tbuckley/cabot-search huggingface dataset:
Comparison of Tumor Regression Grade Systems for Locally Advanced Rectal Cancer After Multimodality Treatment
Authors: Atthaphorn Trakarnsanga, Mithat Gönen, Jinru Shia, Garrett M. Nash, Larissa K. Temple, José G. Guillem, Philip B. Paty, Karyn A. Goodman, Abraham Wu, Marc Gollub, Neil Segal, Leonard Saltz, Julio Garcia-Aguilar, Martin R. Weiser
Journal: JNCI Journal of the National Cancer Institute (2014)

Tumor regression grade (TRG) is a measure of histopathological response of rectal cancer to neoadjuvant chemoradiation and is associated with outcomes. Several TRG systems are used: Mandard (5,3-tier), Dowrak/Rödel (5,3-tier), Memorial Sloan Kettering Cancer Center (MSKCC), and American Joint Committee on Cancer (AJCC) Cancer Staging. A single measure of rectal cancer response would assist in comparing results across institutions, and in designing future rectal cancer studies. In this study, the predictive accuracies of the various published classification schemes are compared.Review of a prospective database identified 563 patients with locally advanced rectal cancer (T3/4 and/or N1) treated between 1998 and 2007 with long-course chemoradiation and total mesorectal excision. TRG was determined by measuring proportion of tumor mass replaced by fibrosis. Patients were classified into TRG schemes, which were compared by analyzing association with recurrence and survival using concordance index. Probabilities of recurrence-free survival were estimated using the Kaplan-Meier method. All statistical tests were two-sided.All TRG systems were predictive of recurrence. Concordance indices of the three-tier Mandard, three-tier Dowrak/Rödel, three-tier MSKCC, and four-tier AJCC systems were: 0.665, 0.653, 0.683, and 0.694, respectively (higher number = better prediction). The AJCC system more accurately predicted recurrence than the three-tier Mandard (P = .002) or Dowrak/Rödel (P = .006) and had a higher concordance index than MSKCC, although this did not reach statistical significance (P = .068).When classifying rectal cancer response to chemoradiation, the AJCC Staging Manual (7(th) edition) system is most accurate and should be adopted as the standard.
Who benefits from the new act?
Authors: David Crepaz-Keay
Journal: BMJ (2005)

Depriving someone of their liberty is one of the most serious actions that a state can take. To do this when someone has committed no crime is more serious still. If, in addition, the state then administers chemical and physical treatments that carry a substantial risk of disabling, and sometimes irreversible, damage, it must have the best possible justification for doing so.

The government's proposal to replace the current mental health act gives us an opportunity to assess whether the proposed legislation is fit for purpose. An analysis of the issues around capacity suggests it leaves much to be desired in that respect.1 This is important, but it is not the only way in which the current proposal fails to justify the denial of basic rights.

What is proposed (and, in fact, what we currently have) is not a mental health act but a compliance with treatment act. This was made explicit by Paul Boateng, who, when he was parliamentary under secretary of state for health, said that: “Non compliance can no longer be an …
Control of in vivo blood clearance time of polymeric micelle by stereochemistry of amphiphilic polydepsipeptides
Authors: Akira Makino, Eri Hara, Isao Hara, Ryo Yamahara, Kensuke Kurihara, Eiichi Ozeki, Fumihiko Yamamoto, Shunsaku Kimura
Journal: Journal of Controlled Release (2012)
Induction of nitric oxide by erythropoietin is mediated by the β common receptor and requires interaction with VEGF receptor 2
Authors: Larysa Sautina, Yuri Sautin, Elaine Beem, Zhuo Zhou, Anna Schuler, Jennafer Brennan, Sergey I. Zharikov, YanPeng Diao, Jorg Bungert, Mark S. Segal
Journal: Blood (2009)
End-of-Round Time Compression in Physician Handoff Sessions
Authors: Laura Jones, Thomas Kannampallil, Amy Franklin
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
Food Allergy-Reply
Authors: Dean D. Metcalfe
Journal: JAMA (1983)

<h3>In Reply.—</h3> The diagnosis and treatment of adverse reactions to foods remain unsatisfactory. Basic research is needed to explore the pathogenesis of these reactions and clinical research required to improve diagnostic approaches as well as therapeutic alternatives. As might be expected, this situation has led to a number of inadequately tested individual approaches to the diagnosis and treatment of adverse reactions to foods, and there were, no doubt, physicians in addition to Dr Wilson who found themselves in disagreement with aspects of the review on food allergy. Specifically, Dr Wilson has made a series of statements in a critique of this chapter that require comment. First, he has written that exclusion of a food and "its products" from the diet for five days before challenge eliminates the "phenomenon of adaptation," which "may prevent the recognition of common offending ingestants." Conversely, he states that eliminating a specific food beyond ten days
Physiological changes underlying jet lag
Authors: H. Simpson
Journal: BMJ (1982)

Fluid intake can increase or decrease the effect of dietary fibre on gastrointestinal function depending on the type (water, tea, coffee, etc,) and quantity of fluid consumed.Chocolate, coffee, tea, cocoa, and some carbonated beverages (usually colas) contain methylxanthines, caffeine, theophylline, and theobromine.1The methylxanthines cause stimulation of the central nervous system, diuresis, and relaxation of smooth muscle.The various methylxanthines differ greatly in the intensity of their actions on various structures.'Consumption of tea in large quantity causes a fall in faecal bile acid output and an increase in intestinal transit time, while water in the same quantity produces opposite effects.Theo- phylline present in the tea by inducing diuresis causes extracellular dehydration and an increase in intestinal absorption of water leading to constipation.2Coffee does not cause gall-bladder emptying.3The methylxanthines present in the coffee inhibit gall-bladder emptying.Ingestion of water causes gall-bladder emptying4 and a rise in total serum bile acids5 similar to a meal.Rise in total serum bile acids -is seen in a cholecystectomised patient also after ingestion of water (personal observation).The probable existence of a "gastrobiliary" reflex has been postulated,6 and ingestion of water may stimulate this reflex.Entry of food into the proximal part of small intestine initiates a "gastroileal" reflex,7 and water may initiate this reflex also.Dihydroxy bile acids inhibit colonic absorption of water.8Waterholding and bile salt binding are physical properties of dietary fibre.9Increase in water intake will allow increase in the amount of water presented to the large bowel, leading to an increase in the water content of faeces, which may help in more complete evacuation of faeces.Hence in dietary fibre therapy water intake at regular intervals in sufficient quantity should be advised.
Effect of inhaled steroids on lung function in young children: a cohort study
Authors: C.S. Devulapalli, G. Haaland, M. Pettersen, K.H. Carlsen, K.C. Lødrup Carlsen
Journal: European Respiratory Journal (2004)

The objectives of the present study were to determine the use of inhaled corticosteroids (ICS) for treating recurrent bronchial obstruction (rBO) in young children up to 2 yrs of age and to assess possible modifying effects of ICS on lung function in young children with rBO. From an observational, noninterventional birth cohort of 3,754 newborn children (3,697 with complete questionnaire data by 2 yrs of age), 306 children with documented rBO by age 2 yrs (cases) were identified along with 306 matched controls. Two tidal flow/volume measurements were taken, one at presentation of disease (children were steroid naïve) and one at 2 yrs of age (mean age 11.2 and 25.6 months, respectively), from: 21 cases who subsequently received ICS (ICS+); 33 who did not (ICS−); and in 15 controls. The mean±sd duration of ICS treatment was 10.3±6.5 months. The main outcomes were treatment with ICS and baseline ratio of time to peak expiratory flow/total expiratory time ( t PTEF / t E ). From the entire cohort, 77 children (2.1%) and 21% of children with rBO had received ICS by 2 yrs of age. Baseline t PTEF / t E was significantly lower at the first visit only in ICS+ as compared to ICS− subjects, as well as in ICS+ and ICS- as compared to controls. The mean difference in baseline t PTEF / t E from first to second visit was borderline statistically significant in the ICS+ group only and correlated significantly with duration of ICS treatment. The present observational cohort study demonstrated that one-fifth of young children with recurrent bronchial obstruction had received inhaled corticosteroids. Early inhaled corticosteroid treatment improved lung function by age 2 yrs, mostly in those with the longest duration of treatment.
Ethnic differences in hepatic steatosis: An insulin resistance paradox?
Authors: Richard Guerrero, Gloria L. Vega, Scott M. Grundy, Jeffrey D. Browning
Journal: Hepatology (2008)

Nonalcoholic fatty liver disease is a burgeoning problem. We have previously shown that Hispanics were at greater risk for nonalcoholic fatty liver disease than were African-Americans despite a similar prevalence of risk factors between these groups. We have performed the largest, population-based study to date (n = 2170) utilizing proton magnetic resonance (MR) spectroscopy, dual-energy x-ray absorptiometry, and multislice abdominal MR imaging to determine the contribution of body fat distribution to the differing prevalence of hepatic steatosis in the three major U.S. ethnic groups (African-American, Hispanic, Caucasian). Despite controlling for age and total adiposity, African-Americans had less intraperitoneal (IP) fat and more lower extremity fat than their Hispanic and Caucasian counterparts. The differences in hepatic triglyceride content (HTGC) between these groups remained after controlling for total, abdominal subcutaneous, and lower extremity adiposity; however, controlling for IP fat nearly abolished the differences in HTGC, indicating a close association between IP and liver fat regardless of ethnicity. Despite the lower levels of IP and liver fat in African-Americans, their prevalence of insulin resistance was similar to Hispanics, who had the highest levels of IP and liver fat. Furthermore, insulin levels and homeostasis model assessment values were highest and serum triglyceride levels were lowest among African-Americans after controlling for IP fat. Conclusion: IP fat is linked to HTGC, irrespective of ethnicity. The differing prevalence of hepatic steatosis between these groups was associated with similar differences in visceral adiposity. The metabolic response to obesity and insulin resistance differs in African-Americans when compared to either Hispanics or Caucasians: African-Americans appear to be more resistant to both the accretion of triglyceride in the abdominal visceral compartment (adipose tissue and liver) and hypertriglyceridemia associated with insulin resistance. (HEPATOLOGY 2009.)
Comparison of Sucrose and Glucose in the Oral Electrolyte Therapy of Cholera and Other Severe Diarrheas
Authors: Darwin L. Palmer, F. T. Koster, A. F. M. Rafiqul Islam, A. S. M. Mizanur Rahman, R. Bradley Sack
Journal: New England Journal of Medicine (1977)

Oral glucose electrolyte solution is now established as simple, effective and relatively inexpensive fluid-replacement therapy1 2 3 4 5 for severe diarrheal disease, the leading cause of morbidity in the developing world. Cholera, the illness with most massive stool loss, has been treated successfully with oral solution in the hospital as well as in the field situation,6 , 7 and in children8 9 10 as well as in adults. The electrolyte components (table salt, sodium bicarbonate and a potassium salt) are cheap, available and easily stored. Glucose, which is necessary to promote intestinal absorption of sodium and concomitantly of water,11 is relatively expensive and may not be available . . .
"Presbycolon" Problems in the Nursing Home
Authors: Eddy D. Palmer
Journal: JAMA (1976)

THERE is no need to argue whether "presbycolon" is a valid physiologic concept. As a term simply to imply the wretched bowel malfunction of so many elderly persons it has some usefulness. In this sense, presbycolon means primarily constipation plus its complications, mainly colon gas and impaction. It is common enough to rank with joint pain, dizziness, forgetfulness, depression, and bladder problems as one of the most frequent forms of misery encountered in the nursing home. <h3>Forms of Constipation</h3> Presbycolon in this sense does not imply a specific form of physiologic breakdown. All three forms of constipation are encountered in the elderly patient—hypertonic, hypotonic, and dyschezial ("rectal" or "habit" constipation). The hypotonic form is most common, as it also is among young children, although it is least common among young adults. Hypotonic constipation is characterized by late arrival of feces at every point along the colon, with diminished water absorption.
Dicer is selectively important for the earliest stages of erythroid development
Authors: Natalija Buza-Vidas, Valeriu B. Cismasiu, Susan Moore, Adam J. Mead, Petter S. Woll, Michael Lutteropp, Luca Melchiori, Sidinh Luc, Tiphaine Bouriez-Jones, Deborah Atkinson, Donal O'Carroll, Sten Eirik W. Jacobsen, Claus Nerlov
Journal: Blood (2012)
P5 DICHOTOMAL EFFECT OF IMMUNOSUPPRESSANTS ON HEPATITIS E VIRUS INFECTION: CALCINEURIN INHIBITORS STIMULATE BUT MYCOPHENOLIC ACID INHIBITS VIRAL REPLICATION
Authors: Y. Wang, X. Zhou, L.J.W. van der Laan, H.L.A. Janssen, H.J. Metselaar, M.P. Peppelenbosch, Q. Pan
Journal: Journal of Hepatology (2014)
Transplantation of the Human Heart
Authors: Denton A. Cooley
Journal: JAMA (1968)

Until recently cardiac transplantation in man was considered to be primarily investigational and of limited practical value in treatment of heart disease. Four seriously ill and incapacitated patients underwent cardiac transplantation with restoration of adequate cardiac function and circulation in each. Two patients are alive and apparently well 6 weeks and 3 1/2 weeks, respectively, after operation. Donor-recipient blood and tissue compatibilities were studied and considered acceptable. Donors all suffered from brain injury, either blunt or penetrating, and one had a spontaneous intracranial hemorrhage. Immunosuppressive agents consisted of corticosteroids, azathioprine, and antilymphocytic globulin (ALG). No unequivocal evidence of threatened rejection has appeared in any patient, and in the longer survivors, convalescence was unremarkable. This experience suggests that human cardiac transplantation is feasible and deserves further clinical trial.
Germany: everyone has to be insured for cost of long term care
Authors: A. Tuffs
Journal: BMJ (2002)

Since the 1 January 1995 every German citizen has to be insured against the risk of needing special care as a consequence of either disease or old age. About 1.7% of people's wages is deducted every month for this type of insurance, together with a contribution for their health insurance.

Even those with private insurance are obliged to join the nursing care insurance scheme of their insurance company.

Currently, about two million …
Trisomy of a Large Chromosome
Authors: Malcolm A. Ferguson-Smith
Journal: JAMA (1961)

<h3>To the Editor:—</h3> In their report inThe Journal, Sept. 17, page 221, on a mentally defective patient with mongoloid characteristics, Dr. Sandberg and his colleagues interpret their chromosome analysis as indicating trisomy of the 6th chromosome—a hitherto undescribed anomaly. In view of the observation of a double complement of sex chromatin in 70% of oral mucosal nuclei, it would seem that a more realistic conclusion is that the patient is another example of the triple-X syndrome (Jacobs and others:<i>Lancet</i><b>2</b>:423 [Sept. 20] 1959; Jacobs and others:<i>ibid.</i><b>1</b>:1213 [June 4] 1960; Stewart and Sanderson:<i>ibid.</i><b>2</b>:21 [July 2] 1960; Ferguson-Smith, Handmaker, and Hill, to be published). The authors dismiss this possibility on the basis that the arm-length ratios of the trisomic chromosomes are not characteristic of the X-chromosomes, and also that the X-chromosomes may be separately identified by virtue of heteropyknosis. However, no measurements are
De futuro urbanorum
Authors: R E Williams
Journal: BMJ (1998)

At the time of my first paper in the BMJ on the immense advantage of a bicycle to a general practitioner needing to visit patients in central London I had covered only 6000 miles (9656km), an average during those first exploratory three years of only 8 miles (12.8 km) per working day.1 Now, 23 years and three bicycles later, the mileage is over 62 000 (100 000 km), which is nearly 21/2 times round the earth or a quarter of the way to the moon.

These innumerable short journeys have added up to a small urban odyssey, which has been not only highly efficient but enjoyable. Once I had experienced the freedom of movement and saving of time provided by my bicycle it became increasingly unthinkable to return to the frustrating torpor of trying to use my car for the job that I was doing. The only excuses for my previous 13 car-bound years in general practice are that the car was the expected mode of transport and …
Large increments in psoralen?ultraviolet A (PUVA) therapy are unsuitable for fair-skinned individuals with psoriasis
Authors: None KIRBY, None BUCKLEY, None ROGERS
Journal: British Journal of Dermatology (1999)

The ideal psoralen-ultraviolet A (PUVA) regimen for chronic plaque psoriasis has yet to be established. There are four components to a PUVA regimen: the dose of psoralen, the starting dose of UVA, the frequency of treatment and the incremental UVA dose protocol. Recent studies have been directed at trying to optimize the efficacy of PUVA while minimizing acute side-effects and the risk of cutaneous carcinogenesis, believed to be independently related to the cumulative dose of UVA and the total number of treatments. The British Photodermatology Group recommends two twice-weekly PUVA regimens: one starts with 50% of the minimal phototoxic dose (MPD) and uses weekly increments of 40%, 30%, 25%, 20%, 15%, 10% and 5% of the previous dose to a maximum of 14.5 J/cm2; the other starts with a fixed dose based on skin type and uses weekly dose increments of 40%, decreasing to 20% once erythema develops. We undertook a prospective randomized controlled trial comparing these regimens in 85 Irish patients. The clearance rate with the MPD regimen was lower than with the skin type regimen, 67.5% vs. 95% (P < 0.05). The reasons for treatment failure were grade 3 erythema and severe PUVA itch. There was a trend suggesting that patients with skin types I and II, but not skin type III, required a higher cumulative UVA dose and fewer exposures to clear with the MPD regimen than the skin type regimen, although this did not reach statistical significance. Grades 2 or 3 erythema were very common in both treatment groups (52.5% of the skin type group and 45% of the MPD group). This is the third study to suggest that patients with skin types I and II receive a higher total UVA dose when the starting dose is 50–70% of the MPD (rather than 0.5 J/cm2 for skin type I and 1.0 J/cm2 for skin type II) and when large dose increments are used. We suggest that smaller dose increments should be used in patients with skin types I and II.
Pharmaceutical design of a novel colon-targeted delivery system using two-layer-coated tablets of three different pharmaceutical formulations, supported by clinical evidence in humans
Authors: Takeshi Goto, Norifumi Tanida, Takaaki Yoshinaga, Shuji Sato, D.J Ball, I.R Wilding, Eiji Kobayashi, Akio Fujimura
Journal: Journal of Controlled Release (2004)
Genetic Counseling in Hemoglobinopathies
Authors: Charles E. Jackson
Journal: JAMA (1972)

<h3>To the Editor.—</h3> "An Automated Mass Screening Program for Sickle Cell Disease" (<b>218</b>:1680, 1971) was of great interest to us because of our efforts in surveying a black population with a major impetus on genetic counseling. The authors are to be congratulated on their efforts toward increasing public awareness of the sickle cell problem, and we are in agreement with the need for using all the available communication media to accomplish this. We also agree with their recommendation that screening programs should have an educational emphasis and should involve the school population on a voluntary basis. However, for accurate genetic counseling the proposed automated screening technique is inadequate because it fails to detect hemoglobin C, known to be present in 2% to 3% of the US black population. This failure to provide information to hemoglobin C carriers will create an erroneous feeling of security—they would think that they could marry