tbuckley/cabot-search huggingface dataset:
PWE-058 Postprandial suppression of reflux by a raft forming alginate (gaviscon advance) compared to a simple antacid: technical assessment of pH-impedance monitoring and clinical feasibility study in gastro-oesophageal reflux disease (GORD) patients
Authors: R Sweis, A Anggiansah, T Wong, M R Fox
Journal: Gut (2012)

<h3>Introduction</h3> Proton Pump Inhibitors (PPI) reduce acid reflux but not the frequency or proximal extent of reflux events that are a cause for persistent symptoms on PPI. Alginate preparations containing bicarbonate are effective for short-term control of reflux symptoms by formation of a viscous raft above the meal and acid neutralisation. However mechanistic studies have found equivocal effects of alginates on reflux suppression. It is unclear whether this was due to lack of effect, study power or technical issues. <h3>Aim</h3> (i) technical assessment of pH-impedance equipment (Sandhill) in patients taking acid and reflux suppressants (ii) in vivo assessment of mechanistic effects of Gaviscon Advance (GA; Reckitt Benckiser) and Milk of Magnesia (MM; Boots) on postprandial reflux. <h3>Methods</h3> (i) To assess effects on signal detection 10 patients took 10 ml GA or MM followed by repeated, single 10 ml swallows of orange juice (pH 4) until chemical and volume clearance was detected (ii) A randomised, controlled, double-blind, cross-over clinical study in 20 GORD patients (9 male: 11female; age 25–63) referred for investigation of reflux symptoms. On subsequent days at the beginning and end of a 24 h monitoring period, patients were randomised to receive either 10 ml GA or MM (both mint flavoured) after a mixed test meal (600 kcal). Postprandial distal and proximal reflux events (acid and non-acid) were documented over 4 h by pH-impedance with the patient in the upright, seated position. <h3>Results</h3> (i) Technical: After intake of 10 ml GA or MM the pH and impedance signal fully recovered after median 6 (2–12) and 4 (2–10) swallows of orange juice. (ii) Clinical: During the 4 h postprandial observation acid exposure time (mean 2.3% (SD 3.3%) vs 3.4% (4.2%), p=0.296) and number of distal reflux events (20.5 (13.6) vs 22.5 (9.4), p=0.500) was similar after ingestion of GA and MM. There was a trend to less proximal reflux events with the alginate compared to the antacid (10.5 (8.9) vs 13.9 (8.3), p=0.070). No difference in the number of symptoms (5.0 (6.0) vs 4.2 (8.3), p=0.701) and reflux related symptoms (2.5 (4.0) vs 2.8 (5.6), p=0.988) was reported. <h3>Conclusion</h3> Standard pH-impedance monitoring is suitable for clinical studies of reflux suppression in GORD patients. Distal reflux was similar but a trend to suppression of proximal reflux by GA compared to MM is present. This feasibility data indicates that trials will require 70 GORD patients to demonstrate effects (power 90%, p&lt;0.05) on proximal reflux suppression after meals by alginates. More prolonged studies are required to assess effects on symptom control. <h3>Competing interests</h3> R Sweis: None declared, A Anggiansah: None declared, T Wong: None declared, M Fox Grant/Research Support from: Reckitt Benckiser.
Statistical power, sample size, and their reporting in randomized controlled trials
Authors: D. Moher
Journal: JAMA (1994)

<h3>Objective.</h3> —To describe the pattern over time in the level of statistical power and the reporting of sample size calculations in published randomized controlled trials (RCTs) with negative results. <h3>Design.</h3> —Our study was a descriptive survey. Power to detect 25% and 50% relative differences was calculated for the subset of trials with negative results in which a simple two-group parallel design was used. Criteria were developed both to classify trial results as positive or negative and to identify the primary outcomes. Power calculations were based on results from the primary outcomes reported in the trials. <h3>Population.</h3> —We reviewed all 383 RCTs published in<i>JAMA, Lancet</i>, and the<i>New England Journal of Medicine</i>in 1975, 1980, 1985, and 1990. <h3>Results.</h3> —Twenty-seven percent of the 383 RCTs (n=102) were classified as having negative results. The number of published RCTs more than doubled from 1975 to 1990, with the proportion of trials with negative results remaining fairly stable. Of the simple two-group parallel design trials having negative results with dichotomous or continuous primary outcomes (n=70), only 16% and 36% had sufficient statistical power (80%) to detect a 25% or 50% relative difference, respectively. These percentages did not consistently increase overtime. Overall, only 32% of the trials with negative results reported sample size calculations, but the percentage doing so has improved over time from 0% in 1975 to 43% in 1990. Only 20 of the 102 reports made any statement related to the clinical significance of the observed differences. <h3>Conclusions.</h3> —Most trials with negative results did not have large enough sample sizes to detect a 25% or a 50% relative difference. This result has not changed over time. Few trials discussed whether the observed differences were clinically important. There are important reasons to change this practice. The reporting of statistical power and sample size also needs to be improved. (<i>JAMA</i>. 1994;272:122-124)
Cardiovascular Actions of Lead and Relationship to Hypertension: A Review
Authors: Stephen J. Kopp, John T. Barron, June P. Tow
Journal: Environmental Health Perspectives (1988)

Chronic and acute lead poisoning cause overt, clinical symptoms of cardiac and vascular damage with potentially lethal consequences. Morphological, biochemical, and functional derangements of the heart have all been described in patients following exposure to excessive lead levels. Disturbances in cardiac electrical and mechanical activity and postmortem evidence of morphological and biochemical derangements of the myocardium have all been reported following excessive exposure to lead in humans. In addition, signs of vascular degeneration, abnormal vascular smooth muscle function, and altered vessel compliance have been described in humans chronically and acutely exposed to toxic lead levels. Similar cardiovascular complications have been detected following excessive lead exposure in experimental animals. Myocarditis, electrocardiographic disturbances, heightened catecholamine arrhythmogenicity, altered myocardial contractile responsiveness to inotropic stimulation, degenerative structural and biochemical changes affecting the musculature of the heart and vasculature, hypertension, hypercholesterolemia, atherosclerosis, and increased vascular reactivity to alpha-adrenergic agonists have been among the reported cardiovascular disturbances linked to lead poisoning. Less certain are the cardiovascular effects of subclinical lead poisoning. Although controversial, chronic low-level lead exposure has been linked to hypertension and other cardiovascular disturbances in both clinical and experimental studies. In general, it can be concluded that lead over a wide range of exposure intensities can induce significant changes in the function of the cardiovascular system. Evidence points to the involvement of multiple sites of action. Cardiac and vascular sites, as well as sites within the central nervous system, have all been implicated in the sequelae of cardiovascular effects. The exact pathogenic mechanisms that underlie the actions of lead in the cardiovascular system, however, have yet to be elucidated definitively.(ABSTRACT TRUNCATED AT 250 WORDS)
Evaluation of paradoxic beneficial effect of obesity in patients undergoing percutaneous coronary intervention: The obesity paradox? Luis Gruberg, Roxana Mehran, George Dangas, Lowell F. Satler, Hongsheng Wu, Natalie Gevorkian, Rakefet Einav-Gruberg, Asuncion Purser, Augusto D. Pichard, Kenneth M. Kent, Ron Waksman. Washington Hospital Center, Washington, DC, Cardiovascular Research Foundation, New York, NY
Journal: Journal of the American College of Cardiology (2001)
Transient cerebral ischemia. Prevalence and prognosis in a biracial rural community
Authors: H. R. Karp
Journal: JAMA (1973)

A study was made of transient cerebral ischemia in a biracial rural community in Evans County, Georgia. Of the 2,455 stroke-free persons in the population sample, 28 were found to have had well-defined attacks of transient cerebral ischemia. The prevalence of transient cerebral ischemia in the white population was higher than that in the black community. Approximately one fifth of the people having transient cerebral ischemia developed a complete stroke or died of ischemic heart disease during the three- to five-year period of observation following the survey examination. Community surveys for transient cerebral ischemia appear to be a useful health measure for the detection of a small but important group of people who have a high risk of developing serious manifestations of cerebral or coronary vascular disease.
Commentaire de travail de Ellrichmann M et al., pp. 526
Journal: Endoscopy (2013)

See also: Prospective evaluation of malignant cell seeding after percutaneous endoscopic gastrostomy in patients with oropharyngeal/esophageal cancersEndoscopy 2013; 45(07): 526-531DOI: 10.1055/s-0033-1344023
<i>Circulation</i> : Clinical Summaries
Journal: Circulation (2015)

Takayasu arteritis (TA) is a chronic inflammatory vasculitis of unknown origin affecting large vessels, predominantly the aorta and its main branches.The first-line therapy is based on steroids, but one-half of TA patients have steroid-resistant or relapsing diseases for which the addition of other immunosuppressive agents to steroid therapy may be required to achieve remission.Preliminary studies have reported the efficacy of biological-targeting treatments such as TNF-α antagonists and anti-IL-6 receptor (tocilizumab) in TA refractory to other immunosuppressive therapies, but long-term outcome and comparison to disease-modifying antirheumatic drugs and between biologics are lacking.In this study we demonstrate that biological-targeted treatments (ie, TNF-α antagonists and tocilizumab) can lead steroids or disease-modifying antirheumatic drugs-refractory TA to remission with 93% of improvement (ie, complete and partial responders) at 12 months.The 3-year relapse-free survival after biological-targeting treatment initiation compared to the period 'before' (ie, disease-modifying antirheumatic drugs period, mainly methotrexate and azathioprine) was of 90.9% (83.5-99.0)versus 58.7% (43.3-79.7),(p=0.009),respectively.The 3-year cumulative incidence of vascular complication was of 5.1% versus 16.6%, (p=0.08), after biological-targeting treatment initiation compared to the period 'before' (ie, disease-modifying antirheumatic drugs period), respectively.The proportion of vascular complications was equivalent under TNF-α antagonists and tocilizumab (7 [13%] versus 1 [7%], p>0.05), respectively.The 3-year relapse free survival under TNF-α antagonists and tocilizumab were 91% and 85.7%, (p=0.81),respectively.Thus, TNF-α antagonists and tocilizumab seem to have similar efficacy in TA.Biological-targeted treatments (ie, TNF-α antagonists or tocilizumab) in TA have relatively good safety profile.See p 1693.
Update to Open Access Status
Authors: Christoph Correll, Hassan Lakkis, Kimberly Vanover, Gedeon Axsome
Journal: JAMA Psychiatry (2020)

Tineke Grent-‘t-Jong, PhD; Ruchika Gajwani, PhD; Joachim Gross, PhD; Andrew I. Gumley, PhD; Rajeev Krishnadas, MD, PhD; Stephen M. Lawrie, MD; Matthias Schwannauer, PhD; Frauke Schultze-Lutter, PhD; Peter J. Uhlhaas, PhD
Treatment, End-Stage Renal Disease Attributed to Diabetes Mellitus—United States, 1980-1989
Journal: JAMA (1992)

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
Transfusion-associated acquired immunodeficiency syndrome in the United States
Authors: T. A. Peterman
Journal: JAMA (1985)

By Aug 15, 1985, one hundred ninety-four cases of possible transfusion-associated acquired immunodeficiency syndrome (AIDS) had been reported to the Centers for Disease Control. Cases received their transfusions in 30 states. Infants account for 10% of the cases, suggesting an increased susceptibility to developing AIDS. Investigations one to six years after the transfusions have identified high-risk donors to 47 cases. Of 47 high-risk donors tested, 40 had a reactive serology for human T-cell lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV) antibody, including five with no risk for AIDS by history. The HTLV-III/LAV was isolated from 23 of 26 seroreactive high-risk donors, most of whom remained asymptomatic. Blood components that transmitted HTLV-III/LAV included red cells, platelets, plasma, and whole blood. The time from transfusion to diagnosis of AIDS ranged from four to 84 months. The risk of developing AIDS after a blood transfusion has been low and will be lowered further by using both self-deferral and antibody screening. (<i>JAMA</i>1985;254:2913-2917)
International, multicenter study on the outcome of locoregional therapy before liver transplant for hepatocellular carcinoma extending the Milan criteria
Authors: Helena Degroote, Federico Piñero, Charlotte Costentin, Andrea Notarpaolo, Ilka F. Boin, Karim Boudjema, Cinzia Baccaro, Luis G. Podestá, Philippe Bachellier, Giuseppe Maria Ettorre, Jaime Poniachik, Fabrice Muscari, Fabrizio Di Benedetto, Sergio Hoyos Duque, Ephrem Salamé, Umberto Cillo, Adrian Gadano, Claire Vanlemmens, Stefano Fagiuoli, Fernando Rubinstein, Patrizia Burra, Marcelo Silva, Hans Van Vlierberghe, Christophe Duvoux
Journal: Journal of Hepatology (2020)
CRITIQUE&amp;amp;CAVIL...
Authors: George X. Trimble
Journal: JAMA (1974)

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
Clinical Mycology
Authors: Patricia Charache
Journal: Annals of Internal Medicine (2003)

Medical Writings: Book Notes6 May 2003Clinical MycologyPatricia Charache, MDPatricia Charache, MDJohn Hopkins University Baltimore Maryland.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-9-200305060-00030 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Anaissie EJ, McGinnis MR, and Pfaller MA, eds. 608 pages. New York: Churchill Livingstone; 2003. $139. IBSN 0443079374. Order phone 800-545-2522.Field of medicine: Medical mycology.Format: Hardcover book.Audience: Practitioners, housestaff, and students interested in patients with potential or active fungal infections.Purpose: To emphasize the expanding importance of fungal infections by considering the pathogens and their disease presentations.Content: The book has four sections: one that covers general principles, one organized by fungal pathogens, one organized by clinical presentations in specific patient groups and individual body sites, and a two-chapter section that describes geographic diseases and mycotic toxins.... Author, Article, and Disclosure InformationAffiliations: John Hopkins University Baltimore Maryland. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 6 May 2003Volume 138, Issue 9Page: 776KeywordsAspergillosisClinical microbiologyFungal diseasesFungal pathogensMicrobiologyMycologyPathogensPopulation statisticsSoftware toolsToxins ePublished: 6 May 2003 Issue Published: 6 May 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Influence of alcohol use, race, and viral coinfections on spontaneous HCV clearance in a US veteran population
Authors: Barbara A Piasecki, James D Lewis, K Rajender Reddy, Scarlett L Bellamy, Steven B Porter, Robert M Weinrieb, Donald D Stieritz, Kyong-Mi Chang
Journal: Hepatology (2004)

Hepatitis C virus (HCV) is spontaneously cleared in 15% to 45% of individuals during primary infection. To define the role of alcohol, race, and HBV or HIV coinfections in natural HCV clearance, we examined these parameters in 203 spontaneously HCV-recovered subjects (HCV Ab(+)/RNA(-) subjects without prior antiviral therapy) and 293 chronically HCV-infected patients (HCV Ab(+)/RNA(+)). Subjects were identified from 1,454 HCV antibody-seropositive US veterans tested for HCV RNA between January 2000 and July 2002 at the Philadelphia Veterans Affairs Medical Center. In univariate analysis, alcohol use disorder (odds ratio [OR] 0.52; 95% CI, 0.31-0.85; P =.006) and black race (OR 0.65; 95% CI, 0.44-0.96; P =.024) were both associated with decreased likelihood of spontaneous HCV clearance. In multivariate analyses adjusting for race, HIV infection, age, and alcohol use disorder, alcohol remained strongly associated with reduced HCV clearance (OR 0.49; 95% CI, 0.30-0.81; P =.005). In contrast, the association between black race and viral clearance was no longer statistically significant (adjusted OR 0.72; 95% CI, 0.48-1.09; P =.125). HIV coinfection was negatively associated with HCV clearance (OR 0.37; 95% CI, 0.16-0.83; P =.016), while HBV coinfection was positively associated with HCV clearance (unadjusted OR 5.0; 95% CI, 1.26-28.6; P =.008). In conclusion, the likelihood of spontaneous clearance of HCV may be influenced by alcohol and viral coinfections.
Selected Articles from This Issue
Journal: Clinical Cancer Research (2021)

Patients with EGFR-mutant NSCLC initially respond to EGFR-targeted therapy, although drug resistance often develops. Bertino and colleagues conducted a Phase Ib trial assessing the combination of navitoclax, an oral BCL-2/BCL-xL inhibitor, with osimertinib, a third-generation EGFR TKI, in patients with EGFR-mutant NSCLC. This combination was well tolerated and showed evidence of clinical efficacy, with 100% of patients in an escalation study showing an objective response. Reduction in plasma EGFR mutations were observed in the majority of patients. This work supports the further clinical investigation of this combination in NSCLC.Radiation therap. is thought to enhance antitumor immune responses and may affect the efficacy of immunotherapy, such as sipleucel-T. Marshall and colleagues performed a randomized phase II trial evaluating sipuleucel-T with or without radium-223 for men with metastatic castration resistant prostate cancer. Unexpectedly, combination treatment led to lower peripheral T-cell immune responses to the target antigen, PA2024, than treatment with sipuleucel-T alone. Regardless, patients receiving the combination showed PSA decline and had improved PFS and OS. Additional study of this combination in a larger cohort is warranted.Tumor mutational burden (TMB) is a predictive biomarker for efficacy of immune checkpoint blockade in NSCLC. Blood TMB (bTMB) assessments offer several advantages over tissue TMB (tTMB). Si and colleagues evaluated the accuracy and reproducibility of the GuardantOMNI ctDNA platform for quantifying bTMB. Patients received first-line darvalumab with or without tremelimumab versus chemotherapy alone in metastatic non-small cell lung cancer as part of the MYSTIC study. The success rate for obtaining valid TMB scores was higher for bTMB than tTMB. Cross-validation analysis confirmed the selection of bTMB ≥20 mut/Mb as the optimal cut-off for clinical benefit with durvalumab plus tremelimumab versus chemotherapy. Such analytical validation studies improve the reliability of TMB estimates to aid in clinical decision making.Fusions in receptor tyrosine kinases (RTKs) occur rarely in colorectal cancer (CRC) but represent potential actionable targets. Singh and colleagues characterized CRC harboring RTK fusions. RTK fusions were enriched in right-sided tumors with wild-type BRAF and RAS. One-third of the CRC cases with RTK fusions were microsatellite stable (MSS). Two patients with MSS CRC and RTK fusions derived clinical benefit from targeted therapy. One patient with an ALK fusion was treated with two sequential ALK targeted agents, crizotinib and alectinib, whereas the second patient with a ROS1 fusion was treated with entrectinib for 10 months, with treatment ongoing. These results confirm that RTK fusions are targetable in CRC, although a clinical trial is warranted to further assess targeted therapies in these patients.
Pneumocranium from gunshot wound of brain
Authors: W. J. Gardner
Journal: JAMA (1970)

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