tbuckley/cabot-search huggingface dataset:
Adding radiotherapy to hormone treatment improves survival in older men with prostate cancer
Authors: S. Mayor
Journal: BMJ (2015)

Giving radiotherapy in addition to hormone therapy improves survival in older men with locally advanced prostate cancer when compared with the commonly used approach of using only hormonal treatment in this age group, an analysis of US data has shown.

Researchers compared the effectiveness of androgen deprivation therapy and radiotherapy with that of hormonal treatment alone in 31 541 men who had had prostate cancer diagnosed …
Caloric restriction may retard cancers
Authors: D. Josefson
Journal: BMJ (1997)

Scientists at the United States National Institute of Health's Institute of Environmental Health Sciences have uncovered a mechanism by which restricting calorie intake could retard the development and progression of cancers. The work, which was led by Dr Sandra Dunn and Dr Frank Kari, is reported in Cancer Research (1997;57:4667-72).

Dietary factors contribute to an estimated 33% of deaths from cancer in the West. Furthermore, a wasting syndrome is a prominent feature of many cancers and chronic illnesses, and …
Unusual Case of Tuberous Sclerosis
Authors: A. J. N. Warrack
Journal: BMJ (1950)

Tuberous sclerosis is a condition found in the brain as a feature of the syndrome epiloia.Critchley and Earl (1932) described 29 cases of epiloia, and in a review of the litera- ture pointed out the essential features of the disease.Classical cases are characterized by mental deficiency,
Further Use of Teaching Otoscope
Authors: Jeff Altman
Journal: JAMA (1980)

<h3>To the Editor.—</h3> Teele and Klein (242:2664, 1979) wrote a letter to the editor ofThe Journalabout the new teaching pneumatic otoscope. Their communication prompted our trial of a further use of this instrument, patient education. With the second port directed anteriorly and the patient holding a hand mirror, patients are able to share the view. Some effort is needed in moving and angling the mirror to get an adequate view; patients with wide-open, straight ear canals are able to see their tympanic membranes more readily. Thus, the teaching pneumatic otoscope can also be used to share findings with patients or to demonstrate the ill effects (artophic changes) of cotton swab use.
Radical prostatectomy reduced long-term mortality more than watchful waiting in early prostate cancer
Authors: Julio Hajdenberg
Journal: Annals of Internal Medicine (2014)

ACP Journal Club17 June 2014Radical prostatectomy reduced long-term mortality more than watchful waiting in early prostate cancerJulio Hajdenberg, MD, FACPJulio Hajdenberg, MD, FACPUF Health Cancer Center at Orlando Health, Orlando, Florida, USA (J.H.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-160-12-201406170-02010 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationBill-Axelson A, Holmberg L, Garmo H, et al. Radical prostatectomy or watchful waiting in early prostate cancer. N Engl J Med. 2014;370:932-42. https://pubmed.ncbi.nlm.nih.gov/24597866Clinical Impact RatingsGIM/FP/GP: References1 Wilt TJ, Brawer MK, Jones KM, et al; Prostate Cancer Intervention versus Observation Trial (PIVOT) Study Group. Radical prostatectomy versus observation for localized prostate cancer. N Engl J Med. 2012;367:203-13. [PMID: 22808955] Google Scholar2 Barry MJ, Gallagher PM, Skinner JS, Fowler FJ, Jr. Adverse effects of robotic-assisted laparoscopic versus open retropubic radical prostatectomy among a nationwide random sample of Medicare-age men. J Clin Oncol. 2012;30:513-8. [PMID: 22215756] Google Scholar Author, Article, and Disclosure InformationAffiliations: UF Health Cancer Center at Orlando Health, Orlando, Florida, USA (J.H.)This article was published at Annals.org on 3 June 2014. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byRadical prostatectomy versus deferred treatment for localised prostate cancer 17 June 2014Volume 160, Issue 12Page: JC10KeywordsAndrogensProstate cancerProstatectomyRadical prostatectomyUrine ePublished: 17 June 2014 Issue Published: 17 June 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
RELATION OF CALCIUM CONTENT OF THE SPINAL FLUID TO POSTLUMBAR PUNCTURE HEADACHE
Authors: MARCUS NEUSTAEDTER
Journal: JAMA (1925)

The problem of postlumbar puncture headache is an exceedingly perplexing one and no solution of it has been offered so far. Theories have been advanced, but they were merely of a speculative nature not substantiated by any pathologic or experimental evidence. It is commonly known that the amount withdrawn has no bearing on the production or severity of the headache. Nor do the cytologic, serologic or chemical findings in the spinal fluid bear any relation to it. It is significant, however, that, comparatively speaking, only a small percentage of patients suffer from post-puncture headache. Early in 1923, a paper by Depisch and Richter-Quittner 1 on the etiology of headache attracted our attention. They found that a total lack of calcium in the spinal fluid or the presence of only very small amounts is the cause of headache. They determined the calcium content of spinal fluids of twenty-one patients of various
Cooperation between major histocompatibility complex mismatched mononuclear cells from a human chimera in the production of antigen-specific antibody.
Authors: M G Roncarolo, J L Touraine, J Banchereau
Journal: Journal of Clinical Investigation (1986)

Fetal liver and thymus transplantation can be successfully employed for the treatment of severe combined immunodeficiency disease. In virtually all cases, donor and recipient cells are HLA mismatched. In a patient suffering from a severe combined immunodeficiency disease, full immunological reconstitution was obtained after fetal liver and thymus transplantation. HLA typing revealed that the patient's T cells were of donor origin, while the B cells and monocytes were of host origin. Despite this complete HLA mismatch, the patient was found to mount a subnormal to normal antibody response in vivo. This finding is in contrast with the concept that antigen recognition by T cells is major histocompatibility complex (MHC) restricted. To define the mechanism responsible for this in vivo antibody response, antibody production by peripheral blood mononuclear cells from the patient was tested in vitro after in vivo booster. The in vitro anti-tetanus toxoid antibody production was similar to that of the control group. In addition, specific proliferative responses to tetanus toxoid were obtained. Immunoglobulin allotype determination showed that antibodies were synthetized by host B cells. The results of the present study indicate that transplanted T lymphocytes and recipient cells cooperate despite complete HLA mismatch.
Relationship Between Respiratory Syncytial Virus and Newcastle Disease--Parainfluenza Group
Authors: A. P. Waterson, D. Hobson
Journal: BMJ (1962)

BRITISHl not turn his inventive powers to cineradiography, but that was Macintyre's triumph, first shown in public in 1897.By April, 1896, the first excitement was over and the potentialities of the x ray as an aid to diagnosis were known to all.There had also been some trial of its bactericidal effect, which Ddlepine26 and Schuster had found to be negligible at ordinary dosage.Therapy was tried later in the same year for a skin condition and even for a tumour.To-day, looking at the old photographs and recalling the voices of past friends, one captures some of the double joy of discovering a fresh wonder of Nature which is at the same time an undefiled benefit to mankind.My thanks are due to Dr.
Thyroid Hormone and Breast Cancer
Authors: Alvin B. Hayles
Journal: JAMA (1977)

To the Editor.—  We have had opportunity to study the letters by Drs Venezian and MacCornack and to reconsider the two articles they discuss, which deal with the prevalence of breast cancer in women who have had thyroid hormone treatment of various durations. We write this letter as a result of comments by some of our colleagues that they could not understand the data analyses in these documents. Only in the initial paper by Kapdi and Wolfe were the data both clearly presented and analyzed (albeit somewhat incompletely).  We do not quarrel with the methodology or the arithmetic of this material. What bothers us is that there was no simple, commonsense presentation of the data. We suggest that the data provided by Kapdi and Wolfe could have been presented so that understanding would be both correct and immediate.  The essentials are the relations of prevalence (percentage of women with breast
S17 Impact of COPD severity and sputum production on antibiotic resistance
Authors: S. J. Thurston, G. C. Donaldson, T. D. McHugh, J. A. Wedzicha
Journal: Thorax (2011)

<h3>Introduction</h3> Bacterial infections are a well-known trigger for exacerbations of COPD. A variety of antibiotics are regularly prescribed for this group of patients but the risk and frequency of antibiotic resistance in the COPD population is less understood. Routine culture data can be evaluated to establish resistance prevalence and patterns. <h3>Methods</h3> Culture data were collected from the sputum samples of 293 patients in the London COPD cohort over a period of 5 years (01/01/2006–31/12/2010) mean (±SD) months in study 28.4(±19.9); age 69.9 years (±8.9); predicted FEV<sub>1</sub> 47.8% (±16.5); male gender 58%; exacerbation samples 48.9%; sputum producers 77.5%. Identification of bacterial presence was established and where clinically indicated drug sensitivity tests (DSTs) were performed. A resistant sample was reported as any bacterial isolate resistant to at least one antimicrobial agent. <h3>Results</h3> 92/293 (31.4%) patients had at least one bacteria positive sample over the study period. 87/92 (94.6%) patients had samples where DSTs were performed on bacteria positive samples. Resistance was observed in 69/87 (79.3%) patients. 30/293 (10.2%) patients were resistant to all samples where DSTs were performed. 227/293 (77.5%) of patients were sputum producers. There was no significant relationship between predicted FEV<sub>1</sub> and antibiotic resistance frequency in this cohort (X<sup>2</sup>-test; p=0.577). Patients who were classified as regular sputum producers were more likely to exhibit resistance in culture positive bacteria (p=0.048). <h3>Conclusion</h3> Results from this analysis conclude that an estimated 23.5% of COPD patients will develop resistance to an antimicrobial agent within 28.4 months of follow-up with sputum producers being at a higher risk. This study highlights the importance of investigating sputum samples with determination of resistance patterns. Information on resistance patterns and transmission of resistance in COPD can allow more appropriate and targeted antibiotic therapy for COPD exacerbations with improved outcomes.
What are the priorities for prevention and control of non-communicable diseases and injuries in sub-Saharan Africa and South East Asia?
Authors: D. Chisholm, R. Baltussen, D. B. Evans, G. Ginsberg, J. A. Lauer, S. Lim, M. Ortegon, J. Salomon, A. Stanciole, T. T.-T. Edejer
Journal: BMJ (2012)

Last year's UN high level meeting sought to galvanise the international community into scaling up its response to the escalating global burden of non-communicable diseases. With resources tight, <b>D Chisholm and colleagues</b> examine which interventions should be given priority for action and investment
BISMUTH IODOFORM PETROLATUM PASTE IN THE TREATMENT OF RECENT WOUNDS
Authors: M. L. EMERSON
Journal: JAMA (1918)

Since May 1, 1917, Drs. Walton and Haig and I have used this paste, which consists of iodoform, 2 parts; bismuth subnitrate, 1 part, and liquid petrolatum sufficient to make a suspension, in 2,000 cases of recent injuries in hospital and private practice. Secondary treatments and infected wounds previously treated by any other method are not included.  We have had 725 cases of scalp wounds, and in none has there occurred a cellulitis about the forehead, the vertex or the occipital region. This was unusual, for in our hospitals there were generally one or two cases of scalp infection most of the time, no matter what treatment was used.  It is well known that because of an abundant blood supply, there is a great tendency for scalp wounds to heal without treatment. Yet, never during the past five years have we recorded so many consecutive cases without infection until we
Risk Adjustment or Risk Avoidance?
Authors: Jerome P. Kassirer, Marcia Angell
Journal: New England Journal of Medicine (1998)

Federal officials were taken off guard recently by the announcement that nearly 100 managed-care plans had decided either to withdraw from the Medicare managed-care program or to end their participation in some regions of the country. More than 400,000 Medicare beneficiaries in 29 states are affected. They will have to seek new plans or re-enroll in the traditional fee-for-service Medicare program and pay for supplementary insurance.13 The exodus came in the wake of Congress's mandate that by the year 2000 the Health Care Financing Administration (HCFA) must introduce diagnosis-based risk adjustment into the formula for determining capitation payments to . . .
Gap junction-mediated spread of cell injury and death during myocardial ischemia–reperfusion
Authors: D García-Dorado
Journal: Cardiovascular Research (2004)

Gap junction-mediated intercellular communication (GJMIC) has been known for a long time to be essential in propagation of electrical impulse in the heart, and the contribution of altered GJMIC to the genesis of arrhythmias has been extensively investigated. However, although it is well known that GJMIC allows the exchange of biologically important molecules between adjacent cells, the pathophysiological significance of such chemical coupling during myocardial ischemia and reperfusion is much less known. It has been solidly established that ischemia impairs GJMIC and eventually leads to electrical uncoupling, but recent studies suggest that GJMIC may still allow synchronization of the onset of ischemic rigor contracture and of the progression of ischemic injury beyond rigor onset. During reperfusion, GJMIC has been shown to mediate cell-to-cell propagation of hypercontracture and cell death, and there is evidence that this phenomenon explains the continuity of areas of contraction band necrosis and contributes to final infarct size. Finally, there is increasing evidence that GJ or their protein components are involved in the genesis of the protective effect of ischemic preconditioning, although probably through mechanisms independent from modulator of GJMIC. GJ play an important role in the pathophysiology of cell injury and death during myocardial ischemia-reperfusion and are potential targets for new cardioprotective therapeutic strategies.
Irish rugby injury survey: Dungannon Football Club (1986-87).
Authors: K Addley, J Farren
Journal: British Journal of Sports Medicine (1988)

The injuries sustained during one season by players at an Ulster Senior Rugby Club were documented with reference to time of injury, phase of play, team position, and nature of injury. The overall injury pattern in Irish rugby as found in this study is broadly comparable with that in similar studies in England and Scotland. Eighty-four players were injured in total. Three of these had fractures of which one required hospital admission for open reduction of a fractured wrist. The remaining eighty-one players had various types and grades of soft-tissue damage. The tackle accounted for approximately one-third of all injuries. There were few serious injuries and none involving the spine. Injuries to forwards made up almost sixty per cent of the total.
P196 INVESTIGATION OF HEPATITIS C VIRUS ADAPTATION TO HOST GENETIC POLYMORPHISMS
Authors: J. Drobnik, J. Lemay, J.M. Carlson, Z. Kutalik, D. Heckerman, M.H. Heim, J.-F. Dufour, E. Patin, D. Semela, A. Cerny, B. Nalpas, R. Malinverni, D. Moradpour, S. Pol, B. Müllhaupt, F. Negro, L. Abel, P.-Y. Bochud, T. Kuntzen
Journal: Journal of Hepatology (2014)
One in 10 women in England takes antidepressants, survey shows
Authors: J. Wise
Journal: BMJ (2014)

One in 10 women in England reported taking antidepressants in one week in 2013, double the rate among men, a survey has found.

The annual Health Survey for England 1 found that 11% of women took antidepressants, compared with 5.5% of men. Their use was most common among middle aged women, as 16% of women aged 45 to 64 reported taking them. The figures also showed a significant gap between rich and poor people: 17% of the nation’s poorest women reported taking antidepressants, compared …
Nobel Prizes Emphasize Clinical Applications
Authors: Teri Randall
Journal: JAMA (1990)

THIS YEAR'S Nobel prizes in Physiology or Medicine and in Chemistry go to two clinically oriented physicians and a chemist whose work is said to have contributed to "the high standards of living and health." In an unusual departure from favoring achievements in basic science, the Nobel committee announced that two American transplant surgeons will receive the prize in Physiology or Medicine. It will be shared by Joseph E. Murray, MD, Brigham and Women's Hospital, Boston, Mass, and E. Donnall Thomas, MD, Fred Hutchinson Cancer Research Center, Seattle, Wash. The two, who have known each other since each was a resident at Peter Bent Brigham (now Brigham and Women's) Hospital after World War II, were commended for "paving the way for transplantation" in humans. Murray performed the first successful organ transplant in humans, a kidney procedure that involved identical twins, in 1954. He went on to breach the "immunosuppressive barrier"
Obstetrics and Gynecology Annual
Authors: George D. Wilbanks
Journal: JAMA (1972)

The<i>Obstetrics and Gynecology Annual</i>has been initiated to present scholarly review articles for senior residents and recently certified specialists. In such a volume the material can be more scholarly and more current than in a text and better organized than in a periodical. On the other hand, varied authors, annual deadlines, disconnected subjects, and eventually the dangers of repetition may create problems. The editor has begun reasonably well for 1972, compiling a series of "critical authoritative reviews." The 16 different reviews range widely from the esoteric to the practical. Longo's superb chapter, "Placental Transfer Mechanisms," and "The Role of the Spiral Arteries in the Pathogenesis of Pre-eclampsia" by Brosens, Robertson, and Dixon are probably more specialized than is necessary for board review but have value for those interested in these areas. Practical, "how to do it" chapters such as "Principles of Obstetric Anesthesia," by Gottschalk, and "Laparoscopy in Gynecologic
Communicating Evidence for Participatory Decision Making
Authors: Ronald M. Epstein, Brian S. Alper, Timothy E. Quill
Journal: JAMA (2004)

ContextInformed patients are more likely to actively participate in their care, make wiser decisions, come to a common understanding with their physicians, and adhere more fully to treatment; however, currently there are no evidence-based guidelines for discussing clinical evidence with patients in the process of making medical decisions.ObjectiveTo identify ways to communicate evidence that improve patient understanding, involvement in decisions, and outcomes.Data Sources and Study SelectionSystematic review of MEDLINE for the period 1966-2003 and review of reference lists of retrieved articles to identify original research dealing with communication between clinicians and patients and directly addressing methods of presenting clinical evidence to patients.Data ExtractionTwo investigators and a research assistant screened 367 abstracts and 2 investigators reviewed 51 full-text articles, yielding 8 potentially relevant articles.Data SynthesisMethods for communicating clinical evidence to patients include nonquantitative general terms, numerical translation of clinical evidence, graphical representations, and decision aids. Focus-group data suggest presenting options and/or equipoise before asking patients about preferred decision-making roles or formats for presenting details. Relative risk reductions may be misleading; absolute risk is preferred. Order of information presented and time-frame of outcomes can bias patient understanding. Limited evidence supports use of human stick figure graphics or faces for single probabilities and vertical bar graphs for comparative information. Less-educated and older patients preferred proportions to percentages and did not appreciate confidence intervals. Studies of decision aids rarely addressed patient-physician communication directly. No studies addressed clinical outcomes of discussions of clinical evidence.ConclusionsThere is a paucity of evidence to guide how physicians can most effectively share clinical evidence with patients facing decisions; however, basing our recommendations largely on related studies and expert opinion, we describe means of accomplishing 5 communication tasks to address in framing and communicating clinical evidence: understanding the patient's (and family members') experience and expectations; building partnership; providing evidence, including a balanced discussion of uncertainties; presenting recommendations informed by clinical judgment and patient preferences; and checking for understanding and agreement.
P16 Fluticasone propionate/formoterol fumarate combination therapy has an efficacy and safety profile similar to that of its individual components administered concurrently: a randomised controlled trial
Authors: D. Bumbacea, A. Dymek, H. Mansikka
Journal: Thorax (2010)

<h3>Introduction and objectives</h3> A new asthma therapy combining fluticasone propionate (FP) and formoterol fumarate (FORM) in a single pressurised metered dose inhaler (FP/FORM) has been developed. The efficacy and safety of FP/FORM (500/20 μg) were compared with its components FP and FORM, administered concurrently (FP+FORM), with FP alone and with FP/FORM (100/10 μg). <h3>Methods</h3> Adults with moderate–severe reversible asthma were randomised 1:1:1:1 to 8 weeks of treatment with FP/FORM (500/20 μg or 100/10 μg), FP+FORM (500 μg+24 μg), or FP 500 μg alone (all twice daily) in a double-blind, double-dummy, multicentre, parallel-group study. The primary endpoint was change in mean morning pre-dose FEV<sub>1</sub> from baseline to end of treatment for FP/FORM (500/20 μg) and FP+FORM. Results for FP/FORM (500/20 μg) and FP+FORM are presented. <h3>Results</h3> FP/FORM was as effective as FP+FORM, with an increase in mean morning pre-dose FEV<sub>1</sub> of 0.345 l (n=133) and 0.284 l (n=140), respectively at the end of week 8 (per protocol groups; least squares (LS) mean of the treatment difference: 0.060 l; non-inferiority 95% CI:−0.059 to 0.180; p&lt;0.001). The co-primary objective of this study supported this finding. The mean change in FEV<sub>1</sub> from pre-morning dose on Day 0–2 h post-morning dose at end Week 8 was 0.518 l in the FP/FORM group and 0.500 l in the FP+FORM group (per protocol groups; LS mean of the treatment difference: 0.018 l; non-inferiority 95% CI:−0.098 to 0.135; p&lt;0.001). Six patients receiving FP/FORM and 11 patients receiving FP+FORM discontinued due to lack of efficacy (per protocol groups). In both treatment groups, mean asthma symptom scores and sleep disturbance scores were low (intent to treat groups, Day 0: mean asthma symptom scores &lt;1.2; mean sleep disturbance scores &lt;0.7) and improved from Day 0 to end week 8. Salbutamol rescue medication use was comparable (median percentage of study days used: FP/FORM: 23.95%; FP+FORM: 21.05%; Hodges Lehmann difference: 0.06; 95% CI:−4.29 to 4.44; p=0.835). 19.5% of FP/FORM and 19.9% of FP+FORM patients experienced at least one AE. Most AEs were mild or moderate. <h3>Conclusion</h3> FP/FORM and FP+FORM had similar efficacy and safety profiles.