tbuckley/cabot-search huggingface dataset:
Treatment trends among men with metastatic castration sensitive prostate cancer (mCSPC): Results from the US component of an international study.
Authors: Pedro C. Barata, Andrea Leith, Amanda Ribbands, Rachel Montgomery, Matthew Last, Bhakti Arondekar, Alexander Niyazov, Jasmina Ivanova
Journal: Journal of Clinical Oncology (2022)

66 Background: Novel hormonal therapies (NHTs) and taxane-based chemotherapy (CT) were initially approved for the treatment of metastatic castration resistant prostate cancer (mCRPC) and are now approved for use in mCSPC. Little is known about the recent uptake of these treatments in mCSPC. This study evaluated mCSPC treatment trends from 2016 to 2020 in the US. Methods: Participating physicians collected information from medical charts for the next consecutive 8 men with advanced prostate cancer (4 men with mCSPC, and 4 men with mCRPC) during January-August 2020. A subset of men with current mCRPC had historical mCSPC treatment information available. Treatments were categorized into 4 mutually exclusive categories: (1) androgen deprivation therapy (ADT) ± first-generation anti-androgen (1st gen AA); treatment intensification with (2) NHT, (3) taxane CT ± NHT, and (4) other treatments (e.g., radium-223, sipuleucel-T, non-taxane CT). To account for the availability of new mCSPC treatments, treatment patterns across all lines of mCSPC therapy were described for men initiating treatment in 2016-2018 and 2019-2020. Results: 239 men with mCSPC were included (146 with mCSPC at data collection; 93 with mCRPC at data collection and who had historical information on mCSPC treatments). Mean age was 69 years; 69% had bone metastases and 30% had visceral metastases. Most patients were managed by oncologists (75%), while 48% were treated at academic/cancer centers. From 2016-2018 to 2019-2020, mCSPC treatment intensification with NHT increased while treatment intensification with taxane CT or other therapies declined. (Table) Conclusions: In this real-world study of adult men with mCSPC, increased use of NHT was observed over time indicating that more men will have been exposed to NHT when they progress to mCRPC. This suggests an unmet need for novel therapies in mCRPC. Funding: Pfizer. [Table: see text]
Abstract 221: Mean Arterial Pressure and Impact on Organ Function and Survival During Targeted Temperature Management After Out-of-Hospital Cardiac Arrest
Authors: Johannes Grand, Christian Hassager, Matilde Winther-Jensen, Sebastian Wiberg, Jakob H Thomsen, Martin Frydland, Jesper Kjaergaard
Journal: Circulation (2018)

Introduction: Hemodynamic instability is common after resuscitated out-of-hospital cardiac arrest (OHCA). However, data on hemodynamic treatment-goals are sparse. This study investigates mean arterial pressure (MAP) in patients surviving 48 hours after OHCA in relation to organ injury and survival as a post hoc analysis of a large multicenter trial cohort. Hypothesis: We hypothesized that low MAP during TTM was associated with more organ injury. Methods: Post-hoc analysis of the prospective randomized TTM-trial including 851 comatose OHCA patients surviving more than 48 hours with available blood pressure data. Neuron-specific enolase (NSE) (brain injury) was the primary endpoint and estimated glomerular filtration rate (eGFR) (renal function) was the secondary endpoint. Measurements and Main Results: Patients were stratified by mean MAP during TTM in the following groups; &lt;70 mmHg (22%), 70-80 mmHg (43%), and &gt;80 mmHg (35%). NSE at 24, 48 and 72 hours was inversely related to mean MAP: 28 ng/ml [95% confidence interval (CI) 24-33], 26 [23-29], 21 [19-24] ng/mL; p group =0.002 for low, intermediate and high MAP groups. After adjusting for potential confounders, this association remained significant (p group_adjusted =0.006). A similar result was seen for eGFR (p group_adjusted =0.003). Mean MAP was not associated with mortality after 180 days, however higher mean MAP was independently associated with lower odds of renal replacement therapy (odds ratio adjusted = 0.75 [95% CI, 0.63-0.88] per 5 mmHg increase; p &lt; 0.001]) (figure 1). Conclusions: Lower mean MAP during TTM was independently associated with increased biomarkers of brain injury and initiation of renal replacement therapy in a large cohort of comatose OHCA patients. Increasing blood pressure above the guideline-recommended threshold of 65 mmHg during TTM could potentially mitigate organ injury and be renal-protective. This hypothesis should be investigated in prospective trials.
Leads from the MMWR. Tuberculosis control among homeless populations
Journal: JAMA (1987)

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
PAUL GOTTLIEB WERLHOF (1699-1767) THROMBOCYTOPENIC PURPURA
Journal: JAMA (1968)

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
Vesicoureteral Reflux
Authors: Rudolph Oppenheimer
Journal: JAMA (1971)

<h3>To the Editor.—</h3> The natural history of vesicoureteral reflux is still controversial. A case of probable primary reflux in a woman of 73 years showing remarkable roentgenographic changes without serious impairment of renal function is therefore of interest. The patient, a spinster, was referred by an internist because of pyuria and a history of intermittent cystitis for more than 20 years. She had consulted an internist because of an attack of acute diarrhea during which she had lost 20 lb. She had had occasional afebrile symptoms of lower urinary tract infection for about 20 years. Her general health had been excellent, she had never been pregnant, and her last menstrual period had been at about 50 years of age. Physical examination revealed post-menopausal atrophy of the vaginal mucosa and a large rectocele. The catheterized urine showed a trace of albumin, much pus, and many bacilli. After two-weeks treatment with sulfamethoxazole,
Effect of Hypoxia on Newborn Animals
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 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
Incidence and outcomes of nodal metastasis in clinically nonmuscle-invasive bladder cancer.
Authors: Muhannad Alsyouf, Seyedeh Sanam Ladi Seyedian, Alireza Ghoreifi, Antoin Douglawi, Anne K. Schuckman, Hooman Djaladat, Siamak Daneshmand
Journal: Journal of Clinical Oncology (2022)

577 Background: Radical cystectomy (RC) is recommended in NMIBC patients with high risk of progression or persistent disease despite intravesical therapy. The role and extent of lymphadenectomy is controversial and not universally performed in this population. The objective of this study is to evaluate the incidence and pattern of nodal metastasis in patients undergoing radical cystectomy for treatment of clinically non-muscle invasive bladder cancer. Methods: Prospectively collected data of patients who underwent RC and ‘super-extended’ LND with intent-to-cure for urothelial carcinoma of the bladder between 2002 and 2019 were examined. Inclusion criteria were(a) clinical stage Ta, Tis,or T1, (b) muscle present and not involved,(c) no prior diagnosis of T2 disease, (d) no prior neoadjuvant therapy, and (e) super-extended lymphadenectomy performed to level of IMA with mapping information available. Logistic regression analysis was used to evaluate for predictors of node metastasis. Results: A total of 223 patients met inclusion criteria with a median follow up of 8.2 years (IQR 4.1-10.7). Lymph node metastasis was identified in 8.1% (18/223) of the cohort. Nodal metastasis was present in 0 patients with cTis, 0 patients with cTa, and 11.6% (18/155) of patients with cT1 disease. Of the 18 patients with LNM in cT1 disease, 61% (11/18) had positive nodes below the common ileac vessel bifurcation, 6% (1/18) had positive nodes below the level of aortic bifurcation, and 33% (6/18) had distant metastasis to lymph nodes beyond aortic bifurcation. No skip metastasis were identified. After RC, 89% of cT1 with nodal metastasis had muscle invasive disease. On logistic regression analysis, presence of LVI on TURBT specimen was a significant predictor of LNM (OR 6.8, CI 2.2-20.9). Five-year RFS was 91%, 82%, and 61% in patients with pNMIBC, cNMIBC, and pMIBC, respectively. Conclusions: Routine lymph node dissection is necessary in patients undergoing RC for cT1 disease due to risk of upstaging and LNMs. Presence of LVI in TURBT specimen of cNMIBC is a predictor of nodal metastasis. In patients with nodal disease, metastasis beyond the limits of a standard lymph node template occurred in two-thirds of patients, however a standard pelvic node dissection would have identified all patients with node positive disease.
The Efficacy and Safety of Imeglimin as Add-on Therapy in Patients With Type 2 Diabetes Inadequately Controlled With Sitagliptin Monotherapy
Authors: Pascale Fouqueray, Valdis Pirags, Michaela Diamant, Guntram Schernthaner, Harold E. Lebovitz, Silvio E. Inzucchi, Clifford J. Bailey
Journal: Diabetes Care (2014)

This 12-week study assessed the efficacy and tolerability of imeglimin as add-on therapy to the dipeptidyl peptidase-4 inhibitor sitagliptin in patients with type 2 diabetes inadequately controlled with sitagliptin monotherapy.In a multicenter, randomized, double-blind, placebo-controlled, parallel-group study, imeglimin (1,500 mg b.i.d.) or placebo was added to sitagliptin (100 mg q.d.) over 12 weeks in 170 patients with type 2 diabetes (mean age 56.8 years; BMI 32.2 kg/m(2)) that was inadequately controlled with sitagliptin alone (A1C ≥7.5%) during a 12-week run-in period. The primary efficacy end point was the change in A1C from baseline versus placebo; secondary end points included corresponding changes in fasting plasma glucose (FPG) levels, stratification by baseline A1C, and percentage of A1C responders.Imeglimin reduced A1C levels (least-squares mean difference) from baseline (8.5%) by 0.60% compared with an increase of 0.12% with placebo (between-group difference 0.72%, P < 0.001). The corresponding changes in FPG were -0.93 mmol/L with imeglimin vs. -0.11 mmol/L with placebo (P = 0.014). With imeglimin, the A1C level decreased by ≥0.5% in 54.3% of subjects vs. 21.6% with placebo (P < 0.001), and 19.8% of subjects receiving imeglimin achieved a decrease in A1C level of ≤7% compared with subjects receiving placebo (1.1%) (P = 0.004). Imeglimin was generally well tolerated, with a safety profile comparable to placebo and no related treatment-emergent adverse events.Imeglimin demonstrated incremental efficacy benefits as add-on therapy to sitagliptin, with comparable tolerability to placebo, highlighting the potential for imeglimin to complement other oral antihyperglycemic therapies.
Journal club
Authors: Jonathan Stamen
Journal: Thorax (2021)

Despite effective antituberculous chemotherapy, there is significant morbidity following completed treatment regimens including lasting impact on lung function, which is linked with all-cause mortality.This has led to interest in the use of adjunctive host-directed therapies.In an open-label, phase 2, randomised control trial, Wallis et al (Lancet 2021:doi10.1016/S2213-2600(20)30448-3)investigated the safety and preliminary efficacy of four adjunctive hostdirected therapies for pulmonary tuberculosis.A total of 200 patients across three sites in South Africa with rifampicin-susceptible Mycobacterium tuberculosis were randomly assigned (1:1:1:1:1) to receive either CC-11050, everolimus, auranofin, ergocalciferol in addition to standard anti-tuberculosis therapy or standard therapy alone for 180 days.Three of 11 treatment-emergent serious adverse events were attributable to host-directed treatment: lifethreatening thrombocytopaenia in an auranofin recipient which resolved after auranofin discontinuation, intra-abdominal sepsis resulting in death in another auranofin recipient and tuberculosis spondylitis in an ergocalciferol recipient.The CC-11050 and everolimus groups did not contain any serious adverse events that could be attributed to treatment.Furthermore, relative to the control group, the CC-11050 and everolimus groups showed a greater improvement in mean forced expiratory volume in 1 s (FEV 1 ) at day 180 (6.30%, 95% CI 0.06% to 12.54%; p=0.048; and 6.56%, 95% CI 0.18% to 12.95%; p=0.044, respectively).No treatments showed a significant difference in forced vital capacity (FVC) or on measures of sputum culture status during the study.The authors conclude that encouraging safety and efficacy findings for CC-11050 and everolimus, including their effect on FEV 1 recovery, warrants further study.
AMA Vietnam Medical School Project
Journal: JAMA (1968)

The American Medical Association has for the past two years endeavored to provide advice and assistance for South Vietnam's medical schools. This has been done by means of a contract with the Agency for International Development, which provides financial support for the Vietnam Medical School Project. <h3>History</h3> The American Medical Association's involvement in the Project grew from a study of the programs and facilities of the Faculty of Medicine at the University of Saigon carried out in February 1966 at the invitation of the US Agency for International Development and the Government of Vietnam. This survey was conducted by a four-man team: Robert C. Long, MD, Board of Trustees, delegation chairman; William A. Sodeman, MD, Council on Medical Education; Ernest B. Howard, MD, Assistant Executive Vice-President; and Walter S. Wiggins, MD, Department of Medical Education. The purpose of their visit was to ascertain how best to use the resources of
Iatrogenic Jaundice
Authors: Joseph W. Cooch
Journal: JAMA (1961)

<h3>To the Editor:—</h3> On page 1690 ofThe Journal, vol. 174, Nov. 26, 1960, appears an article by Dr. Schaffner, entitled "Iatrogenic Jaundice." Although the article gives a fine description of the liver damage resulting from various drugs which should be noted, there are other forms of iatrogenic jaundice not mentioned in the article. Among these are those resulting from transfer of virus by the use of inadequately sterilized needles or other medical instruments, the sequelae of certain blood transfusions, as well as the results of the use of plasma which contains the virus of serum hepatitis. These mechanisms of the production of jaundice are quite as much caused by physicians as the administration of the drugs which Dr. Schaffner describes.
Panic disorder.
Authors: I Marks
Journal: BMJ (1983)

<h3>Background</h3> Promotion of physical activity in primary care has had limited success. Wearable technology presents an opportunity to support healthcare practitioners (HCPs) in providing personalised feedback to their patients. <h3>Aim</h3> To explore the differing thoughts and feelings of both HCPs and at-risk patients provided with personalised multidimensional physical activity feedback. <h3>Design &amp; setting</h3> Qualitative study with HCPs (<i>n</i> = 15) and patients at risk of cardiovascular disease or type 2 diabetes (<i>n</i> = 29), recruited from primary care. <h3>Method</h3> HCPs and patients wore a physical activity monitor for 7 days and were subsequently shown their personalised multidimensional feedback, including sedentary time, calorie burn, short (1-minute) or long (&gt;10-minute) bouts of moderate-to-vigorous activity during semi-structured interviews. Transcripts were analysed thematically with comparisons made between individuals of high (<i>n</i> = 21) and low (<i>n</i> = 23) physical activity levels as to their cognitive–affective responses to their data. <h3>Results</h3> Personalised feedback elicited positive emotional responses for highly active participants and negative emotional responses for those with low activity. However, individuals with low activity demonstrated largely positive coping mechanisms. Some low active participants were in denial over feedback, but the majority valued it as an opportunity to think of ways to improve physical activity (cognitive reappraisal) and started forming action plans (problem-focused coping). Around half of all participants also sought to validate their feedback against peers. <h3>Conclusion</h3> Personalised, visual feedback elicits immediate emotional and coping responses in participants of high and low physical activity levels. Further studies should explore whether multidimensional feedback could help practitioners explore diverse ways for lifestyle change with patients.
CAESAREAN SECTION
Authors: S. J. Cameron
Journal: BMJ (1922)

I m gir sterilized -at the time Caesarean section is performed, or should she be allowed to run the risk of becoming pregnant again?So recently as ten years ago it was widely held that the majority of cases should be sterilized at the time of the first Caesarean section.At the present day the general view is in complete opposition to this, and it is held to be rarely justifiable to sterilize a patient except in such circumstances as we have already considered, where the condition found at operation renders this course necessary in order to obtain a successful result-for example, hysterectomy for fibroids.Now that Caesarean section is so frequently performed for conditions otlher than obstruction in the pelvis, obviously there is no reason why many of the mothers should not have any number of subsequent labours-and a number do so.In cases of pelvic contraction, however, the view generally held is, " once a Caesarean always a Caesarean," and there are many cases on record of women undergoing Caesarean section four, five, or even more times, quite successfully.Unfortunately it is a fact that in a certain number of cases the uterine scar is not strong enough to withstand the strain of a subsequent pregnancy, and rupture of the uterus has been found to occur far too frequently.The direct cause of the weakness of the scar i%*sepsis at the time of the original operation.Another fact to be noted is the relatively high rate of sterility following the operation.This, I think, is due not so much to the operation itself as to the fear that it engenders in the minds of the patients and their husbands and con- sequent avoidance of pregnancy.In conclusion, I should like to emphasize, first, the supreme imporjnce of educating ourselves and-a far more difficult matter-our patients and their mothers and mothers-in-law in the absolute necessity of keeping a careful watch on all women throughout the period of pregnancy; it is the only means of avoiding occasional disaster.Secondly, the urgent need for the provision of maternity beds in all large towns and country districts.Possibly since the introduction of the panel system and the almost universal employment of midwives in maternity cases in industrial districts we may be able to view these questions in a more detaclhed spirit than lheretofore.In any case the remedy lies first and foremost in our own hands; if we make it our business to insist that beds for maternity cases are provided, I feel convinced that the time will not be far distansi when women will clamour to be admitted to them.