tbuckley/cabot-search huggingface dataset:
ARE WE NEGLECTING THE ART OF PHYSICAL DIAGNOSIS IN OUR MODERN MEDICAL EDUCATION?
Authors: G. Gill Richards
Journal: Annals of Internal Medicine (1942)

Editorial1 August 1942ARE WE NEGLECTING THE ART OF PHYSICAL DIAGNOSIS IN OUR MODERN MEDICAL EDUCATION?G. GILL RICHARDSG. GILL RICHARDSSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-17-2-362 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe American Board of Internal Medicine was organized in June 1936, for the sole purpose of improving the standards of practice in the fields of internal medicine. During these six years examinations have been given by this Board to doctors who have felt themselves ready to be classified and accredited as specialists in the field of internal medicine and who have met the requirements laid down by the Board.Each candidate is required to take a written examination covering the basic sciences, as well as clinical problems, broad enough in scope to give the Board a fairly accurate evaluation of... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *Address (slightly abbreviated) presented at the St. Paul meeting of the American College of Physicians, April 20, 1942. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 August 1942Volume 17, Issue 2Page: 362-367KeywordsMedical education ePublished: 1 December 2008 Issue Published: 1 August 1942 PDF downloadLoading ...
Individual Determinants of Vaccine Therapy
Authors: John Nemunaitis
Journal: Clinical Cancer Research (2006)

PL-14  We have previously demonstrated activity and encouraging survival response with immunotherapy composed of autologous tumor cells genetically modified to secrete GM-CSF in advanced stage NSCLC (3 complete responses in 33 treated patients). In an effort to remove the requirement and variability associated with genetic transduction of individual autologous tumors we studied a bystander platform composed of autologous tumor cells mixed with an allogeneic GM-CSF transfected secreting cell line. Evidence of treatment-induced immune activation was demonstrated; however, objective tumor responses were not seen. We subsequently performed a randomized dose variable phase II trial involving NSCLC patients. One of 3 doses (1.25, 2.5, 5.0 x107 cells/injection 9 months x 16 months) of a non-viral TGFβ2 antisense gene based allogeneic tumor cell vaccine, were administered. Seventy five patients received a total of 550 vaccinations. No significant (≥ grade 3) adverse events associated with administration of the vaccine were observed. A dose-related survival difference was demonstrated in patients who received ≥ 2.5 x 107 cells/injection versus those who received
Abstract 12444: Outcomes After Starting Beta-Blockade Within a Clinically Sensible Period Before Major Elective Noncardiac Surgery
Authors: Duminda N Wijeysundera, Dennis T Ko, Harindra C Wijeysundera, Lingsong Yun, W. Scott Beattie
Journal: Circulation (2014)

INTRODUCTION: Guidelines recommend that perioperative beta-blockade be started days to weeks before surgery. Nonetheless, all randomized trials except for the controversial DECREASE trials started treatment ≤1 day before surgery, while most observational studies did not distinguish between long-term beta-blockade versus beta-blockers started for perioperative reasons. We thus conducted a population-based cohort study of the effectiveness of beta-blockade started within a clinically sensible period (8-60 days) before surgery. METHODS: Following research ethics approval, we conducted a cohort study of patients (≥66 years) who underwent major elective noncardiac surgery from 2003 and 2012 in Ontario, Canada. Propensity-score methods were used to form a matched cohort that reduced important differences between patients who started beta-blockers 8-60 days before surgery versus controls (no beta-blockers within 1 year before surgery). We measured the association of beta-blockade with 30-day (death, MI, stroke) and 1-year (death) outcomes post-surgery. Subgroup analyses were performed based on Revised Cardiac Risk Index class and history of prior CAD. RESULTS: The cohort included 4268 beta-blocked patients and 154,357 controls. Metoprolol (median daily dose 50 mg) was prescribed to 36% of beta-blocked patients, atenolol (median 25 mg) to 26%, and bisoprolol (median 5 mg) to 37%. In the matched cohort (n=8492), beta-blockade was not associated with death (RR 0.96; CI 0.70-1.32), MI (RR 0.92; CI 0.72-1.17), and stroke (RR 1.31; CI 0.68-2.52) at 30-days, or death at 1-year (Figure). Associations with outcomes did not differ significantly across subgroups. CONCLUSIONS: Outcomes were not altered in patients who start perioperative beta-blockade within a clinically sensible period before surgery. A large randomized trial is needed to determine if the continued use of perioperative beta-blockade in clinical practice is justified.
Obesity in the NFL—Reply
Authors: Joyce B. Harp, Lindsay Hecht
Journal: JAMA (2005)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Abstract 1983: Real-time imaging of exosomes dynamic of cross-talking and cell trafficking in 3D Gelfoam® histoculture
Authors: Mako Yamamoto, Shinji Miwa, Yukihiko Hiroshima, Shuya Yano, Fuminari Uehara, Yasunori Matsumoto, Atsushi Suetsugu, Kimi Homma, Robert M. Hoffman
Journal: Cancer Research (2014)

Abstract Exosomes are small membrane vesicles (30-100 nm) released by many types of cells during normal physiological processes and are thought to play an important role in cell-to-cell communication to promote tumor metastasis. Exosomes contain diffusible factors, such as cytokines, growth factors and extracellular matrix molecules and also mediate local and systemic cell communication through the horizontal transfer of information, such as mRNAs, microRNAs and proteins. However, the exosome dynamics and trafficking between cancer cells and tumor stromal cells in a metastatic niche are still unclear. In this study, in order to image the movement of cancer cell-derived exosomes, we developed a confocal time lapse imaging system to use green fluorescent protein (GFP)-tagged CD63, which is a general marker of exosomes, expressed in breast cancer cells cultured on 3-dimentional Gelfoam® histoculture. We demonstrated that 3D Gelfoam® culture enabled imaging of structural cell-to-cell contact between neighboring cells and exosome behavior in real-time. This system makes it possible to monitor real-time exosome dynamics and cross-talking between cancer cells and other cells and to identify the mechanism of exosome release and uptake such as in a metastatic niche. Citation Format: Mako Yamamoto, Shinji Miwa, Yukihiko Hiroshima, Shuya Yano, Fuminari Uehara, Yasunori Matsumoto, Atsushi Suetsugu, Kimi Homma, Robert M. Hoffman. Real-time imaging of exosomes dynamic of cross-talking and cell trafficking in 3D Gelfoam® histoculture. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1983. doi:10.1158/1538-7445.AM2014-1983
Abstract 1636: NMR discovery and molecular-basis of small molecule inhibitors of STAT3
Authors: Andrew T. Namanja, Ralf Buettner, Richard Jove, Yuan Chen
Journal: Cancer Research (2014)

Abstract Hyperactivation of the signal transducer and activator of transcription 3 (STAT3) transcription factor is a critical molecular anomaly that promotes the constitutive transcription of pro-oncogenic genes in many tumor cells. Therefore, the direct inhibition of STAT3 signaling is a promising strategy to treat cancer. However, targeting transcription factors with small molecule drugs has proved to be challenging. To facilitate the generation of inhibitor leads with good ADME (absorption, distribution, metabolism, and excretion) attributes, we employed fragment-based screening by nuclear magnetic resonance spectroscopy (NMR) in conjunction with electrophoretic mobility shift assay (EMSA) to identify small molecule inhibitors of STAT3. The inhibitors confer specificity for STAT3; inhibit the activation and nuclear accumulation of STAT3; inhibit STAT3 transcription of cell cycle regulatory genes and the proliferation of STAT3-dependent cancer cell lines. We have used two-dimensional methyl NMR of STAT3 to reveal atomic resolution insights on the basis for inhibition. Our results establish an innovative approach to targeting STAT3 that may also be applied to other transcription factors associated with cancer and other diseases. Citation Format: Andrew T. Namanja, Ralf Buettner, Richard Jove, Yuan Chen. NMR discovery and molecular-basis of small molecule inhibitors of STAT3. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1636. doi:10.1158/1538-7445.AM2014-1636
Using the Pancreas for Common Bile Duct Cannulation?
Authors: J. Devière
Journal: Endoscopy (2003)

Selective opacification and deep cannulation of the bile ducts is one of the most difficult features of therapeutic biliary endocopy. ”Random” opacification with a catheter in the common duct has a diagnostic yield of approximately 70 % with pancreatography and 30 % with cholangiography, and represents a typical problem for beginners in endoscopic retrograde cholangiopancreatography (ERCP). Selective cannulation of the common bile duct (CBD) depends on finding the orifice and the correct axis at the correct level. It is widely accepted that selective CBD cannulation should be successful in at least 95 % of the cases for senior endoscopists. There are some rules, based on a knowledge of detailed papillary anatomy, that may help standardize the technique of biliary cannulation. The roof of the orifice has to be approached from below and slightly from the right. Thereafter, the catheter has to go from the left to the right to follow the ”frontal” anatomy of the distal CBD, before coming back to the initial position (Figures [1]- [3]). In this approach, expert endoscopists are not only following the anatomy but following changes induced in the ductal anatomy due to catheter pressure. In some cases, such as peridiverticular papillas, or after Billroth I gastrectomy, the prepapillary segment of the CBD may be distorted, and the maneuvers are more difficult. It was for these particular indications that we described the use of a guide wire inserted into the pancreas to facilitate biliary cannulation [1] by straightening of the papillary region.
The Roles of Cellular Nanomechanics in Cancer
Authors: Murali M. Yallapu, Kalpana S. Katti, Dinesh R. Katti, Sanjay R. Mishra, Sheema Khan, Meena Jaggi, Subhash C. Chauhan
Journal: Medicinal Research Reviews (2014)

Abstract The biomechanical properties of cells and tissues may be instrumental in increasing our understanding of cellular behavior and cellular manifestations of diseases such as cancer. Nanomechanical properties can offer clinical translation of therapies beyond what are currently employed. Nanomechanical properties, often measured by nanoindentation methods using atomic force microscopy, may identify morphological variations, cellular binding forces, and surface adhesion behaviors that efficiently differentiate normal cells and cancer cells. The aim of this review is to examine current research involving the general use of atomic force microscopy/nanoindentation in measuring cellular nanomechanics; various factors and instrumental conditions that influence the nanomechanical properties of cells; and implementation of nanoindentation methods to distinguish cancer cells from normal cells or tissues. Applying these fundamental nanomechanical properties to current discoveries in clinical treatment may result in greater efficiency in diagnosis, treatment, and prevention of cancer, which ultimately can change the lives of patients.
Abstract P178: Dairy Consumption and Risk of Becoming Overweight or Obese in Middle-Aged and Older Women.
Authors: Susanne Rautiainen, Lu Wang, I-Min Lee, JoAnn E Manson, Julie E Buring, Howard D Sesso
Journal: Circulation (2014)

Background: Dairy products have been positively associated with weight loss and inversely associated with weight gain. However, limited number of studies has investigated the role of dairy consumption in the prevention of becoming overweight or obese. The aim of this study was to prospectively investigate how consumption of dairy products was associated with the risk of becoming overweight or obese among initially normal-weight women. Methods: We studied 19,180 women aged ≥45y from the Women’s Health Study free of cardiovascular disease (CVD), cancer, and diabetes with an initial body mass index (BMI) of 18.5-&lt;25 kg/m 2 . Dairy intake was assessed through a 131-item food-frequency questionnaire. Total dairy intake was defined as the sum of servings per day of low-fat dairy products (skim/low-fat milk, sherbet, yogurt, and cottage/ricotta cheese) and high-fat dairy products (whole milk, cream, sour cream, ice cream, cream cheese, other cheese, and butter). Women self-reported body weight along with obesity-related risk factors on baseline and annual follow-up questionnaires. In multivariable-adjusted analyses, we included the following covariates: baseline age, randomization treatment, BMI, smoking status, vigorous exercise, postmenopausal status, postmenopausal hormone use, history of hypercholesterolemia, history of hypertension, multivitamin use, alcohol intake, total energy intake, and fruit and vegetable intake. Results: During a mean follow-up of 11.2y (216,979 person-years), 8,582 women became overweight or obese (BMI ≥25 kg/m 2 ). The multivariable-adjusted mean changes in body weight (95% confidence interval (CI)) during the follow-up were 3.9 (3.5-4.3), 3.9 (3.5-4.2), 3.8 (3.5-4.2), 3.7 (3.4-4.1), and 3.4 (3.0-3.7) lbs in quintiles 1-5 of total dairy consumption (P-trend: 0.01), respectively. In multivariable-adjusted analyses (Table 1) , women in the highest versus lowest quintile of had a rate ratio (RR) of 0.91 (0.84-0.98, P-trend: 0.16) of becoming overweight or obese. No associations were observed in highest quintiles of low-fat dairy and high-fat dairy intakes. Conclusion: Greater consumption of dairy products may be inversely ssociated with risk of becoming overweight or obese in women.
Serum C-Telopeptide Collagen Crosslinks and Plasma Soluble VEGFR2 as Pharmacodynamic Biomarkers in a Trial of Sequentially Administered Sunitinib and Cilengitide
Authors: Peter H. O'Donnell, Sanja Karovic, Theodore G. Karrison, Linda Janisch, Matthew R. Levine, Pamela J. Harris, Blase N. Polite, Ezra E.W. Cohen, Gini F. Fleming, Mark J. Ratain, Michael L. Maitland
Journal: Clinical Cancer Research (2015)

Fit-for-purpose pharmacodynamic biomarkers could expedite development of combination antiangiogenic regimens. Plasma sVEGFR2 concentrations ([sVEGFR2]) mark sunitinib effects on the systemic vasculature. We hypothesized that cilengitide would impair microvasculature recovery during sunitinib withdrawal and could be detected through changes in [sVEGFR2].Advanced solid tumor patients received 50 mg sunitinib daily for 14 days. For the next 14 days, patients were randomized to arm A (cilengitide 2,000 mg administered intravenously twice weekly) or arm B (no treatment). The primary endpoint was change in [sVEGFR2] between days 14 and 28. A candidate pharmacodynamic biomarker of cilengitide inhibition of integrin αvβ3, serum c-telopeptide collagen crosslinks (CTx), was also measured.Of 21 patients, 14 (7 per arm) received all treatments without interruption and had all blood samples available for analysis. The mean change and SD of [sVEGFR2] for all sunitinib-treated patients was consistent with previous data. There was no significant difference in the mean change in [sVEGFR2] from days 14 to 28 between the arms [arm A: 2.8 ng/mL; 95% confidence interval (CI), 2.1-3.6 vs. arm B: 2.0 ng/mL; 95% CI, 0.72-3.4; P = 0.22, 2-sample t test]. Additional analyses suggested (i) prior bevacizumab therapy to be associated with unusually low baseline [sVEGFR2] and (ii) sunitinib causes measurable changes in CTx.Cilengitide had no measurable effects on any circulating biomarkers. Sunitinib caused measurable declines in serum CTx. The properties of [sVEGFR2] and CTx observed in this study inform the design of future combination antiangiogenic therapy trials.
Abstract 1692: Peroxynitrite Mediates Diabetes-induced Endothelial Dysfunction by Reducing eNOS Expression: Possible Role of Rho Kinase (ROCK) Activation
Authors: Azza B El-Remessy, Huda E Tawfik, Suraporn Matragoon, Tayyeba K Ali, Ruth B Caldwell, Robert W Caldwell
Journal: Circulation (2006)
Clinical Epidemiology: The Essentials.
Authors: Robert H. Fletcher, Suzanne W. Fletcher, Grant S. Fletcher
Journal: Annals of Internal Medicine (1991)

Now in its Fifth Edition, Clinical Epidemiology: The Essentials is a comprehensive, concise, and clinically oriented introduction to the subject of epidemiology. Written by expert educators, this text introduces students to the principles of evidence-based medicine that will help them develop and apply methods of clinical observation in order to form accurate conclusions. The Fifth Edition includes more complete coverage of systematic reviews and knowledge management, as well as other key topics such as abnormality, diagnosis, frequency and risk, prognosis, treatment, prevention, chance, studying cases and cause.
Erythropoietin and Transfusions Among Critically Ill Patients
Authors: Sean M. Bagshaw, William A. Ghali
Journal: JAMA (2003)

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
Comparing health inequality in men and women
Authors: G. Holt
Journal: BMJ (2000)

Priority setting in health careOf course we should ask the tax payer Editor-Torgerson and Gosden argue that eliciting public views on healthcare priority setting is a waste of money. 1 It is implicit in their argument that the many health economists who dabble in this allegedly inefficient activity should know better.As health economists and practitioners of the dark art of including the public in priority setting, we believe that we ought to respond to this charge.The problem with Torgerson and Gosden's argument is that it does not distinguish between facts and values.It seems reasonable to assume that patients normally know less than clinicians about the facts concerning the effects of different treatments.As Torgerson and Gosden argue, this form of asymmetric information is one reason why many British health economists believe that public funding of health care is more efficient than private funding, which provides clinicians with a profit motive for supplying unnecessary treatments to illinformed patients.Torgerson and Gosden assert that patients generally know less than specialists about the "facts" concerning the effects of alternative priority setting decisions, and they conclude that setting priorities on the basis of ill-informed opinions is inefficient.What Torgerson and Gosden do not recognise, however, is the possibility that patients generally know more than specialists about their own values concerning their health and the health of others.This kind of asymmetrical information can lead well meaning clinicians, managers, and policymakers to provide inefficient healthcare services, poorly in tune with patients' values.That is why health economists have devoted considerable energy to developing methods of valuing the effects of treatments from the patient's point of view.That is also why health economists are now devoting energy to developing methods of consulting patients about their values concerning priority setting.Asymmetrical information about facts can cause inefficiency in a private system, which is why we need a public system.Asymmetrical information about values can cause inefficiency in a public system, which is why we need to include the public in healthcare priority setting.Efficient decision making requires the use of best available information about facts and values.Our experience in conducting preference elicitation studies suggests that asking the taxpayer can be a fruitful source of information about the latter-and that public opinions are more sophisticated, and less predictable, than Torgerson and Gosden like to think.