tbuckley/cabot-search huggingface dataset:
Successful re-initiation of calcineurin inhibitors in patients with posterior reversible encephalopathy syndrome (PRES)
Authors: A. Meerasahib, T. B. Donohue, R. W. Childs
Journal: Journal of Clinical Oncology (2008)

18014 Background: Posterior Reversible Encephalopathy Syndrome (PRES) is characterized by headache, altered mental status, seizure or visual loss and is associated with white matter vasogenic edema predominantly affecting the posterior occipital and parietal lobes of the brain. It often occurs after abrupt increases in blood pressure in the background of calcineurin inhibitor therapy. Methods: Retrospective study of 10 patients (pts) diagnosed with PRES while receiving cyclosporine (CSA). Results: Six children, (mean age 10.7 y; range 8–14 y), and 4 adults (mean age 28 y, range 20–35 y) were diagnosed with PRES. Seven had severe aplastic anemia as a primary diagnosis while one pt each had MDS, AML- M4 and Pre B-ALL. Seven had undergone an allogeneic stem cell transplant and all 10 pts were on CSA when PRES occurred. Besides CSA use, potential inciting risk factors for PRES include: concomitant infections (7pts), grade 3–4 GVHD (4 pts), use of ATG (5 pts), high dose steroids (5 pts), meropenem (4 pts) and hypomagnesemia (5 pts). Eight pts experienced seizures and 5 had visual disturbances. The average Mean Arterial Pressure (MAP) when PRES was diagnosed (132 mmHg; range 108–169) was significantly higher than baseline (mean rise 36.94 mmHg; range 12–85). MRI findings of increased T2 fluid attenuated inversion recovery signal predominantly involved the posterior brain regions (8 pts), but atypical findings of global involvement with frontal preponderance were seen in 2 pts. Nine pts required anti-epileptic drugs (AED) acutely; the 8 pts who seized continued AED (single agent levetiracetam in 7/8 pts). Continuous infusional antihypertensives were required for acute BP management in 4 pts; 7 pts required maintenance antihypertensives. CSA was never discontinued in 2 pts and restarted in all pts (median 2 days; range 0–79 days, from diagnosis of PRES to reinitiating CSA) without recurrence of PRES. Conclusions: The “typical” characteristics of specific posterior and white matter involvement is not always observed in PRES. Single agent levetiracetam can effectively prevent recurrent PRES-associated seizures. Prompt BP management and seizure prophylaxis can safely allow for continuing or promptly restarting calcineurin inhibitors critical to pt management. No significant financial relationships to disclose.
Serum cystatin C as disgnostic marker of acute kidney injury after cardiopulmonary bypass: a word of caution
Authors: Anders Svensson, Csaba P Kovesdy, John-Peder Escobar Kvitting, Ingemar Cederholm, Zoltán Szabó
Journal: Journal of the American Society of Nephrology (2014)

Serum cystatin C as disgnostic marker of acute kidney injury after cardiopulmonary bypass: a word of caution
New Protease Inhibitors for the Treatment of Chronic Hepatitis C: A Cost-Effectiveness Analysis Author Names
Authors: Shan Liu, Lauren E. Cipriano, Mark Holodniy, Douglas K. Owens, Jeremy D. Goldhaber-Fiebert
Journal: Annals of Internal Medicine (2012)

Background
Chronic hepatitis C (HCV) is a difficult to treat disease affecting over 3 million Americans. Protease inhibitors increase the effectiveness of standard therapy but are costly. A genetic assay may identify patients most likely to benefit from this treatment advance.
Abstract 4348: Quality of Acute Myocardial Infarction Care and Outcomes in 33,997 Patients Aged 80 Years or Older: Results From GWTG-CAD
Authors: Hector M Medina, Christopher P Cannon, Xin Zhao, Adrian F Hernandez, Eric D Peterson, Gregg C Fonarow
Journal: Circulation (2009)

Background: Prior studies have demonstrated that older patients with acute myocardial infarction (AMI), particularly those aged ≥80 years, are less likely to receive evidence-based therapies, yet i...
Intestinal folate absorption
Authors: Williamson Strum, Peter F. Nixon, Joseph B. Bertino, Henry J. Binder
Journal: Journal of Clinical Investigation (1971)

Intestinal absorption of the monoglutamate form of the principal dietary and circulating folate compound, 5-methyltetrahydrofolic acid (5-MTHF), was studied in the rat utilizing a synthetic highly purified radiolabeled diastereoisomer. Chromatography confirmed that the compound was not altered after transfer from the mucosa to the serosa. Accumulation against a concentration gradient was not observed in duodenal, jejunal, or ileal segments at 5-MTHF concentration from 0.5 to 500 nmoles/liter. Unidirectional transmural flux determination also did not indicate a significant net flux. Mucosal to serosal transfer of 5-MTHF was similar in all segments of the intestine and increased in a linear fashion with increased initial mucosal concentrations. Further, no alteration in 5-MTHF transfer was found when studied in the presence of metabolic inhibitors or folate compounds. These results indicate that 5-MTHF is not absorbed by the rat small intestine by a carrier-mediated system and suggest that 5-MTHF transfer most likely represents diffusion.
Abstract 1494: Hepatocyte Growth Factor Attenuates Angiotensin II Induced Renal Fibrosis through TGF-β1 Suppression by Anoikis of Myofibroblasts
Authors: Kazuma Iekushi, Yoshiaki Taniyama, Junya Azuma, Fumihiro Sanada, Norio Dosaka, Hiroshi kusunoki, Nobutaka Koibuchi, Hiromi Rakugi, Ryuichi Morishita
Journal: Circulation (2008)

Progression of chronic kidney disease (CKD) is characterized by the persistent accumulation of extracellular matrix. Especially, α-SMA positive myofibroblast which produce high amounts of TGF-β1 are considered to play a key role in interstitial fibrosis. Previous studies demonstrated that hepatocyte growth factor (HGF) improved kidney fibrosis in murine models, where direct molecular mechanisms of myofibroblasts have not yet been understood. We tested the hypothesis in vivo using cardiac specific overexpression HGF mice (HGF-Tg), which showed a significant increase in serum HGF concentration. Angiotensin II (Ang II) infusion significantly induced renal fibrosis in wild type mice, while renal fibrosis was significantly decreased in HGF-Tg mice accompanied by the degrease in interstitial myofibroblasts (P&lt;0.05). Quantitative analysis demonstrated 1.69-folds induction of profibrtic cytokine, TGF-β1 mRNA in HGF-Tg with Ang II group compared with wild type with Ang II, and Collagen type I and IV mRNA expression was significantly decreased in HGF-Tg mice with Ang II. The antifibotic action of HGF-Tg mice was concordant with an increase in MMP-2, MMP-9 expression (1.32-fold, 1.33-fold vs wild type with Ang II infusion, P&lt;0.05, respectively), and decreased TIMP-1, TIMP-2 expression (1.5-fold, 1.28-fold vs wild type with Ang II infusion, P&lt;0.05, respectively). To further investigate the anti-fibrotic effect of HGF, we used cultured human mesangial cells (HMC). When HMC were treated with TGF-β1, cells underwent to phenotypic change similar to myofibroblasts, accompanied by the significant increase in c-Met/HGF receptor (P&lt;0.05). Under such conditions, HGF induced anoikis-induced apoptosis of myofibroblasts. It also linked with FAK phosphorylation especially p-FAK (Y925) (P&lt;0.05). When GM6001 (a broad-spectrum MMP inhibitor) was added with HGF, HGF-induced apptosis was significantly decreased. It was suggested that increased activities of MMPs underlie the major mechanism of HGF mediated anoikis induced apoptosis. The present study demonstrated that HGF elicited myofibroblast anoikis. Activation of MMPs in fibrotic kidney might be considered as a target to attenuate the progression of CKD.
Abstract 13250: Percutaneous Coronary Intervention with Drug-Eluting Stents Versus Coronary Artery Bypass Graft Surgery for Unprotected Left Main Coronary Artery Stenosis: A Meta-Analysis of Randomized Clinical Trials
Authors: Mahboob Alam, Saima A Shahzad, Henry D Huang, I-Hui Chiang, David Paniagua, Biswajit Kar, K B Ramanathan, Alpesh R Shah, Neal S Kleiman, Hani M Jneid
Journal: Circulation (2011)

Background: Patients with unprotected left main coronary artery (ULMCA) stenosis are increasingly treated with PCI using DES. However, there is paucity of long-term data from randomized clinical tr...
Genetic and Functional Analyses Identify NAT2 as a Human Insulin Sensitivity Gene
Authors: Joshua W. Knowles, Ke Hao, Weija Xie, Michael N. Weedon, Zhongyang Zhang, Jussil Paaanen, Mark O. Goodarzi, Ola Hansson, James S. Pankow, Indumathi Chenemsetty, Ivan Carcamo-Orive, Themisrocles Assimes, Andrew Morris, Yii-Der I. Chen, Eric E. Schadt, Ville-Petteri Makinen, Xia Yang, Fahi Abbasi, Alan Attie, Mark Keller, Danielle Greenawalt, Jerome I. Rotter, Alan Sinako, Agnes Hsiung, Heather J. Cordell, Gerald Reaven, Leif Groop, Markku Laakso, Erik Ingelsson, Timothy M. Frayling, Mark Walker, Thomas Quertermous
Journal: Circulation (2013)
Abstract P249: Determinants of Descending Aortic Dimensions in a Multi-Ethnic Population: The Dallas Heart Study
Authors: David A Guel, Matthias Peltz, Amit Khera, Donald D McIntire, Ronald M Peshock, Michael E Jessen
Journal: Circulation (2012)

Introduction: Accurate description of normal aortic size is fundamental to our ability to define aortic aneurysms. However, current definitions of normal aortic dimensions are based on small population samples with limited data on other variables. This study used data from a large unselected community population to define normal aortic dimensions and to examine relationships between aortic size and demographic and anthropometric variables. Methods: Data came from a validated multiethnic urban population sample. Adults (age 18 – 65) underwent collection of demographic and medical history data. A subset of participants (n=2643) underwent gated aortic MRI to measure descending aortic diameter at the level of the pulmonary artery bifurcation. Age, gender, ethnicity (white, black, Hispanic or other) and multiple indices of body size and composition were collected or calculated from available data (body mass index [BMI], body surface area [BSA]). Dual-energy x-ray absorptiometry was used to calculate total body fat mass and lean body mass. A univariate analysis was performed relating descending aortic diameter to each variable. A stepwise variable selection using a p-value criteria of 0.15 for entry and removal was used to identify variables independently associated with aortic size. Results: By univariate analysis, increased aortic size was associated with increased age, male gender, black ethnicity, and greater height, weight, waist and hip circumference, BMI, BSA , total body fat mass and total body lean mass. By multivariable analysis, age, lean body mass, ethnicity, gender, waist circumference, and hip circumference emerged as significant determinants of descending aortic diameter (see Table). Conclusions: The diameter of the descending aorta appears to increase with age and is larger in certain ethnic groups and in subjects with greater indices of body size. Definitions of normal values for descending aortic dimensions may need to consider these factors.
Doctors should beware of asking for too high a salary
Authors: C. Tiarks, P G Houghton
Journal: BMJ (1998)

Editor—In the last paragraph of his letter about doctors’ salaries, Baker asked if the profession really wishes to be seen by society in the same light as accountants and lawyers.1 I would answer that the profession naturally wishes to retain its individual identity of integrity and responsibility but would nevertheless wish to have at least the same value placed on it as is placed on the legal and accountancy professions. 

Though our remuneration improved dramatically after the doldrums of the 1960s, since 1980 in general practice it has dropped to less than half that of our comparators defined by Pilkington in the report that preceded the introduction of the Doctors’ and Dentists’ Review Body.2

Baker’s friend, who may well augment his practice profits from earnings outside the NHS, is both fortunate and exceptional. The average Scottish general practitioner, despite length of service, earns £43 245, which is 93.1% of intended average net remuneration (£46 450 pa)—below the lowest consultant scale of £43 750; consultants will inevitably rise to a minimum of £56 470 after five years. (These figures are calculated from the latest figures for average net income according to government statistical region as the percentage of the British average, the figures used by the Doctors’ and Dentists’ Review Body for 1997-8 being used.) 

One quarter of general practitioners in Highland area who are “induced” (receive “inducement payments” for general practitioners to remain in practices that are not otherwise financially viable) are restricted to practice profits of only 82.4% of intended average net remuneration. Successive governments have failed to recognise the importance of the old adage “The labourer is worthy of his hire.” We are right to seek a fair improvement in our remuneration to secure the high standards already attained and to reverse the worrying decline in morale and recruitment.
Abstract 6025: Optimal Stent Deployment. Five Seconds Is Not Enough
Authors: Thomas Hovasse, Thierry Lefèvre, Alice Ohanessian, Sanjay Sastry, Marta Bande, Nabil Bendaoud, Yves Louvard, Marie-Claude Morice
Journal: Circulation (2008)

Background . The risk of thrombosis which had been well described since the advent of stenting, is currently being re-addressed in the era of drug-eluting stents (DES). Among the predictors of thrombosis risk, there are some factors which may be favourably influenced by the operator. Indeed, the quality of stent deployment is crucial, which has been well demonstrated with IVUS. Inadequate deployment may be associated with numerous parameters. The time factor has never been explored accurately so far. Objectives. The purpose of this study was to analyse the relationship between the duration of stent balloon inflation and the quality of stent deployment as measured by StentBoost ™ in patients with de novo lesions. Methods. StentBoost ™ is a software developed by Philips on the flat panel detector, which averages frames, correcting for motion by using the balloon markers. This creates an enhanced image of the stent with an improved signal-to-noise ratio and allows precise measurements. Pressure of stent deployment was selected according to the reference diameter of the lesion and the diameter/pressure chart of the stent delivery system. A constant pressure was applied for 25 seconds and stent size measured at 5, 15, 25 sec., after deflation and post dilatation when performed. Primary endpoint was optimal stent expansion defined as minimal stent diameter/reference diameter at the lesion site &gt; 80%. Results. Data were collected prospectively in 77 patients aged 67.8± 12.4 yrs, diabetic (38%), acute coronary syndrome (37 %), in whom 109 stents (length 18.7±6.4 mm; diameter 2.96±0.49 mm) were deployed at a mean pressure of 13.5±2.48 atm. Lesion reference diameter was 3.06±0.58 mm. Conclusion. Better stent implantation may be achieved by increasing the duration of stent deployment. This may influence the risk of stent thrombosis.
Abstract 16798: Patterns of Anticoagulation following Bioprosthetic Valve Implantation: Observations from ANSWER
Authors: J. Matthew Brennan, Karen P Alexander, Audra B Hodges, John C Laschinger, Kent W Jones, Sean O'Brien, Laura E Webb, Rachel Dokholyan, Eric D Peterson
Journal: Circulation (2010)

Background: The American College of Cardiology/American Heart Association (ACC/AHA) guidelines recommend warfarin for 3 months following bioprosthetic valve replacement (BVR), yet strong evidence s...
Abstract 9577: Non-Invasive Estimation of Pulmonary Blood Flow Using Photoacoustic Spectroscopy in Patients with Congenital Heart Disease
Authors: Jonathan Rhodes, Brian S Fromm, Diego Porras, Alexander Opotowsky, Mark E Alexander, Tracy J Curran, Julieann O'Neill, Jennifer L Smith, Kathleen M Solly
Journal: Circulation (2012)

Background: Measurements of pulmonary blood flow (PBF) using inert gas rebreathing technology have recently been enhanced by the introduction of photoacoustic spectroscopy (PAS). PAS is non-invasive, non-toxic, and can estimate PBF in &lt;5 min. It has been employed successfully in adults with structurally normal hearts. Experience in patients with congenital heart disease (CHD) is, however, limited and its validity in patients with intracardiac shunts has not been evaluated. We compared estimates of PBF obtained with PAS technology to those obtained at cardiac catheterization. Methods: Fick-based estimates of PBF (using assumed oxygen consumption) were compared to PAS estimates in 50 CHD patients; 28 without intracardiac shunts, 10 with right to left (R--&gt;L) shunts and 12 with left to right (L--&gt;R) shunts. PAS estimates were acquired 1 day prior to catheterization while the patients were conscious, in a recumbent position. Fick-based estimates were acquired by individuals blinded to the PAS results. Results: Median age was 18.5 yrs (range 8-78). Among subjects without shunts or with R--&gt;L shunts, Fick and PAS-based estimates of PBF correlated reasonably well (r=0.59 and 0.75, respectively; p&lt;0.01 for both groups; r=0.72, p&lt;0.0001 combined). Bland-Altman analysis revealed good agreement (mean bias 0.3±0.5 l/min/m 2 ; 95% limits of agreement -0.8 - +1.3 l/min/m 2 ), similar to historical comparisons of Fick and thermodilution techniques. In contrast, the correlation between PBF estimates among subjects with L--&gt;R shunts was poor (r=0.24; p&gt;0.05). Conclusion: PAS provides accurate, rapid estimates of PBF in children and adults with CHD who have no residual shunt, as well as those with R--&gt;L shunts. Measurements in subjects with L--&gt;R shunts are less reliable, likely due to early re-circulation. Algorithms that take this phenomenon into account may improve the reliability of PAS measurements in patients with L--&gt;R shunts.
Oral vinorelbine as a fixed-weekly schedule in taxanes-refractory advanced HRPC: A single institution experience
Authors: A. Rodriguez Garzotto, J. Sepulveda, A. Cortijo, L. Garcia, I. Garcia Rodriguez, E. Ciruelos, A. Rodriguez Antolin, H. Cortes-Funes, D. Castellano
Journal: Journal of Clinical Oncology (2009)

e16084 Background: Vinorelbine (VRL) has been shown to be active in hormone-refractory prostate cancer (HRPC). Oral formulation of VRL represents a significant advance in the treatment of advanced cancer. The recommended doses are 60–80 mg/m 2 (d1–8 q3wks).We evaluated efficacy and toxicity of different VRL schedule administered as a fixed-weekly dose of 60 mg/m2. The purpose of this study was to evaluate the toxicity profile and efficacy of this schedule in terms of PSA response, objective response and clinical benefit (CB) response. Methods: Pts characteristics were: PS 0–2, adequate bone marrow, liver and renal functions. Oral VRL was adminestered at weekly dose of 60 mg/m2 until disease progression/intolerable toxicity. PSA response was defined as a &gt;50% fall in PSA from baseline, confirmed by a second PSA value 4 or &gt; weeks later. Pts with measurable soft tissue disease met traditional guidelines for tumour responses. Progression was defined by objective disease progression or PSA increase of &gt;50% above nadir or &gt;25% above baseline. Pts were monitored clinically and with serial PSA measurements every 1 week. Results: Thirty seven pts with progressive HR metastatic prostate cancer were evaluated. Mean (range) age was 67 years (50–88), median PSA level was 90 ng/ml (1- 4314), and median Gleason score was 7 (6–9). 23 (62%) pts had previous taxane chemotherapy and 14 pts (38%) were chemo-naive. Pts received a mean of 5.5 cycles (1cycle=3wks) (range:1–24). Median follow-up was 12 months. Thirty three of 37 Pts (97%) achieved a decline in serum PSA. CB response was achieved in 15 out of 37 pts(40%). The PSA response was observed in 13 pts (35%). Objective response was not observed and only 6 pts showed SD (16%). The relative dose-intensity was 94%. There were no reported grade 3–4 toxicities. Only 1 treatment discontinuation was observed (esopahgitis g2). Toxicities consisted primarily of g2 anemia (25%) and mild nausea (32%). Conclusions: Oral Vinorelbine administered as a fixed-weekly schedule of 60 mg/m2 is a safe regimen in pts with advanced HRPC. This regimen of oral vinorelbine is an effective and well-tolerated treatment in this setting, despite a major dose-intensity administered. Further studies will be evaluated in chemo-naive and/or elderly population. No significant financial relationships to disclose.
Mental Growth of Children in Relation to Rate of Growth in Bodily Development. A Report of the Bureau of Educational Experiments, New York City.
Authors: Buford Jennett Johnson
Journal: JAMA (1925)

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