tbuckley/cabot-search huggingface dataset:
Glycosuria of pregnancy.
Authors: J. Fine
Journal: BMJ (1967)

Stroke -B adshaw and Casey MEDICAL JOU2RNALUz) or occluded, then the damage has already been done and restora- tion of normal carotid blood flow is unlikely to achieve clinical improvement. SummaryThe clinical and radiological features of 47 patients with stroke are presented, of whom 24 had stenosis and 23 occlusion of the relevant internal carotid artery.One patient died and two became hemiplegic after per- cutaneous carotid arteriography.Thirty-three patients had only supportive treatment, five received anticoagulants for three to eight weeks, and hypertension was reduced in seven with methyldopa.Two patients with carotid stenosis died of related and one of unrelated disease.The survivors were followed for between six months and eight years.Overall, neurological progress was highly satisfactory in 65% and unfavourable in 35%.Five patients with carotid occlusion died of related and two of unrelated disease.The survivors were followed for between one and ten years.Overall, neurological progress was highly satisfactory in 45% and unfavourable in 55%.The presence of marked irregularity in the calibre of the retinal arterioles and/or atheroma of limb vessels was usually associated with a poor prognosis.ADDENDUM.-Theprogress of all survivors in this series has been followed up to 1 November 1966.One patient with carotid stenosis previously classified as having moderate disablement has improved and now has only slight disability, the remainder are unchanged.
MOTOR NOTES FOR MEDICAL MEN
Authors: H. M. Buist
Journal: BMJ (1916)

TAIEr restr ictions introduced in Janutary by the Home Office Order concenming lights on motor cars form the subject of complaints by many doctors, on the ground that these niew regulationss iua.ke it impossible for them to dirive on dark country roads, with their lighting equip.ment muasked in accordanee with the new regulations.It will be recalled that the Medical Secretary of tlle British Medical Association wrote, on December 31st, 1915, to the home Office stating that a number of letters had been received by tlhe Association fromi practitioners in rural areas pointing out the inconveniences and dangers wlicih might arise from the new Order that has come into force tlhis year, and asking for some relaxation of it to be made as regards the cars of dloctors whlen in use for professional purposes.The official reply claimed that in the framing of
Virginia Apgar and the Apgar score: kudos and a correction
Authors: L. J. Butterfield
Journal: JAMA (1997)

<h3>To the Editor.</h3> —The captivating collage by Mr Skolnick on Dr Virginia Apgar<sup>1</sup>included the history of the Apgar Memorial String Quartet, the beguiling personality of Dr Virginia Apgar, and that incredible 1957 nocturnal caper at the Harkness Pavillion when she and Carleen Hutchins "liberated" the curly maple shelf of a telephone booth that they transposed to the back of Apgar's viola. It is an unfortunate gaffe, however, that the article claims that the Apgar score "is often highly predictive of the child's later psychocognitive development" to those who would retire or defend the Apgar score. This issue has been debated ad nauseum with the usual conclusion that the Apgar score is still the best clinical tool for the evaluation of the newly born infant and that it was never intended to predict later outcome.<sup>2</sup>
PNEUMOCOCCAL MENINGITIS
Authors: C. Worster-Drought, Alex. M. Kennedy
Journal: BMJ (1917)

THE following observations are based upon a study of nine cases of pneumococcal meningitis which have come under our direct care, the ages of the patients varying between the wide limits of three months and forty-one years.In five cases the disease was the so-called primary form-that is, no lesion conceivably due to active pneumococcal in- fection was discovered elsew'here.Tliis diagnosis, in three cases, was confirmed by post-mvzortem examination; in the remaining two an .autopsy was not obtainable, but, clinically, no other lesion could be detected.In four cases meningitis occurred as a secondary infection. PRIMARY MENINGITIS.Of the five cases, two vwer& infants, aged three and fouLr inonths respectively, one was a boy of 11, and two were adults aged 22 and 41.The adults had had catarrhal "'colds".for three or four days, followed by severe head- ache,-prior to the appearance of meningeal symptoms, while the younger infant lhad lhad sudden convulsions.Following the appearance of headache, vomiting occurred in four of the five cases, and delirium rapidly supervened in the two adults.SE,CONDARY MENINGITIS.Of tlle four cases in wllich meningitis occurred as a secondary infection to a focus elsewlhere, in two the primary lesion was a lobar pneumonia, in one middle-ear disease, and, in tlle last, an empyema of tlle sphenoidal sinus.The number of cases of pneumonia in whicl a secondary meningitis occurs is probably less than 2 per cent.Lobar Piewimo7lia.-The first case, that of a child aged 14 months, was admitted to hospital with a temperature of 1030 F.,
Insomnia
Authors: A. H. Douthwaite
Journal: BMJ (1958)

The purpose of this article is to discuss drugs used for insomnia.That they should form only a small part of treatment must be stressed, but the wider aspects of the problem, though of great importance, cannot be en- compassed in this account.It must be noted that insom- nia is one of the few states which we are called upon to control without, as a rule, any certainty that it exists.
Abstract 17362: A Multidisciplinary Heart Team Approach to High Risk Transvenous Pacemaker and Defibrillator Lead Extraction Improves Mortality
Authors: Ryan G Aleong, Matthew Zipse, Christine Tompkins, Tamas Seres, David Fullerton, Muhammad Aftab
Journal: Circulation (2018)

Introduction: There is a risk of serious complications with high-risk lead extraction (LE) that may increase mortality. Current guidelines do not provide definitive guidance on collaborative involvement of cardiac surgery as compared to other procedures such as TAVR procedures. We report a single center experience of the benefits of a collaborative approach between cardiac surgery and cardiac electrophysiology (EP). Hypothesis: MDHT will improve outcomes in LE Methods: High risk lead extractions had dwell times of at least 4 years for pacemaker leads and 2 years for ICD leads. A multidisciplinary heart team (MDHT) was created based on the TAVR model that includes a combined lead management clinic and a monthly multidisciplinary conference. Prior to MDHT creation, high risk lead extractions were performed either in the hybrid operating room (OR) and cardiology procedure lab with a surgeon on call as needed. After the MDHT creation all cases were performed in the hybrid operating room by a cardiac surgeon, cardiac anesthesiologist and EP together with an interventional radiologist readily available. Results: Prior to MDHT, 169 patients underwent 344 leads extractions. There were six major procedural complications (3.6%) that included 2 procedural deaths (1.2%) during that period (SVC tear, Tricuspid valve avulsion). Following the creation of MDHT, there have been 47 cases performed with 85 leads extracted. There have been two complications requiring surgical repair (one SVC laceration, one RV laceration), which were surgically repaired. With the creation of a MDHT, the rate of major complications was unchanged (Pre vs. Post MDHT 3.6% vs. 4.3%) but there was a lower mortality rate (Pre vs. Post MDHT 1.2% vs. 0%). Conclusions: High risk lead extraction had a fixed complication rate at our institution however a MDHT decreased mortality. A structured multidisciplinary approach, involving EP and cardiac surgery, decreased mortality in a medium sized lead extraction center and should be considered at all centers.
EDITORIAL NOTES.
Authors: C. S. Ayres
Journal: JAMA (1890)

<h3>HOME.</h3><h3>The Metropolitan Medical Society.</h3> A new medical society has been started in New York city, which will not limit its membership to the city itself but will draw from the entire metropolitan district. Meetings will be held twice a month. <h3>Medical Students Named in a Will.</h3> Mayor Grant, of New York city, has received information that the will of Count Henry Hardegg, who died at Vienna, Austria, in May last, names that former city as a possible legatee. The bequest, if it ever comes, is to be set apart for the benefit of struggling medical students. The amount of the legacy has not yet been discovered. <h3>The Arkansas State Asylum Damaged by Fire.</h3> The Insane Asylum at Little Rock, Arkansas, was very nearly destroyed by fire on the 16th instant. One wing was burned down, involving a loss of $35,000. There was no loss of life although the inmates,
Abstract 205: Blood Flow Backward into the Vein During Chest Compression; The Correlation Between the Vessel Pressure and Return of Circulation in Out-of-Hospital Cardiac Arrest
Authors: Yasuaki Koyama, Tasuku Matsuyama, Tetsuya Hoshino, Nobutake Shimojo, Satoru Kawano, Yoshiaki Inoue
Journal: Circulation (2018)

Introduction: Little is known about the hemodynamic flow during chest compression (CC) for patients with cardiac arrests; some previous studies reported blood may flow backward into vein and oxygenated blood may not forward into artery during CC. We set out to describe the pattern of the hemodynamic flow during CC and identify the relationship between the pattern and their outcome. Method: We prospectively enrolled out-of-hospital cardiac arrest (OHCA) patients admitted to our emergency department (ED) and for whom femoral arterial and venous pressure were successfully measured from May 2017 to April 2018. The exclusion criteria was those with traumatic OHCA, who received extracorporeal membrane oxygenation or who aged &lt;15 years. We inserted a 4Fr catheter both in femoral artery and vein. The standard advanced cardiac life support was provided with manual or mechanical CC. We defined the case that the artery pressure was higher than the venous pressure as the A group, and the opposite case as the V group. The proportion of ROSC in both groups was statistically evaluated by chi-square test. Results: Total 70 patients were transported to our ED during the study period. Of the 25 patients for whom femoral arterial and venous pressure were tried to measure, 22 patients (90%) were successful and included in our final analysis. Each group had 11 patients. In A group, seven out of 11 patients achieved ROSC, whereas no patients did in V group (p=0.006). Conclusion: In this study, half of the patients predominantly showed the backward flow during CC and no patients could achieve ROSC in this group. This suggests that blood flowing backward into venous may be associated with the lower quality of CC during CPR.
Folia Clínica Internacional, Barcelona
Journal: JAMA (1966)

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
Targeting the epigenetic processes to enhance antitumor immunity in small cell lung cancer
Authors: Hao Luo, Jinlu Shan, Hong Zhang, Guanbin Song, Qing Li, Cheng-Xiong Xu
Journal: Seminars in Cancer Biology (2022)

Dysregulation of the epigenetic processes, such as DNA methylation, histone modifications, and modulation of chromatin states, drives aberrant transcription that promotes initiation and progression of small cell lung cancer (SCLC). Accumulating evidence has proven crucial roles of epigenetic machinery in modulating immune cell functions and antitumor immune response. Epigenetics-targeting drugs such as DNA methyltransferase inhibitors, histone deacetylase inhibitors, and histone methyltransferase inhibitors involved in preclinical and clinical trials may trigger antitumor immunity. Herein, we summarize the impact of epigenetic processes on tumor immunogenicity and antitumor immune cell functions in SCLC. Furthermore, we review current clinical trials of epigenetic therapy against SCLC and the mechanisms of epigenetic inhibitors to boost antitumor immunity. Eventually, we discuss the opportunities of developing therapeutic regimens combining epigenetic agents with immunotherapy for SCLC.
"Home brew' compared with commercial preparation for enteral feeding.
Journal: BMJ (1982)

interview after an emergency referral she presented many biological symptoms and signs of depression.For three weeks, attempts were made to treat her with antidepressants as an outpatient, but she was admitted to inpatient psychiatric care after becoming acutely agitated and violent at home.Failure to respond to a combination of tetracyclic antidepressants and phenothiazines lead to the application of electric convulsion treatment four times.She made an excellent response, and was fit for discharge to outpatient care after six weeks as an inpatient.The social factors included profound language difficulties, leading to marked social isolation, aggravated by the lack of extended family support together with profound disappointment at the delivery of a fifth daughter.
Error in Author Listing and Affiliation
Journal: JAMA Dermatology (2022)

Andrew Creadore, MD; Sheena Desai, MD, MBA; Allireza Alloo, MD; Anna K. Dewan, MD, MHS; Mina Bakhtiar, MD; Carla Cruz-Diaz, MD; Alisa Femia, MD; Lindy Fox, MD; Kimberly L. Katz, MD; Robert Micheletti, MD; Caroline A. Nelson, MD; Alex G. Ortega-Loayza, MD, MCR; J. Randall Patrinely Jr, BA; Molly Plovanich, MD; Misha Rosenbach, MD; Sheila Shaigany, MD; Bridget E. Shields, MD; Jamal Z. Saleh, MD; Zakariyah Sharif-Sidi, MD; Kanade Shinkai, MD, PhD; Jacob Smith, BS; Chang Su, MD; Karolyn A. Wanat, MD; Jill K. Wieser, MD; Shari Wright, MD; Megan H. Noe, MD, MPH, MSCE; Arash Mostaghimi, MD, MPA, MPH
Association of functional outcomes by decision-making approach in men with metastatic prostate cancer (mPC).
Authors: Frank Schumacher, Irene B. Helenowski, Kelvin A. Moses, James Benning, Alicia K. Morgans
Journal: Journal of Clinical Oncology (2022)

78 Background: Multiple treatments with similar efficacy exist for mPC resulting in multifaceted treatment choices. Shared decision-making (SDM) engages patients and may be associated with superior outcomes in men with prostate cancer. We assessed the association of decision locus of control (DLOC) (SDM vs. physician- or patient-directed decisions) and measures of patient quality of life (QOL), including patient reported functional outcomes, and decision satisfaction. Methods: Patients completed surveys of decision-making practices after a clinic visit in which a decision occurred. Patients also completed the EORTC QLQ-C30 QOL instrument at baseline (time of decision), and 2- and 4-months. Scores for each QOL dimension and pain were calculated for each time point, and the least-squared means were compared among DLOC groups to evaluate for associations using a mixed effects model. Results: 101 patients participated, with median age of 69 years [range: 49-92]. Most patients were white (80%) and married (82%). A majority of patients reported experiencing SDM in the clinic visit assessed (63, 62%). At baseline, there was no significant difference in patient reported QOL dimensions among DLOC groups, but patients reporting physician-directed decisions reported significantly greater baseline pain than the SDM group (Table). At 4 months, patient reported physical functioning was superior among patients reporting patient-directed (p=0.005) or SDM (p=0.03) than those who reported physician-directed decision-making. There was a trend toward greater decision satisfaction among patients who reported patient-directed (p=0.06) or SDM (p=0.10) at 4-months compared to men reporting physician-directed decision-making. There were no differences at 4 months for social, emotional, cognitive, or role functioning between DLOC groups. Conclusions: Patients who reported greater control during treatment decisions had superior physical functioning and a trend toward greater decision satisfaction at 4 months compared with patients reporting physician-directed decisions, suggesting measurable domains of benefit from involvement in the decision-making process. Continued research evaluating the association between physical and psychological outcomes and DLOC is needed, including larger studies within more diverse populations.[Table: see text]
Implications of androgen receptor (AR) alterations identified by genomic testing of tissue and blood from advanced prostate cancer (aPC) patients (pts).
Authors: Zeynep Busra Zengin, Nicholas Henderson, Joseph J. Park, Alicia Ali, Clara Hwang, Pedro C. Barata, Mehmet Asim Bilen, Laura Graham, Deepak Kilari, Abhishek Tripathi, Matthew Labriola, Shoshana Rothstein, Rohan Garje, Vadim S Koshkin, Vaibhav G. Patel, Michael Thomas Schweizer, Andrew J. Armstrong, Rana R. McKay, Ajjai Shivaram Alva, Tanya B. Dorff
Journal: Journal of Clinical Oncology (2022)

138 Background: AR alterations such as ligand binding domain mutations and amplification evolve under the selective pressure of testosterone suppression and AR targeted agents (ARTA) such as abiraterone or enzalutamide, but their relevance to ARTA treatment outcomes remain unclear. Methods: PROMISE is a multi-institutional retrospective clinical-genomic database inclusive of aPC pts who had tissue and/or blood based genomic testing by commercially available CLIA-certified platforms. We analyzed men who received second generation ARTA and stratified patients according to genomic testing timing (pre-/post-ARTA), castration resistance, type of AR alteration, and PSA decline ≥50% on first ARTA. Time to progression (TTP) from first ARTA initiation was estimated using the Kaplan-Meier method and differences between subgroups defined by AR alteration status were assessed using the log-rank test. Results: 854 pts who received ARTA and had tissue-based (n = 600) or blood-based (n = 335) genomic testing were included. Median age was 62 (range, 33-93). Pre- and post-ARTA genomic testing was available in 387 and 467 pts, respectively. AR alterations were identified in 16% (61/387) of pre-ARTA and 48% (226/467) of post-ARTA pts with AR amplifications in 10% (38/387) and 35% (161/467) of the pts, respectively. 15/52 pts who had pre- and post-ARTA testing developed a new AR alteration. In pre-ARTA cohort; castration status, median TTP, and PSA response for 1st ARTA according to alteration status are summarized in the table. In the post-ARTA group, the most common AR mutations were L702H (53%), followed by T878A (33%); whereas, in the pre-ARTA group, the H875Y (26%) mutation was most common. AR mutations in post-ARTA group were seen at similar rates regardless of prior docetaxel exposure (14.3% vs 18.0%, p = 0.46) and following first abiraterone vs enzalutamide/apalutamide exposure (48.6% vs 48.3%, p = 1.0). Conclusions: AR mutations, unlike amplifications, were associated with shorter TTP on abiraterone. Genomic testing should be considered before second line ARTA.[Table: see text]
The impact of baseline peripheral cytokines on survival in metastatic clear cell renal cell carcinoma (RCC) treated with nivolumab: NIVOREN GETUG-AFU 26 Translational study.
Authors: Lucia Carril, Marie Naigeon, Cécile Dalban, Aude Desnoyer, Nathalie Rioux-Leclercq, Catherine Sautes-Fridman, Maxime Meylan, Yann-Alexandre Vano, Benoit Beusenlick, Salem Chouaib, Caroline de Oliveira, Florence Tantot, Bernard Escudier, Laurence Albiges, Nathalie Chaput
Journal: Journal of Clinical Oncology (2022)

379 Background: The NIVOREN GETUG-AFU 26 study reported safety and efficacy of nivolumab in patients with RCC in a “real world setting”. A translational research program was launched to quantify baseline cytokine levels and correlate them with outcomes to nivolumab. Methods: Extreme responder patients (pts) treated with nivolumab as part of the phase II NIVOREN GETUG-AFU 26 were included in this TRAINING cohort. A panel of 14 different plasma cytokines and proteins (VEGF, VCAM-1, IL-6, IL-7, IL-8, IL-10, APRIL, BAFF, 4-1BB, BCA, SDF-1, MDC, IFN-gamma and TNF-alpha) were quantified for each plasma sample using the Elisa-based Meso Scale Discovery electrochemiluminescence assay. The association between baseline cytokine levels and objective response rate (ORR), progression-free survival (PFS) and overall survival (OS) was evaluated. Results: Overall, 80 pts, 40 responders and 40 progressors, were included for cytokine analysis. Baseline characteristics were similar to the overall trial population. The IMDC risk score breakdown was 11.3% good, 56.3% intermediate and 32.5% poor. With a median follow-up of 21.2 months, mOS data was immature at data cut-off. Overall survival rate was 67.3% at 12 months and median PFS was 3.8 months. Increased levels of IL-6 (75 th percentile=P75), IL-7 (P75), IL-8 (P50) and VEGF (P50) were significantly negatively associated with survival (IL-6: HR=2.44, p=0.0112; IL-7: HR=2.38, p=0.0123; IL-8: HR=2.80, p=0.0045, and VEGF: HR=2.43, p=0.0133). 4-1BB (P50) was associated with improved OS (HR=0.39, p=0.0375). Higher levels of IL-8 (P50) and VEGF (P50) were associated with worse PFS (IL-8: HR=2.50, p=0.0133, and VEGF: HR=1.96, p=0.0132) and worse ORR (IL-8: p=0.013, and VEGF: p=0.044). Except for IL-8 and VEGF, no other associations with response were observed. Conclusions: Higher baseline plasma levels of IL-6, IL-7, IL-8 and VEGF were significantly associated with worse survival outcomes in mRCC pts treated with nivolumab within TRAINING cohort of the NIVOREN trial. In contrast, 4-1BB was significantly associated with improved OS. IL-8 and VEGF were also associated with worse PFS and ORR. VALIDATION cohort within the entire NIVOREN study is ongoing.