tbuckley/cabot-search huggingface dataset:
Intense immunosuppressive therapy followed by autologous peripheral blood selected progenitor cell reinfusion for severe autoimmune disease
Authors: Maurizio Musso, Ferdinando Porretto, Alessandra Crescimanno, Francesca Bondì, Vita Polizzi, Renato Scalone
Journal: American Journal of Hematology (2001)

Autologous stem cell transplantation (HSCT) has been shown to be effective in curing a large spectrum of autoimmune disorders. Case reports are being collected in the EBMT/EULAR Autoimmune Disease Stem Cell Project registry, which reports transplant-related mortality (TRM) of 6%. In order to reduce TRM and preserve the anti-autoimmune effect we evaluated a more immunoablative as opposed to myeloablative conditioning regimen for the autotransplant of severe immunomediated diseases. We enrolled patients affected by systemic lupus erythematosus (SLE: 3 patients), by autoimmune thrombocytopenic purpura (AITP: one patient), by thrombotic thrombocytopenic purpura (TTP: one patient), by pure red cell aplasia (PRCA: one patient), and by a severe cryoglobulinemia (one patient). All patients were mobilized with cyclophosphamide (Cy) 4 g/m2 + G-csf. Conditioning regimen consisted of Cy 50 mg/kg/day (days −6 and −5); anti-T-globulin (ATG) 10 mg/kg/day and 6-methylprednisolone (PDN) 1 g/day (days −4, −3, and −2). Immunomagnetically selected CD34+ cells were re-infused on day 0. In three patients neutrophil count fell below 0.5 × 109/l, while a PLT count below 20 × 109/l was registered in two patients. Extrahematological toxicity was very low. Four patients (2 SLE, 1 TTP, 1 cryoglobulinemia) are in complete corticosteroid-free remission with a median follow up of 335 days. The third SLE patient improved considerably; however, he still needs low-dose corticosteroid maintenance. The AITP and PRCA patients achieved a CR but soon relapsed; nevertheless, the procedure restored a steroid-sensitive status. The use of this immunoablative conditioning regimen in auto-HSCT transplant was shown to be effective in controlling disease progression and could be a valuable strategy in reducing TRM. Am. J. Hematol. 66:75–79, 2001 © 2001 Wiley-Liss, Inc.
Drug-resistant tuberculosis: inconsistent results of pyrazinamide susceptibility testing
Authors: D. Hewlett
Journal: JAMA (1995)

<h3>To the Editor.</h3> —Pyrazinamide, in combination with isoniazid and rifampin, often plays a prominent role in the therapy of tuberculosis.<sup>1</sup>Frequently, pyrazinamide susceptibility testing is performed, and the results generally dictate if pyrazinamide will or will not be used as a component of treatment of or prophylaxis for drug-resistant tuberculosis. Recently, our institution had a nosocomial outbreak of drug-resistant tuberculosis. When identically paired isolates were sent to two reference laboratories, however, discordant pyrazinamide susceptibility results were reported. From 1991 to 1993, a total of 55 patients with tuberculosis resistant to rifampin, isoniazid, streptomycin sulfate, and ethambutol hydrochloride were identified by our institution.<sup>2</sup>Ten identically paired isolates of<i>Mycobacterium tuberculosis</i>from 10 different patients were sent to two reference laboratories for susceptibility testing. Restriction fragment length polymorphism (RFLP) analyses were performed by the Centers for Disease Control and Prevention (CDC), the Public Health Research Institute, and/or the Albert Einstein
Clinical, Pathological and Radiological Features of Sickle Cell Trait
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
Adverse Reactions to Drugs-- Not Just What, But How Often
Journal: JAMA (1973)

The Boston Collaborative Drug Surveillance Program (BCDSP) and the methods it employs have been described previously inThe Journal.<sup>1</sup>The program is designed to collect and analyze data on therapeutic and diagnostic drug usage in the medical wards of nine cooperating hospitals in three countries. While the goals are to reveal several aspects of information about drug usage, including the detection of unsuspected adverse reactions, a major purpose is to provide quantitative data on known reactions. If a prescribing physician is to make an intelligent appraisal of risks vs expected benefits from a drug, he needs at least a reasonable estimate of the likelihood of an undesired effect. Schemes for the spontaneous reporting of adverse reactions have generally proven futile in revealing any approximation of the incidence of a given reaction within the population exposed. The BCDSP, through careful monitoring of a finite patient population, provides a quantitative measure
The future of pediatrics: again
Authors: V. A. Fulginiti
Journal: JAMA (1987)

Recently, a number of articles have been published concerning the future of the discipline of pediatrics.<sup>1-5</sup>These articles reflect a growing concern among those who care for our children that societal forces are impinging on the fabric of pediatric practice and that not all of these forces are benign or friendly. The report in this issue ofThe Journalby the Council on Long Range Planning and Development of the American Medical Association, produced in cooperation with the American Academy of Pediatrics, is the latest in this series of analyses.<sup>6</sup>It carefully catalogs some of the most critical societal influences as objectively as possible. The report also makes recommendations for action by organized medicine in response to these influences. The report is admirable in its description of the problem, but less satisfactory in offering tangible solutions or approaches. The major societal impact on pediatric practice and child health
Clinical Lectures on the Examination of Patients before Operating on them
Authors: W. S. Savory
Journal: BMJ (1873)

TVHE last, though most important of all inquiries, is the personal ex amination of the patient -the study of his general condition and the scrutiny of his principal organs by the surgeon.Now, independently of any particular disease in any organ, persons differ very widely indeed in their capability of bearing an operation, both in the power of sustaining shock and in the power of subsequent repair.Note that the capacity for reaction must not be confounded with the power of resistaice.Indeed, as the rule, they are inversely proportionate to each other.A certain degree of shock may produce very +obvious disturbance of the system in the young, which, nevertheless, soon subsides.
Contact urticaria to play dough: a possible sign of dietary allergy
Authors: S.E. Baron, C. Moss
Journal: British Journal of Dermatology (2003)

A 3‐year‐old boy, one of triplets, with eczema from 4 months of age suffered a severe reaction at nursery. Whilst playing with play dough his hands and forearms became immediately erythematous, swollen and intensely itchy. The contact urticaria took 2 hours to subside. There was no concomitant flaring of his eczema. Cautious re‐exposure identified red play dough as the cause. Because of the possibility of allergy to red dyes in foods and medicines (to which he had never been exposed), and future exposure to play dough, further tests were carried out to identify the precise allergen. Information about constituents of their products was obtained from the manufacturers of Playdo®, Early Learning Centre Soft Stuff®, Play Stuff® and Ivanhoe® play dough, Smarties® and coloured antibiotic syrups. The child then underwent open patch testing. Smarties® and Smartie‐sized pieces of play dough were applied to the forearm under micropore® adhesive tape. Cotton wool soaked in the antibiotic syrups was applied to the back under micropore® adhesive tape. After 20 minutes there was acute contact urticaria to the red Playdo®, the red Smartie® and the red Cefaclor syrup. At 40 minutes there was a milder reaction to the orange Playdo® and orange Smartie®. The child was given oral chlorpheniramine and the reactions settled over the next hour. The common ingredient of red and orange Playdo® and red and orange Smarties® is the colourant E124. Cefaclor syrup contains E129 as a colourant.
Management of Fibromyalgia
Authors: Lawrence J. Leventhal
Journal: Annals of Internal Medicine (2000)

Letters20 June 2000Management of FibromyalgiaLawrence J. Leventhal, MDLawrence J. Leventhal, MDGraduate Hospital; Philadelphia, PA 19146 (Leventhal)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-132-12-200006200-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Wolfe is surprised that I did not mention his study (1), but my review focused on controlled trials. Although Wolfe and colleagues' study yielded important information, the authors stated that they did not test specific treatments in fibromyalgia and that the patients' conditions may have worsened over time had the patients not sought conventional treatment. Additionally, concern should be raised on how information on treatment failures at tertiary care centers gathered by fibromyalgia experts translates to patient responses in community settings.Dr. Wolfe indicates that I do not define “what works” and that it is “fundamentally wrong ...Reference1. Wolfe F, Anderson J, Harkness D, Bennett RM, Caro XJ, Goldenberg DL, et al . Health status and disease severity in fibromyalgia: results of a six-center longitudinal study. Arthritis Rheum. 1997;40:1571-9. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Graduate Hospital; Philadelphia, PA 19146 (Leventhal) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoManagement of Fibromyalgia Lawrence J. Leventhal Management of Fibromyalgia Frederick Wolfe Management of Fibromyalgia Arthur Huppert Management of Fibromyalgia Norman Muilenburg Management of Fibromyalgia Hideto Akama Management of Fibromyalgia Lawrence J. Cohn Metrics Cited ByUpdate on Fibromyalgia Therapy 20 June 2000Volume 132, Issue 12Page: 1005KeywordsAnalgesicsClinical trialsDrug therapyFibromyalgiaMotivationRheumatology Issue Published: 20 June 2000 CopyrightCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Primary Myocardial Disease: Part I. Clinical Features
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
NURSING EDUCATION
Journal: JAMA (1934)

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
PATH-13. THE ORIGIN OF HUMAN GLIOBLASTOMA (IDH WILDTYPE) IS NOT THE LOCATION OF THE TUMOR BUT THE SUBVENTRICULAR ZONE
Authors: Seok-Gu Kang, Joo Ho Lee, Seon Jin Yoon, Ji-Hyun Lee, Se Hoon Kim, Eui Hyun Kim, Jong Hee Chang, Jeong Ho Lee
Journal: Neuro-Oncology (2018)

Two hypotheses about the origin of human glioblastoma (GBM) genesis are known to be dedifferentiation of cancer cells and orthodox differentiation of cancer stem cells. However, little is known about whether the direction of the human GBM genesis begins at the site of the tumor or at the subventricular zone (SVZ) where normal neural stem cells (NSCs) are present. Here, we describe direct molecular genetic evidence from patient brain tissue and genome-edited mouse models that show astrocyte-like NSCs in the SVZ to be the cell of origin that harbors the driver mutations of human GBM. First, we performed deep sequencing of triple-matched tissues, consisting of i) normal SVZ tissue away from the tumor mass, ii) tumor tissue, and iii) normal cortical tissue (or blood), from 28 patients with GBM, isocitrate dehydrogenase-wild type (IDH-wildtype) or other types of brain tumors. In doing so, we found that normal SVZ tissue away from the tumor in 56.3% of GBM IDH-wildtype patients contained low-level GBM driver mutations (down to ~1% of the mutational burden) that were observed at high levels in their matching tumors. Moreover, via single cell sequencing and laser microdissection analysis of patient brain tissue and genome editing of a mouse model, we discovered that astrocyte-like NSCs carrying driver mutations migrate from the SVZ and lead to the development of high-grade malignant gliomas in distant brain regions. Altogether, our results highlight NSCs in human SVZ tissue as the cell of origin that harbors the driver mutations of GBM. In addition, the origin of human glioblastoma is not the location of the tumor but the subventricular zone.
Retraction: The Receptor-Type Protein Tyrosine Phosphatase J Antagonizes the Biochemical and Biological Effects of RET-Derived Oncoproteins
Authors: Angela Iervolino, Rodolfo Iuliano, Francesco Trapasso, Giuseppe Viglietto, Rosa Marina Melillo, Francesca Carlomagno, Massimo Santoro, Alfredo Fusco
Journal: Cancer Research (2018)
Comment: the unidisciplinary vs the multidisciplinrpprach to oncology
Authors: P. Rubin
Journal: JAMA (1971)

The medical literature dealing with cancer should be rewritten. Prior to this, however, the practice of oncology will have to change. It is undergoing change slowly but steadily, and the direction is that of carefully planned prospective treatment of cancer. Among physicians, a reawakening that they can do better is beginning to occur. Advances may be small and in different disciplines, but added together, they can yield as much as "major breakthroughs." In order for these breakthroughs to be realized there must be careful studies which are cooperative in nature. Today, such studies are viewed as gigantic national efforts with many universities and cancer centers participating. Surprisingly, members of the same specialty have demonstrated a capacity to meet and organize for scientific work on a national level; however cooperation within a single institution by all members of an oncology team is generally lacking, even in most major university hospitals. The
Outcomes of multivisceral resection of gastric gastrointestinal stromal tumors.
Authors: Sabha Ganai, Mitchell Posner, Vivek N. Prachand, John C. Alverdy, Eugene A. Choi, Irving Waxman, Marco G. Patti, Kevin K. Roggin
Journal: Journal of Clinical Oncology (2012)

91 Background: Despite the recent introduction of imatinib and laparoendoscopic techniques to the management of gastric gastrointestinal stromal tumors (GISTs), outcomes remain uncertain in the setting of multivisceral involvement. Methods: We conducted a retrospective review of 69 consecutive patients who underwent resection of gastric GISTs from October 2002 through August 2011. Median follow-up was 19 months (interquartile range [IQR] 4-37). Results: Patients were 51% female, with a mean age of 65 ± 13 years and BMI of 30 ± 8 kg/m 2 . Patients undergoing multivisceral resection (n=13) had a longer interval from diagnosis to surgery (7.4 [IQR 1.9 – 15.0] vs. 1.3 [IQR 0.7-3.5] months, p&lt;0.01), greater use of neoadjuvant imatinib (62% vs. 4%, p&lt;0.001), and greater preoperative tumor size (12 ± 8 vs. 4 ± 3 cm, p&lt;0.001) in comparison to gastric-only resections (n=56). Patients were less likely to be managed laparoscopically (8% vs. 71%, p&lt;0.001), had a longer operative time (286 ± 92 vs. 152 ± 65 min, p&lt;0.001), and were less likely to be R0 (69% vs. 98%, p&lt;0.001). While patients undergoing multivisceral resection were more likely to have a pathological complete response to therapy (23% vs. 0, p&lt;0.01), they were also more likely to have metastatic disease present (31% vs. 0, p&lt;0.01). Hospital length of stay was greater (median 8 [IQR 7-9] vs. 3 [IQR 2-6] days, p&lt;0.001). There were no significant differences in grade or mitotic index between groups, or in the use of adjuvant imatinib (54% vs. 23%). Overall survival was less in patients undergoing multivisceral resection (63% vs. 86% at 3 years, p&lt;0.05), as was disease-free survival (52% vs. 71% at 3 years, p&lt;0.05). Median disease-free survival was 50 and 66 months, respectively (p&lt;0.01). Controlling for tumor size, grade, resection status, and the use of neoadjuvant imatinib, multivisceral resection was an independent predictor of disease-free survival (p&lt;0.05). Conclusions: Multivisceral involvement is associated with tumors of greater size, and despite an increased use of neoadjuvant imatinib, it is associated with poor outcome for patients with gastric GISTs.
Early predictors of career achievement in academic medicine
Authors: F. L. Brancati
Journal: JAMA (1992)

<h3>Objective.</h3> —To identify early personal and scholastic factors that predict academic career choice and long-term career achievement among academic physicians. <h3>Design.</h3> —A longitudinal cohort study. <h3>Participants.</h3> —Nine hundred forty-four male physicians who graduated from The Johns Hopkins University School of Medicine, Baltimore, Md, from 1948 through 1964. <h3>Outcome Measures.</h3> —Career achievement outcomes included attained faculty rank in 1990 and the number of citations (20 to 24 years after graduation) to published work. <h3>Results.</h3> —Of the 944 physicians, 424 (45%) had chosen academic careers. Scholastic performance and research experience in medical school were independently associated with having chosen an academic career (<i>P</i>&lt;.001). Among academicians, higher attained rank in 1990 was independently associated with the following: (1) membership in Alpha Omega Alpha (relative risk [RR]=4.94,<i>P</i>=.0001); (2) rank in the top third of the graduating class (RR=2.68,<i>P</i>=.01); and (3) research experience in medical school (RR=3.11,<i>P</i>=.0001). These three factors were also independently associated with more citations to participants' published work (<i>P</i>&lt;.05). <h3>Conclusion.</h3> —These data suggest that scholastic performance and research experience during medical school predict career achievement in academic medicine over 20 years in the future. (<i>JAMA</i>. 1992;267:1372-1376)
House Staff Work Hours, Supervision, and Quality of Care-Reply
Authors: Lee Goldman
Journal: JAMA (1993)

<h3>In Reply.</h3> —Drs Friedmann and Griffen highlight that many factors aside from working hours are pertinent to any inquiry about quality of care and quality of education in teaching hospitals. Supervision was in full compliance with Code 405 during both study periods, so our study addressed working hours alone. Future efforts should explore the balance between supervision, autonomy, service, and education necessary to achieve high-quality patient care and resident education without one suffering at the expense of the other. Furthermore, while we agree that residency is arduous, we believe that Dr Carmichael has, unfortunately, misinterpreted our conclusions. We did not condemn shortened resident hours. Our study suggests that restricted hours do not guarantee improved quality of care, particularly if achieved via a system of cross-coverage resulting in an increased patient-to-physician ratio and loss of continuity. Training programs can limit hours by numerous strategies. We do not denounce shortened hours, we
Evidence for self-selection among health maintenance organization enrollees
Authors: M. Jackson-Beeck
Journal: JAMA (1983)

Inpatient utilization and health care costs of employees and their families were studied for 11 employee groups covered by Blue Cross and Blue Shield in the Minneapolis-St Paul area during the year before optional health maintenance organization (HMO) enrollment. Before enrolling in HMOs, those joining averaged 53% fewer inpatient days (470 days/1,000<i>v</i>994 days/1,000) than those retaining fee-for-service (FFS) coverage. Both hospital and professional expenditures were lower among HMO enrollees. Age-specific analysis showed higher inpatient use of continuing FFS subscribers in every category. Self-selection may be an important determinant of differences in use and costs when comparing HMOs with FFS coverage. (<i>JAMA</i>1983;250:2826-2829)