tbuckley/cabot-search huggingface dataset:
Novel technique to repair leaked biliary stone extraction balloon
Authors: Sachin Dev Munjal, Yogita Munjal
Journal: Endoscopy (2022)

Accessories used for biliary stone extraction include balloon catheters and wire baskets. The stone extraction balloon consists of a catheter with a soft, pliant balloon located at the tip [1]. Although these balloons are meant for single use, in developing countries these balloons are reused after sterilization with ethylene oxide. Mostly these balloons get punctured by the sharp edges of stones and leak from the proximal end, or sometimes they burst due to excessive pressure applied during stone extraction.
RNA interference as a novel treatment strategy for chronic hepatitis B infection
Authors: Rex Wan-Hin Hui, Lung-Yi Mak, Wai-Kay Seto, Man-Fung Yuen
Journal: Clinical and Molecular Hepatology (2022)

Chronic hepatitis B (CHB) is a major cause of liver-related morbidity and mortality. Functional cure of CHB, defined as sustainable hepatitis B surface antigen (HBsAg) seroclearance, is associated with improved clinical outcomes. However, functional cure is rarely attainable by current treatment modalities. RNA interference (RNAi) by small-interfering RNA (siRNA) and anti-sense oligonucleotide (ASO) has been studied as a novel treatment strategy for CHB. RNAi targets post-transcriptional messenger RNAs and pregenomic RNAs to reduce hepatitis B virus (HBV) antigen production and viral replication. By reducing viral antigens, host immune reconstitution against HBV may also be attained. Phase I/II trials on siRNAs have demonstrated them to be safe and well-tolerated. siRNA is effective when given in monthly doses with different total number of doses according to different trial design, and can lead to sustainable dose-dependent mean HBsAg reduction by 2-2.5 log. Incidences of HBsAg seroclearance after siRNA therapy have also been reported. ASOs have also been studied in early phase trials, and a phase Ib study using frequent dosing regimen within 4 weeks could achieve similar HBsAg reduction of 2 log from baseline. Given the established efficacy and safety of nucleos(t) ide analogues (NAs), future RNAi regimens will likely include NA backbone. While the current evidence on RNAi appears promising, it remains undetermined whether the potent HBsAg reduction by RNAi can result in a high rate of HBsAg seroclearance with durability. Data on RNAi from phase IIb/III trials are keenly anticipated.
Mass radiography.
Authors: T F Jarman
Journal: BMJ (1970)

procedure somewhat, but recently liver biopsy under peritoneoscopic control has been found a much more valuable procedure in clinical practice.The liver can easily be visualized using a fibreoptic peritoneoscope, and the area for liver biopsy carefully selected.Needle biopsy under direct vision using the peritoneoscope can then be performed (Fig.).This tech- cases m 16, liver biopsy was .... The, .........,.
THE SITUATION AT BERLIN.
Journal: JAMA (1891)

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
MINERS' NYSTAGMUS
Authors: A. S. Percival
Journal: BMJ (1923)

MINERS' NYSTAGMUS.TRu B 757 fecble-mindedness, indolence, licentiousness, and dishon-esty."The cost to the State had risen to 2,500,000 dollars.The one Who investigated this fanlily histbry most justly remarked that this evil anght have been averted by preventing the reproduction of the first degenerate.'T'he second was the striking example ofsuperiority and de- genieracy in the well known case of the Kallikaklfamily, published by H. H. Goddard.21A young soldier of good stock had a son by a feeble-minded girl, from whom there have descended in a direct line 480 individuals, -of whom only 46 are known to have been normal.Of the rest, some are unknown or doubtful, and the othlers turned out to be feeble-minded, alcoholic, some of the women grossly immoral (mostly prostitutes), epileptics, and criminals.Years later he married a woman of good family, who bore several children, and the descendants turned out well, many of them being distinguished.The two families lived in the same environment.These two families show wlhat evil can be done from the feeble-minded scattered all over the empire.In conclusion, I need hardly say that I am fully aware of the opposition my suggestion wil meet with in this country, not only on sentimental grounds but on those of State inter- ference with the liberty of the subject, and the possibility of evasions, which would certainly be attempted.Nevertheless, those who seriously consider what is best for the future of our race, in view of the facts I hiave mentioned, cannot but agree that it ought to be of the highest importance; we should at least endeavour to secure the advent of only healthy children, and as we lhave the means at our hand we ought to avail ourselves'of them and prevent the propagation of the mentally defective.
Obstetric anaesthetic and analgesic services in Wales.
Authors: B M Hibbard, G Rees, M Rosen
Journal: BMJ (1979)

A survey of obstetric anaesthetic services in Wales covering 21 major units in which over 31 000 deliveries take place annually showed inadequacies in staffing at consultant and resident anaesthetist level. At least 20 additional consultant sessions were required to meet the recommendations of the Association of Anaesthetists of Great Britain and Ireland. If patients9 requests for epidural analgesia are to be met some reorganisation and centralisation of facilities is needed.
Reining in Gastric Cancer
Journal: Cancer Discovery (2013)

Abstract A study in 7 Latin American communities revealed that factors such as being male, being older than 45, having fewer children in the household, and taking antibiotics as prescribed were significantly associated with reduced risk of recurrent infection with Helicobacter pylori, a bacterium tied to two thirds of the world's cases of gastric cancer. Prevention efforts geared to specific populations may be the best way to eradicate the infection.
Lead poisoning.
Authors: H A Waldron
Journal: BMJ (1972)

herbal and other aperients and enemata, and I suspect they often spend long periods straining in an effort to overcome supposed constipation.Could the suggestion that the squatting posture protects leg veins be tested by observing the prevalence of venous dis- orders in communities which have adopted low-residue diets but retained the traditional squatting position (such as some affluent Asian communities)?-Iam, etc.,
Abstract 284: Association of Neurological Outcome and Survival With Interventions by Bystander and Emergency Medical Service for Unwitnessed Out-of-Hospital Cardiac Arrest Patient; Results From the JCS-ReSS Study
Authors: Chisato Okamoto, Yoshio Tahara, Atsushi Hirayama, Satoshi Yasuda, Teruo Noguchi, Kunihiro Nishimura, Naohiro Yonemoto, Hiroaki Shimokawa, Hiroshi Nonogi, Ken Nagao
Journal: Circulation (2018)

Introduction: Although studies have shown that bystander cardiopulmonary resuscitation (CPR) in witnessed out-of-hospital cardiac arrest (OHCA) is associated with better neurological prognosis, whether bystander and Emergency Medical Service (EMS) interventions are associated with prognosis in unwitnessed OHCA patients is not fully elucidated. We aimed to investigate the prognostic importance of bystander and EMS interventions among unwitnessed OHCA patients in Japan. Methods and Results: This study was a nation-wide population-based observational study of OHCA in Japan from 2011 to 2015 based on data from the All-Japan Utstein Registry. The outcome measures were neurological outcome and survival at 30-day. The neurologically favorable outcome was defined as Glasgow-Pittsburgh cerebral performance category score 1 or 2. First, to investigate the effectiveness of bystander interventions, we included 105,655 unwitnessed cardiogenic OHCA patients (aged 18-80 years). Of these, 1,614 (1.5%) showed neurologically favorable outcome and 3,273 (3.1%) survived at 30-day. Multivariate logistic regression analysis adjusting for age, sex, geographical region, year and EMS response time showed that bystander CPR was associated with neurologically favorable outcome (adjusted odds ratio [aOR] 1.49, 95% CI 1.35-1.65, P&lt;0.001). Additionally, to investigate the effectiveness of EMS interventions for patients with non-shockable rhythm, we examined 43,342 patients who were performed public CPR and had the initial rhythm of pulseless electrical activity (PEA) or asystole. Of these, 101 (0.2%) showed neurologically favorable outcome and 453 (1.0%) were survival at 30-day. Advanced airway management by EMS was negatively associated with neurologically favorable outcome (aOR 0.55, 95% CI 0.37-0.81, P=0.003) and administration of epinephrine by EMS was associated with survival (aOR 2.35, 95% CI 1.89-2.92, P&lt;0.001). Conclusions: Among unwitnessed OHCA patients, bystander CPR was associated with neurologically favorable prognosis. For unwitnessed OHCA patients with non-shockable rhythm, epinephrine administration was associated with survival, but advanced airway management was negatively associated with neurological outcome.
A multicenter real-life U.K. study of use of immunotherapeutic agents in metastatic urothelial cancer.
Authors: Prantik Das, Anand Sharma, Ruchir Bhandari, JunHao Lim, Aruni Ghose, Jessica Davies, Ajith Nair, Nikhil Vasdev, Maja Moldawa, Ahmad Karimi, Colin Ward, Alison Richardson, Sadmeet Singh, Amjad Peracha, Shaista Ahmed
Journal: Journal of Clinical Oncology (2022)

504 Background: First-line chemotherapy for patients with cisplatin-ineligible metastatic urothelial carcinoma (mUC) is associated with short response duration and high toxicity. Pembrolizumab(PEM) and atezolizumab (ATZ) are associated with long-term, durable remissions as a first-line treatment of cisplatin-ineligible, PD-L1-positive patients with mUC. For patients who progressed during or after platinum-based chemotherapy, Immunotherapy also prolongs survival with less toxicity and better quality of life compared with further lines of chemotherapy. There have been no studies directly comparing the effectiveness of PEM to ATZ in mUC patients. Methods: A cohort of 112 patients from 3 UK centres were included. 62, previously untreated cisplatin ineligible mUC patients who showed PDL1 positivity were given either ATZ or PEM once every 3 weeks until progression. 49 patients who had initial platinum based chemotherapy subsequently had ATZ or PEM as second line treatment following their disease progression The primary endpoint was Overall Survival(OS) and secondary endpoints included objective rate(ORR), response duration and safety. Results: The median age was 69 ( Interquartile range 43-91) and 23% were female and 77% were male. Among, patients who received immunotherapy 1st line, 82% had baseline renal impairment(GFR &lt; 60), and 18% had Eastern Cooperative Oncology Group performance status 2. For chemo naïve patients, median OS was 11.5 months for PEM and 5 months for ATZ respectively. ORR was 22 % for ATZ vs 50% for PEM and median duration of treatment was 4.5 and 2.5 months for PEM and ATZ respectively. When used in 2nd line median OS is 7 months for ATZ irrespective of PDL1 status and not reached for PEM yet. Grade 2 and above toxicities were reported in 18 % ATZ patients vs 10% in PEM patients, commonest were pneumonitis, tiredness, hepatitis and dermatitis. No treatment related deaths were reported. Conclusions: This study suggests that pembrolizumab has higher response rate and better survival compared to atezolizumab in cisplatin-ineligible patients with mUC and also in the 2nd line setting after disease progression following platinum based agents. Both agents were well tolerated.
AN IMPENDING DOWNFALL: METASTATIC RIGHT ATRIAL SPINDLE CELL SARCOMA COMPLICATED WITH TUMOR THROMBUS
Authors: Erick Fernando Caballero Vasquez, Alejandro Herrera-Ramos, Thania Camila Aguirre Urbina, Francisco Somoza-Cano, Cesar Somoza-Toro
Journal: JACC CardioOncology (2022)
Prescribing Mandrax.
Authors: C G Brown
Journal: BMJ (1973)

dose, adjuvant has been reintroduced, and the recommended schedule for the vaccination of children has been changed.In Israel a similar improvement in the efficacy of pertussis vaccine has been noted,7 but with fewer accompanying changes.In that country the improvement dates from 1968, when the inclusion of agglutinogen 3 in their vaccine was ensured.The earlier vaccine, which gave unsatisfactory protection, did, however, contain adjuvant and it also achieved a mouse-protective potency of four international units per human dose.8Moreover, the vaccination schedule in Israel has not been altered.The one feature common to the improvements in British and Israeli vaccines is that their manufacturers now make deliberate attempts to ensure that their products contain enough agglutinogen 3.But ought our hopes for the wellbeing of vaccinated children to be based merely on the good-will of present well-informed staff, adequate though this proves to be at present?Or should we for- mulate requirements which would ensure that present knowledge is not forgotten?To conclude: though there is evidence that for some years before 1967 the pertus- sis vaccine of Glaxo Laboratories was less effective than that of Wellcome La;boratories, there is ample reason to believe that this does not apply to vaccine made during the last six years.There is also further evidence that effective pertussis vaccines are those that con- tain sufficient agglutinogen 3.
Rubella embryopathy.
Authors: J R Duncan, A Kenney
Journal: BMJ (1978)

sweating but, probably by reduction of anxiety, his generalised psoriasis was vastly improved.The axillae of a 28-year-old woman were also treated without upsetting her psoriasis.Patients usually prefer a cure to palliation.One short session of cryotherapy usually gives a lasting (up to three years' follow-up) reduction of sweating to normal levels or less.Cryotherapy is worth considering if the aluminium solution is poorly tolerated or ineffective, or needs too frequent application.
Glaucoma.
Authors: J Romano
Journal: BMJ (1970)

The past two or three decades have witnessed great strides in the possibilities of early detection and treatment of glaucoma.It remains, however, a tragically common cause of blindness.This is particularly true of the underdeveloped countries of the world, but it is still the third commonest cause of new blind registrations in Britain.Recent surveys carried out in many different countries have been startlingly in agreement:1 % to 2 (%. of the entire population over the age of 40 is
Abstract 292: TRPA1 Promoting Myofibroblast Differentiation Mediate Pressure Overload-Induced Cardiac Fibrosis
Authors: Shuang Li, Dong Han, Dachun Yang
Journal: Circulation (2018)

Background: Hypertensive ventricular remodeling is a common cause of heart failure. Activation and accumulation of cardiac fibroblasts is the key contributors to this progression. Our previous studies indicate that transient receptor potential ankyrin 1 (TRPA1), a Ca 2+ channel necessary and sufficient, play a prominent role in ventricular remodeling. However, the molecular mechanisms regulating remain poorly understood. Methods: We used TRPA1 agonists cinnamaldehyde (CA) pretreatment and TRPA1 knockout mice to understand the role of TRPA1 in ventricular remodeling of hypertensive heart. We also examine the mechanisms through gene transfection and in vitro experiments. Results: TRPA1 overexpression fully activated myofibroblast transformation, while fibroblasts lacking TRPA1 were refractory to transforming growth factor β (TGF-β) -induced transdifferentiation. TRPA1 knockout mice showed hypertensive ventricular remodeling reversal following pressure overload. We found that the TGF-β induced TRPA1 expression through calcineurin-NFAT-Dyrk1A signaling pathway via the TRPA1 promoter. Once induced, TRPA1 activates the Ca 2+ -responsive protein phosphatase calcineurin, which itself induced myofibroblast transdifferentiation. Moreover, inhibition of calcineurin prevented TRPA1-dependent transdifferentiation. Conclusion: Our study provides the first evidence that TRPA1 regulation in cardiac fibroblasts transformation in response to hypertensive stimulation. The results suggesting a comprehensive pathway for myofibroblast formation in conjunction with TGF-β, Calcineurin, NFAT and Dyrk1A. Furthermore, these data indicate that negative modulation of cardiac fibroblast TRPA1 may represent a therapeutic strategy against hypertensive cardiac remodeling.
Abstracts
Journal: Annals of the Rheumatic Diseases (1952)

the disease, usually in a severe form, had at the time of investigation, been present for a minimum period of 5 years.Four stages are described in the evolution of rheumatoid arthritis of the joint beginning, radiologically, with narrowing of the upper and inner part of the intra- articular space and ending with deformity of the femoral head and acetabulum, with displacement of both in an upward and inward direction.Arrest may take place at any stage, with development of bony sclerosis; bony ankylosis apparently never occurs.The importance of early recognition is stressed, and one physical sign which may help to distinguish the condition from osteo-arthritis is mentioned flexion of the hip is limited at an early stage.
Postcoital contraception.
Authors: C Brewer
Journal: BMJ (1977)

It was recently pointed out in a paper by the author that the IUD, which works generally by aborting early pregnancies, is in violation of the British Offences Against the Person Act of 1861 unless the procedures for abortion required by the 1967 Abortion Act are complied with. It is illogical for Parliament to seek to impose strict restrictions on abortion while allowing the IUD to be freely available. If this situation is permitted, one must ask what are the legal and moral grounds for the distinction between IUD use and abortion.
Abstract 282: Relation Between the Post-Cardiac Arrest Cerebral Regional Saturation of Oxygen and Outcomes
Authors: Chih-Heng Chang, Pei-I Su, Min-Shan Tsai, Wei-Ting Chen, Wei-Tien Chang, Wen-Jone Chen, Chien-Hua Huang
Journal: Circulation (2018)

Background: Outcome prognostication is still challenging in post-cardiac arrest patients although many methods have been introduced. Cerebral regional saturation of oxygen (crSO2) is one method that might relate to tissue viability, but its correlation with outcome of post-cardiac arrest patient remains unclear. We assessed the hypothesis that there might be significant correlation between the crSO2 level and the pre-cardiac arrest state and the prognosis of post-cardiac arrest patients. Methods: Adult post-cardiac arrest patients who received targeted temperature management (TTM) as our ICU protocol and who were under monitoring of frontal crSO2 by cerebral near-infrared spectroscopy (NIRS) were included. TTM was divided into phase 1 induction, phase 2 maintenance, and phase 3 rewarming. We recorded the value of frontal crSO2 every hour, and further data calculation (minimal, maximal, average, difference between phases) were done. Demographic and resuscitation variables, including pre-arrest CPC status were recorded. The primary outcome was the relation between crSO2 and mortality outcomes. The Mann-Whitney test was applied for analysis. Results: There were 28 post-cardiac arrest adult patients included since Nov. 2015 to Nov. 2017. In-hospital mortality rate were 53.6 % (15/28). For all patients, we found no significance between any crSO2 data of each phase and in-hospital mortality or neurological outcome when discharge. The median level of both side maximal average crSO2 at phase 3 in mortality group were 59 and was 62 in survival group, p= 0.354. Interestingly, the median level of both side maximal average crSO2 at phase 3 were 66 in the patients of pre-arrest CPC 1 and was 56 in pre-arrest CPC 2 (P=0.0328). In pre-arrest CPC 2 group, the both side maximal average crSO2 in phase 3 was significant lower in the in-hospital mortality group (median level 50 vs. 58, p=0.029). Conclusion: The crSO2 levels among different TTM phases were not significant correlated with mortality or neurological outcome. However, the pre-arrest CPC status may correlate with the crSO2. In patients with pre-arrest CPC 2, crSO2 had significant correlation with mortality. The crSO2 recorded by NIRS might be correlated to outcome in selected post-cardiac arrest patients.
Association between on-treatment eosinophil dynamics and outcomes in metastatic renal cell carcinoma patients treated with ipilimumab/nivolumab.
Authors: Yu-Wei Chen, Matthew D Tucker, Hesham Yasin, Kristin Kathleen Ancell, Nancy B. Davis, Scott Mattox Haake, Elizabeth Kaiser, Renee McAlister, Wendy Kimryn Rathmell, Kerry Schaffer, Deborah Wallace, Katy Beckermann, Brian I. Rini
Journal: Journal of Clinical Oncology (2022)

364 Background: Baseline neutrophil to eosinophil ratio (NER) has been associated with response to immunotherapy in metastatic renal cell carcinoma (mRCC). The association of on-treatment changes in NER and absolute eosinophil count (AEC) during induction with ipilimumab/nivolumab and relation to clinical outcomes are reported. Methods: Patients with mRCC treated with ipilimumab/nivolumab at Vanderbilt-Ingram Cancer Center were identified. Contal and O’Quigley’s method was used to determine the optimal cutpoint associated with improved progression free survival (PFS) and overall survival (OS). Multivariable Cox proportional hazard function was used to assess the association between clinical outcomes and on treatment (week 3/6/9/12) maximum AEC and lowest NER, separately. Results: 63 patients were identified: 81% clear cell histology and 79% male; 24% IMDC favorable risk, 52% intermediate risk, and 24% poor risk. When maximum AEC was coded as a continuous variable, every increase of 100 AEC was associated with improved PFS (HR: 0.89, p-value: 0.017) and OS (HR: 0.87, p-value: 0.053). When the on treatment maximum AEC was dichotomized at the optimal cutpoint of 380 cells/µL, patients with maximum AEC ≥ 380 cells/µL had longer PFS (mPFS: 11.5 months vs 2.7 months, p-value: 0.001) and OS (mOS: 29.6 months vs 16.8 months, p-value: 0.08). When on treatment lowest NER was dichotomized at the optimal cutpoint of 13.2, patients with lowest NER &lt;13.2 had improved PFS (mPFS: 12.5 months vs 2.7 months, p-value:&lt;0.001) and OS (mOS: non-reached vs 16.5 months, p-value: 0.003). After baseline characteristic adjustment (Table), higher on treatment AEC was associated with improved PFS (HR: 0.38, p-value: 0.004), and lower on treatment NER was associated with improved PFS (HR:0.34, p-value:0.002) and OS (HR: 0.38, p-value: 0.036). Conclusions: Higher AEC and low NER while on treatment are associated with improved clinical outcomes in ipilimumab/nivolumab-treated patients with mRCC. Prospective study is warranted to validate these biomarkers.[Table: see text]