tbuckley/cabot-search huggingface dataset:
Toward Accountable Cancer Care
Authors: Justin E. Bekelman, Miranda Kim, Ezekiel J. Emanuel
Journal: JAMA Internal Medicine (2013)

Cancer accounts for over 500 000 deaths and nearly $ 125 billion in medical costs annually, second only to heart disease.While interventions arising from the Affordable Care Act aim to improve care quality and reduce cost growth for patients with heart disease, reforms directed toward cancer care have received comparatively little attention.Research and innovation have led to measurable improvements in survival and quality of life for patients with cancer.Treatment now often resembles the management of chronic disease, incorporating both acute in-patient and longitudinal outpatient care.However, the delivery of cancer care is inherently multispecialty and multisetting medical care that easily produces fragmentation, generating high costs and care variability.Achieving accountable cancer care will require tailored payment and delivery system reform.Surgical, medical, and radiation oncology cancer specialists "quarterback" complex, interdisciplinary cancer care and symptom management.Their roles change and evolve with treatment phase, and most specialists do not provide the full scope of primary care services.Primary care providers (PCPs) continue to manage the comorbid illnesses of cancer patients, and over half of PCPs counsel patients on cancer treatment decisions involving major procedures. 1 This unsteady balance of patient care does not fit neatly into current concepts of accountable care organizations or medical homes, which focus on primary and preventive care, or medical neighborhoods.Under the traditional fee-for-service system, cancer specialists are economically incentivized to deliver more care, be it surgeries, chemotherapies, or radiation fractions, rather than evidence-based care. 2 Fee-for-service payments also do not encourage better symptom management or care coordination among cancer specialists and between cancer specialists and PCPs.Uncoordinated cancer care results in overuse of unnecessary-and underuse of necessary-tests and treatments, avoidable hospitalizations, and gaps in the management of comorbid illness.Three principles of reform should drive accountable cancer care.First, accountable cancer care should align provider incentives toward patient-centered, coordinated care among cancer specialists and PCPs.It is imperative that accountable cancer care move beyond fee-
One Hundred Alcoholic Women in Medicine
Authors: LeClair Bissell
Journal: JAMA (1987)

To examine the patterns of diagnosis, referral, and help-seeking behaviors of alcoholic women physicians, 95 women physicians and five women medical students were interviewed. Both groups were self-described alcoholics and members of Alcoholics Anonymous and were abstinent from alcohol for at least one year. Subjects participated in one-hour interviews with a recovered alcoholic professional woman. Addictions to drugs other than alcohol were common, with only 40% reporting addiction to alcohol alone. Seventy-three reported serious suicidal ideation prior to sobriety, 26 after the drinking ended. Thirty-eight had made overt suicide attempts, 15 more than once. The presence of alcoholics in the nuclear family and marital instability were common. Treatment experiences varied from none other than Alcoholics Anonymous (21%) to long-term residential treatment of 15 weeks or more per episode (23%). Most had reached treatment through circumstances other than referral by therapists or intervention by impaired-physician committees. Their current procedures should be evaluated with the particular needs of women in mind.
Clinical utility of marrow cell tissue cultures in acute leukemia of childhood
Authors: Zeev Estrov, Tom Grunberger, Melvin H. Freedman
Journal: American Journal of Hematology (1986)

Abstract To determine the clinical value of tissue culture techniques in the study of acute leukemia, marrows from 50 children (40 acute lymphoblastic [ALL], 10 acute myeloblastic [AML]) were cultured by the use of an AML blast colony assay and the CFU‐GEMM assay. In the AML assay, AML marrow gave rise to high numbers of blast colonies within 24 to 48 hr; in sharp contrast, 37 of 40 ALL marrows did not yield colonies in this assay. In the CFU‐GEMM assay, AML marrow produced excessive numbers of monocyte‐macrophage CFU‐C colonies, an obvious background of individual macrophages and clusters, and occasional blast colonies. ALL marrow yielded very low numbers of granulocytic CFU‐C colonies, no background of macrophage cells, and no blast colonies. These clear‐cut differences in cellular growth kinetics in vitro between ALL and AML marrows should allow confirmation of the type of acute leukemia within 24 to 48 hr. The colony assays may also be valuable in differentiating ALL from AML in difficult diagnoses when conventional approaches are nondiagnostic.
Fecal Occult Blood Tests for Colorectal Cancer
Authors: Paramvir Singh
Journal: Annals of Internal Medicine (1993)

Letters15 March 1993Fecal Occult Blood Tests for Colorectal CancerParamvir Singh, MD and Steven H. Gallo, MDParamvir Singh, MDSearch for more papers by this author and Steven H. Gallo, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-6-199303150-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:St. John and colleagues [1] deserve congratulations for their extensive study on the comparison of specificity and sensitivity of fecal occult blood testing (FOBT) methods in screening for colorectal neoplasia. They did not, however, adequately address the importance of the timing of the collection or the experience of the person doing it. As little as 5 mL of blood in the upper gastrointestinal tract (secondary to dental extraction and so forth) may produce positive FOBT results, and an inexperienced processor can increase screening positivity fourfold [2].Although widely used, Hemoccult II results may be affected by dietary ...References1. St. John DJ, Young GP, McHutchison JG, Deacon MC, Alexeyeff MA. Comparison of the specificity and sensitivity of Hemoccult and HemoQuant in screening for colorectal neoplasia. Ann Intern Med. 1992; 117:376-82. Google Scholar2. Niv Y. Fecal occult blood test—the importance of proper evaluation. J Clin Gastroenterol. 1990; 12:393-5. Google Scholar3. Kapparis A, Frommer D. Immunological detection of occult blood in bowel cancer patients. Br J Cancer. 1985; 52:857-61. Google Scholar4. Simon JB. The pros and cons of fecal occult blood testing for colorectal neoplasms. Cancer Metastasis Rev. 1987; 6:397-411. Google Scholar5. Bang KM, Tillett S, Hoar SK, Blair A, McDougall V. Sensitivity of fecal hemoccult testing and flexible sigmoidoscopy for colorectal cancer screening. J Occup Med. 1986; 28:709-13. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 March 1993Volume 118, Issue 6Page: 472KeywordsBloodCancer screeningColorectal cancerColorectal neoplasiaDrugsGastrointestinal tractHematologic testsPeroxidasesSpecificity Issue Published: 15 March 1993 CopyrightCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Successful treatment of vulval melanoma <i>in situ</i> with topical 5% imiquimod cream
Authors: A.A. Lonsdale-Eccles, J.M. Morgan, S. Nagarajan, D.J. Cruickshank
Journal: British Journal of Dermatology (2006)

Journal Article Successful treatment of vulval melanoma in situ with topical 5% imiquimod cream Get access A.A. Lonsdale‐Eccles, A.A. Lonsdale‐Eccles Departments of Dermatology and Pathology and Search for other works by this author on: Oxford Academic Google Scholar J.M. Morgan, J.M. Morgan Departments of Dermatology and Pathology and Search for other works by this author on: Oxford Academic Google Scholar S. Nagarajan, S. Nagarajan Departments of Dermatology and Pathology and Search for other works by this author on: Oxford Academic Google Scholar D.J. Cruickshank D.J. Cruickshank The Gynaecology Cancer Centre, The James Cook University Hospital, Middlesbrough TS4 3BW, U.K. E‐mail: a.a.lonsdale‐eccles@ncl.ac.uk Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 155, Issue 1, 1 July 2006, Pages 215–217, https://doi.org/10.1111/j.1365-2133.2006.07297.x Published: 01 July 2006
Current treatment of hepatitis B
Authors: G Dusheiko, N Antonakopoulos
Journal: Gut (2007)

After an inflammatory stimulus, lymphocyte migration into draining lymph nodes increases dramatically to facilitate the encounter of naive T cells with Ag-loaded dendritic cells. In this study, we show that CD73 (ecto-5′-nucleotidase) plays an important role in regulating this process. CD73 produces adenosine from AMP and is expressed on high endothelial venules (HEV) and subsets of lymphocytes. <i>Cd73</i><sup>−/−</sup> mice have normal sized lymphoid organs in the steady state, but ∼1.5-fold larger draining lymph nodes and 2.5-fold increased rates of L-selectin-dependent lymphocyte migration from the blood through HEV compared with wild-type mice 24 h after LPS administration. Migration rates of <i>cd73</i><sup>+/+</sup> and <i>cd73</i><sup>−/−</sup> lymphocytes into lymph nodes of wild-type mice are equal, suggesting that it is CD73 on HEV that regulates lymphocyte migration into draining lymph nodes. The A<sub>2B</sub> receptor is a likely target of CD73-generated adenosine, because it is the only adenosine receptor expressed on the HEV-like cell line KOP2.16 and it is up-regulated by TNF-α. Furthermore, increased lymphocyte migration into draining lymph nodes of <i>cd73</i><sup>−/−</sup> mice is largely normalized by pretreatment with the selective A<sub>2B</sub> receptor agonist BAY 60-6583. Adenosine receptor signaling to restrict lymphocyte migration across HEV may be an important mechanism to control the magnitude of an inflammatory response.
Genetic variation in PSCA is associated with susceptibility to diffuse-type gastric cancer
Authors: Hiromi Sakamoto, Kimio Yoshimura, Norihisa Saeki, Hitoshi Katai, Tadakazu Shimoda, Yoshihiro Matsuno, Daizo Saito, Haruhiko Sugimura, Fumihiko Tanioka, Shunji Kato, Norio Matsukura, Noriko Matsuda, Tsuneya Nakamura, Ichinosuke Hyodo, Tomohiro Nishina, Wataru Yasui, Hiroshi Hirose, Matsuhiko Hayashi, Emi Toshiro, Sumiko Ohnami, Akihiro Sekine, Yasunori Sato, Hirohiko Totsuka, Masataka Ando, Ryo Takemura, Yoriko Takahashi, Minoru Ohdaira, Kenichi Aoki, Izumi Honmyo, Suenori Chiku, Kazuhiko Aoyagi, Hiroki Sasaki, Shumpei Ohnami, Kazuyoshi Yanagihara, Kyong-Ah Yoon, Myeong-Cherl Kook, Yeon-Su Lee, Sook Ryun Park, Chan Gyoo Kim, Il Ju Choi, Teruhiko Yoshida, Yusuke Nakamura, Setsuo Hirohashi
Journal: Nature Genetics (2008)
Long-Term Intravesical Adjuvant Chemotherapy Further Reduces Recurrence Rate Compared with Short-Term Intravesical Chemotherapy and Short-Term Therapy with Bacillus Calmette-Guérin (BCG) in Patients with Non–Muscle-Invasive Bladder Carcinoma
Authors: Martin G. Friedrich, Uwe Pichlmeier, Hartwig Schwaibold, Stefan Conrad, Hartwig Huland
Journal: European Urology (2007)
Role of the pericardium in the regulation of myocardial blood flow and its distribution in the normal and acutely failing left ventricle of the dog
Authors: J. R ALLARD, E. W GERTZ, E. D VERRIER, J D. BRISTOW, J. I E HOFFMAN
Journal: Cardiovascular Research (1983)

The effects of the pericardium on the amount and distribution of left ventricular myocardial blood flow were studied. In 10 normal dogs, transfusion of blood from a donor dog resulted in modest increases in coronary flow and ventricular diameter that were greater with an open than a closed pericardium. The ratio of subendocardial to subepicardial flow remained normal with or without the pericardium, at low and high diastolic ventricular pressure, and before and after pharmacological vasodilatation with chromonar. In 18 dogs, cardiac failure was induced by constant infusion of the metabolic inhibitor, phenformin. Modest ventricular dilatation occurred if the pericardium was open. A progressive rise in myocardial blood flow developed in those with the pericardium open (1.06 rising to 3.02 ml·g−1·min−1). A lesser increase (0.62 to 1.75 ml·g−1·min−1) was seen in dogs with the pericardium closed; they selectively increased subendocardial flow, producing an average subendocardial to subepicardial flow ratio of 2.25. Pharmacological vasodilatation then resulted in uniform transmural flow. The pericardium can influence myocardial flow indirectly by influencing myocardial metabolic demand, when the heart is stressed. It may have a beneficial role in preventing the increased oxygen and coronary flow requirements produced by ventricular dilatation.
Acute Glomerulonephritis as a Complication of Varicella
Authors: Ayse M. Yuceoglu
Journal: JAMA (1967)

Three patients, one child and two adults, showed clinical and laboratory evidence of acute glomerulonephritis in association with varicella. All three had mild to moderate proteinuria and microscopic or gross hematuria prior to or with the onset of rash. In one of the patients, renal biopsy established the diagnosis of acute glomerulonephritis. The histopathologic picture seen was identical to that described for poststreptococcal disease. Renal function studies done indicate that renal disease associated with varicella may severely compromise the function of the kidney.
Clinical significance of microvessel density and vascular endothelial growth factor expression in hepatocellular carcinoma and surrounding liver: Possible involvement of vascular endothelial growth factor in the angiogenesis of cirrhotic liver
Authors: Osama N. El-Assal, Akira Yamanoi, Yukiko Soda, Minekazu Yamaguchi, Masahiko Igarashi, Akitaka Yamamoto, Toru Nabika, Naofumi Nagasue
Journal: Hepatology (1998)

As in other tumors, the assessment of microvessel density (MVD) in hepatocellular carcinoma (HCC) may be essential to perform an effective anti-angiogenic therapy for this tumor. The relationship between vascular endothelial growth factor (VEGF) and MVD of HCC as well as the surrounding liver remains to be elucidated. In 71 patients who had undergone curative hepatic resection for HCC, MVD and VEGF expressions were evaluated for HCC and the liver by quantitative reverse-transcription polymerase chain reaction (RT-PCR) and/or immunostaining. The intensity and extent of VEGF immunoreactivity were evaluated using a computer image analyzer-cell analysis system (CAS). Angiographic data were re-evaluated and compared with MVD in 50 tumors. Tumoral MVD was significantly correlated with tumor capsule formation (t test, P = .0016). Small HCCs (< or = 2 cm) had a significantly lower MVD compared with moderate-sized HCCs (2-5 cm) (t test, P = .016), and the MVD of large HCCs was relatively lower than that of moderate tumors. Tumor vascularity on angiography was not correlated with the MVD. Neither VEGF mRNA levels nor protein expression in HCC were correlated with the tumoral MVD or any histopathological features of the tumor. However, cirrhotic livers had significantly higher MVD and VEGF expressions compared with noncirrhotic livers (t test, P = .0015 and P = .047, respectively). Only the MVD of tumor was significantly correlated with intrahepatic recurrence (t test, P = .0048) and disease-free survival (DFS) rates (log rank test, P = .0035). Moreover, the MVD was an independent predictor for DFS by multivariate analysis (chi2 test, P = .03). In conclusion, the MVD in HCC may be involved in the dismal prognosis of this tumor, and VEGF may be associated with the angiogenic process of the cirrhotic liver, but not with the angiogenesis of HCC.
Endoscopic retrieval of a proximally migrated biliary stent within the gallbladder lumen
Authors: F. Gleeson, B. Petersen, M. Levy
Journal: Endoscopy (2008)

Endoscopic techniques for retrieval of migrated biliary endoprostheses include stent cannulation and subsequent balloon retrieval, balloon placement parallel to the stent with traction retrieval, and the use of a wire basket, snare, Soehendra stent retriever, or rat-tooth forceps [1] [2] [3]. The technique chosen depends on the extent of proximal stent migration, the presence of ductal dilatation or biliary stricture, and the endoscopist’s experience. This report describes the retrieval of a proximally migrated biliary stent located within the gallbladder lumen.
Game's Afoot in Many Lands for Forensic Scientists Investigating Most-Extreme Human Rights Abuses
Authors: Andrew A. Skolnick
Journal: JAMA (1992)

DEAD MEN may tell no tales, but their bones speak plenty to those who know the language. When the bones are the remains of victims of state-sponsored murder, those trained in the techniques of forensic archeology, anthropology, and medicine can help them to bear witness against the government's human rights abuses. <i>Desaparecidos</i>, or "disappeared ones," is the Latin American euphemism for persons who were kidnapped, murdered, and secretly disposed of so that there are no public martyrs or evidence of government involvement. <h3>'Dirty War'</h3> While most notably practiced by the Argentine junta during its so-called Dirty War against "terrorists" between 1976 and 1983 (<i>JAMA</i>. 1989;261:1388-1389,1393), the military of Guatemala is widely credited with introducing the practice beginning in the 1960s. In January 1991, a civilian was elected to the Guatemalan presidency; however, human rights groups say that the military still runs much of the country and political killings continue. Recently,
Perspectives from New Schools — The Costs and Financing of Medical Education
Authors: R. M. Magraw, J. J. Hahn, H. L. Autrey, J. L. Preissig
Journal: New England Journal of Medicine (1973)

Abstract New perspectives on costs and financing medical education emerge in the course of development of new medical schools. Separate budgets are necessary for each of the principal missions: instruction, patient care and research. Cost allocation of such joint services as these (despite activity analysis) is inevitably approximate and partly arbitrary. Present concepts of a "full-time faculty" interfere with accountability for and perhaps with performance of these various functions. Individual clinical faculty members must become practitioners with personal contractural responsibilities for care of patients. The patients' influence in the transactions in teaching institutions will be exerted through their newly acquired purchasing power. In basic science distinctions are necessary between the costs of educating medical students and those of educating graduate students. (N Engl J Med 289:558–562, 1973)
Factors Contributing to High Costs and Inequality in China's Health Care System
Authors: Houli Wang, Tengda Xu, Jin Xu
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
Dystrophin is a tumor suppressor in human cancers with myogenic programs
Authors: Yuexiang Wang, Adrian Marino-Enriquez, Richard R Bennett, Meijun Zhu, Yiping Shen, Grant Eilers, Jen-Chieh Lee, Joern Henze, Benjamin S Fletcher, Zhizhan Gu, Edward A Fox, Cristina R Antonescu, Christopher D M Fletcher, Xiangqian Guo, Chandrajit P Raut, George D Demetri, Matt van de Rijn, Tamas Ordog, Louis M Kunkel, Jonathan A Fletcher
Journal: Nature Genetics (2014)
THE IDEAL ANTACID
Authors: John L. Kantor
Journal: JAMA (1927)

<h3>To the Editor:</h3> —In their article inThe Journal, May 14, p. 1557, Drs. Loevenhart and Crandall point out the advantage of calcium carbonate in gastric hyperacidity, and conclude that it is the "ideal antacid." In this connection, would it not be appropriate to point out that other neutral antacids, not mentioned in this article, have already been the subject of not a little clinical and laboratory investigation? All the advantages claimed for calcium carbonate have likewise been claimed for the neutral tribasic phosphates of magnesium and calcium. First "reintroduced" into clinical medicine by Greenwald, these salts have been studied independently by Shattuck and by me. The results were published inThe Journalin 1923 and 1924. Since that time, the phosphates have had their share of the usual commercial exploitation. Perhaps a comparative study of the relative values of all the neutral antacids, including calcium carbonate, might next be
Angiopoietin-2 promotes myeloid cell infiltration in a β2-integrin–dependent manner
Authors: Alexander Scholz, Victoria Lang, Reinhard Henschler, Marcus Czabanka, Peter Vajkoczy, Emmanouil Chavakis, Janina Drynski, Patrick N. Harter, Michel Mittelbronn, Daniel J. Dumont, Karl H. Plate, Yvonne Reiss
Journal: Blood (2011)
Pain: the Gift Nobody Wants
Authors: A. Papagiannis
Journal: BMJ (2011)

The Greek word “stigma” literally means a visible mark on the skin. It is also used to designate the characterisation of a person in a negative way that leads to discrimination. Leprosy carried a stigma from Biblical times well into the 20th century. This stigma had its roots in the external deformities that gave patients a repulsive look. A dysmorphic appearance combined with fear of contagion leading to epidemics made patients outcasts. Literature and cinema (for example, Ben Hur , Papillon ) perpetuated the idea of leprosy as a “curse of God.” Eventually the name itself was replaced by the politically inoffensive “Hansen’s disease.”

The traditional view was that the flesh …