tbuckley/cabot-search huggingface dataset:
In vivo diagnosis of diminutive colonic polyps: Does FICE or Indigo carmine chromoendoscopy improve the accuracy?
Authors: G. Longcroft-Wheaton, D. Cowlishaw, B. Higgins, P. Bhandari
Journal: Gut (2011)

<h3>Introduction</h3> The current paradigm for the management of colonic polyps is to remove all lesions and send for histopathological evaluation, which dictates the surveillance interval. However, this is expensive and can result in a delay in arranging the surveillance interval for the patient. Studies using vital stains with zoom endoscopes have suggested that in vivo histology prediction is possible but has been perceived as too messy and impractical for every day use. This study aims to evaluate the accuracy of FICE and indigo carmine dye spray in the prediction of in vivo histology for diminutive polyps (&lt;10 mm). <h3>Methods</h3> Procedures were performed using fujinon colonoscopes and EPX 4400 processor. Polyps &lt;10 mm were assessed using white light (WLI) followed by FICE, followed by indigo carmine spray, with the predicted diagnosis recorded with each modality of imaging. Finally, the polyps were removed and sent for histological analysis, with the pathologist blinded to the diagnosis made by the endoscopist. The predicted diagnosis for WLI, FICE and IC were compared to the true histology to calculate the accuracy, sensitivity and specificity of in vivo assessment. Mcnemear9s test was used for the statistical comparison of modalities of imaging. <h3>Results</h3> A total of 232 polyps &lt;10 mm in size were examined, consisting of 2 polyp cancers, 153 adenomas and 77 hyperplastic polyps. FICE and IC significantly improved the accuracy of the in vivo diagnosis of polyps as compared to WLI endoscopy (see table 1). In vivo prediction of polyp histology allowed us to set the correct surveillance interval in 83% of cases using WLI alone and in 97% of cases using either FICE or IC based on BSG guidelines. <h3>Conclusion</h3> FICE and indigo carmine significantly improves the in vivo diagnosis of diminutive colonic polyps. This has the potential to improve the management of polyps and setting the accurate surveillance interval at the time of the procedure, with a significant impact on the cost and quality of care.
A Phase Ib Trial of Erlotinib, an EGFR Inhibitor, and Everolimus (RAD001), an mTOR Inhibitor, in Patients with Metastatic Breast Cancer.
Authors: I. Mayer, J. Means-Powell, Y. Shyr, C. Arteaga
Journal: Cancer Research (2009)

Abstract Background: The EGFR and the PI3K pathways have been implicated in breast cancer's prognosis and mechanisms of resistance to conventional therapies. Preclinical data have shown synergy between EGFR and PI3K/Akt pathway blockade. Therefore, we conducted a phase Ib trial to determine the maximum tolerated dose (MTD) and antitumor activity of Erlotinib, an oral EGFR tyrosine kinase inhibitor, and Everolimus (RAD001), an oral mTOR inhibitor, given daily to patients with metastatic breast cancer.Materials and Methods: This was an open-label, phase I dose-escalation study. Everolimus was started at 2.5 mg/d and Erlotinib was started at 100 mg/d on a 28-day treatment cycle. Doses were escalated over 6 levels (Everolimus 2.5, 5 or 10 mg daily with Erlotinib 100 or 150 mg daily). Treatment was continued until consistent dose-limiting toxicity (DLT) was observed or until progression of disease. All toxicities were documented using the NCI CTC v.3. Disease assessment was done every 2 months after initiation of therapy.Results: A total of 14 patients were enrolled on the first 2 dose levels (Erlotinib 100 mg with Everolimus 2.5 mg [level I] and 5 mg [level II] daily). Eight patients were enrolled on level I and 6 patients were enrolled on level II. The median age of all patients enrolled was 55 years of age, and 92% of them had visceral disease. Half of the patients had ER+ disease, 35% had HER2 + disease, and 15% had triple-negative disease. The median number of previous chemotherapy regimens in the metastatic setting was 4. Two patients on the level II cohort discontinued trial due to grade 3 stomatitis prior to their first disease assessment. Of the remaining 13 patients, 11 progressed at the time of their first disease assessment, and 1 patient on the dose level I cohort had a partial response that lasted for 7 months. The most common toxicities were rash (16%), transaminase elevation (15%), stomatitis (13%), fatigue (7%) and diarrhea (5%). Grade 3 and 4 toxicities were overall uncommon (3.5%), and mostly consisted of stomatitis, transaminase elevation and rash. Stomatitis was the only DLT, and was seen at dose level II. The MTD was determined to be Erlotinib 100 mg and Everolimus 2.5 mg daily.Discussion: In patients with metastatic HER2-negative breast cancer the combination of Erlotinib and Everolimus was overall well tolerated, but clinically ineffective from a tumor activity point of view in this heavily pre-treated patient population. Stomatitis was one of the most common toxicities and also the DLT in the cohort treated with dose level II. In view of the plethora of novel active agents currently in clinical trials in breast cancer, we do not believe the above combination warrants further testing in this disease. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3094.
Everything you wanted to know about your anatomy but were too afraid to ask
Authors: M. A. Glueck
Journal: BMJ (2001)

Hold on to your clothes and run for cover. Whole body scanners are appearing on vacated land and parking lots as rapidly as Starbucks go up and ageing department stores come down. Diagnostic body imaging scans are becoming faster, better, and cheaper. The question for patients and doctors alike is whether or not this makes good medical and economic sense.

In the United States, self-referred whole body computed tomographic scanning with electron beam technology is now available. LifeScore in San Diego, California, offers a whole body scan for about $800 (£560), which takes several minutes. A doctor immediately reviews each examination and has a consultation with the patient. Abdominal-pelvic or neck examinations are available for a mere $300 (£210).

LifeScore faces competition from InsideTrac, in Beverly Hills, California, two hours to the north. InsideTrac offers heart scans for $375 (£262); add the body and it becomes $795 (£556). For $1325 …
A New Method for Treatment of Barbiturate Dependence
Authors: David E. Smith
Journal: JAMA (1970)

A technique for withdrawal of patients physically dependent upon barbiturates is applicable to either a medical or psychiatric inpatient service. The technique involves substituting phenobarbital, a long-acting barbiturate, for the addicting agent, and subsequent withdrawal of the phenobarbital. Phenobarbital provides a more constant barbiturate blood level than the shorter-acting barbiturates, which are the usual withdrawal agents. The more constant blood level allows for the safe utilization of smaller daily doses of barbiturates during withdrawal. The method is also suggested treatment for dependence upon many of the newer sedative-hypnotics.
Morphologie substrates of sudden death: Questions and answers
Authors: Thomas N. James, Robert O. Brandenburg, Charles Fisch, Harry A. Fozzard, Donald B. Hackel, Lawrence E. Hinkle, Francis J. Klocke, Michael F. Oliver, Suzanne Oparil, Lino Rossi, Borys Surawicz, Jack L. Titus, Mario Vassalle, James V. Warren
Journal: Journal of the American College of Cardiology (1985)
Rheumatoid arthritis in Dubai--delayed diagnosis and low usage of disease modifying antirheumatic drugs
Authors: H. Badsha, K Ooi Kong, P P Tak
Journal: Annals of the Rheumatic Diseases (2007)

Information on rheumatoid arthritis (RA) among Arab populations in the Middle East is scarce. Studies have suggested that patients with RA living in Arab countries have similar clinical features, but less extra-articular manifestations, compared with those living in Western countries.1–4 Therefore, the aim of our study was to prospectively gather data on patients with RA who presented to a newly established musculoskeletal disease centre in Dubai (United Arab Emirates).

Demographic and clinical data were collected over a 10-month period for patients meeting the American College of Rheumatology criteria for RA. All statistical analyses were performed using Intercooled STATA V.8.2.

A total of 47 patients, consisting …
Protein Split Products in Relation to Immunity and Disease.
Authors: Victor C. Vaughan, J. Walter Vaughan
Journal: JAMA (1913)

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
Budd-Chiari syndrome: blocked veins, open mind
Authors: D PATCH, A BURROUGHS
Journal: Gut (1999)

See article on page 568 

The article by Fisher et al (see page 568) on the various techniques that may be used in the management of Budd-Chiari syndrome is timely, and demonstrates some important points. This condition must be considered as part of the differential diagnosis of ascites in all patients, though the mode of presentation may be protean and hence may trap the unwary. The classic syndrome of ascites, hepatomegaly and abdominal pain occurs with obstruction of hepatic venous outflow at any level—from the hepatic venules (e.g. veno-occlusive disease) to the suprahepatic vena cava. Constrictive pericarditis may also mimic the presentation. The syndrome may run a number of clinical courses which also partly determine treatment. The applicability of any treatment is also influenced by the fact that the inferior vena cava may be blocked in 20% of cases, and portal vein thrombosis evident in 10%.

The patient may present with fulminant hepatic failure, with notable coagulopathy, encephalopathy and renal impairment. A more indolent presentation is also well recognised, with ascites with a high protein content, mildly impaired hepatic function, and a variable degree of fibrosis on biopsy. Finally, well compensated patients with hepatic vein obstruction and no ascites have been described; the development of numerous intrahepatic collaterals with time is said to account for this difference.1 …
Impact of improved treatment of sexually transmitted diseases on HIV infection in rural Tanzania: randomised controlled trial
Authors: H. Grosskurth, J. Todd, E. Mwijarubi, P. Mayaud, A. Nicoll, G. ka-Gina, J. Newell, H. Grosskurth, J. Todd, P. Mayaud, A. Nicoll, J. Newell, D. Mabey, R. Hayes, F. Mosha, K. Senkoro, J. Changalucha, A. Klokke, E. Mwijarubi, G. ka-Gina, K. Mugeye
Journal: The Lancet (1995)
94 KRÜPPEL-LIKE FACTOR 6 REGULATES PPAR ALPHA SIGNALING IN STEATOHEPATITIS VIA REPRESSION OF MIR-10B
Authors: L.P. Bechmann, D. Vetter, R.A. Hannivoort, U.E. Lee, M.I. Fiel, G.L. Patman, U. Munoz, Y.M. Lee, P. Kocabayoglu, H.L. Reeves, S.L. Friedman
Journal: Journal of Hepatology (2011)
β2-Adrenergic Receptor Polymorphism and Obesity in Type 2 Diabetes
Authors: Keiji Yoshioka, Toshihide Yoshida, Toshikazu Yoshikawa
Journal: Diabetes Care (2003)

We read with interest the observation letter by van Tilburg et al. (1) reporting that the Glu27Gln polymorphism of the β2-adrenergic receptor (B2ADR) has no important effect on BMI, metabolic control, or plasma lipids. However, the authors did not mention the physical activity …
Detection of ebaf, a novel human gene of the transforming growth factor beta superfamily association of gene expression with endometrial bleeding.
Authors: R Kothapalli, I Buyuksal, S Q Wu, N Chegini, S Tabibzadeh
Journal: Journal of Clinical Investigation (1997)

Human endometrium is unique since it is the only tissue in the body that bleeds at regular intervals. In addition, abnormal endometrial bleeding is one of the most common manifestations of gynecological diseases, and is a prime indication for hysterectomy. Here, we report on a novel human gene, endometrial bleeding associated factor (ebaf), whose strong expression in endometrium was associated with abnormal endometrial bleeding. In normal human endometrium, this gene was transiently expressed before and during menstrual bleeding. In situ hybridization showed that the mRNA of ebaf was expressed in the stroma without any significant mRNA expression in the endometrial glands or endothelial cells. The predicted protein sequence of ebaf showed homology with and structural features of the members of TGF-beta superfamily. Fluorescence in situ hybridization showed that the ebaf gene is located on human chromosome 1 at band q42.1. Thus, ebaf is a novel member of the TGF-beta superfamily and an endometrial tissue factor whose expression is associated with normal menstrual and abnormal endometrial bleeding.
HYPERMOBILITY: A RISK FACTOR FOR FAILURE FOLLOWING ACL RECONSTRUCTION
Authors: MA Akhtar, F Ashton, JF Keating
Journal: British Journal of Sports Medicine (2013)

Hypermobility is associated with increased risk of sporting injuries. This study was performed to assess the risk of failure following primary ACL reconstruction in patients with hypermobility. Prospective data were collected for 28 patients undergoing primary ACL reconstruction between October 2008 and July 2009 including demographic details, sports played, hypermobility and Benign Joint Hypermobility Syndrome (BJHS). Electronic records from emergency and orthopaedic departments were checked in April 2013 for failure of ACL reconstruction. Beighton score of 4 or above was used to diagnose hypermobility. Brighton criteria were used to diagnose BJHS. The mean age was 27 y (range 15–54). There were 19 males and 9 females. 24 patients (86%) were involved in contact sports and football was the most common sport played in 9 patients (37%). The mean Beighton score for these patients was 2.8 (range 0–9). 10 patients (36%) in this group had a Beighton score of 4 or more indicating hypermobility (Group A). 18 patients (64%) had Beighton score less than 4 (Group B). The mean age for Group A (10 patients) was 26 years (range 14–40). There were 4 male and 6 females. 9 patients were involved in contact sports. 3 patients (30%) had failure of ACL reconstruction. The mean Beighton score for these patients was 5.9 (range 4–9). 3 patients (30%) had BJHS. The mean age for Group B (18 patients) was 28 years (range 15–54). There were 15 males and 3 females. 15 patients were involved in contact sports. The mean Beighton score was 1 (range 0–3). No patient had failure of ACL reconstruction. Hypermobile patients had a higher incidence of failure of ACL reconstruction (30% vs 0%). 30% patients fulfilled the Brighton criteria for BJHS. These factors should be assessed before ACL reconstruction to select the appropriate graft. Further studies are needed to decide the best graft for ACL reconstruction in the presence of hypermobility.
Computerisation of diabetic clinic records.
Authors: G B Watkins, T Sutcliffe, D A Pyke, P J Watkins
Journal: BMJ (1980)

A simple system for putting diabetic records on a computer file is achieved by using stationery that combines the usual handwritten records (not computerised) with the minimum of essential data suitable for punching on to computer tape. The record may be brought up to date at a selected time time interval. This simple, cheap system has been in use in a busy clinic for six years. The information on about 8000 diabetics now held in the computer file is used chiefly to help research by creating registers of patients with specified characteristics, such as treatment, heredity complications, and pregnancy. A complete up-to-date index of the entire clinic population is always available, and routine clinic statistics are returned every six months.
How campaigners and the media push bad science
Authors: A. Alaszewski
Journal: BMJ (2011)

Brian Deer’s three articles in the BMJ series provide a compelling account of bad science and bad scientists.1 2 3 He documents how Andrew Wakefield and his scientific colleagues “discovered” a new disease or syndrome (autistic enterocolitis) “caused” by the measles, mumps, and rubella (MMR) vaccine and tried to convince others of the existence of this disease. Wakefield and colleagues’ Lancet article, published in February 1998,4 was based on weak evidence and the selective presentation of data from a limited number of preselected cases. Despite this the article was sympathetically received by reviewers and editors of the Lancet , journalists hostile to public health, many parents of autistic children, and some parents who were considering the MMR vaccine.

Deer’s story of the Lancet article can be seen as a modern tragedy, about the hubris of a group of scientists that results in a medical disaster. The scientists suffered some of the consequences; for example, Wakefield lost his job, reputation, and medical licence in the United Kingdom. There were other victims. The children involved in …
Do we hear our patients? And would a patient's page help?
Authors: J. S Maxmin
Journal: BMJ (2002)

Today I spoke at a medical education meeting about a communication skills course I have been piloting for our senior house officers. Attendance has been patchy and poor. I wondered if the consultants were really supportive about releasing them from duties to attend the course. I tried to explain the importance of integrating both informative and receptive behaviours in the medical interview. Everybody knows that we need to give information accurately in ways that patients can understand. But how can you explain succinctly the importance of the receptive behaviours—that is, understanding what the patient and relatives are really concerned about …

My recurring nightmare last night was particularly vivid. Geoff, my partner, was lying in his hospital bed. But was it really him and was he alive or dead? The horror increased as Dr Harold Shipman came into the picture. How or why I don't know. It was a relief to wake up. The Shipman element must represent my continuing anger …
Pneumothorax During Surgery
Authors: William K. Hamilton
Journal: JAMA (1966)

A 50-year-old man had symptoms of hoarseness, sore throat, and difficult swallowing for one year. He was a heavy smoker and in recent months had noticed some shortness of breath. Roentgenograms showed mild pulmonary amphysema and subglottic tumor formation. Biopsy of the larynx established the diagnosis of epidermoid carcinoma, and laryngectomy with radical neck dissection was planned. Preoperative sedation with meperidine hydrochloride and atropine sulfate was satisfactory, and induction of anesthesia was accomplished easily with nitrous oxide, oxygen, and halothane. A moderate depth of anesthesia, as determined by clinical signs, was maintained. Respirations were assisted and compliance was satisfactory. The skin incision was designed to allow low tracheostomy. Although some bubbles had been noticed in the midline as the trachea was being dissected, things went quite smoothly until tracheostomy was performed. Shortly after an anode endotracheal tube with inflated cuff was properly placed in the distal tracheal stoma, impedance to
NICE replies to claim that its guidance on place of birth falls short of neutrality
Authors: S. Bewley, M. Baker, C. Carson
Journal: BMJ (2015)

We wish to correct O’Brien and colleagues’ misapprehensions about a BMJ headline that they misquote,1 2 which was not derived from the National Institute for Health and Care Excellence (NICE) intrapartum care guideline or press release. They are also mistaken about the meta-analysis (and its published erratum),3 which was considered and excluded, while its individual studies were appraised individually for inclusion. They quote selectively rather than present the whole picture, as NICE recommends. Further detailed rebuttal can be found online.

NICE guideline …
GATA-3 expression identifies a high-risk subset of PTCL, NOS with distinct molecular and clinical features
Authors: Tianjiao Wang, Andrew L. Feldman, David A. Wada, Ye Lu, Avery Polk, Robert Briski, Kay Ristow, Thomas M. Habermann, Dafydd Thomas, Steven C. Ziesmer, Linda E. Wellik, Thomas M. Lanigan, Thomas E. Witzig, Mark R. Pittelkow, Nathanael G. Bailey, Alexandra C. Hristov, Megan S. Lim, Stephen M. Ansell, Ryan A. Wilcox
Journal: Blood (2014)
Effect of intravenous N-acetylcysteine infusion on haemostatic parameters in healthy subjects
Authors: T T Knudsen, S Thorsen, S A Jensen, K Dalhoff, L E Schmidt, U Becker, F Bendtsen
Journal: Gut (2005)

<b>Background and aim:</b> N-acetylcysteine is used to treat paracetamol overdose but depresses the activity of plasma coagulation factors II, VII, and X, which are often used to assess liver injury. The aim of this study was to investigate the effect of N-acetylcysteine on haemostasis in normal volunteers. <b>Methods:</b> Haemostatic parameters in 10 healthy subjects were analysed before and following intravenous infusion of therapeutic doses of N-acetylcysteine, as well as in vitro. <b>Results:</b> N-acetylcysteine induced significant decreases in plasma levels of vitamin K dependent haemostatic proteins in vivo, being maximal at one hour following the start of infusion, with maximal decreases from 1.00 to 0.73 (0.67–0.79) (mean (95% confidence interval)), 0.66 (0.58–0.73), 0.81 (0.73–0.90), 0.64 (0.57–0.70), 0.74 (0.65–0.82), and 0.61 (0.54–0.67) for factor II, VII, IX, and X activities, protein C activity, and free protein S reactivity, respectively. These data suggest that N-acetylcysteine induces protein modifications affecting activity. Five subjects developed an adverse reaction to infusion of N-acetylcysteine and these were associated with a rapid increase in levels of factor VIII and its carrier protein von Willebrand factor (vWf) from 1.0 to 1.85 (1.08–2.62) and 1.77 (0.83–2.71), respectively, which suggests that the allergic reaction induced release of vWf from endothelial cells. N-acetylcysteine did not affect factor VIII or vWf in subjects without adverse reactions, and nor did it affect factor V or antithrombin in any of the subjects. <b>Conclusion:</b> Therapeutic doses of N-acetylcysteine cause abnormal haemostatic activity, and this should be taken into account when using haemostatic function tests as an indicator of hepatic injury.