tbuckley/cabot-search huggingface dataset:
In praise of uncertainty
Authors: Fiona Godlee
Journal: BMJ (2005)

Imagine that you have just been told that your child has cancer. As the news sinks in, you are likely to want to know what the best treatment is and to be assured that your child will get it. You may not want to hear that we don't know what the best treatment is and that the only way to find out for sure is to enter your child into a trial.

If a parent's decision is hard, so too is the job of the trialist. With a child's future in the balance, how comfortable are you that encouraging a parent to enrol is …
Augmentation of myocardial digoxin concentration in hemorrhagic shock.
Authors: B L Lloyd, R R Taylor
Journal: Circulation (1975)

The effect of the shock state on myocardial digoxin uptake and plasma digoxin levels was examined in unanesthetized dogs following hemorrhage. Five minutes after intravenous administration of tritiated digoxin the myocardial digoxin content in animals with shock was greater than in normal animals in both left ventricle (LV) (165 plus or minus 15 (SD) ng/g vs 130 plus or minus 26 ng/g, P smaller than 0.02 and right ventricle (RV) (142 plus or minus 13 ng/g vs 111 plus or minus 22 ng/g. P smaller than 0.02) as was the plasma digoxin concentration (61.6 plus or minus 11.8 ng/ml vs 44.3 plus or minus 4.6 ng/ml, P smaller than 0.02). After one hour, in another group of dogs, the difference in myocardial concentration of digoxin between test and normal groups was even greater (LV: 213 plus or minus 26 ng/g vs 133 plus or minus 13 ng/g, P smaller than 0.001; RV: 171 plus or minus 9 ng/g vs 111 plus or minus 8 ng/g. P smaller than 0.001) despite lower plasma digoxin concentration in the test group (12.9 plus or minus 2.9 ng/ml vs 17.3 plus or minus 2.5 ng/ml, P smaller than 0.05). Diminished peripheral blood flow, peripheral digoxin delivery and uptake were probably responsible for the early difference in plasma digoxin levels. Resultant greater plasma concentrations of digoxin presented to the myocardium in the early phase, coupled with relative preservation of myocardial blood flow, may explain the greater myocardial uptake in animals with shock although myocardial mechanical factors may also be implicated. Augmented uptake of digoxin by the myocardium in canine hemorrhagic shock may be relevant to the altered susceptibility to glycoside action in clinical shock syndromes.
A TABLE OF OCULAR EXTRINSIC PARALYSES.
Authors: HORACE M. STARKEY
Journal: JAMA (1901)

In the "International Clinics," Vol. iii, Fourth Series, 1894, appeared an article by Prof. F. C. Hotz, on "The Diagnosis of Paralyses of the Ocular Muscles by the Double Image Test," which was a distinct advance in simplifying the methods of detecting the affected muscle in these perplexing cases. In studying that article, it occurred to the writer that the subject might be further simplified by exhibiting these paralyses with the position of the false image in graphic or tabular form. Soon afterward he prepared the table, which, with some modification of terms, has been used by him in teaching and in practical work since. As the table has stood the test of time and has commended itself to many practitioners and students, it is now presented for the consideration of this Section, in the hope that it may prove of value to others. Let us consider briefly the more
Pleural abrasion: a new method of pleurodesis.
Authors: U U Nkere, S C Griffin, S W Fountain
Journal: Thorax (1991)

Sixty patients (48 male, 12 female; median age 32 (range 16-72) years) underwent pleural abrasion for persistent or recurrent pneumothorax. Fifty patients had recurrent pneumothorax and 10 persistence of a first pneumothorax despite conservative treatment; two had bilateral pneumothoraces. Pleural abrasion was carried out with a domestic nylon scouring pad and blebs or bullae were ligated or stapled and excised. Intercostal drainage was discontinued after a median time of two days, median serosanguinous loss was 250 ml, and the median postoperative stay in hospital was four days. During the median follow up period of 32 (range 19-52) months pneumothorax has recurred in one patient.
Patients' preference for male or female breast surgeons: questionnaire study
Authors: I. Reid
Journal: BMJ (1998)

Patients' preferences in the provision of health care are an important consideration. Although several studies have investigated patients' preferences for male or female general practitioners,1–3 few studies have considered preference for male or female surgeons, and preference of women for male or female breast surgeons has not been reported. Until recently the small numbers of female consultant surgeons in Britain meant that patients did not have a choice of male or female surgeon. This will change, however, with increasing numbers of female consultants and may have implications for the staffing of specialist breast units.

In September 1997 a female consultant surgeon became available at Victoria Infirmary's specialist breast clinic, …
ABC of Breast Diseases: Psychological aspects
Authors: P Maguire
Journal: BMJ (1994)

### Psychological morbidity Most women who present with breast lumps are emotionally distressed. A substantial proportion of women whose lumps prove to be benign remain distressed and may become clinically anxious or depressed, particularly if they suffer from chronic breast pain. Up to 30% of women with breast cancer develop an anxiety state or depressive illness within a year of diagnosis, which is three to four times the expected rate in matched community samples. After mastectomy 20-30% of patients develop persisting problems with body image and sexual difficulties. Breast conserving surgery reduces problems with body image, but this is offset by increased fears of recurrence. Consequently, the type of surgery does not affect psychiatric morbidity. Immediate breast reconstruction after mastectomy may reduce this morbidity provided that the possible complications have been discussed fully and understood, that the patient wants it for herself and not because of pressure from others, and that it is carried out expertly. Psychiatric morbidity further increases when radiotherapy or chemotherapy is used. ### Problems of recognition #### Reasons for non-disclosure of psychological morbidity Few patients mention psychological morbidity because they do not think that it is acceptable to do so. Doctors can promote disclosure of such problems by asking questions and clarifying the responses about patients' perceptions of the nature of their illness and their reactions to it and about their experience of losing a breast or having radiotherapy or chemotherapy. By being empathic, making educated guesses about how a patient is feeling, and summarising what has been disclosed, doctors promote both disclosure and expression of related feelings. #### Disclosure by patients ##### Inhibited by
Receipt of Appropriate Primary Breast Cancer Therapy and Adjuvant Therapy Are Not Associated With Obesity in Older Women With Access to Health Care
Authors: Diana S.M. Buist, Laura Ichikawa, Marianne N. Prout, Marianne Ulcickas Yood, Terry S. Field, Cynthia Owusu, Ann M. Geiger, Virginia P. Quinn, Feifei Wei, Rebecca A. Silliman
Journal: Journal of Clinical Oncology (2007)

Purpose Many studies have reported body mass index (BMI) increases the risk of breast cancer recurrence and breast cancer–specific mortality. Few studies have reported or examined whether breast cancer treatment differs by BMI. The purpose of this study was to examine the association between BMI at breast cancer diagnosis and receipt of appropriate primary tumor therapy and adjuvant therapy. Methods We identified 897 women age ≥ 65 years diagnosed with stage I or II breast cancer from 1990 to 1999 at five health care organizations. We used medical records to confirm demographics, tumor characteristics, treatment, comorbid conditions, and to calculate BMI at diagnosis (&lt; 25 kg/m 2 , n = 328; 25 to &lt; 30 kg/m 2 , n = 305; 30 to &lt; 35 kg/m 2 , n = 188; ≥ 35 kg/m 2 , n = 76). We defined primary therapy based on National Guidelines as receiving breast-conserving surgery with radiation therapy and axillary node dissection, simple mastectomy with axillary node dissection, or modified radical mastectomy (73% overall); adjuvant therapy was defined as receipt of hormonal therapy, chemotherapy, or both (60% overall). Results The median BMI was 26.7 kg/m 2 (range, 14.6 to 61.2). The proportion of women receiving primary therapy and adjuvant therapy was lowest for women less than 25 kg/m 2 (69% and 56%, respectively) and greatest for obese I (78% and 64%, respectively). There were no differences in receipt of primary or adjuvant treatment across BMI in univariate or multivariable models (after adjusting for age, stage, comorbidity, diagnosis year, and hormone receptor positivity). Conclusion Receipt of appropriate primary therapy and adjuvant therapy is not associated with BMI in older women with access to health care. Additional research in larger samples and more diverse settings is needed.
Reliability of clinical techniques for detecting splenic enlargement.
Authors: S Sullivan, R Williams
Journal: BMJ (1976)

<i>Background:</i> Cancer diagnosis has the potential to overshadow patients’ general medical care needs. This study examined changes in general medical care among elderly patients with colorectal cancer (CRC), from before diagnosis through long-term survival. <i>Methods:</i> This longitudinal cohort study used 1993 to 1999 Surveillance, Epidemiology, and End Results and 1991 to 2001 Medicare claims data for 22,161 patients with stage 0 to 3 CRC and 81,669 controls aged 67 to 89 years. Outcomes were preventive services (influenza vaccination, mammography) and, among diabetics, HgbA1c and lipid testing in the phase before diagnosis, the phase after initial treatment, the surveillance phase, and the survival care phase. Logistic regression provided adjusted relative risks of care receipt for patients with stage 0 to 1 cancer, stage 2 to 3 cancer, and no cancer. <i>Results:</i> In the phase before diagnosis through the surveillance phase, patients with stage 0 to 1 CRC had the highest annual preventive service rates. Patients with stage 2 to 3 CRC made substantial gains in preventive service use, especially mammography, after diagnosis (influenza vaccination, 46.4% before diagnosis to 50.2% after initial treatment; mammography, 31.4% before diagnosis to 40.2% after initial treatment) but not in diabetes care (eg, HgbA1c, 53.4% before diagnosis to 54.9% after initial treatment). <i>Conclusions:</i> CRC diagnosis seems to facilitate receipt of preventive services but not diabetes care for elderly, later-stage patients. Additional strategies such as strengthening partnerships between cancer patients, primary care physicians, and cancer care physicians are needed to improve care for a chronic disease like diabetes.
Antielastin autoimmunity in tobacco smoking–induced emphysema
Authors: Seung-Hyo Lee, Sangeeta Goswami, Ariel Grudo, Li-zhen Song, Venkata Bandi, Sheila Goodnight-White, Linda Green, Joan Hacken-Bitar, Joseph Huh, Faisal Bakaeen, Harvey O Coxson, Sebastian Cogswell, Claudine Storness-Bliss, David B Corry, Farrah Kheradmand
Journal: Nature Medicine (2007)
Priority in Publication.
Authors: E. C. Dudley
Journal: JAMA (1906)

Chicago, Dec. 12, 1906. <h3>To the Editor:</h3> —Will you favor me by publishing the following letter from Dr. Watkins, together with my statement of the case, both of which I submit herewith: <h3>Dr. E. C. Dudley: My Dear Doctor:</h3> —InThe Journalof the American Medical Association for Nov. 17, 1906, I note an article by you on "The Utilization of the Broad Ligaments in Complete Descent of the Uterus," etc. I quote the following from your paper: "I propose a new operation, the essential factor of which is the utilization of the broad ligaments as supports of the pelvic floor without removal of the uterus." In your paper I am given no credit for this operation, although it was described in the<i>Medical and Surgical Report</i>of St. Luke's Hospital for the year 1905, which was published in the early part of 1906, and in which you and I
Basophil response and the induction of a tolerance in venom immunotherapy: a long‐term sting challenge study
Authors: R. Eržen, M. Košnik, M. Šilar, P. Korošec
Journal: Allergy (2012)

Abstract Background There is no in vitro test to predict the induction of long‐term tolerance in patients treated with venom immunotherapy ( VIT ). The aim of this study was to investigate whether immunotherapy‐induced changes in basophil responsiveness reflect a state of protection and the induction of a tolerance. Methods Twenty‐three patients with allergic reaction after H ymenoptera sting (11 wasp and 12 honeybee) were treated with VIT . In all patients, a CD 63 basophil activation test was performed before the beginning of immunotherapy, after 1 year and after completing 4–6.5 years of immunotherapy (approximately 1 year after stopping). The tolerance was then evaluated by a sting challenge test. The basophil activation test was repeated 3–6 months after the challenge. Results Twenty‐two subjects showed a negative sting challenge, and one subject, a positive sting challenge. Allergen‐specific basophil response remained unchanged after 1 year of immunotherapy. However, after immunotherapy, a significant and approximately fourfold decrease was demonstrated in all tolerant subjects mainly in response to submaximal 0.1 μg/ml allergen concentration. This depression was sustained and did not change with the sting challenge test. In a nontolerant patient with a positive sting challenge, basophil response did not change. Conclusions Our results suggest that the depression of allergen‐specific basophil response seems to be associated with the induction of a tolerance after completing a course of VIT .
In Vivo-Restricted and Reversible Malignancy Induced by Human Herpesvirus-8 KSHV: A Cell and Animal Model of Virally Induced Kaposi's Sarcoma
Authors: Agata D'Agostino Mutlu, Lucas E. Cavallin, Loïc Vincent, Chiara Chiozzini, Pilar Eroles, Elda M. Duran, Zahra Asgari, Andrea T. Hooper, Krista M.D. La Perle, Chelsey Hilsher, Shou-Jiang Gao, Dirk P. Dittmer, Shahin Rafii, Enrique A. Mesri
Journal: Cancer Cell (2007)
Radioembolization With 90Y Resin Microspheres for HCC Patients With Extensive Tumor Thrombosis Into the Extrahepatic Vessels
Authors: Hojjat Ahmadzadehfar, Claus Christian Pieper, Samer Ezziddin, Hans Jürgen Biersack, Carsten Meyer
Journal: Clinical Nuclear Medicine (2014)

99mTc-MAA uptake in the portal vein tumor thrombus may be a predictor of a favorable response to radioembolization. We report here 2 patients with hepatocellular carcinoma and massive intrahepatic and extrahepatic tumor thrombus that showed 99mTc-MAA uptake in SPECT/CT, who underwent radioembolization with 90Y resin microspheres. The patients did not experience any adverse effects.
Cardiac arrest after crush injury.
Authors: C Allister
Journal: BMJ (1983)

Allergy to purified bovine, porcine, and human insulinsWe report a case of local and generalised allergy to highly purified insulins that persisted despite change to human insulin. Case reportA 44 year old non-atopic man was diagnosed as being diabetic in 1978 and started insulin treatment in April 1981 with once daily Lentard (highly purified bovine and porcine insulin).Five days later he noticed local itchy weal and flare reactions lasting one to two hours.Insulin was stopped after six weeks.In March 1982 once daily Actrapid and Monotard (highly purified porcine insulins) were introduced.After his second injection local reactions re- appeared and persisted despite oral prednisolone.On 1 April 1982 he experienced generalised itching, sweating, vomiting, dizziness, and collapse three minutes after an injection.Previous injection sites became red, swollen, and indurated.He was hypotensive but not hypoglycaemic.Insulin was stopped.Thirst, polyuria, and ketonuria returned and twice daily Humulin S (recombinant human insulin) was started two days later as previous prick tests with human insulin had shown no reactions.Prick tests three days later showed immediate local reactions to all commercially available insulins IgG insulin binding during illness IgG insulin binding (,ugll)
Red cell flux during the cardiac cycle in the rabbit myocardial microcirculation
Authors: G A. Klassen
Journal: Cardiovascular Research (1997)

Objective: (1) To measure regional phasic myocardial red cell flux during a cardiac cycle using a laser Doppler velocimeter. (2) To test the responses of regional red cell flux to a vasodilator (adenosine), a vasoconstrictor (angiotensin II), and an inotrope (isoproterenol). Methods: Using an anaesthetised open-chest rabbit with the pericardium intact a 140-μm-tip fibre optic probe was placed in the left ventricular myocardium in various locations. With the fibre in place drugs were given to alter myocardial loading conditions while red cell flux was registered. Results: Phasic red cell flux was similar in the epicardium to endocardium giving an average endo/epi ratio of 1.14 in the rabbit heart. At least two peaks of increased red cell flux within a single cardiac cycle were observed. Some unique patterns for red cell flux were observed in specialised myocardial structures. Adenosine increased red cell flux but minimally changed the pattern of phasic flux throughout the cycle. Conclusions: Laser Doppler velocimetry permits the recording of phasic red cell flux during the cardiac cycle in the myocardial microcirculation. Its pattern is determined by both coronary arterial inflow and venous outflow. The pattern of red cell flux may be characteristic for a region—probably determined by difference in tissue pressure (attributable to the pattern of muscle fibre shortening and collagen tethering) and changes in capillary length and density.
New Clues to HDL’s Benefits Revealed
Authors: Tracy Hampton
Journal: JAMA (2007)

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
Testicular cancer has increased in many populations worldwide
Authors: Roger Dobson
Journal: BMJ (2005)

The number of cases of testicular cancer has increased by an average of 60% over 25 years in 21 populations across five continents, according to new research.

But the researchers, from the US National Cancer Institute, found big differences, with some rates 10 times higher than others. Why this increase has occurred and what is responsible remain unclear, say the researchers.

Although the incidence of cancer of the testis has risen markedly in many Western populations over the past half century, it has not been clear whether rates in other populations have also increased. In the research, which was published online on 9 February in …
A Challenge for the Hospice Movement
Authors: John F. Potter
Journal: New England Journal of Medicine (1980)

The term hospice originally designated the way stations or refuges where medieval pilgrims were sheltered, fed, and protected during their arduous journey to the Holy Lands. Today, the hospice is a resource for the patient with terminal cancer.The hospice movement has offered outstanding support to the patient dying of cancer. The care of such patients is not ideally carried out in the hospital, which is geared to curing the acutely ill. Many dying cancer patients have been overtreated in hospitals1 and deprived of the support of their loved ones. These deficiencies in the care of cancer patients were recognized . . .
Annual deaths from climate change could reach half a million by 2030
Authors: A. Cole
Journal: BMJ (2009)

More than 300 000 people are dying each year, and millions more endure ill health as a result of climate change, says the first report to focus exclusively on the human impact of global warming.

The report, from the Global Humanitarian Forum, says that most of the deaths are caused by malnutrition, diarrhoea, and malaria. It estimates that 90% are the result of gradual environmental changes, with 10% attributable to weather disasters. The health of another 235 million people is being seriously affected.

The report predicts that by 2030 the annual death …
Abstract 1134: Fumarate activates NRF2 in tissues with fumarate hydratase mutation
Authors: Aikseng Ooi, Douglas Whitten, Ximing J. Yang, Ming Zhou, Stéphane Richard, Bin Tean Teh, Kyle A. Furge
Journal: Cancer Research (2012)

Abstract Fumarate hydratase (FH) mutation is associated with hereditary type 2 papillary renal cell carcinoma. Recently, we as well as others found that nuclear factor (erythroid-derived 2)-like 2 (NRF2) activation is a dominant feature of FH mutation. We demonstrate that in hereditary type 2 papillary renal cell carcinoma, fumarate covalently modified KEAP1 and leads to its ubiquitination. Consequently, NRF2 become activated. This predicts that similar mode of NRF2 activation may also be present in other tissues with FH mutation; overexpression of NRF2 target genes in various FH mutated tissues support the prediction that NRF2 is activated in these tissues. Variation in NRF2 targets expression may account for phenotypic differences among tumors associated with FH mutation. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 1134. doi:1538-7445.AM2012-1134
Physiological loading of isolated mammalian cardiac muscle.
Authors: W J Paulus, V A Claes, D L Brutsaert
Journal: Circulation Research (1976)

Cat papillary muscles were subjected to a complex loading function resulting from an analysis of the heart as a pump. The papillary muscle was assumed to be a hypothetical bundle of circumferential muscle fibers in the wall of a simplified cylindrical ventricle. The loading included inertial, resistive, and capacitive components of the cardiovascular system. Changes of ventricular dimensions were taken into account by application of a Laplace relationship. When this complex dynamic loading function was imposed on a shortening muscle by means of an electromagnetic feedback system, the developed force continuously changed with time. The time course of this changing force corresponded to the time course of calculated stress in the intact ejecting heart. Directly displayed force-velocity loops also were similar to loops obtained for the intact heart. Loads proportional to velocity of shortening (damping), acceleration of shortening (inertia), and to the square of shortening velocity (Bernoulli) were investigated separately. Cardiac muscle appeared rather insensitive to inertial loads, and the contribution of inertial loads in the early phase of a contraction under physiological pump loading was minimal. Moreover, during all these dynamic loadings, as long as loading was dynamically increasing or decreasing, velocity of shortening was respectively lower or higher at any muscle length and total load, when compared to velocity at the same length and load under static (constant preload and afterload only) loading.