tbuckley/cabot-search huggingface dataset:
Sunset
Journal: JAMA (1998)

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
Sunitinib as adjuvant therapy for women with early-stage breast cancer and disseminated tumor cells in bone marrow.
Authors: J. Li, M. E. Melisko, P. N. Munster, M. Pelayo, M. M. Moasser, A. J. Chien, J. Scott, L. Esserman, J. W. Park, H. S. Rugo
Journal: Journal of Clinical Oncology (2011)

1094 Background: Detection of DTC in BM is a prognostic factor in early BC, especially if DTCs persist after completion of adjuvant chemoRx; DTCs could serve as a surrogate marker for anti-tumor effects. Sunitinib (SU) is an oral multitargeted receptor tyrosine kinase inhibitor; preclinical and clinical studies have shown that SU has direct anti-tumor and anti-angiogenic effects in BC, and inhibits tumor-associated osteolysis, suggesting a potential use in targeting DTC. We designed a phase II study to evaluate the effect of SU on DTC in patients (pts) with BC and detectable DTC after adjuvant Rx. Methods: Pts with stage I-III BC were eligible if they had >10 DTC/mL on unilateral BM within 12 weeks of study entry (Park, ASCO 2002). Eligible pts were treated with SU for 6 months (mo) at 37.5 mg/day. Concomitant hormonal therapy was allowed. Repeat BM aspirations were performed at 6 mo and one year. DTCs were detected by immunomagnetic enrichment + flow cytometry (IE/FC) as previously described (Greenberg, ASCO 2010). Results: 13 pts were enrolled, 11 (4 stage I, 4 stage II, 3 stage III, 9 ER+) completed Rx and had a 6 mo BM. Mean baseline DTC was 29 DTC/ml (range 10.2-105.8 DTC/ml), 10/11 (90.1%) pts had reduced DTC at 6 mo, average reduction is 39% (range 1 - 90%), 2/11(18.2%) had < 10 DTC/mL. 5 pts had a one year BM; further drop in DTC was seen in all 5. Median follow up (FU) is 13.1 mo (range 7- 20), no patient has had disease relapse. The most common adverse events were grade 3 neutropenia (18%) and grade 2 hand foot syndrome (18%). Other toxicities included neuropathy, thrombocytopenia, mucositis, diarrhea and hypertension. 10 pts were dose reduced due to toxicity; 3 pts had 2 dose reductions. Despite encouraging DTC results, the study was closed early due to lack of SU benefit and toxicity in metastatic BC phase III trials. Conclusions: Despite the small sample size, daily SU as adjuvant Rx in high risk BC resulted in a 39% reduction in DTCs in 90% of pts; 2 pts had < 10 DTCmL. Median FU is short. These data suggest that use of a more effective and less toxic antiangiogenic agent could be an attractive strategy for the treatment of high risk BC; more studies are needed to further understand this approach.
Cholecystectomy in a Trial of Adjuvant Chemotherapy After Pancreatic Cancer Resection—Reply
Authors: John P. Neoptolemos, Deborah D. Stocken, Markus W. Büchler, for the European Study Group for Pancreatic Cancer
Journal: JAMA (2010)

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
Leads from the MMWR. Measles in a population with religious exemption to vaccination--Colorado
Journal: JAMA (1985)

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
CENTENARY OF THE FRENCH ACADEMY OF MEDICINE
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 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
Impact of adjuvant therapy in patients with a microscopically positive margin after resection for gastroesophageal cancer.
Authors: Lucy Xiaolu Ma, Osvaldo Espin-Garcia, Charles Henry Lim, Peiran Sun, Di Maria Jiang, Hao-Wen Sim, Akina Natori, Bryan Anthony Chan, Daniel Yokom, Stephanie Moignard, Chihiro Suzuki, Eric Xueyu Chen, Geoffrey Liu, Carol Jane Swallow, Gail Elizabeth Darling, Rebecca Wong, Sara Hafezi-Bakhtiari, James Conner, Elena Elimova, Raymond Woo-Jun Jang
Journal: Journal of Clinical Oncology (2019)

4069 Background: A microscopically positive (R1) resection margin following resection for gastroesophageal (GE) cancer has been documented to be a poor prognostic factor. The optimal strategy and impact of different modalities of adjuvant treatment for an R1 resection margin remain unclear. Methods: A retrospective analysis was performed for patients (pts) with GE cancer treated at the Princess Margaret Cancer Centre from 2006-2016. Electronic medical records of all pts with an R1 resection margin were reviewed. Kaplan-Meier and Cox proportional hazards methods were used to analyze recurrence free survival (RFS) and overall survival (OS) with stage and neoadjuvant treatment as covariates in the multivariate analysis. Results: We identified 78 GE cancer pts with an R1 resection. 11% had neoadjuvant chemotherapy, 14% chemoradiation (CRT), 75% surgery alone. 28% had involvement of the proximal margin, 13% distal, 56% radial, 3% had multiple positive margins. By the American Joint Committee on Cancer 7th edition classification, 88% had a pT3-4 tumour, 66% pN2-3 nodal involvement, 64% grade 3, 68% with lymphovascular invasion. 3% were pathological stage I, 21% stage II and 74% stage III. Adjuvant therapy was given in 46% of R1 pts (24% CRT, 18% chemotherapy alone, 3% radiation alone, 1% reoperation). Median RFS for all pts was 12.6 months (95% CI 10.3-17.2). Site of first recurrence was 71% distant, 16% locoregional, 13% mixed. Median OS was 29.3 months (95% CI 22.9-50) for all pts. The 5 year survival rate was 23% (95% CI 12%-43%). There was no significant difference in RFS (log-rank test p = 0.63, adjusted p = 0.14) or OS (log-rank test p = 0.68, adjusted p = 0.65) regardless of adjuvant therapy. Conclusions: Most pts with positive margins after resection for GE cancer had advanced pathologic stage and prognosis was poor. Our study did not find improved RFS or OS with adjuvant treatment and only one pt had reresection. The main failure pattern was distant recurrence, suggesting that pts being considered for adjuvant RT should be carefully selected. Further studies are required to determine factors to select pts with good prognosis despite a positive margin, or those who may benefit from adjuvant treatment.
The foundation of the British Museum
Journal: BMJ (2005)

of patients without pyuria who had an acute dysuria syndrome very similar to those with low count bacteriuria but for which no organism could be found. 6 Implications for clinical practiceIf these findings are confirmed empirical treatment with antibiotics of (dipstick positive and dipstick negative) patients presenting in primary care is justified irrespective of dipstick findings.The downside of such a strategy is an increase in adverse events, superinfection, and increased antibiotic pressure with the consequent promotion of bacterial resistance.This further highlights the tension between relieving symptoms expeditiously with the desire to minimise unnecessary antibiotic use. ConclusionsFurther clinical and microbiological study of the group of women who seem not to have infection yet whose symptoms are relieved more quickly with a short course of trimethoprim is needed.At a population level, we need a more discriminating way to avoid unnecessary antibiotic exposure in all women presenting with symptoms of urinary tract infection.This study would not have been possible were it not for the (unpaid) efforts of the general practitioners and practice nurses of the sentinel network who identified and recruited suitable patients.Research nurses Toni Stewart, Felicity Beats, and Margaret Sutherland were responsible for the data collection.Alison Parsons provided invaluable office support for the network and follow-up of missing data.
Use of the Enzyme-Linked Immunosorbent Assay (ELISA) in Immunotoxicity Testing
Authors: J. G. Vos, E. I. Krajnc, P. Beekhof
Journal: Environmental Health Perspectives (1982)

Based on an earlier described macromethod for the routine measurement of IgM and IgG in rat sera, a mechanized micro enzyme-linked immunosorbent assay (ELISA) was developed. The assay was performed in the wells of microtiter plate thus minimizing the quantities of reagents and antisera needed. Data on reproducibility of the assay and calculation of IgM and IgG levels are provided. For the functional assessment of the humoral immunity of the rat, ELISA is a powerful tool. In an earlier report, assays for the titration of thymus-independent IgM antibodies to E. coli LPS and the IgM and IgG response to the thymus-dependent antigen tetanus toxoid were described. More recently it was shown that the antigen ovalbumin elicits a thymus-dependent IgM, IgG and IgE response which could be readily measured with the enzyme immunoassay, as well as a delayed-type hypersensitivity reaction. As the optimum ovalbumin concentration for both types of reactions was the same, it is concluded that the ovalbumin model offers the advantage that both humoral and cellular immunity can be studies simultaneously in the same animal.
Manipulative therapy and physiotherapy for persistent back and neck complaints.
Authors: C. Deighton
Journal: BMJ (1992)

competence to examine the spine fully enough to define which tissue or tissues were responsible for producing the pain, and is it not unsafe to attempt to manipulate patients with vertebrogenic pain of unknown origin?Am I to assume that among the undiagnosed disc, sacroiliac, and facet lesions there were also hip lesions, which may refer pain to the lower back?Ifno one was capable ofdiagnosing the lesions initially, they cannot have been capable of directing those patients with back or neck pain resulting from nuclear disc lesions to traction- surely the primary treatment for such patients.The study does not state what exercises the physiotherapists dispensed.Back or neck pain resulting from disc lesions may well be worsened by conventional strengthening or mobilising exer- cises but may be helped by certain movementsfor example, those designed by Robin McKenzie.The survey was too poorly constructed to reflect adequately what manipulative physiotherapists of today are capable of and the effective treatment patients should receive.
Terminal Dehydration as an Alternative to Physician-Assisted Suicide
Authors: William W. Stead
Journal: Annals of Internal Medicine (1998)

Letters15 December 1998Terminal Dehydration as an Alternative to Physician-Assisted SuicideWilliam W. Stead, MDWilliam W. Stead, MDArkansas Department of Health; Little Rock, AR 72205Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-12-199812150-00033 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I was pleased to see Miller and Meier's article on terminal dehydration and physician-assisted suicide [1]. It follows quite nicely the triad of papers on the same subject published in Annals in 1996 [2-4]. At the time, I wrote the editor a letter in which I described my unpleasant experiences with the death of two older sisters whose expressed wishes were cruelly ignored [5].I have recently gone through the death of my last (and favorite) sister. It was a totally different experience, thanks to more enlightened management of the terminally ill. After a severe bout of ...References1. Miller FG, Meier DE. Voluntary death: a comparison of terminal dehydration and physician-assisted suicide. Ann Intern Med. 1998; 128:559-62. Google Scholar2. Payne K, Taylor RM, Stocking C, Sachs GA. Physicians' attitudes about the care of patients in the persistent vegetative state: a national survey. Ann Intern Med. 1996; 125:104-10. Google Scholar3. Cassell EJ. Clinical incoherence about persons: the problem of the persistent vegetative state. Ann Intern Med. 1996; 125:146-7. Google Scholar4. Gilligan T, Raffin TA. Whose death is it, anyway? Ann Intern Med. 1996; 125:137-40. Google Scholar5. Stead WW. Physicians' attitudes about patients in the persistent vegetative state [Letter]. Ann Intern Med. 1997; 126:90. Google Scholar Author, Article, and Disclosure InformationAffiliations: Arkansas Department of Health; Little Rock, AR 72205 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByTo Feed or Not to Feed? A Case Report and Ethical Analysis of Withholding Food and Drink in a Patient With Advanced DementiaForgoing Artificial Nutrition or Hydration in Patients Nearing Death in Six European CountriesNurses' Experiences with Hospice Patients Who Refuse Food and Fluids to Hasten Death 15 December 1998Volume 129, Issue 12Page: 1080-1081KeywordsComaEatingLiving willsNursesNursing homesShinglesSuicide Issue Published: 15 December 1998 CopyrightCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Effects of manufacturing oral contraceptives on blood clotting.
Authors: L Poller, J M Thomson, B W Otridge, K F Yee, S H Logan
Journal: BMJ (1979)

In monitoring the effects of industrial exposure resulting from the pharmaceutical manufacture of oestrogen-progestogen combinations by coagulation studies acceleration of some clotting tests was found. The most pronounced changes were in workers most closely associated with the industrial process. Less pronounced changes were found in women employees not closely concerned with the processing and may have been secondary to the postmenopausal bleeding to which they were prone. A safer work procedure elaborated by the Employment Medical Advisory Service was monitored by clotting studies for over a year but the three most highly exposed subjects showed no substantial improvement.
Phase II study of cyclophosphamide, etoposide and estramustine (CEE) in patients with androgen independent prostate cancer (AIPC)
Authors: M. A. Choudry, V. Chilakapati, C. Crump, R. Bunner, F. J. Hendler, R. V. La Rocca, L. Bhupalam, V. R. Sharma, D. M. Miller, D. A. Laber
Journal: Journal of Clinical Oncology (2004)

4708 Background: Novel and effective therapies for patients with AIPC are needed. Oral therapy offers the tremendous advantage of independence and avoids all the catheter-related complications. Cyclophosphamide, etoposide and estramustine have shown synergistic activity against AIPC. The optimal dose and schedule of these agents have not been defined. Our goal is to develop an effective and easy to administer oral palliative regimen that does not require hospitalization or intravenous access. Methods: Objectives are to evaluate the efficacy and safety of this triple drug regimen. Each treatment cycle consists of cyclophosphamide 50 mg/m2 p.o., etoposide 50 mg/m2 p.o. and estramustine 280 mg p.o. administered on days 1–14, every 28 days. Response was assessed by RECIST guidelines (JNCI 92(3):205–216, 2000), and PSA levels (PSA Working Group JCO 17(11):3461–7, 1999). Results: From October, 2001 to December, 2003, 15 subjects with AIPC were enrolled. All patients are evaluable for toxicity and 14, who completed at least 2 cycles, for response. Median baseline characteristics: age 66 years (55–86); ECOG performance status 2 (0–3); PSA 356 ng/ml (26–2268); prior hormonal manipulations 4 (1–5), and 4/15 had prior chemotherapy. Total number of cycles administered: 62 with median of 4 (2–7 cycles/patient). Response: 10/15 patients are still alive. PSA response: Out of 14 subjects, 7 (50 %) had > 50% decrease and 3 (21%) had >80% decrease. Measurable disease: 9/15 patients had measurable lesions by RECIST criteria. Six had SD (67%) and 3 PD (33%). Toxicity: Grade 3–4: 40% neutropenia, 20% thrombocytopenia, 7% anemia. 4 patients (27%) developed a thrombotic events. 3 with DVTs, two spontaneous and one after a 14-hours car trip. 1 subject with a strong history of cardiac complications had a myocardial infarction. No episodes of neutropenic fever or bleeding occurred. Conclusions: CEE is a well-tolerated, all oral, easy to administer and effective triple drug therapy for patients with metastatic androgen-independent prostate cancer. Effective prevention for thrombotic events must be considered in these patients. No significant financial relationships to disclose.
Intestinal Adaptation
Authors: R. Hermon Dowling
Journal: New England Journal of Medicine (1973)

The enerous length of the human small intestine —350 cm in life and 600 cm when relaxed after death —ensures a large functional reserve. After extensive small-bowel resection, however, many patients lose this reserve, and serious malabsorption and malnutrition may develop. The ultimate fate of such patients largely depends on the regenerative capacity of the residual intestine to compensate for the loss of absorptive surface produced by resection. A recent paper by Bury1 on carbohydrate absorption after massive small-bowel resection in the rat is one of a series of papers from several centers that examines this compensatory or adaptive ability . . .
Clinical significance of vascular endothelial growth factor and basic fibroblast growth factor gene expression in liver tumor
Authors: M MISE
Journal: Hepatology (1996)

Hepatocellular carcinoma (HCC) is a typical hypervascular tumor. However, the relationship between the vascularity of HCC and the expression of angiogenic factors has not been investigated. In addition, no detailed studies have examined the possible involvement of angiogenic factors in the grade of malignancy of HCC. The aim of this study was to determine which angiogenic factors regulate tumor angiogenesis and contribute to the invasive ability of liver tumors, especially of HCC. Northern blot analysis was used to examine the transcriptional expression of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (FGF), and acidic FGF in resected surgical specimens (20 HCC and 9 metastatic liver tumors). Correlations between messenger RNA (mRNA) expression and arteriographic findings, as well as histopathological findings, were evaluated. Immunohistochemistry was performed to identify the localization of cells expressing VEGF in HCC. Higher levels of VEGF mRNA were observed in 12 of 20 HCC and 2 of 9 metastatic liver tumors than in corresponding nontumorous tissues. The degree of VEGF mRNA expression was significantly correlated with the intensity of tumor staining in angiograms (P <.01). On immunohistochemical observation, VEGF protein was intensely detected in HCC cells. Furthermore, basic FGF mRNA was detected in 9 of 20 HCC and was related to the capsular infiltration of cancer cells (P <.05). In contrast, no significant difference was observed in the very low levels of acidic FGF mRNA found in the tumorous and nontumorous portions of the liver. In conclusion, these results suggest that VEGF contributes to angiogenesis of liver tumors, whereas basic FGF may be involved in the invasion of HCC into the surrounding tissues.