tbuckley/cabot-search huggingface dataset:
Guidelines for follow up after resection of colorectal cancer
Authors: J H Scholefield, R J Steele
Journal: Gut (2002)

Follow up after colorectal resection is a surgical tradition, which has become a routine part of clinical practice consuming considerable amounts of scarce resources and for which there is precious little evidence of benefit to the patient.

Colorectal cancer is a common condition and is the third most common cancer in the UK. The main treatment for this disease is surgical excision. Each consultant colorectal surgeon sees an average of 50 new patients with colorectal cancer each year and probably sees them in an outpatient clinic between one and four times per year. The cost of this type of follow up is uncertain but a recent survey in the United States showed the cost of five years’ follow up varied from $900 to $27 000 per patient.1 As there are over 30 000 new cases of colorectal cancer per annum in England and Wales the use of NHS resources for this group of patients alone is likely to run into tens of millions of pounds per annum.



1.  Although there is no evidence that intensive follow up for the detection of recurrent disease improves survival, it is reasonable to offer liver imaging to asymptomatic patients under the age of 70 in order to detect operable liver metastases once during the first two years after resection. (Recommendation Grade:A) 

2.  Although there is no evidence that colonoscopic follow up improves survival, it does produce a yield of treatable tumours. It is recommended that a “clean” colon is examined by colonoscopy five years after surgery and thereafter at five yearly intervals up to the age of 70 years. (Recommendation Grade:B) 

3.  In the absence of randomised trials, the only realistic argument for routine follow up is patient support and audit. Audit should be focused on outcome measures.



There are approximately 30 000 new cases of …
Lymphocyte Sensitization in Asthma with Special Reference to Nature and Identity of Intrinsic Form
Authors: E. A. Caspary, E. L. Feinmann, E. J. Field
Journal: BMJ (1973)

Studies of lymphocyte sensitization in patients with asthma showed that the intrinsic and extrinsic forms of the disease fell into two distinct groups. Intrinsic disease showed a general sensitization to a number of non-specific antigens, while the extrinsic form had only slight elevation above normal values. These findings suggest that intrinsic asthma results from a defect of general immunity, whereas extrinsic asthma is a specific sensitization.
Eruptive lingual papillitis with household transmission: a prospective clinical study
Authors: O. Roux, J.P. Lacour
Journal: British Journal of Dermatology (2004)

Eruptive lingual papillitis with household transmission (ELP) is an acute stomatitis of unknown cause occurring in children, with possible spread to one or several members of the family.To verify clinical features and search for clinical characteristics of ELP.A prospective case series, including an analysis of epidemiological and clinical factors, was conducted within private paediatric practices in collaboration with a dermatology department at the University Hospital of Nice, France.Thirty-eight children (21 girls and 17 boys) with clinical criteria of ELP referred from 1 February 2000 to 31 January 2002 were included in the study. Mean age at diagnosis was 3 years and 6 months. Thirty-three children attended day nursery or school. The seasonal distribution of observed cases showed a peak of incidence in spring. The eruption started abruptly. Fever was found in 15 (39%) cases. Difficulties in feeding were observed in all cases; intense salivation in 23 (61%) cases. The glossitis was characterized by inflammatory hypertrophy of the fungiform papillae on the tip and dorsolateral part of the tongue. Enlarged submaxillary or cervical lymph nodes were noted in 16 (42%) cases. Angular cheilitis was observed in four (11%) children. Spontaneous regression of the stomatitis occurred between the second and 15 days of clinical evolution. Mean duration was 7.3 days. Transmission to one or several members of the family was noted in 20 (53%) cases. Recurrence of symptoms was observed in five (13%) children.This study confirms some clinical characteristics of ELP: localized lesions of the fungiform papillae on the tip and dorsolateral part of the tongue, high frequency of intrafamilial transmission, and possibility of recurrence. This study also showed unsuspected clinical data such as possible occurrence of fever and angular cheilitis. ELP resembles an entity termed 'transient lingual papillitis' or commonly 'lie bumps'. The origin of this eruption remains unknown, but the transmission data could suggest a possible infectious origin.
Adoptive transfer of lymphocytes sensitized to the major surface glycoprotein of Pneumocystis carinii confers protection in the rat.
Authors: S A Theus, R P Andrews, P Steele, P D Walzer
Journal: Journal of Clinical Investigation (1995)

Pneumocystis carinii is a major opportunistic pathogen and a leading cause of morbidity in patients with AIDS. CD4+ cells have been shown to be important in host defenses against P. carinii, but the antigen(s) involved with this response have not been identified. We undertook the present study to determine whether the major surface glycoprotein (MSG) of P. carinii contains epitopes that can elicit a protective cellular immune response. Spleen cells and purified CD4+ cells isolated from Lewis rats, pulsed 1-4 d with MSG, and injected into corticosteroid-treated Lewis rats with pneumocystosis resulted in significant reduction in the P. carinii burden, as judged by organism quantitation and lung histology. The protective response demonstrated by the donor cells was dependent on previous exposure to P. carinii, cell concentration, and time of incubation with MSG. In addition, reconstitution with MSG-specific CD4+ cells resulted in an early hyperinflammatory response within the lungs of these animals with a high percentage of mortality. Thus, in this model, MSG can elicit an immune response mediated by CD4+ cells, which has a harmful as well as helpful effect on the host, and these responses occur despite the presence of corticosteroids.
Tympanic Perforation Following Upper Gastrointestinal Endoscopy
Authors: L. W. Mason
Journal: Endoscopy (2005)

A 50-year-old man presented to the ear, nose, and throat casualty clinic with bleeding from the left external auditory meatus. He had undergone upper gastrointestinal endoscopy that morning without the use of a local anaesthetic throat spray or sedation. During the procedure, it was noted that the patient was gagging excessively, following which he experienced a searing pain in the left ear. On questioning, the patient stated that he had been suffering from a coryzal-type illness for the previous week and still had a blocked nose. Before this episode, he had not experienced any problems with his ears. On examination of the left ear, a small perforation was found on the anterior portion of the pars tensa. A diagnosis of tympanic perforation following upper gastrointestinal endoscopy was made, and the patient was treated with antibiotic ear drops for 1 week to prevent any secondary infection. No follow-up appointment was arranged [1].
Experiences with the severity scoring of atopic dermatitis in a population of German pre-school children
Authors: T. SCHÄFER, D. DOCKERY, U. KRÄMER, H. BEHRENDT, J. RING
Journal: British Journal of Dermatology (1997)

Severity scoring of atopic dermatitis (SCORAD) was introduced as a standard tool but has not been used in a population‐based epidemiological study; the objective of the present study was to determine the practicability of this instrument in this setting. We assessed the distribution of the severity of atopic eczema in the community and investigated differences between east and west Germany. A factor analysis was then carried out to characterize the variables of this scoring system and to analyse possible relationships within them. A multicentre cross‐sectional study was carried out in five east German and two west German locations in 1994; pre‐school children (5–6 years old) were investigated and cases of atopic eczema identified by a dermatological examination. The SCORAD was used to determine the severity of atopic eczema and the results assessed using analysis of variance and principal component analysis (varimax rotation). In all, 1511 (76·2%) of the children originally contacted participated and 11·3% were diagnosed with atopic eczema at the time of examination. The median severity score was 21·4 (interquartile range 13·5) and there was a tendency to higher scores in west Germany for the mean overall score, the intensity score and the extent. 'Erythema' (1·30 vs. 1·06; P= 0·006) and 'excoriation' (0·77 vs. 0·36; P= 0·002) were significantly more prominent in children with eczema from west Germany (adjusted for observer). Interobserver variabilities of the SCORAD parameters were calculated, adjusted for location and were in accordance with earlier findings. Principal component analysis identified three independent factors accounting for 54·1% of the total variance. A severity factor, characterized by 'extent', 'lichenification', 'excoriation' and 'pruritus', was separated from a factor with an acute eczema‐type profile ('erythema', 'oedema', 'oozing') and a factor whose major characteristics were 'extent', 'dryness', and 'sleep loss'. We conclude that atopic eczema is frequent in pre‐school children. The SCORAD proved to be readily applicable and useful in epidemiological studies, but further validation is needed.
Abstract OT3-2-03: An efficacy and safety trial of preoperative chemo-endocrine therapy in luminal B (HER2-negative) breast cancer: A prospective multi-institutional study
Authors: R Matsunuma, H Ogura, Y Ide, Y Hosokawa, Y Taki, M Yoshida, Y Tokunaga, K Koizumi, T Sato, Y Hozumi, H Mori, Y Miyamoto, T Watanabe, N Shiiya
Journal: Cancer Research (2013)

Abstract Background: The St.Gallen consensus guideline recommends the sequential administration chemotherapy followed by of endocrine therapy as postoperative therapy for the higher risk ER-positive breast cancer patients based on results of a single study (Albain et al, Lancet 2009). In metastatic settings however, several trials conducted in the 1980's demonstrated that tumor response rates were higher when chemotherapy and tamoxifen were concomitantly administered, than when chemotherapy and tamoxifen administered were given sequentially. In the preoperative settings, pathological complete response (pCR) rate can be used a surrogate marker to predict event-free survival or overall survival in Luminal B(HER2-negative) breast cancer. We therefore designed a prospective randomized safety and efficacy trial in order to test a hypothesis that the concomitant administration of an aromatase inhibitor and chemotherapy improves pathological complete response(pCR) rate than chemotherapy alone in the preoperative setting. Trial design: The trial is a prospective, multi-center, randomized comparison of chemotherapy alone versus concomitant chmo-endocrine therapy evaluating the efficacy in terms of pCR rate and safety in preoperative settings in patients with Luminal B (HER2-negative) breast cancer. 94 patients were to be accrued into this trial. - arm A (control): 12 cycles of weekly paclitaxel(80mg/m2) followed by 4 cycles of every 3-week AC(Doxorubicine 60mg/m2, Cyclophosphamide 600mg/m2). - arm B (experimental): The same chermotherapy as arm A and anastrozole in postmenopausal patients or anastrozole+leuprolerine in premenopansal patients. Eligibility criteria: 1)Female patients with operable and histologically confirmed invasive breast cancer; 2)HER2-negative; 3)Either ER -positive or PgR-positive; 4)Either Ki67-LI&amp;gt; = 14% and NG&amp;gt; = 2 or NG = 3 regardless of Ki67-LI. Endpoints : Primary endpoint is the pCR rate. Secondary endpoints are the clinical response rate(RECIST), the adverse events(CTC-AE ver.4.0), the breast conserving rate and the health related quality of life. Statistical Considerations : The pCR rates in the control arm and the experimental arm are expected to be 10% and 25%, respectively. In order to show the superiority of the experimental arm with an alfa error at 5% and beta error at 20%, calculated number of patients needed were 96. Present Accrual and Target Accrual: As of June 06, 2013, 18 patients were enrolled from 8 institutions. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr OT3-2-03.
Discovery of betulinic acid as a selective inhibitor of human melanoma that functions by induction of apoptosis
Authors: Emily Pisha, Heebyung Chai, Ik-Soo Lee, Tangai E. Chagwedera, Norman R. Farnsworth, Geoffrey A. Cordell, Christopher W.W. Beecher, Harry H.S. Fong, A. Douglas Kinghorn, Daniel M. Brown, Mansukh C. Wani, Monroe E. Wall, Tina J. Hieken, Tapas K. Das Gupta, John M. Pezzuto
Journal: Nature Medicine (1995)
Comprehensive analysis of the α-fetoprotein-specific CD8+ T cell responses in patients with hepatocellular carcinoma
Authors: Robert Thimme, Michaela Neagu, Tobias Boettler, Christoph Neumann-Haefelin, Nadine Kersting, Michael Geissler, Frank Makowiec, Robert Obermaier, Ulrich T. Hopt, Hubert E. Blum, Hans Christian Spangenberg
Journal: Hepatology (2008)

Abstract Hepatocellular carcinoma (HCC) is the fifth most common malignancy worldwide, with a poor prognosis and limited therapeutic options. Therefore, the development of novel therapeutic strategies is of high priority. α-Fetoprotein (AFP) is overexpressed in the majority of HCCs. Priming of immune responses against AFP results in significant protective antitumoral T cell responses in the mouse model. Little information is available about the hierarchy, breadth, frequency, and peripheral versus intrahepatic distribution of AFP-specific CD8+ T cell responses in patients with HCC. To address these important issues we comprehensively analyzed CD8+ T cell responses against full-length AFP in peripheral blood, tumor liver tissue, and nontumor liver tissue from patients with HCC using overlapping AFP peptides. The AFP-specific CD8+ T cell response was also tested in peripheral blood and liver from patients chronically infected with hepatitis C virus (HCV) and compared to the HCV-specific CD8+ T cell response. The majority of patients with HCC showed AFP-specific responses, with many responses directed against previously unreported epitopes. These responses were primarily detectable in the HCC tissue and mainly targeted the C-terminus of AFP. Interestingly, AFP-specific T cells were not only found in patients with HCC but also in patients with chronic HCV infection, other liver diseases, and less frequently in healthy subjects. Conclusion: In patients with HCC, a high frequency of AFP-specific CD8+ T cells directed against different epitopes suggest that AFP has a strong and broad immunogenicity. Further, CD8+ T cells specific for the self-antigen AFP are present in the normal T cell repertoire and are not centrally or peripherally deleted. Our results provide support for strategies to boost AFP-specific CD8+ T cell responses in patients with HCC but also demonstrate a diversity of immune responses that may be needed for protection. (Hepatology 2008;48:1821-1833.)
RED GINSENG EXTRACTS IMPROVED CORONARY FLOW RESERVE AND INCREASED ABSOLUTE NUMBERS OF VARIOUS CIRCULATING ANGIOGENIC CELLS IN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION
Authors: Doosup Shin, Soon Jun Hong, Jae Hyoung Choi, Ju Hyeon Kim, Je Sang Kim, Jae Hyoung Park, Chul-Min Ahn, Do-Sun Lim
Journal: Journal of the American College of Cardiology (2010)
General Health Checks in Adults for Reducing Morbidity and Mortality From Disease
Authors: Allan V. Prochazka, Tanner Caverly
Journal: JAMA Internal Medicine (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 Internal Medicine 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 Internal Medicine journal
Some public attitudes about health and the environment.
Authors: R H Baxter
Journal: Environmental Health Perspectives (1990)

Public opinion is formed both by long-term developments and--at the other extreme--by single unanticipated events. This suggests that readers of opinion survey findings should note field interviewing dates and further determine what the news media have been reporting about relevant developments and events. Personal health and the cost of health care are high on the public's agenda; this is an important backdrop to a review of public attitudes and priorities related to health and the environment. What about the environment? Americans increasingly believe that we are not spending enough on environmental protection and improvement. The public thinks of environmentalists in a favorable light, and a very sizeable minority believe they have too little influence--the same number who feel it's "about right." Our surveys have shown that the more people perceive an environmental threat to their safety, well-being and health, the more they will want regulation or industry action to meet the threat. High on the public's anxiety list are hazardous wastes (especially their disposal) and the transport and use of toxic materials in manufacturing and processing, industrial accidents involving the release of pollutants, the leakage of chemical waste into the soil, and the pollution of water and air from industrial sources. Our data support the assumption that for the foreseeable future these and certain other ecological dangers will be seen as serious by large majorities of Americans. For example, even the safety of drinking water has slowly become more questionable in the public's mind.(ABSTRACT TRUNCATED AT 250 WORDS)
A Method to Estimate the Chronic Health Impact of Air Pollutants in U.S. Residences
Authors: Jennifer M. Logue, Phillip N. Price, Max H. Sherman, Brett C. Singer
Journal: Environmental Health Perspectives (2011)

Background: Indoor air pollutants (IAPs) cause multiple health impacts. Prioritizing mitigation options that differentially affect individual pollutants and comparing IAPs with other environmental health hazards require a common metric of harm.Objectives: Our objective was to demonstrate a methodology to quantify and compare health impacts from IAPs. The methodology is needed to assess population health impacts of large-scale initiatives—including energy efficiency upgrades and ventilation standards—that affect indoor air quality (IAQ).Methods: Available disease incidence and disease impact models for specific pollutant–disease combinations were synthesized with data on measured concentrations to estimate the chronic heath impact, in disability-adjusted life-years (DALYs) lost, due to inhalation of a subset of IAPs in U.S. residences. Model results were compared with independent estimates of DALYs lost due to disease.Results: Particulate matter ≤ 2.5 μm in aerodynamic diameter (PM2.5), acrolein, and formaldehyde accounted for the vast majority of DALY losses caused by IAPs considered in this analysis, with impacts on par or greater than estimates for secondhand tobacco smoke and radon. Confidence intervals of DALYs lost derived from epidemiology-based response functions are tighter than those derived from toxicology-based, interspecies extrapolations. Statistics on disease incidence in the United States indicate that the upper-bound confidence interval for aggregate IAP harm is implausibly high.Conclusions: The approach demonstrated in this study may be used to assess regional and national initiatives that affect IAQ at the population level. Cumulative health impacts from inhalation in U.S. residences of the IAPs assessed in this study are estimated at 400–1,100 DALYs lost annually per 100,000 persons.
Hypertension and Hyperparathyroidism
Authors: F. D. Rosenthal, S. Roy
Journal: BMJ (1972)

Of 40 patients with primary hyperparathyroidism 13 were hypertensive. Nine presented with hypertension and, of these, seven were discovered to have hyperparathyroidism by the routine determination of serum calcium in 900 patients referred for investigation of hypertension. The association of hypertension and hyperparathyroidism is well recognized but the cause is in doubt. The incidence of primary hyperparathyroidism in patients with hypertension is about 1 in 130, which is considerably higher than in the general population (1 in 1,000-2,000). All patients with hypertension should have a routine serum calcium estimation. Parathyroidectomy in these otherwise asymptomatic cases may prevent renal damage.
THE SITE OF THE SWEAT GLAND DEFECT IN FIBROCYSTIC DISEASE.*
Authors: SAM SHUSTER, T. McKENDRICK, MARIE STAMMERS
Journal: British Journal of Dermatology (1965)

Journal Article THE SITE OF THE SWEAT GLAND DEFECT IN FIBROCYSTIC DISEASE. Get access SAM SHUSTER, SAM SHUSTER The Institute of Dermatology, Homerton Grove, London, E.9. and the Hospital for Sick Children, Great Ormond Street, London, W.C Search for other works by this author on: Oxford Academic Google Scholar T. McKENDRICK, T. McKENDRICK The Institute of Dermatology, Homerton Grove, London, E.9. and the Hospital for Sick Children, Great Ormond Street, London, W.C Search for other works by this author on: Oxford Academic Google Scholar MARIE STAMMERS MARIE STAMMERS The Institute of Dermatology, Homerton Grove, London, E.9. and the Hospital for Sick Children, Great Ormond Street, London, W.C Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 77, Issue 2, 1 February 1965, Pages 105–109, https://doi.org/10.1111/j.1365-2133.1965.tb14608.x Published: 01 February 1965
Evaluating educational interventions
Authors: M Wilkes, J Bligh
Journal: BMJ (1999)

Recent extensive changes have taken place in medical education at all levels in both the United Kingdom and the United States. These changes need to be assessed to measure how well reforms have achieved their intended outcomes. Educational innovation can be complex and extensive, and its measurement and description is made more difficult by the confounding and complicating effects of each later stage in the continuous curriculum. The radical curriculum reform at undergraduate level in the United Kingdom, managed care in the United States, and the increasing use of community sites for learning in both countries may greatly affect how medicine is practised and managed in the next century.1 We should know more about the educational processes and outcomes that result from the new courses and programmes being developed in medical schools and postgraduate training.
Book Review Carotid Artery Stenosis: Current and Emerging Treatments (Neurological Disease and Therapy. Vol. 72.) Edited by Seemant Chaturvedi and Peter M. Rothwell. 359 pp., illustrated. Boca Raton, Fla., Taylor &amp; Francis, 2005. $169.95. 0-8247-5417-4
Authors: John W. Norris
Journal: New England Journal of Medicine (2006)