were significantly different between CRC patients and controls. A year after diagnosis, miRNA expression profiles were significantly modified in patients responding to treatment and were no longer different from those measured in controls. On the other hand, patients not responding to therapy maintained low expression levels in their second sampling. As selection during metastasizing may shift molecular patterns by which CRC liver metastases retain their unique molecular profile, we thus elaborated our results on CRC patients with liver metastasis and measured these circulating miRNAs repeatedly over two years. The first sampling was performed at the time of post therapy developed liver metastasis (i.e., recurrence), and every 3 months depending on patients` conditions (i.e., covering the liver resection, administration of chemotherapy etc). Detailed results of the study will be presented during the meeting. Conclusions: The present study aimed to explain why patients with the same cancer stage may differ in treatment susceptibility and long-term outcomes.
Isoniazid Hepatitis
Authors: WILLIS C. MADDREY
Journal: Annals of Internal Medicine (1973)

Hepatitis secondary to isoniazid given as a chemoprophylactic drug for tuberculosis was observed in 14 patients over a 5-year period. Three of these patients died with fulminant hepatic failure, and 8 of the 11 surviving patients had bridging or multilobular necrosis, or both, on liver biopsy. Rechallenge with isoniazid led to an accelerated recurrence of severe hepatitis in two patients and abnormal serum transaminases within 2 days in a third. A prodromal period characterized by fatigue, weakness, anorexia, and malaise was noted in all patients before the appearance of jaundice. The duration of the symptomatic interval during which isoniazid was continued was longer (mean, 4.6 weeks) in the patients with bridging or multilobular necrosis than in those with only diffuse hepatitis (mean, 2.2 weeks), suggesting that once symptoms appear continued use of the drug causes more severe liver damage. These observations support the need for close medical follow-up of patients on isoniazid therapy, with immediate investigation of symptoms that suggest an adverse reaction.
Intravenous injection of crude marihuana
Authors: A. B. King
Journal: JAMA (1970)

<h3>To the Editor.—</h3> We appreciate the opportunity to reply to some of the questions raised by Drs. Fane and Decker. As reported in the case description, the patient related that she had taken at most one to three tablets or capsules of each of the other drugs, one of which was a combination. Moreover, her statement was subsequently corroborated by her lover, who stated also that the aspirin ingested had come from a bottle of 1,000 tablets. He did not know the exact quantity it had contained, however. Barbiturate and bromide levels were obtained on admission by members of the house staff. Assays for propoxyphene, chlordiazepoxide, and chloral hydrate or its metabolites were not readily available to them. At autopsy, no bolus or unabsorbed drug was found, but it should be recalled that death occurred six days after the ingestion. We felt that the peak level of salicylate (142 mg/100
Intestinal Intussusception
Authors: A. K. Young
Journal: BMJ (1884)

90, prove that the popular ideas as to the purity of sea-air are quite correct and scientific.Experiments were carried out on board the Giroinde, a French mail steamer, between Bordeaux and Rio Janeiro, by the commander, Captain AMoreau, assisted by Dr. Plantymanisioni.M. MIoreau had previously studied the subject at the Paris observatory of Montsouris, under Dr. P. Minquel, from whom he reoeived
Cervical Cancer Screening
Authors: _ _
Journal: Journal of the National Comprehensive Cancer Network (2008)

Cervical carcinoma remains a health issue for women worldwide. Cervical cytology screening is the current method for early detection, and the NCCN Cervical Cancer Screening Clinical Practice Guidelines in Oncology provide direction for evaluating and managing this process, including clarified and revised recommendations on screening techniques and intervals and follow-up of abnormal screening results, including colposcopy. Human papillomavirus (HPV) DNA testing for primary cervical cancer has been approved by the FDA, and HPV DNA testing for high-risk virus types can also be used as a component of both primary screening and workup of abnormal cytology results. Colposcopy, along with colposcopically directed biopsies, has become the primary method for evaluating women with abnormal cervical cytologies. Special considerations for colposcopy performed during pregnancy are also discussed. For the most recent version of the guidelines, please visit NCCN.org
10-year follow-up results of mitral balloon valvotomy in 500 consecutive patients using inoue balloon technique Mohamed E. Fawzy, J. Buraiki, M. Stefadouros, M. Chaudhry, H. Hegazy, M. Awad, Z. Al-Halees. King Faisal Specialist Hospital, Riyadh, Saudi Arabia
Journal: Journal of the American College of Cardiology (2001)
Safety and efficacy of pressurized intraperitoneal aerosolized chemotherapy in appendiceal and colorectal cancer patients with peritoneal carcinomatosis: A first-in-US phase I study.
Authors: Mustafa Raoof, Paul Henry Frankel, Marwan Fakih, Joseph Chao, Dean Lim, Yanghee Woo, Isaac Benjamin Paz, Michael Lew, Mihaela C. Cristea, Lorna Rodriguez-Rodriguez, Yuman Fong, Wiebke Solass, Rebecca Meera Thomas, Sue Chang, Andrew M. Blakely, Richard L. Whelan, Danielle Deperalta, Marc A. Reymond, Amit Merchea, Thanh Hue Dellinger
Journal: Journal of Clinical Oncology (2022)

125 Background: Pressurized intraperitoneal aerosolized chemotherapy (PIPAC) is being evaluated as a novel minimally invasive palliative treatment of peritoneal metastases (PM). Prior studies have established the feasibility and safety of repeated PIPAC treatments in gastrointestinal and gynecologic cancers. The goal of the present phase 1 trial was to establish the safety and feasibility of PIPAC oxaliplatin in a highly chemotherapy refractory colorectal and appendiceal cancer patient population. Methods: Patients with biopsy-proven peritoneal metastases from colorectal or appendiceal cancer underwent up to three PIPAC treatments using oxaliplatin (92 mg/m 2 ) with a six-week interval at two academic centers. Patients with bowel obstruction, extra-peritoneal metastases, or poor performance status (ECOG&gt;2) were excluded. PIPAC was nebulized over 5 min with a 30 min aerosol dwell time. Apart from the first PIPAC cycle, the patients also received a sensitizing dose of 5FU/LV (400mg/m 2 ) within 24 hours of the procedure. Primary end point was safety as assessed by dose limiting toxicities within 6 weeks of the first PIPAC. Secondary endpoints included safety with the addition of 5FU/LV, efficacy, surgical morbidity, technical failure rate, progression-free and overall survival, pharmacokinetics (PK), and quality of life assessment. Results: A total of 8 patients were included: 5 colorectal; and 3 appendiceal. Median number of prior chemotherapy cycles was 2 (Interquartile range – IQR; 1.5-3.5). All patients were refractory to systemic oxaliplatin-based chemotherapy. Median time from diagnosis to PIPAC was 16 months (IQR; 5.6, 17.5) and Peritoneal Carcinomatosis Index was 29 (IQR; 20.5, 31.5). Five (62.5%) patients completed 3 PIPAC cycles while in 3 (37.5%) patients PIPAC was discontinued due to disease progression within the peritoneal cavity. No surgical complication or dose limiting toxicity was observed. Only one patient developed grade 3 treatment-related toxicity after first PIPAC (anemia), and another patient after second PIPAC (abdominal pain and anemia). At the completion of PIPAC treatment 5 patients had stable disease and 3 had disease progression. Pharmacokinetic, histologic response and preliminary survival data will be presented at the meeting. Conclusions: PIPAC with oxaliplatin is safe and feasible in a highly chemotherapy refractory cohort of appendiceal and colorectal carcinomatosis patients with or without sensitizing 5-FU/ LV. Clinical trial information: NCT04329494.
Adolescent Medicine
Authors: Robert W. Blum
Journal: JAMA (1990)

It was not long ago that the term "biopsychosocial" was linked to adolescent medicine in a somewhat pejorative manner to refer to those factors that were poorly understood but acknowledged to contribute to health status outcomes. Over the past few years there has been significant research that has increased our understanding of the interface between and among the biologic, behavioral, emotional, and social forces that influence adolescent health and well-being. This article will focus on two areas where significant advances have been made: the interface of biology and behavior, and an emerging understanding of the relationships between health status, health risk behavior, and achievement among adolescents. The emerging field of psychoneuroendocrinology has increasingly demonstrated hormonal influence on emotional processes.<sup>1</sup>Whereas the exact mechanisms have yet to be clearly elucidated, there is evidence that suggests that both androgens and estrogens influence brain functioning and, in turn, significantly influence behavior. From
Neutralizing antibodies against the SARS-CoV-2 Delta and Omicron variants following heterologous CoronaVac plus BNT162b2 booster vaccination
Authors: Eddy Pérez-Then, Carolina Lucas, Valter Silva Monteiro, Marija Miric, Vivian Brache, Leila Cochon, Chantal B. F. Vogels, Amyn A. Malik, Elena De la Cruz, Aidelis Jorge, Margarita De los Santos, Patricia Leon, Mallery I. Breban, Kendall Billig, Inci Yildirim, Claire Pearson, Randy Downing, Emily Gagnon, Anthony Muyombwe, Jafar Razeq, Melissa Campbell, Albert I. Ko, Saad B. Omer, Nathan D. Grubaugh, Sten H. Vermund, Akiko Iwasaki
Journal: Nature Medicine (2022)

The recent emergence of the SARS-CoV-2 Omicron variant is raising concerns because of its increased transmissibility and its numerous spike mutations, which have the potential to evade neutralizing antibodies elicited by COVID-19 vaccines. Here we evaluated the effects of a heterologous BNT162b2 mRNA vaccine booster on the humoral immunity of participants who had received a two-dose regimen of CoronaVac, an inactivated vaccine used globally. We found that a heterologous CoronaVac prime vaccination of two doses followed by a BNT162b2 booster induces elevated virus-specific antibody levels and potent neutralization activity against the ancestral virus and the Delta variant, resembling the titers obtained after two doses of mRNA vaccines. Although neutralization of Omicron was undetectable in participants who had received a two-dose regimen of CoronaVac, the BNT162b2 booster resulted in a 1.4-fold increase in neutralization activity against Omicron compared with the two-dose mRNA vaccine. Despite this increase, neutralizing antibody titers were reduced by 7.1-fold and 3.6-fold for Omicron compared with the ancestral strain and the Delta variant, respectively. These findings have immediate implications for multiple countries that previously used a CoronaVac regimen and reinforce the idea that the Omicron variant is associated with immune escape from vaccines or infection-induced immunity, highlighting the global need for vaccine boosters to combat the impact of emerging variants.