tbuckley/cabot-search huggingface dataset:
End-of-Life Care
Authors: Robert L. Kane
Journal: JAMA (2005)

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
Estrogens and the aging process. The detection, prevention, and retardation of osteoporosis
Authors: M. E. Davis
Journal: JAMA (1966)

Follow-up of postmenopausal patients who have been on long-term estrogen replacement therapy has provided a large number of women for a prospective study of osteoporosis. The development of new and simple instrumentation has made it possible to evaluate bone changes easily and accurately in serial or survey studies. The degree of osteoporosis is determined by the transmission of low-energy radiation from radioactive iodine 125 through an in vivo bone sample. The measure used here is the linear absorption coefficient of overall bone of a phalanx. The results show that postmenopausal osteoporosis is prevented or retarded by estrogen replacement therapy as compared with an unsupplemented control group.
RATIO BETWEEN DEATHS FROM TRAUMATIC FRACTURE OF CRANIAL BONES AND FROM ALCOHOL
Journal: JAMA (1921)

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
A first-in-human first-in-class (FIC) trial of the monocarboxylate transporter 1 (MCT1) inhibitor AZD3965 in patients with advanced solid tumours.
Authors: Sarah E. R. Halford, Paul Jones, Steve Wedge, Sandra Hirschberg, Sidath Katugampola, Gareth Veal, Geoffrey Payne, Chris Bacon, Sarah Potter, Melanie Griffin, Maxime Chenard-Poirier, George Petrides, Graham Holder, Hector C Keun, Udai Banerji, Elizabeth R. Plummer
Journal: Journal of Clinical Oncology (2017)

2516 Background: A key metabolic alteration in tumour cells is an increased dependency on the glycolysis, resulting in the production of lactate, which is transported out of cells by MCTs. Inhibition of MCT-1 leads to a profound inhibition of cancer cell growth in preclinical models. AZD3965 is a FIC inhibitor of MCT-1, and we report results from the phase I study of this agent. Methods: Patients with advanced solid tumours were treated with oral (po) AZD3965 at total daily doses of 5-30mg given once (od) and twice daily (bd). Exclusion criteria included a history of retinal or cardiac disease due to preclinical toxicology findings in the eye and heart (which express MCT-1). The primary objectives were to determine the safety, dose limiting toxicities (DLT) and maximum tolerated dose (MTD) of AZD3965. Intensive pharmacokinetic (PK) profiling was performed with subsequent modelling for receptor occupancy. Pharmacodynamic profiling included imaging to detect pH changes and tumour glucose uptake; plasma/urine metabolomics and MCT-1 and MCT-4 tumour expression by immunohistochemistry. Results: 35 patients (20M:15F median age 65) were treated at dose levels 5, 10, 20, and 30mg od and 15 and 10mg bd. AZD3965 was generally well tolerated with nausea and fatigue (CTCAE Gr1-2) the most commonly reported side effects. A single DLT of cardiac troponin rise was observed at 20mg od. Asymptomatic, reversible retinal ERG changes were observed in all but the lowest dose levels, with DLTs observed at doses above 20mg od. PK data indicate exposures in the preclinical efficacy range. Metabolomic changes in urinary lactate and urinary ketones correlate with on-target activity. The increase in urinary ketones is likely to be attributable to the role of MCT1 in physiological ketone transport. Conclusions: The MCT1 inhibitor AZD3965 can be administered to patients at doses which engage the drug target, with a MTD of 20mg od po. DLTs seen were primarily dose dependent, asymptomatic and reversible changes in retinal function, which were an expected on-target effect. Investigation of the activity of AZD3965 is ongoing in tumours known to express MCT1. Clinical trial information: NCT01791595.
Gall-Bladder Disease: Roentgen Interpretation and Diagnosis.
Journal: JAMA (1930)

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
Abstract 181: Kawasaki Disease in Children Six Months and Below - Clinical Experience from Chandigarh, North India
Authors: Sikha Agarwal, Anju Gupta, Manojkumar Rohit, Deepti Suri, Amit Rawat, Surjit Singh
Journal: Circulation (2015)

Kawasaki disease (KD) is a medium vessel vasculitis of childhood. Clinical presentation in infancy is often characterized by paucity of symptoms. We report our experience of managing 15 children with KD aged 6 months and below at the Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India. To the best of our knowledge there are no data on this aspect of KD from any developing country. Objective: To describe the clinical and laboratory profile of children with KD aged 6 months and below in our cohort Methods: Records of Pediatric Rheumatology Clinic from 1994 - 2014 were analyzed. Fifteen of the 415 children with KD, diagnosed on the basis of American Heart Association criteria, were aged 6 months and below. Fourteen children were given intravenous immunoglobulin and 3 also received infliximab. Results: Incomplete KD was present in 13 children (87%). Mucosal changes were present in 11 (73%); extremity changes in 10 (66%); rash in 9 (60%); conjunctival injection in 8 (53%) and lymphadenopathy in 3 (20%) children. Irritability at presentation was noted in 13 (87%); 4 (26%) had respiratory symptoms and 2 (13%) children had BCG scar reactivation. Eleven patients were diagnosed beyond day 10 of illness. Of 12 patients, in whom C-reactive protein was estimated, 11 had raised levels. Thrombocytopenia was seen in 3 patients - one of these developed scrotal gangrene. Coronary artery abnormalities were present in 5 (33%) patients. Two children died from disease related complications - one of these had giant coronary artery aneurysm. Conclusions: Incomplete forms of KD are commonly seen in children below 6 months of age. This may result in delayed diagnosis.
Cisplatin (CDDP) plus vinorelbine (NVB) as first-line treatment for advanced non-small-cell lung cancer (NSCLC): Retrospective analysis to improve the patient’s convenience on day 8 NVB administration
Authors: M. Provencio, R. de las Peñas, M. Cobo, B. Massuti, A. Artal, J. M. Muñoz-Langa, R. Garcia-Gomez, A. Sanchez- Ruiz, R. Rosell
Journal: Journal of Clinical Oncology (2008)

19049 Background: Severe neutropenia observed during chemotherapy (CT) is a clinical finding leading to treatment modification and, sometimes, life-threatening events. The combination of CDDP and NVB is a reference regimen in first-line therapy for advanced NSCLC. As with other CT, a blood count must be performed prior to each administration. In order to improve treatment convenience, it would be of interest to determine a patient profile for which it would not be necessary to perform this test prior to day 8 NVB administration. Methods: Data on 180 patients (pts) included in a prospective study developed by the Spanish Lung Cancer Group have been analyzed. Multivariate logistic regression was used to determine a patient profile with low risk to develop severe neutropenia on day 8 and with no risk to present any derived haematological complication. Treatment consisted of CDDP 75 mg/m2 day 1 plus NVB 25 mg/m2, days 1, 8 every 21 days. Patient’s characteristics were: Median age 62.5 years (y) (range 39–78); males: 87.2%; smokers: 80.6%; all PS 0–1; adenocarcinoma, 48.2% / squamous, 36%; stage IIIB: 17.2%, IV: 82.8%. Results: We analyzed 750 cycles (cy). NVB was administered on day 8 on 661 cy (88.1%) and the dose reduced or canceled in 2% cy due to haematological toxicity. No risk factors have been observed on first cy. In the univariate analysis, the report of a haematological toxicity in a previous cycle was significantly associated with the finding of a new haematological toxicity. In the multivariate analysis, the best model is derived with age and haematological toxicity leading to dose modification. In a subgroup analysis, the probability to present haematological toxicity at day 8 in patients aged 70 y or less with no dose modification on the previous cy is 1.6% (CI95% [0.8%-3%]). Conclusions: The findings of this retrospective analysis could lead to consider not performing a blood count prior to day 8 NVB administration for patients aged 70 y or less who presented a good haematological tolerability profile during previous cycles following the administration of a cisplatin-based regimen for advanced NSCLC first-line treatment. A prospective trial with oral NVB and CDDP is ongoing. No significant financial relationships to disclose.
Magnitude of procaspase-8 overexpression determines severity of myocyte apoptosis-induced cardiomyopathy in transgenic mice: An echo-Doppler cardiographic study Madhulika Chandra, Detlef Wencker, Richard N. Kitsis, Jamshid Shirani. Albert Einstein College of Medicine, Bronx, NY
Journal: Journal of the American College of Cardiology (2001)
Concordance between PD-L1 assays for metastatic renal cell carcinoma (mRCC) and metastatic urothelial carcinoma (mUC).
Authors: Jason Zhu, Matthew Labriola, Sachica Cheris, Xin Liu, Kathryn Perkinson, Zuowei Su, Shannon McCall, Jiaoti Huang, Rajan Gupta, Andrew J. Armstrong, Daniel J. George, Tian Zhang
Journal: Journal of Clinical Oncology (2019)

577 Background: Immune checkpoint inhibitors (ICIs) are now standard of care for mRCC and mUC patients (pts). PD-L1 status is gaining importance as a predictive biomarker, particularly for cisplatin-ineligible mUC. Four different PD-L1 assays vary in thresholds of PD-L1 positivity dependent on tumor type, with limited concordance studies. Given real-world limitations in PD-L1 testing, concordance between assays are needed to distinguish positive (pos)/negative (neg) results and treatment selection. We undertook comparisons of Dako 28–8 and Ventana SP142 assays in mRCC and Dako 22C3 and Ventana SP263 assays in mUC. Methods: 32 patients with mRCC and 18 patients with mUC who had received ICI therapy at Duke Cancer Institute were identified. FFPE archival tumor samples for pts with mRCC were evaluated with Dako 28–8 and Ventana SP142 PD-L1 immunohistochemistry (IHC) assays. For pts with mUC, FFPE archival tumor samples were evaluated with Dako 22C3 and Ventana SP263 PD-L1 IHC assays. Scoring was validated by two pathologists using the scoring system for each assay. PD-L1 status was subsequently correlated to best RECIST response (objective response rate (ORR) defined as stable disease or better)). Results: The majority of mRCC cases (29/32, 91%) were concordant between Dako 28-8 and Ventana SP142 assays (8 cases pos and 21 cases neg), with 3 discordant cases (1 case pos for Dako 28-8 but neg for Ventana SP142 and 2 cases neg for Dako 28-8 but pos for Ventana SP142). The majority of mUC cases (17/18, 94%) were also concordant between Dako 22C3 and Ventana SP263 assays (2 pos cases and 15 neg cases), with 1 indeterminate Dako 22C3 test due to background lymph node. In mRCC, the ORR for PD-L1 pos cases was 45% (5/11) versus 33% (8/24) for PD-L1 neg cases. In mUC, the ORR for PD-L1 positive cases was 50% (1/2) versus 31% (5/16) for PD-L1 neg cases. Conclusions: There was strong concordance between PD-L1 tumor/immune cell assays chosen for comparison in both mRCC and mUC with similar performance characteristics. Although PD-L1 positivity enriches for response to ICIs, many patients respond who are PD-L1 negative. PD-L1 status could be used interchangeably for the majority of cases when selecting treatment in mRCC and mUC.
Cautiously optimistic researchers study hyperthermia's potential uses
Authors: V. Cowart
Journal: JAMA (1984)

The use of heat to treat disease, primarily neoplasms, is an idea medicine has alternately embraced and rejected from at least the time of ancient Greece. Today, it is as controversial as ever, and even the most optimistic researchers are cautiously so as studies continue. "Those diseases that medicines do not cure, iron [surgery?] cures; those that surgery cannot cure, fire cures; those that heat cannot cure are to be reckoned wholly incurable." —Hippocrates (Aphorism 87) Today's "fire" (as mentioned in the above aphorism) is largely in the hands of the radiation oncologists, physicists, engineers, and others who are seeking to make hyperthermia a useful medical tool, based on sound physical and clinical principles. An accumulation of data, both in humans and animals, indicates that tumor cells are particularly sensitive to the destructive effects of temperatures of at least 41.5 °C (106.7 °F). Surrounding tissue appears to be less sensitive.
丹麦银屑病患者中的局部外用皮质类固醇的使用
Authors: M.T. Svendsen, M.S. Ernst, K.E. Andersen, F. Andersen, H. Johannessen, A. Pottegåard
Journal: British Journal of Dermatology (2019)

银屑病是一种慢性炎症性皮肤病,在欧洲影响大约 2‐4% 的人群。银屑病对患者的生活质量产生不利影响,且与若干银屑病‐相关合并症(与银屑病同时发生的疾病)相关。局部外用药物意味着它们直接用在皮肤上,是轻中度银屑病的推荐一线治疗,但它们所报告的现实生活使用却是相矛盾的。此研究调查了银屑病患者对于局部外用药物和其他抗银屑病治疗的现实生活使用情况。丹麦研究者们基于全国范围的丹麦卫生注册数据进行了一项药物利用研究,这些数据包括所有在 2005‐2015 年间首次获得银屑病住院诊断且被开具至少一种局部外用药物的 18 岁以上患者(7,743 名患者)的数据。在诊断后对这些患者进行了 3 年随访。在众多发现中,作者们报告称,最频繁使用的局部外用抗银屑病药物是含有皮质类固醇和钙泊三醇的复方药物,占总使用量的 31%。患者在医院诊断前后的局部外用药物使用增多。使用量在地理区域以及个体患者之间也有显著差异,25% 患者使用了 70% 的总局部外用治疗量。抗银屑病局部外用药物的总使用量在此研究期间下降了 19%,同时,一种名为甲氨蝶呤的药物的使用(通过片剂或注射液形式使用)则增高了 70%。作者们得出结论,局部外用抗银屑病药物的使用在时间、地区实践和患者间差异方面显示出了相当高的多样性。
Travellers' diarrhoea.
Authors: M J Farthing
Journal: BMJ (1993)

<h3>Objectives</h3> The combination of a selective serotonin reuptake inhibitor (SSRI) or serotonin–norepinephrine reuptake inhibitor (SNRI) with tramadol can result in serotonin syndrome, characterised by neuromuscular and autonomic nervous system excitation and altered mental state. The incidence of serotonin syndrome with this combination of drugs is low, and the serotonin syndrome is generally mild or moderate in form, but can be life threatening and is more easily prevented than treated. We aimed to investigate whether prescribers in a general hospital were aware of this risk and if it influenced their prescriptions. <h3>Methods</h3> A questionnaire was sent to 194 physicians in a general teaching hospital with over 650 beds in The Netherlands. The questionnaire presented four cases, two of whom used an SSRI or SNRI among other medications, and asked the respondents to prescribe an opioid in each case. The respondents were not aware of the focus of our research. Actual prescription rates of tramadol in admitted patients who did or did not use an SSRI or SNRI were assessed using the hospital pharmacy database. <h3>Results</h3> Based on the questionnaire, respondents prescribed tramadol equally in patients with or without concomitant use of SSRIs/SNRIs. About one-third of respondents who prescribed tramadol indicated they were aware of the potential interaction with SSRIs/SNRIs. About one-fifth deliberately avoided tramadol because a potential interaction with SSRIs/SNRIs was identified. However, there was no difference in actual tramadol prescriptions, as recorded in the hospital pharmacy database: 23.8% of SSRI/SNRI users received tramadol versus 24.6% of non-SSRI/SNRI-users (calculated OR 0.96; 95% CI 0.78 to 1.17). <h3>Conclusions</h3> In total, 20–30% of prescribers in a general hospital were aware of the potential interaction between tramadol and SSRIs or SNRIs, yet this did not translate to a difference in tramadol prescriptions between SSRI/SNRI users and non-users, as documented in the hospital pharmacy database. A physician9s decision to prescribe tramadol to SSRI/SNRI users may be guided by a comprehensive individual benefit–risk assessment; expected benefits of tramadol may outweigh the small risk of serotonin syndrome. In order to increase awareness of the potential risk of a serotonin syndrome, hospital pharmacies may play an important role in signalling the potential interaction and providing information on the benefits and risks of tramadol and alternative analgesics in the presence of SSRIs or SNRIs.
Phase I-II study of amrubicin and cisplatin in previously untreated patients with extensive stage small cell lung cancer (ED-SCLC) (final report)
Authors: Y. Ohe, S. Negoro, K. Matsui, K. Nakagawa, T. Sugiura, Y. Takada, Y. Nishiwaki, N. Saijo, M. Fukuoka, Y. Ariyoshi
Journal: Journal of Clinical Oncology (2004)

7206 Background: Amrubicin (AMR), a totally synthetic 9-amino-anthracycline, demonstrated excellent single agent activity for ED-SCLC (Yana et al., Proc. ASCO, 1998, abstr.#1734). The aim of this trial was to determine the maximum-tolerated doses (MTDs) of combination therapy of AMR with cisplatin (CDDP), in order to assess the efficacy for ED-SCLC, pharmacokinetics and safety at their recommended doses (RDs). Methods: Eligibility criteria was defined as patients having histologically or cytologically proven measurable ED-SCLC, no previous systemic therapy, an ECOG PS of 0–2, and adequate organ function. AMR was administered iv once a day from day 1 to day 3, as was CDDP on day 1. Treatment was repeated every 3 weeks. Results: Four patients were enrolled at the dose level 1 (AMR 40 mg/m2/day and CDDP 60 mg/m2) and 3 patients at level 2 (AMR 45 mg/m2/day and CDDP 60 mg/m2), respectively. Consequently, the MTDs and RDs were determined to be level 2 and level 1, respectively (Negoro et al., Proc. ASCO, 2003, abstr. #2608). Combination of CDDP did not alter the pharmacokinetics of AMR. 41 patients at RDs have been assessed for efficacy, and 36 patients achieved a response of more than the PR. The response rate was 87.8%. Median survival time (MST) was 14.1 months and one-year survival rate was 64.2% on December of 2003 (interim data). Major toxicity was hematological in nature and a grade 3/4 neutropenia and leukopenia occurred in 95.1% and 65.9%, respectively. Conclusion: The combination of AMR and CDDP has demonstrated an impressively high response rate of 87.8% and MST of 14.1 months in patients with previously untreated ED-SCLC. The most common adverse events observed were grade 3/4 neutoropenia and leukopenia. Results from the phase I-II trial are encouraging. We are presently preparing a phase III clinical trial to compare combination therapy of irinotecan with CDDP. No significant financial relationships to disclose.
Graves' disease progressing to Hashimoto's thyroiditis
Authors: C. Jaffiol
Journal: JAMA (1983)

THE ASSOCIATION of Graves' disease and hypothyroidism with chronic lymphocytic thyroiditis has long been recognized. In some cases, hypothyroidism seems to be the final outcome of Graves' thyrotoxicosis.<sup>1</sup>Many reports are not completely substantiated, however, and none, to our knowledge, reports on the histological appearance of the thyroid gland at both stages of the disease in the same patient. <h3>Report of a Case</h3> A 39-year-old woman (height, 159 cm; weight, 55 kg) was seen in 1972 with thyrotoxicosis, unilateral exophthalmos, and a large, smooth goiter. The six-hour sodium iodide uptake was raised at 68% (normal, 25% to 35% dose), and the scan was homogenous. The patient was euthyroid during antithyroid drug therapy (carbimazole, 30 mg/day), as confirmed at repeated checkups during 1972 and 1973. Treatment was discontinued voluntarily by the patient from 1973 to January 1977. At that time, the patient was again found to be thyrotoxic with a
Santa Librada
Authors: James Wilk
Journal: JAMA (2019)

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