tbuckley/cabot-search huggingface dataset:
Practical use of circulating tumor cells for the management of subsets of metastatic breast cancer patients in a community oncology practice.
Authors: EK Dropkin, ML Graham
Journal: Cancer Research (2009)

Abstract Abstract #5024 Background : An elevated Circulating Tumor Cell Count (CTC) &amp;gt;5 in 7.5 ml of blood predicts worse outcome in metastatic breast cancer (MBC) patients (pt). While the FDA has approved use of this test, its systematic use in practices has been uncommon. We have measured CTC's in all MBC pts in our community oncology practice receiving hormonal therapy or chemoRx +/- biologic therapies to determine if a strategy to treat all pts to a sustained CTC count of &amp;lt; 5 could decrease the death rate, and if recognized molecular subsets of breast cancer [ER+, HER2 (H2)-; Triple Negative; H2+] have different patterns of CTC behavior. Methods: Initially serial CTC levels were measured by the CellSearch technology (Veridex, LLC; Warren NJ) using two commerical laboratories in all pts whether beginning a new therapy with initial recurrence or progression, or if already underway with treatment. Pts had CTC's measured from Nov 20, 2006 thr. June 10, 2008, an 18 mo. period Over time, the majority of pts have begun new treatments with progression, or with new diagnoses. If pts with elevated CTC's improved to &amp;lt;5 for a sustained 3-4 month period of time, we sought less morbid hormonal therapies if ER+, or lower toxicity ChemoRx +/- biologic therapy if ER- or hormone refractory. Results: 376 tests for CTC's were carried out in 72 pts for an average of 5.2 tests per pt (range 1-19). The distribution of the 72 pts according to the three molecular subtypes, the frequency of those measuring &amp;gt;5, &amp;gt;10 or &amp;gt;100 CTC's at any time, and the associated death rates for each group, are shown in Table 1.&amp;#x2028; &amp;#x2028; High numbers of CTC's were seen in each of the three subsets of MBC, and each subtype also had pts with no elevated levels. 2/3 of deaths occurred in pts with 100 or more CTC's at some point in their treatment course. Of pts with these high levels, more than 50% eventually died, while only 3% died over 18 months if serial measurements showed no levels above 5 CTC's. Deaths from MBC in the practice have been reduced from 20 in 2005 and 15 in 2006 to 9 in the 18 mo. during which the CTC's have been uniformly applied in 2007 and 2008. Conclusion: Very high levels of CTC's &amp;gt; 100 constitute an oncologic emergency. The overall death rate in a community oncology practice may be reduced by uniform application of CTC technology. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5024.
Doctor who worked at Barts is struck off for "global deficiencies" in medicine
Authors: C. Dyer
Journal: BMJ (2013)

Significant hypercalcaemia can cause electrocardiogram (ECG) changes mimicking an acute myocardial infarction. It is important to recognise that some ECG changes are due to conditions other than cardiac disease so that appropriate treatment is given, and importantly, inappropriate treatments are avoided.
National randomised controlled trial is needed
Authors: Peter K Donnelly, Louise Hiller, Janet A Dunn
Journal: BMJ (2008)

Dixon and Montgomery recommend that breast cancer follow-up be evidence based, flexible, and tailored to patients’ needs.1 Unfortunately neither their proposal to provide only annual clinical review for two years nor the 2002 guideline from the National Institute for Health and Clinical Excellence, which recommends hospital based follow-up for no longer than three years for asymptomatic patients, is evidence based. A recent Cochrane review showed a wide range of recommendations for follow-up practice and identified the urgent need for a large randomised controlled trial …
Inflammation markers and cytokines in breast milk of atopic and nonatopic women
Authors: S Rudloff, T Niehues, M Rutsch, C Kunz, H Schroten
Journal: Allergy (1999)

Breast milk is thought to contain its own complex immune system. Whether or not this is altered in allergic individuals is not yet known.By ELISA techniques, inflammatory markers (MIP-1alpha, sICAM-1) and T(H)1 (interferon-gamma [IFN-gamma]), as well as T(H)2 cytokines (interleukin [IL]-4, IL-10), were investigated in serum and milk samples from nonallergic (n = 23) lactating women and those with respiratory allergies (n = 19) during the first week postpartum.IFN-gamma was not detected in either serum or milk. IL-10 was more often found to be above the detection limit in both milk and serum samples from allergic mothers. IL-4 was detected in almost all serum samples with a wide variation. In milk, IL-4 was found in about 20% of the samples. MIP-1alpha was not detected in the serum but was detected in the milk of 23% of the nonatopic and 53% of the allergic mothers. Soluble ICAM-1 was present in all samples. Surprisingly, serum levels of sICAM-1 in allergic mothers (271+/-97 ng/ml) were significantly lower (P<0.001) than in nonatopic subjects (375+/-86 ng/ml). Concentrations of sICAM-1 in milk were similar in both groups.The concentrations of proinflammatory markers and cytokines in breast milk did not differ significantly between allergic and nonatopic mothers. In some individuals, high levels of MIP-1alpha, IL-10, and sICAM-1 could be found. However, the significance of these components for the breastfed infant is still unclear.
Pentagastrin gastroprotection against acid is related to H<sub>2</sub> receptor activation but not acid secretion
Authors: S Tanaka, Y Akiba, J D Kaunitz
Journal: Gut (1998)

Pentagastrin enhances gastric mucosal defense mechanisms against acid and protects the gastric mucosa from experimental injury.To investigate whether this gastroprotection is mediated by histamine receptors or occurs as a secondary effect of acid secretion stimulation.The effects of omeprazole (100 mumol/kg), ranitidine (20 mg/kg), and pyrilamine (10 mg/kg) on pentagastrin (80 micrograms/kg/h) induced gastroprotection against acidified aspirin injury were examined in a luminal pH controlled model. The effects of these compounds on pentagastrin enhanced gastroprotective mechanisms were investigated using intravital microscopy, in which intracellular pH of gastric surface cells (pH1), mucus gel thickness, gastric mucosal blood flow, and acid output were measured simultaneously.Pentagastrin protected rat gastric mucosa from acidified aspirin injury. This gastroprotection was abolished by ranitidine, but not omeprazole or pyrilamine. Pentagastrin induced a hyperaemic response to luminal acid challenge, increased mucus gel thickness, and elevated pHi during acid challenge. Ranitidine reversed these enhanced defence mechanisms, whereas omeprazole and pyrilamine preserved these effects.These data indicate that pentagastrin associated gastroprotection and enhanced defence mechanisms against acid result mainly from activation of histamine H2 receptors, and not as an effect of the stimulation of acid secretion.
Comprehensive Injury Research
Authors: John B. Holcomb, David B. Hoyt
Journal: JAMA (2015)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Serum-soluble urokinase receptor levels do not distinguish focal segmental glomerulosclerosis from other causes of nephrotic syndrome in children
Authors: Aditi Sinha, Jaya Bajpai, Savita Saini, Divya Bhatia, Aarti Gupta, Mamta Puraswani, Amit K. Dinda, Sanjay K. Agarwal, Shailaja Sopory, Ravindra M. Pandey, Pankaj Hari, Arvind Bagga
Journal: Kidney International (2014)
A Systematic Review and Meta-analysis of Functional Outcomes and Complications Following Transurethral Procedures for Lower Urinary Tract Symptoms Resulting from Benign Prostatic Obstruction: An Update
Authors: Jean-Nicolas Cornu, Sascha Ahyai, Alexander Bachmann, Jean de la Rosette, Peter Gilling, Christian Gratzke, Kevin McVary, Giacomo Novara, Henry Woo, Stephan Madersbacher
Journal: European Urology (2014)
Interactions of acetylcholine and epinephrine on the dynamics of insulin release in vitro.
Authors: I M Burr, A E Slonim, R Sharp
Journal: Journal of Clinical Investigation (1976)

An in vitro system for perifusion of rat pancreatic islets has been utilized to define the effects of epinephrine on acetylcholine-induced insulin release over varying concentrations of the two agents. Perifusion of islets with epinephrine before challenge with acetycholine produced marked enhancement of both phases of cholinergically induced insulin release; enhancement of the first phase being more marked with increase in acetylcholine concentration and the converse being observed with the second phase. Perifusion of islets with epinephrine during stimulation with acetylcholine produced inhibition of insulin release, an effect dependent upon the concentration of epinephrine and of acetylcholine. There was an order of difference in the acetycholine concentration needed to overcome significant epinephrine-mediated inhibition of the first phase of insulin release (5 X 10(-4) mug/ml) and that needed to overcome inhibition of the second phase (5 X 10(-3) mug/ml). Comparison of the effects of various concentrations of epinephrine on glucose- and acetyl-choline-induced insulin release revealed that epinephrine was a less potent inhibitor of the first phase of acetylcholine-induced insulin release than of the first phase of glucose-induced insulin release. These data provide some insight into the potential interactions between cholinergic and adrenergic autonomic systems in modifying insulin release.
Psychiatrists Set to Approve DSM-IV
Authors: Paul Cotton
Journal: JAMA (1993)

A NEW diagnostic manual slated for final approval this week marks perhaps the most rigorous attempt yet to base psychiatric practice on hard science. Soft science and even what critics say is non-science have plagued psychiatry ever since Sigmund Freud first asserted that women who reported being sexually abused were merely suffering from "penis envy." "More than any other nomenclature of mental disorders,<i>DSM-IV</i>(<i>Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition</i>) is grounded in empirical evidence," says Allen J. Frances, MD, chair, Department of Psychiatry, Duke University Medical Center, Durham, NC. Frances chairs the American Psychiatric Association's 27-member task force that has worked with some 1000 advisers over 5 years, conducting 150 reviews of the scientific literature, 50 data reanalyses with funding from the John D. and Catherine T. MacArthur Foundation (Chicago, Ill), and 12 field trials to evaluate diagnostic criteria. Those trials, funded by the National Institute
Routine Screening for HIV Infection — Timely and Cost-Effective
Authors: Samuel A. Bozzette
Journal: New England Journal of Medicine (2005)

In the United States, HIV infection is generally discovered at an advanced stage, usually in the course of medical care and often during care for complications of AIDS. Earlier diagnosis would be far preferable, because it could speed access to appropriate care and increase the proportion of HIV-infected patients receiving care, thereby improving the quality of care for persons and populations.1 Two articles in this issue of the Journal indicate that widespread use of routine screening could offer these benefits and more at a reasonable cost. Paltiel and colleagues2 and Sanders and colleagues3 both predict that widespread use of routine . . .
TRANSRADIAL VS. TRANSFEMORAL APPROACH FOR PRIMARY ANGIOPLASTY IN ACUTE MYOCARDIAL INFARCTION: ANALYSIS FROM THE HORIZONS-AMI TRIAL.
Authors: Adriano M. Caixeta, Philippe Généreux, Eugenia Nikolsky, Roxana Mehran, Alexandra J. Lansky, Bernhard Witzenbichler, Giulio Guagliumi, Jan Z. Peruga, Bruce R. Brodie, Dariusz Dudek, Ran Kornowski, Franz Hartmann, LeRoy Rabbani, Ecaterina Cristea, Shing-Chiu Wong, George D. Dangas, Martin Fahy, Gregg W. Stone
Journal: Journal of the American College of Cardiology (2010)
Safety and the flying doctor
Authors: Francesco P Cappuccio, Steven W Lockley
Journal: BMJ (2008)

Interest, curiosity, or dismay—which feeling predominates when we learn from BBC Newsnight that our NHS employs doctors who commute from Poland to cover the out of hours duties that local GPs are unable to work because they are too tired at night? Is it interest in an innovative solution for modern pan-European healthcare provision, curiosity in discovering huge variations in the standard of living across the medical profession in an open Europe, or dismay that the government’s emphasis, that healthcare practice should be based on the best scientific evidence, is little more than lip service? 

Working continuously for a long time, particularly at night, increases the risk of making errors and causing injury, which is why many professions limit the number of hours of continuous duty. These risks also apply to the medical profession: tired doctors make mistakes that harm patients (N Engl J Med 2004;351:1838-48) and themselves
Personal health budgets lack transparency, health department finds
Authors: C. White
Journal: BMJ (2011)

Patients in England who receive a personal health budget are being left in the dark over how much money they are going to get, a Department of Health report concludes. 

The report, which was based on interviews with 58 patients in 17 of the 20 primary care trusts taking part in the pilot scheme, said that the levels of personal health budgets, which aim to give patients more choice and control over their care, and how they had been calculated were not clear.

“A basic principle of personal budgets is that holders should know the approximate level of their budget so they can plan its use appropriately,” said the report.

However, it …
Training in care of elderly needs to improve
Authors: S. Mayor
Journal: BMJ (1997)

Leading specialists in the care of elderly people are launching a concerted attack on medical training, research, and services for older people. The first salvo is a national audit for the year 2000 to give a clear picture of how well current training and services meet their health needs.

The recommendation comes in a report, The Impact of Ageing , published last week by the charity Research for Ageing. The advisory panel, including representatives from medicine, nursing, the Department of Health, and the Audit Commission, reviewed a large body of evidence showing that current health services tend to give elderly people low …
Thrombophlebitis in Patients with Severe Poliomyelitis
Authors: Benjamin G. Ferris, B. McNichol, G. Sutin
Journal: New England Journal of Medicine (1958)

THIS report is presented to call attention to the occurrence of idiopathic thrombophlebitis in severely paralyzed patients and to point out that this may occur in other debilitating neuromuscular diseases. There have been references to fatal pulmonary embolism in patients with severe paralysis due to poliomyelitis.1 2 3 4 Furthermore, thrombophlebitis may be expected to occur in any adult patient who is immobilized for a long time. A survey of the patients admitted to the Mary MacArthur Memorial Respirator Unit from its inception in October, 1950, through January 31, 1958, was made to obtain an estimate of the frequency of this complication.The . . .
Hyaluronic acid in bronchoalveolar lavage fluid in patients with sarcoidosis: relationship to lavage mast cells.
Authors: L Bjermer, A Engstrom-Laurent, M Thunell, R Hallgren
Journal: Thorax (1987)

Hyaluronate (hyaluronic acid), a potential marker for activated pulmonary fibroblasts, appears in increased concentrations in bronchoalveolar lavage fluid from patients with sarcoidosis. The mechanisms underlying fibroblast proliferation are largely unknown but activated alveolar T lymphocytes and macrophages probably play a part; the mast cell is also important for fibroblast proliferation. This study was designed to determine whether there is any association between pulmonary mast cells in lavage fluid, which are known to be increased in patients with sarcoidosis, and signs of pulmonary fibroblast activation. A strong correlation was found between lavage fluid hyaluronate and recovered mast cells (r = 0.72, p less than 0.001). Moreover, mast cell and hyaluronate estimations correlated inversely with lung volume and transfer factor for carbon monoxide, and both indices increased with advancing radiological sarcoid stage. Macrophage and granulocyte counts were normal in lavage fluid from patients with sarcoidosis and were not related to lavage fluid hyaluronate or laboratory signs of the disease in the lungs. Lymphocytes were recovered in increased numbers (p less than 0.001) and were related to the lavage fluid mast cells and hyaluronate. It is concluded that in sarcoidosis release of hyaluronate into the airways is related to the degree of lung disease and to the local inflammatory reaction in the lung as defined by increased numbers of mast cells and lymphocytes in lavage fluid. The findings may reflect a link between the immune system, activation of mast cells, and a pulmonary fibroblast proliferation.
Age-dependent differences in galanin-dependent colonic fluid secretion after infection with Salmonella typhimurium
Authors: K Matkowskyj, S V Royan, A Blunier, G Hecht, M Rao, R V Benya
Journal: Gut (2009)

Epithelial cells lining the colon do not normally express galanin type 1 receptors (Gal1Rs). However, subsequent to infection with enteric pathogens such as <i>Salmonella typhimurium</i>, the Gal1R is rapidly upregulated in colonocytes where it contributes to the excess fluid production associated with diarrhoea. Humans infected with non-typhoid <i>Salmonella</i> respond differently according to age: infants develop diarrhoea but not bacteraemia and survive, while the elderly become bacteraemic and die. Thus the aim of this study was to determine if age-related differences exist in response to <i>S typhimurium</i> infection in mice, and whether these differences are due to altered Gal1R expression. Wild-type C57BL/6J mice that were 2 and 15 months old, as well as 2-month-old Gal1R knockout mice, were infected by gavage. Young wild-type mice expressed Gal1R in response to infection, had increased colonic fluid secretion, low rates of bacteraemia and survived. In contrast, 15-month-old wild-type mice expressed fewer Gal1Rs in response to infection, had attenuated increases in colonic fluid secretion, high rates of bacteraemia and died. A similar profile was noted in 2-month-old Gal1R knockout mice. Addition of polyethylene glycol to the drinking water of 15-month-old wild-type mice increased colonic fluid secretion and reduced rates of bacteraemia to those observed in 2-month-old wild-type mice and eliminated fatalities. The difference in response to <i>S typhimurium</i> infection with age may be due, at least in part, to decreased Gal1R expression and decreased amounts of colonic fluid secretion.
Possible Effects of Psychological Therapy on Survival Duration in Cancer Patients
Authors: Alastair J. Cunningham, Claire V.I. Edmonds
Journal: Journal of Clinical Oncology (2005)

Whether or not psychological therapies can prolong the life span of cancer patients has been hotly debated during the last 15 years.Two recent articles in this Journal contribute substantially to the debate: an original study by Kissane et al, 1 which concluded that "cognitiveexistential group therapy does not prolong survival in women with early stage breast cancer," and an Editorial by Dr Goodwin commenting on the study. 2There are now approximately equal numbers of published clinical trials reporting that psychological therapies of various kinds do or do not prolong median life span in patients with metastatic cancers, with later and better-designed studies favoring the negative conclusion.Goodwin proposes that, "for many, the report by Kissane et al will be viewed as the final nail in the coffin for potential survival benefits of psychological interventions in cancer." 2 Such a generalization would, we believe, be unwarranted.What has been demonstrated is that certain kinds of short-term group psychological interventions fail to prolong the mean or median life span of groups of cancer patients.This is a useful finding that sets limits on what we can expect from such interventions, and one that may help to quell the more extreme claims for effects of mind on cancer that are common in the popular press.What should not be dismissed, however, is the possibility that some therapies may have the potential to extend life in certain patients under some conditions.To rule this out risks making a type II error that could inhibit further research on an issue that is of great importance to many cancer patients.We have examined the possible influence of mental variables on cancer progression by asking a different question than that addressed by trials methods-namely, what are the psychological characteristics of people with metastatic cancers who do survive long beyond their prognoses?We have presented prospective data showing a highly significant correlation between strong involvement in psychological and spiritual "self help" strategies and prolonged survival (possible confounding factors being controlled for). 3,4The data obtained in these exploratory studies (and a larger replication of our intervention study is in progress) not only point to a potentially important influence of psychological qualities on survival, but also suggest that we need to consider carefully what methods are best suited to