tbuckley/cabot-search huggingface dataset:
A Randomized Clinical Trial of Cyclosporine in Cadaveric Renal Transplantation
Journal: New England Journal of Medicine (1983)

In a randomized multicenter trial, 209 recipients of cadaveric renal transplants were treated either with cyclosporine and prednisone or with standard therapy that included azathioprine and prednisone. Predicted graft survival at one year was 80.4 per cent in patients receiving cyclosporine and 64.0 per cent in those receiving standard therapy (P = 0.003). Predicted patient survival at one year was 96.6 per cent in patients given cyclosporine and 86.4 per cent in those given standard therapy. A detrimental effect on predicted graft survival at one year was seen in patients treated with cyclosporine if they received kidneys that were perfused by machine for longer than 24 hours (70 vs. 88 per cent, P = 0.005) or if the time used to perform the surgical anastomosis was longer than 45 minutes (60 vs. 89 per cent, P = 0.002). In the group receiving standard therapy, predicted graft survival was better in patients who had had five or more blood transfusions than in those who had had two to four transfusions (77 vs. 55 per cent, P = 0.05). Serum creatinine was 2.6 mg per deciliter in patients receiving cyclosporine 90 days after transplantation and 2.0 mg per deciliter in those receiving standard therapy (P = 0.03). Lymphoma developed in one patient receiving cyclosporine. We conclude that cyclosporine is preferable to azathioprine in preventing renal transplant rejection. Further studies will be required to determine the optimal regimen with this agent.
Metabolism and Mutagenicity of Isoprene
Authors: P. G. Gervasi, V. Longo
Journal: Environmental Health Perspectives (1990)

Liver microsomes of various rodents (mouse, rat, rabbit, and hamster) metabolize isoprene (2-methyl-1,3-butadiene) to the corresponding monoepoxides 3,4-epoxy-3-methyl-1-butene and 3,4-epoxy-2-methyl-1-butene. 3,4-Epoxy-3-methyl-1-butene (half-life 85 min) was found to be the main metabolite, although the stable 3,4-epoxy-2-methyl-1-butene was also formed (about 14-25% with respect to the main epoxide). The kinetic constants (Km and Vmax) for the formation of the major epoxide metabolite of isoprene were determined by gas-liquid chromatography. The minor epoxide was further epoxidized to the isoprene dioxide by the microsomes of all rodents studied. The Km and Vmax were determined and phenobarbital was found to be a good inducer for this epoxidation in all species. The mutagenic activity, using Salmonella typhimurium, and the chemical reactivity (alkylating power and half-life) of the epoxide metabolites of isoprene were investigated and compared to those of other structurally related epoxides. Isoprene and the monoepoxide intermediates of the isoprene biotransformation were not mutagenic in Salmonella typhimurium. However, the isoprene dioxide (2-methyl-1,2,3,4-diepoxybutane) was found to be mutagenic and have alkylating power towards nicotinamide, similar to the structurally corresponding 1,2,3,4-diepoxybutane. In conclusion, the metabolism of isoprene does not lead to the formation of mutagenic monoepoxide (in contrast to butadiene) but the formation of mutagenic and presumably carcinogenic isoprene diepoxide is possible, thereby a genotoxic effect of isoprene in rodents or other species cannot be ruled out.
Over D1 lymph-nodes dissection may question the value of post-operative radiotherapy as a part of an adjuvant program in radically resected gastric cancer patients
Authors: M. Scartozzi, E. Galizia, F. Graziano, V. Catalano, R. Berardi, A. M. Baldelli, G. Catalano, R. R. Silva, R. Cellerino, S. Cascinu
Journal: Journal of Clinical Oncology (2004)

4041 Background: The aim of our study was to asses the effect on local relapse, and consequently on overall and disease free survival, of a limited or an extended lymphadenectomy, in an homogeneus group of radically resected gastric cancer patients. This analysis was performed in order to identify a subgroup of patients possibly not benefiting from a toxic therapeutic approach such chemoradiation therapy. Methods: Patients with radically resected gastric cancer were eligible for our analysis. We divided our patients into 2 groups according to lymphadenectomy type: group A for limited (25 or less than 25 resected lymph nodes) and group B for extended (more than 25 resected lymph nodes) lymph nodes resection. All major clinical characteristics (age, extension within gastric wall, pN stage and extent of lymphadenectomy) were considered for statistical analysis. Results: Four hundred-eighteen patients were analysed: tumour stage at diagnosis was pT2–3 pN1–3 M0 in 339 patients and pT3 N0 M0 in 79 patients. Median age at diagnosis for the whole group was 68 years (range 30–92 years). Three hundred-six patients (73.2%) underwent limited (group A) and 112 (26.8%) extended (group B) lymph nodes dissection. Local recurrence occurred in 21% of patients in group A and in 4.7% of those in group B (p=0.0001). The median survival time (OS) for patients in group A and group B were respectively 58.8 months and 84.8 months (p=0.0371); disease free survivall (DFS) were respectively 28.8 and 59.9 months (p=0.0027). At multivariate analysis extension within the gastric wall, nodal involvement and the number of resected lymph nodes appeared to affect both OS and DFS. Conclusions: Our findings suggest that an inadequate lymph nodes resection can affect survival and result in a higher incidence of local relapse, thus making this latter group of patients optimal candidates for adjuvant chemoradiation. On the other hand, after a R0 resection with an adequate lymphadenectomy, adjuvant chemoradiotherapy should not be recommended outside of prospective randomised trials. No significant financial relationships to disclose.
A reappraisal of H5N1 avian influenza
Authors: None The Lancet
Journal: The Lancet (2006)

Influenza viruses, while commonly known, are strangely neglected, sometimes even misunderstood. Even now, as we try to comprehend the threat of H5N1 avian influenza to human populations, we are forced to admit our ignorance about its biology and pathology. Global surveillance systems are weak. Detailed response plans to an emerging pandemic are absent.
Level 4: Virus Hunters of the CDC
Authors: Anand P. Panwalker
Journal: JAMA (1996)

The Centers for Disease Control and Prevention (CDC) celebrates its 50th anniversary this year. What started as a malaria control agency has blossomed into an institution renowned for its excellence in the field of epidemiology. The first class of Epidemic Intelligence Service (EIS) officers graduated in 1951. These "disease detectives," so wonderfully depicted in the January 1991 issue of the<i>National Geographic</i>magazine by Peter Jaret, have blazed a trail of success and glory worldwide. "The CDC says" has become a common refrain for sweaty-palmed hospital infection control officers prior to the inevitable visit by the Joint Commission on Accreditation of Healthcare Organizations when they wish to provide legitimacy to their infection control ventures. EIS officers have been involved in global programs for the eradication of infectious diseases ranging from poliomyelitis to dracunculiasis. They have investigated and defined the scope of such new diseases as legionnaire disease, toxic shock syndrome,
From the Congressional Office of Technology Assessment
Authors: J. Wagner
Journal: JAMA (1989)

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
Percutaneous transluminal coronary angioplasty
Authors: R. K. Mautner
Journal: JAMA (1979)

CORONARY artery bypass surgery still generates wide-spread controversy. There are divergent viewpoints among competent cardiologists regarding indications, risks, longterm results, and costs. Similarly, questions still arise concerning morbidity and mortality, risk, identification and importance of perioperative infarction, and long-term fate of the native and bypassed coronary vessels, as well as of the vein graft itself. Futhermore, long-term follow-up studies reaffirm the palliative nature of the procedure for the majority of patients. Amid this continuing controversy of the role of aortocoronary bypass in the treatment of various coronary artery disease syndromes, a new method for the treatment of myocardial ischemia has been introduced: percutaneous transluminal coronary angioplasty (PTCA). The method is particularly attractive because of its simplicity. Introduced by a preformed coronary catheter (similar to the standard catheters used for routine coronary angiography), a balloon-tipped catheter is advanced into the obstructed coronary artery segment, rapidly inflated (under 4 to 6 atm)
Study of Gonorrhea in Treated and Untreated Asymptomatic Women as Determined by Fluorescent Antibody and Culture Methods: II. Teen-Age and Young Adults Confined
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
Massachusetts Medical Society
Authors: John Figgis Jewett
Journal: New England Journal of Medicine (1973)

COMMITTEE ON MATERNAL WELFARESalicylate PoisoningA 22-year-old gravida 3, para 2, died at 36 weeks of salicylate poisoning, 19 hours after admission. A post-mortem cesarean section was unsuccessful.Two previous pregnancies had been marked by intrapartum hypertension (blood pressure, 172/126), but neither urinalysis nor other investigations had been undertaken during those episodes. Early on a Saturday, the patient's mother reported that her daughter, a heavy drinker and smoker, now separated from her husband, had consumed a full bottle of aspirin and a variety of other unidentified pills beginning perhaps the night before. An ambulance was sent at once, but . . .
Authors' Names Omitted in Signature.
Journal: JAMA (1995)

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
Safety and immunogenicity of a recombinant outer surface protein A Lyme vaccine
Authors: D. Keller
Journal: JAMA (1994)

<h3>Objective.</h3> —To evaluate the safety and immunogenicity of a recombinant outer surface lipoprotein A (OspA) Lyme vaccine in healthy adults. <h3>Design.</h3> —Randomized, double-blind, placebo-controlled trial. <h3>Setting.</h3> —Clinical research unit of a medical center. <h3>Participants.</h3> —Thirty-six healthy adult volunteers aged 18 through 65 years. <h3>Interventions.</h3> —Volunteers were randomly assigned to receive two 10-μg doses of OspA Lyme vaccine, OspA Lyme vaccine adsorbed to alum, or a buffer placebo. Subjects in the OspA Lyme vaccine group received a third dose. Patients were assessed after each vaccination for a total follow-up period of 1 year. Serum samples for antibody determination were drawn at baseline, 2 and 3 weeks after dose 1, once per week for 4 weeks after dose 2, 20 weeks after dose 2, and 1 month after dose 3. <h3>Main Outcome Measures.</h3> —Local and systemic adverse reactions and antibody levels specific for OspA. <h3>Results.</h3> —The most common reactions were local pain and tenderness at the injection site. Adverse events did not increase following the second or third dose. Two doses of both vaccine formulations elicited high-titer antibodies that inhibited replication of<i>Borrelia burgdorferi</i>in vitro. No differences were noted in antibody levels elicited by the adsorbed and nonadsorbed formulations. <h3>Conclusion.</h3> —Two or three doses of OspA Lyme vaccine are safe and immunogenic in adults. (<i>JAMA</i>. 1994;271:1764-1768)
Antibiotics in chronic obstructive pulmonary disease exacerbations. A meta-analysis
Authors: S. Saint
Journal: JAMA (1995)

<h3>Objective.</h3> —A meta-analysis of randomized trials was performed to estimate the effectiveness of antibiotics in treating exacerbations of chronic obstructive pulmonary disease (COPD). <h3>Data Sources.</h3> —English-language studies published from 1955 through 1994 were retrieved using MEDLINE,<i>Index Medicus</i>, bibliographies, and consultation with experts. MEDLINE search terms included "COPD," "chronic bronchitis," and "antibiotic(s)." <h3>Study Selection.</h3> —Only randomized trials that enrolled patients having an exacerbation of COPD, used an antibiotic in the treatment group and placebo in the control group, and provided sufficient data to calculate an effect size were included in the meta-analysis. <h3>Data Extraction.</h3> —Descriptive and outcome data from each study were independently abstracted by two authors. <h3>Data Synthesis.</h3> —Overall summary effect size of the nine trials satisfying all inclusion criteria was 0.22 (95% confidence interval [CI], 0.10 to 0.34), indicating a small benefit in the antibiotic-treated group. Similar analysis of the six studies that provided data on peak expiratory flow rate changes revealed a summary effect size of 0.19 (95% CI, 0.03 to 0.35) and a summary change in peak expiratory flow rate of 10.75 L/min (95% CI, 4.96 to 16.54 L/min) in favor of the antibiotic-treated group. Sensitivity analyses did not significantly affect these results. <h3>Conclusions.</h3> —These analyses suggest a small but statistically significant improvement due to antibiotic therapy in patients with exacerbations of COPD. This antibiotic-associated improvement may be clinically significant, especially in patients with low baseline flow rates. (<i>JAMA</i>. 1995;273:957-960)
LDH serum levels as prognostic and predictive factor in advanced biliary tract cancer patients treated with first line chemotherapy.
Authors: Luca Faloppi, Michela Del Prete, Andrea Casadei Gardini, Daniele Santini, Nicola Silvestris, Maristella Bianconi, Riccardo Giampieri, Martina Valgiusti, Oronzo Brunetti, Mario Scartozzi, Stefano Cascinu
Journal: Journal of Clinical Oncology (2015)

e15126 Background: Previous data suggested that LDH serum levels may be associated with tumour hypoxia and VEGFA and VEGFR-1 over-expression. LDH may represent an indirect marker of neo-angiogenesis and worse prognosis in many tumour types. In our analysis we assess the role of LDH serum levels predicting clinical outcome for biliary tract cancer (BTC) patients treated with first-line chemotherapy, to individuate a potentially reliable and useful marker for patients stratification. Methods: 114 advanced BTC patients treated with first-line chemotherapy were included. LDH values were collected within one month before and after treatment end. Patients were divided into two groups (low vs. high LDH), according to the LDH pre-treatment level cut-off value determined with ROC curve analysis. Patients were, also, classified according to variation in LDH serum levels pre- and post-treatment (increased vs. decreased). Survival distribution was estimated with Kaplan-Meier method. Disease control rate (DCR) was assessed with chi-square test. Results: Patients proved homogeneous for all clinical characteristics analyzed. Median progression free survival (PFS) was 5.0 and 2.6 months respectively in patients with low and high pre-treatment LDH levels (p = 0.0042, HR = 0.56, 95%CI:0.37-0,87). Median overall survival (OS) was 7.7 and 5.6 months (low vs. high LDH) (p = 0.324, HR = 0.81, 95%CI:0.54-1.24). DCR was 70% vs. 43% (low vs. high LDH) (p = 0.0166). In patients with decreased LDH values after treatment (35 pts) PFS was 6.2 and OS was 12.1 months, whereas PFS was 3.0 and OS was 5.1 in patients with increased LDH levels (79 pts) (PFS: p = 0.0009; HR:0.49; 95%IC:0.33-0.74; OS: p < 0.0001; HR:0.42; 95%IC:0.27-0.63). DCR was 81% vs. 44% (decreased vs. increased LDH variation pre- and post-treatment) (p = 0.0014). Conclusions: Our definitive data seem to suggest a prognostic role of LDH in BTC patients. Our findings show an improved PFS and DCR in patients with low pre-treatment LDH serum levels suggesting a possible predictive role in patients treated with a first-line chemotherapy. After further confirmation in larger trial, these results may be relevant for a better patients stratification and selection.
Doula at the bedside of the patient in labor
Authors: M. G. Rosen
Journal: JAMA (1991)

The benefits of continuous emotional support during labor and delivery are described by Kennell et al<sup>1</sup>in this issue ofThe Journal. Earlier work by Klaus and Kennell<sup>2</sup>contributed to our understanding of the importance of parental interaction in stimulating early infant bonding, and of the importance of early maternal contact with the low—birth weight neonate to lower the incidence of later child abuse. In most hospital labor and delivery rooms, the support person who encourages and assists a mother through her labor is the nurse. The nurse's role also includes starting infusions, checking vital signs, administering medications, attaching and adjusting monitoring instruments, and documenting the progress of labor on the patient's chart. In some hospitals nurses also perform pelvic examinations. While the nurse can give the patient considerable psychological support, this attention may be diverted by responsibility for other patients and by the need to respond to
"A CASE OF CHRONIC ACETANILIDISM"
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
Periodontal Therapy
Authors: Anthony W. Gargiulo
Journal: JAMA (1961)

This second edition is essentially the same text which was published 4 years ago. As with the first edition, this one is almost entirely devoted to the clinical aspects of periodontal treatment. Many of the more recent advances made in periodontal treatment procedures have been included, such as vestibular surgery and the intra-alveolar pocket operation. The new edition gives more attention to the various special problems encountered in everyday periodontal practice. Greater emphasis is placed on recognition of periodontal diseases and local environmental factors. A significant change in the second edition is the greater importance given to diagnosis, evaluation, and treatment planning for the whole dental apparatus. In scope, this edition embraces all aspects of periodontal treatment procedures, new methods, and recent trends in the profession. It would have been desirable to have some of the basic biological factors of periodontology incorporated into this text, as thoroughly covered in the