tbuckley/cabot-search huggingface dataset:
CARCINOMA IN SITU
Authors: Roger S. Siddall
Journal: JAMA (1953)

<h3>To the Editor:</h3> —The recent article by Jacob Hoffman, David M. Farell, and George A. Hahn (Review of 4,152 Biopsies of the Cervix with Relation to Carcinoma in Situ,<i>J. A. M. A.</i><b>151:</b>535 [Feb. 14] 1953) should be of great importance to obstetricians and gynecologists. In spite of the widespread interest in the condition, I have for some time been convinced by experience at Harper Hospital that the actual incidence of carcinoma in situ of the uterine cervix must be extremely low. At this hospital, during the five years 1948-1952, examinations were made of cervical tissue from 4,490 patients. The specimens came not only from biopsies but also from cervical tissue obtained by panhysterectomy and operations on the cervix. Carcinoma was diagnosed in 206, or 4.6% of all 4,490 patients. Among these were several apparent examples of carcinoma in situ, but in all instances further search revealed evidence
Contrasting effects of ultraviolet A1 and ultraviolet B exposure on the induction of tumour necrosis factor‐α in human skin
Authors: None Skov, None Hansen, None Allen, None Villadsen, None Norval, None Barker, None Simon, None Baadsgaard
Journal: British Journal of Dermatology (1998)

Ultraviolet B (UVB) irradiation of the skin causes immunosuppression which is relevant to the induction of skin cancer. The mechanism of this immunomodulation is unclear but various regulatory molecules have been implicated, including cis-urocanic acid (cis-UCA) and the cytokines tumour necrosis factor-α (TNF-α) and interleukin 10 (IL-10). Whether ultraviolet A (UVA) induces similar changes has not been investigated fully. We studied the effect of in vivo UVB and long-wave UVA (UVA1) exposure on the induction of TNF-α, IL-10 and cis-UCA in human skin. Volunteers were irradiated with three minimal erythema doses (MED) of UVB or UVA1. At different times after irradiation, suction blisters were raised from irradiated and from non-irradiated (control) skin. The TNF-α and IL-10 protein concentration, and the percentage of cis-UCA in the blister fluid, were then determined. UVB irradiation of human skin led to a rapid and significant increase in TNF-α concentration in suction-blister fluid, with maximal values 6 h after irradiation (n = 6, P < 0.05). In contrast, UVA1 irradiation led to a decrease in TNF-α concentration in the suction-blister fluid compared with non-irradiated skin, with the lowest values 6 h after irradiation (n = 6, P < 0.05). Both UVB and UVA1 exposure of the skin induced a slight increase in IL-10 concentration. However, the increase in IL-10 was only significant after UVB irradiation (UVB, n = 6, P < 0.05; UVA, n = 7, P < 0.1). As previously shown, both UVB and UVA1 result in the photo-isomerization of trans-UCA and an increased percentage of cis-UCA was found in the suction-blister fluid. Thus the results show differential effects of UVB and UVA1 irradiation on the induction of immunoregulatory molecules, which may help to explain the variation in immune responses after UVB and UVA1 exposure of human skin.
Abstract LB-30: Smac mimetic sensitizes antitumor activity of bacillus Calmette-Guerin stimulated neutrophils against bladder cancer cells
Authors: Goodwin G. Jinesh, Srinivas K. Chunduru, Ashish M. Kamat
Journal: Cancer Research (2010)

Abstract Bacillus Calmette-Guerin (BCG) is the current gold standard therapy for bladder cancer. It is believed to work via recruitment of neutrophils to the tumor microenvironment and releasing cytokines, specifically TRAIL. However, BCG mediated therapy is hampered by relapse and resistance problems indicating the need for alternative or combination therapeutic options. Smac mimetics provide an alternative platform to rescue cells from TRAIL resistance by circumventing the IAP mediated inhibition of caspases. Herein we show that the KU-7 and RT4v6 bladder cancer cell lines are resistant to cell death with BCG stimulated neutrophils alone in vitro but a Smac mimetic kills bladder cancer cells in combination with BCG stimulated neutrophils. The sensitization of bladder cancer cells to Smac mimetic and BCG stimulated neutrophils is associated with the dowregulation of cIAP2 and cIAP1. TNF-α, TRAIL or Smac mimetic compound could not induce significant cell death as single agents in these cell lines, where as Smac mimetic compound in combination with TNF-α or TRAIL induced potent and massive cell death supporting our hypothesis. Our results suggest that Smac mimetics present a viable mechanism based approach to combination therapy with BCG for bladder cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr LB-30.
An IV for the RCT: using instrumental variables to adjust for treatment contamination in randomised controlled trials
Authors: J. B. Sussman, R. A. Hayward
Journal: BMJ (2010)

Although the randomised controlled trial is the “gold standard” for studying the efficacy and safety of medical treatments, it is not necessarily free from bias. When patients do not follow the protocol for their assigned treatment, the resultant “treatment contamination” can produce misleading findings. The methods used historically to deal with this problem, the “as treated” and “per protocol” analysis techniques, are flawed and inaccurate. Intention to treat analysis is the solution most often used to analyse randomised controlled trials, but this approach ignores this issue of treatment contamination. Intention to treat analysis estimates the effect of recommending a treatment to study participants, not the effect of the treatment on those study participants who actually received it. In this article, we describe a simple yet rarely used analytical technique, the “contamination adjusted intention to treat analysis,” which complements the intention to treat approach by producing a better estimate of the benefits and harms of receiving a treatment. This method uses the statistical technique of instrumental variable analysis to address contamination. We discuss the strengths and limitations of the current methods of addressing treatment contamination and the contamination adjusted intention to treat technique, provide examples of effective uses, and discuss how using estimates generated by contamination adjusted intention to treat analysis can improve clinical decision making and patient care.
Anosmia due to nasal administration of corticosteroid.
Authors: H B Whittet, C Shinkwin, A P Freeland
Journal: BMJ (1991)

for them to monitor whether any effective change had occurred.Only 17% of these schemes used information from routine data collection systems, supporting the comment by Ms Mugford and colleagues that the link between routine systems and clinical research and audit is tenuous.This survey was carried out at a time when interest in medical audit had just been awakened, and 37% of schemes were less than one year old; the situation may now be improved.Evidence from countries such as Canada,5 where audit has been practised for far longer, suggests that problems with completing the audit loop are not unique.Though it is not clear how to alter clinical behaviour most effectively, it is essential that at least the basic principles of audit, such as documenting and monitoring progress, are established if the current input of resources is to be used to any effect.
Case 13-1970
Authors: Richard C. Cabot, Benjamin Castleman, Betty U. McNeely, Daniel D. Federman, Robert E. Scully
Journal: New England Journal of Medicine (1970)

Presentation of CaseA twenty-seven-year-old woman, graida 1, para 1, was admitted to the hospital because of progressive virilization.Four months previously, during the seventh month of pregnancy, she became aware of deepening of her voice and coarsening of her features. One week before delivery there was an increase in facial hair. She gave birth to a normal, hill-term female infant. Testosterone enanthate, 360 mg, and estradiol, 16 mg, were administered immediately after delivery to suppress lactation. Subsequently, the signs of virilization progressed, and resumption of the menses did not occur. Two weeks before entry there was a profuse vaginal . . .
Review: Direct thrombin inhibitors are similar to LMWH and vitamin K antagonists for preventing VTE after hip or knee replacement
Authors: Alena Shantsila
Journal: Annals of Internal Medicine (2010)

Source Citation Salazar CA, Malaga G, Malasquez G. Direct thrombin inhibitors versus vitamin K antagonists or low molecular weight heparins for prevention of venous thromboembolism following total hip or knee replacement. Cochrane Database Syst Rev. 2010;(4):CD005981. 20393944
The Patient in the Family: An Ethics of Medicine and Families
Authors: M. Modell
Journal: BMJ (1996)

Hilde Lindemann Nelson, James Lindemann Nelson Routledge, pounds sterling11.99, pp 251 ISBN 0 415 91129 X

We can no longer assume that the primary duty of the doctor is always to act in the best interests of the patient. The conflicts between the needs of individuals, the best interests of the family, and the expectations of society are recurrent themes of The Patient in the Family. They are familiar in general practice—for instance, around the decision of when to send a terminally ill patient to hospital, or a dementing old person into residential care. It is easy to expect too much from “coping” spouses, especially if the patient is happy.

I remember an example that highlights …
AN EVALUATION OF MODERN DIPHTHERIA PROPHYLACTICS
Authors: C. J. McSweeney
Journal: BMJ (1935)

The investigation described below was prompted by reports in American literature of successful immunization of children against diphtheria with potent toxoid prepara- tions administered in less than the three customary 1 c.cm: injections.The experiment was rendered possible by the courtesy and kindness of Dr. R. A. O'Brien,
Inhibition of Adrenal Steroidogenesis by Amino-Glutethimide and the Mechanism of Action
Authors: Alvro M. Camacho
Journal: JAMA (1967)

Four children with adrenal cortical hypofunction were receiving amino-glutethimide in combination with other anticonvulsants. Amino-glutethimide was readministered to one of these patients with development of manifestations and serum electrolyte changes of adrenal insufficiency, with a simultaneous fall in the plasma and urinary 17-hydroxycorticosteroids. Puppies that received amino-glutethimide alone were unresponsive to corticotropin. Histologic alterations of postmortem adrenal specimens in ten of 14 patients receiving amino-glutethimide with other anticonvulsants were reproducible in rats and puppies that received amino-glutethimide alone. Data obtained from studies on humans and animals indicate that defective adrenal steroidogenesis is not due to an adrenocorticotropic hormone (ACTH) deficiency nor to destruction of the adrenal but rather from a blockage in the conversion of cholesterol to Δ5-pregnenolone. This drug may be clinically useful as an adrenal inhibitor.
A pain in the leg and breathlessness
Authors: H. Ranu, E. Holden, B. Madden
Journal: BMJ (2010)

A 45 year old man with no previous medical problems was admitted to hospital with progressive breathlessness and discomfort in his left leg. He had no other symptoms and was not on any regular medications.

On examination he was alert, with a pulse of 80 beats per minute, blood pressure 130/70 and respiratory rate of 20 breaths per minute. Peripheral oxygen saturations were 97% on room air. Heart sounds, jugular venous pressure, and respiratory examination were normal, but his left calf and thigh were markedly swollen and tender. He was initially treated with oxygen via a face mask and intravenous fluids.

Doppler ultrasound of his left leg confirmed extensive thrombus extending into the common iliac vein. A later computed tomography pulmonary angiogram identified a large filling defect within the left main pulmonary artery.

1 What single blood test would be most useful to guide management in this patient?

2 Which other non-invasive test would you request?

3 What systemic treatment should this patient have?

4 What are the long term complications of venous thromboembolism?

### 1 What single blood test would be most useful to guide management in this patient?

#### Short answer

A serum cardiac troponin level (I or T) will help identify whether this patient is at increased risk of clinical deterioration and help guide treatment of his large pulmonary embolism.

#### Long answer

From the information given, the patient has a large pulmonary embolus, but is haemodynamically stable without clinical evidence of right ventricular dysfunction secondary to his pulmonary embolus. Elevated cardiac troponins have a high sensitivity for myocardial injury.1 They are released as a result of right ventricular dilatation caused by a sudden rise in pulmonary artery and right ventricular pressures in patients with large pulmonary embolisms.2 Therefore, a raised cardiac troponin might indicate right ventricular microinfarction, dilatation, or both, and is a risk factor for early mortality after a pulmonary …
Comparative effects of topical anthralin and difluoromethylornithine (αDFMO) on epidermal polyamine concentration in psoriasis
Authors: M. HENRY, J. JUILLARD, G. TELL, P.J. SCHECHTER, J. GROVE, J. KOCH-WESER, E. GROSSHANS
Journal: British Journal of Dermatology (1981)

Journal Article Comparative effects of topical anthralin and difluoromethylornithine (αDFMO) on epidermal polyamine concentration in psoriasis Get access M. HENRY, M. HENRY Clinique Dermatologique, 1 place de l'Hôpital, 67091 Strasbourg Cédex, France Search for other works by this author on: Oxford Academic Google Scholar J. JUILLARD, J. JUILLARD Clinique Dermatologique, 1 place de l'Hôpital, 67091 Strasbourg Cédex, France Search for other works by this author on: Oxford Academic Google Scholar G. TELL, G. TELL Centre de Recherche Merrell International, 16, rue d'Ankara, 67084 Strasbourg Cédex, France Search for other works by this author on: Oxford Academic Google Scholar P.J. SCHECHTER, P.J. SCHECHTER Centre de Recherche Merrell International, 16, rue d'Ankara, 67084 Strasbourg Cédex, France Search for other works by this author on: Oxford Academic Google Scholar J. GROVE, J. GROVE Centre de Recherche Merrell International, 16, rue d'Ankara, 67084 Strasbourg Cédex, France Search for other works by this author on: Oxford Academic Google Scholar J. KOCH‐WESER, J. KOCH‐WESER Centre de Recherche Merrell International, 16, rue d'Ankara, 67084 Strasbourg Cédex, France Search for other works by this author on: Oxford Academic Google Scholar E. GROSSHANS E. GROSSHANS Clinique Dermatologique, 1 place de l'Hôpital, 67091 Strasbourg Cédex, France Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 105, Issue s20, 1 August 1981, Pages 33–34, https://doi.org/10.1111/j.1365-2133.1981.tb00996.x Published: 01 August 1981
Variations in the Responses of Infants to Living Attenuated Poliovirus Vaccines
Authors: Joseph S. Pagano, Stanley A. Plotkin, Hilary Koprowski
Journal: New England Journal of Medicine (1961)

LIVING poliovirus was adapted for use as an immunizing agent a decade ago1; since then there have been an increasing number of studies to determine the action and the most efficacious use of attenuated poliovirus, especially in infants. It was first shown in 1956 that infants can be actively immunized with living attenuated poliovirus vaccine given orally, even while they still have passively acquired maternal poliomyelitis antibodies; these observations were subsequently confirmed.2 3 4 5 However, after it was found that infants less than two or three months old do not seem to be as readily infected with attenuated poliovirus as older . . .
Pediatric Stroke, Health Disparities, and Biological Differences in Disease Pathophysiology
Authors: Lori C. Jordan, Michael R. DeBaun
Journal: JAMA Pediatrics (2013)

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 Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast 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 Pediatrics journal
Defective NF-κB Signaling in Metastatic Head and Neck Cancer Cells Leads to Enhanced Apoptosis by Double-Stranded RNA
Authors: Naoki Umemura, Jianzhong Zhu, Yvonne K. Mburu, Adriana Forero, Paishiun N. Hsieh, Ravikumar Muthuswamy, Pawel Kalinski, Robert L. Ferris, Saumendra N. Sarkar
Journal: Cancer Research (2011)

Abstract Ligands to several Toll-like receptors (TLR), which mediate innate immune responses and chronic inflammation have been used as adjuvants to immunotherapy to enhance their antitumor activity. In particular, double-stranded RNAs that are cognate ligands of TLR3 have been used to trigger proapoptotic activity in cancer cells. However, a mechanistic understanding of TLR3-mediated apoptosis and its potential involvement in controlling tumor metastasis has been lacking. In this study, we used paired cell lines and fresh tumor specimens, derived from autologous primary and metastatic head and neck squamous cell carcinoma, to investigate the role of TLR3 signaling in metastatic progression. Compared with primary tumor cells, metastatic tumor cells were highly sensitive to TLR3-mediated apoptosis after double-stranded RNA treatment. Enhanced apoptosis in metastatic cells was dependent on double-stranded RNA and TLR3 and also the TLR3 effector signaling protein TRIF. Downstream responses requiring NF-κB were critical for apoptosis in metastatic cells, the defects in which could be resuscitated by alternative pathways of NF-κB activation. By elucidating how TLR3 ligands trigger apoptosis in metastatic cells, our findings suggest insights into how to improve their clinical use. Cancer Res; 72(1); 45–55. ©2011 AACR.
US government announces electronic health records project
Authors: Janice Hopkins Tanne
Journal: BMJ (2007)

The US federal government has announced the start of a five year project to encourage small and medium sized medical practices to adopt electronic health records. The secretary of state for health and human services, Mike Leavitt, said that the project was designed to show that electronic health records would reduce medical error and improve quality of care.

The project, which is due to start in spring 2008, will involve up to 1200 doctors' practices and as many as 3.6 million patients.

Participating practices will receive an …
Endometrial Ablation Complicated by Fatal Hyponatremic Encephalopathy
Authors: Allen I. Arieff
Journal: JAMA (1993)

To investigate the occurrence of hyponatremic encephalopathy and the effects of therapy for symptomatic hyponatremia on outcome in women undergoing endometrial ablation.Consultations from university-affiliated and community hospitals from June 1991 to June 1992.Four generally healthy women who underwent elective endometrial ablation for dysfunctional bleeding and developed hyponatremic encephalopathy.Three patients were promptly treated with hypertonic (514 mmol/L) sodium chloride such that the serum sodium level increased from 102 to 123 mmol/L within 24 hours. The fourth patient was not treated until after suffering grand mal seizures followed by respiratory arrest.Of the four patients who developed hyponatremic encephalopathy, the diagnosis was established before respiratory arrest occurred in three. The operative procedure was terminated and all three were aggressively treated with intravenous hypertonic sodium chloride, which raised the serum sodium level to modestly hyponatremic levels (120 to 130 mmol/L). All three completely recovered without sequelae. The fourth patient suffered respiratory arrest before therapy could be initiated. The patient remained comatose, and central diabetes mellitus and insipidus developed. She never regained consciousness and died after several days. Autopsy revealed cerebral edema and tonsillar herniation.The mean (+/- SD) preoperative serum sodium level was 138 +/- 1 mmol/L; at the time of diagnosis of hyponatremia, it was 107 +/- 13 mmol/L. In two patients, hyponatremic encephalopathy was diagnosed intraoperatively because of tremulousness and either hypothermia or hypoxemia. In the other two patients, the diagnosis was made postoperatively because of headache, nausea, emesis, and in one of these patients, respiratory arrest.Women undergoing elective endometrial ablation can develop severe symptomatic hyponatremia, which can be fatal. The presence of symptoms suggesting hypo-osmolality should lead to immediate measurement of plasma sodium level. If hyponatremia with hypo-osmolality is present, early and appropriate therapy for the hyponatremia should be instituted before respiratory insufficiency occurs.
Nutritional Support of Medical Practice
Authors: Frank L. Iber
Journal: JAMA (1984)

This popular book has appeared in a second edition, six years after its initial publication.  majority of the book has been redone; about 25% of the authors are new in this edition.  authors are a rich mixture of nutrition scientists, specialist physicians, and dietitians presenting most of what is known about human nutrition in 36 chapters. These consist of four chapters on the physiological basis of nutrition, ten addressing the major modalities of applied nutrition, and 22 chapters on specific disease entities or frequently encountered nutrition problems.  Outstandingly written and illustrated chapters are presented on Community Nutrition Resources, The Nutrition Support Service in Hospital Practice, and Protein-Calorie Malnutrition and Its Management. Excellent chapters address the treatment of burns, endocrinology and nutrition, and geriatrics. In contrast, the introductory chapters, those addressing curative nutrition— vitamins, diabetes, and neurological disease—are just not up to date with many of the concepts in
Several factors were not considered in study of increase in hay fever and eczema
Authors: V. McClelland, E. Watson, M. Safar
Journal: BMJ (1998)

EDITOR—Butland et al show that the observed doubling in the prevalence of hay fever and eczema in cohorts of British adolescents between 1974 and 1986 cannot be accounted for purely by differences between the cohorts in terms of sex, birth weight, birth order, maternal age, breast feeding, maternal smoking in pregnancy, or father's social class.1 While these results are important, several factors were not considered in the analysis.

Firstly, an increase in public awareness of atopic diseases …