tbuckley/cabot-search huggingface dataset:
Listening to the patient
Authors: U. Chowdhury
Journal: BMJ (2000)

on outcome.The NHS (in Glasgow, at least) seems to deliver health care equitably to women with breast cancer.The poorer survival of women from deprived areas with breast cancer may not be due to their breast cancer or its management but to other factors which result in deprived women (and also men) having a reduced life expectancy compared with affluent groups. 19In particular, the relation of comorbidity and deprivation requires further investigation.We thank the West of Scotland Cancer Surveillance Unit, the medical records officers at the hospitals, and the general practitioners and practice staff for their help with this study.We thank the other members of the steering group for their input: Professor L Fallowfield, Professor J McEwen, and Dr Yvonne Taylor.
The Deep Clavicular Rhomboid Fossa
Authors: Irving A. Shauffer
Journal: JAMA (1966)

IN THE SHORT period of three weeks, we have encountered three cases in which a deep rhomboid fossa of the clavicle was noted roentgenographically. The rhomboid fossa is familiar to radiologists and consists of a roughened area along the lower surface of the medial end of the clavicle which serves as an attachment for the costoclavicular ligament. The latter binds the clavicle to the first rib.<sup>1</sup>Our interest lies in persons in whom the fossa is exaggerated so that the roentgen appearance is that of a crescentic defect which is delineated from the remainder of the clavicle by a band of increased density. Pendergrass and Hodes<sup>2</sup>wrote a comprehensive report on the subject in 1937. Several others<sup>3-7</sup>have written on the subject subsequently. In 1959, Perry et al<sup>8</sup>recorded a case of a pathologic fracture of the clavicle following biopsy of the rhomboid fossa. It was
Chromoendoscopy Using Indigo Carmine Dye Spraying with Magnifying Observation Is the Most Reliable Method for Differential Diagnosis between Non-Neoplastic and Neoplastic Colorectal Lesions: A Prospective Study
Authors: K.-I. Fu, Y. Sano, S. Kato, T. Fujii, F. Nagashima, T. Yoshino, T. Okuno, S. Yoshida, T. Fujimori
Journal: Endoscopy (2004)

Background and Aims: Differential diagnosis between non-neoplastic and neoplastic lesions is very important at colonoscopy, since removal or biopsy of non-neoplastic polyps wastes time and resources. We therefore conducted a prospective study to examine whether indigo carmine dye spraying with and without magnification is more reliable than the conventional method for differential diagnosis. Patients and Methods: 122 patients with 206 lesions of 10 mm or smaller were recruited into this study. All lesions detected on colonoscopy were first diagnosed using the conventional view, then at chromoendoscopy using 0.2 % indigo carmine, and finally at chromoendoscopy with magnification. The diagnosis at each step were recorded consecutively. All lesions were finally categorized as neoplastic or non-neoplastic according to pit pattern; non-neoplastic lesions were biopsied for histological evaluation, and all the neoplastic ones were removed endoscopically. The accuracy rate of each type of endoscopic diagnosis was evaluated, using histological findings as reference. Results: Histologically, 46 lesions (22 %) were non-neoplastic and 160 (78 %) were neoplastic. The overall diagnostic accuracies by conventional view, chromoendoscopy, and chromoendoscopy with magnification were 84.0 % (173/206), 89.3 % (184/206) and 95.6 % (197/206), respectively. Conclusion: Chromoendoscopy with magnification is the most reliable method for determining whether a colorectal lesion is non-neoplastic or neoplastic.
THE DIAGNOSIS OF STONES IN THE BILE DUCTS BY MEANS OF THE WAX TIP
Authors: GOLDER LEWIS McWHORTER
Journal: JAMA (1918)

After I had seen an ensacculated obstructing stone of the common duct at necropsy, which had been overlooked in several operations for the relief of severe biliary obstruction, an aid to the diagnosis of bile duct stones occurred to me. This method is the use of the wax-tipped filiform bougie in the bile ducts and is new in this application, though heretofore it has been used in the diagnosis of ureteral stones. In consequence of an impression or scratch mark being made on the soft wax impregnated on the end of a flexible bougie or probe, the presence of a stone and its location in the bile duct may be positively diagnosed. The wax tip was first used in the diagnosis of ureteral stones through a speculum in the female bladder.<sup>1</sup>Since the passing of the tip through the modern cystoscopes exposed the wax to scratches, it was temporarily
869 COFFEE CONSUMPTION INCREASES HEPATIC EXPRESSION OF CYTOCHROME P450S AND SIGNIFICANTLY REDUCES LIVER FIBROSIS IN PATIENTS WITH NONALCOHOLIC FATTY LIVER DISEASE (NAFLD)
Authors: H. Tillmann, A. Suzuki, H. Pang, A. Dellinger, C.D. Guy, C.A. Moylan, D. Piercy, M. Smith, M.A. Hauser, A.M.E. Diehl, M.F. Abdelmalek
Journal: Journal of Hepatology (2011)
RADIUM TREATMENT OF NEOPLASMS OF THE UPPER AIR PASSAGES
Authors: G. ALLEN ROBINSON
Journal: JAMA (1925)

This is a brief report based on my observation of 500 cases treated with radium during the last five years. A great deal of the data and technic presented herewith belonged to the late Dr. George Stuart Willis. Approximately 1 gm. of the radium element in needles, tubes, plaques and packs has been available for use. Several definite conclusions can be drawn from the observation of these cases, but further study with improved technic over a longer period of time will be necessary to determine the final status of radium therapy in neoplasms of the upper air passages. I am firmly convinced that one who uses radium intelligently must know the physics and chemistry of the subject, the biologic effects, and the technic of application. It would seem probable, therefore, that the best results will be obtained by the cooperation of the radium therapist and the skilled nose and throat
How much help does a vaccine-induced T-cell response need?
Authors: Jeffrey S. Weber, James J. Mulé
Journal: Journal of Clinical Investigation (2001)

Currently, much attention is focused on the development of tumor vaccines that incorporate defined tumor-associated antigen (TAA) peptides. Following the first report of the successful molecular cloning of a gene encoding a cytotoxic T lymphocyte-defined (CTL-defined) TAA (1), critical questions have surfaced — not only with respect to the optimal composition of such vaccines (including the choice of TAA, adjuvant, and delivery mode), but also how its effectiveness should be best measured in terms of laboratory and clinical parameters. There is much controversy surrounding these issues, ranging from whether a particular peptide sequence is truly a tumor rejection antigen to whether a dendritic cell, rather than some particular cytokine or nonspecific agent, would serve as the most efficient adjuvant. In a recent issue of the JCI, Knutson and colleagues describe the immunologic monitoring results of a pilot clinical trial of a multipeptide vaccine admixed with GM-CSF in patients with breast cancer (2). Surprisingly, the authors found that MHC class I–restricted epitope sequences nested inside MHC class II sequences were capable of eliciting CTL immunity.

This work, which incorporated a number of correlative studies measuring immune responses, was aimed in part to test the hypothesis that the direct addition of GM-CSF can boost the generation of local antigen-presenting cells, an idea that has been demonstrated in mice using GM-CSF–transfected cell vaccines (3). Clinically, in small pilot studies conducted by Jager (4) and Jaffee (5) and their colleagues, the addition of GM-CSF appeared to augment antigen-specific CTL responses to peptide- or whole-cell vaccines. In contrast, recently presented preliminary data suggest that GM-CSF does not add to the immunogenicity of a peptide vaccine prepared with incomplete Freund’s Adjuvant (6). Otherwise, no randomized trials testing the clinical or immunologic utility of GM-CSF as an adjuvant in cancer patients have yet been reported. The current study (2) was also intended to test the idea that MHC class II–restricted helper peptides could generate detectable and durable CD4+ T-cell immunity in cancer patients, which would result in augmented MHC class I–restricted CD8+ CTL responses. The authors got an unexpected bonus, since they not only detected helper peptide–specific responses, but they also found that certain MHC class I epitopes that acted on CD8+ CTLs correspond to sequences nested within longer helper peptides that act on CD4+ cells. The authors’ previous small pilot trials (7, 8) demonstrated that breast cancer patients immunized with HER-2/neu helper peptides develop both HER-2/neu peptide–specific T-cell responses and also HER-2/neu protein–specific responses, a consequence of epitope spreading. Immune T cells elicited by vaccination generated delayed-type hypersensitivity (DTH) responses, which indicated the potential ability to traffic distally from the vaccine site.
Case 27-1977
Authors: Richard C. Cabot, Robert E. Scully, James J. Galdabini, Betty U. McNeely, J. Warren Harthorne, Ronald L. Sirota
Journal: New England Journal of Medicine (1977)

Presentation of Case First admission. A 56-year-old man was admitted to the hospital because of coronary-artery disease.He was well until seven months previously, when anterolateral myocardial infarction occurred. Two months before entry congestive heart failure developed, and digoxin and furosemide were begun. Angina occurred on mild exertion. Cardiac catheterization, performed at another hospital, revealed coronary-artery disease that involved three vessels, with total occlusion of the left anterior descending artery, a left ventricular aneurysm and mitral regurgitation.There was a past history of gastric ulcer, with complete healing demonstrated by x-ray films. He had smoked 2 1/2 packages of . . .
Book: Don't Tell the Patient: Behind the Drug Safety Net
Authors: S. Evans
Journal: BMJ (2000)

Bill Inman Highland Park Productions, £17.95, pp 304 ISBN 0967581206 Rating: ![Graphic][1]</img>![Graphic][2]</img> Don't Tell the Patient is an autobio graphical view of Professor Bill Inman's 30 years of distinguished work in drug safety. His medical training at Cambridge University was interrupted by polio. Before the establishment of the clinical school, special arrangements were made to enable him to qualify and complete registration despite his wheelchair. In 1964 he joined the Department of Health and Social Security in the aftermath of thalidomide. He describes the introduction of the “yellow card” … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif
PREDICTIVE VALUE OF ENDOTHELIAL FUNCTION BY NON-INVASIVE PERIPHERAL ARTERIAL TONOMETRY FOR CORONARY ARTERY DISEASE
Authors: Yasushi Matsuzawa, Jing Li, Tatsuo Aoki, Raviteja Guddeti, Taek-Geun Kwon, Rebecca Cilluffo, Lukas Wellkamp, Robert Widmer, Rebecca Nelson, Ryan Lennon, Lilach Lerman, Amir Lerman
Journal: Journal of the American College of Cardiology (2014)
Doctors and industry call on NHS to sustain medicines research
Authors: T. Groves
Journal: BMJ (2011)

Doctors in the NHS need to engage more actively with drug studies if the UK is to remain one of the world’s most successful centres for research, say senior figures from medicine and industry.

Patrick Vallance, senior vice president of medicines discovery and development at GlaxoSmithKline, told a conference at the Royal College of Physicians, London, that the biggest question now for drug companies is “Is anyone going to buy this drug?”

Dr Vallance argued that the “blockbuster” model of drug development is unsustainable, and that new drugs will not be reimbursed in healthcare unless they are innovative and sufficiently differentiated from other treatments. Increasingly, companies will have to show real value to purchasers through effectiveness trials and database studies in clinical practice.

Dr Vallance warned that these studies …
When They Tell Me
Authors: Grey Brown
Journal: JAMA (2008)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Cancer Therapy: Nanobiotechnology Promotes Noninvasive High‐Intensity Focused Ultrasound Cancer Surgery (Adv. Healthcare Mater. 1/2015)
Authors: Yu Chen, Hangrong Chen, Jianlin Shi
Journal: Advanced Healthcare Materials (2015)

As the “bloodless scalpel”, high intensity focused ultrasound (HIFU) is regarded as one of the most promising and representative non-invasive therapeutic modalities for cancer surgery. On page 158 Y. Chen, H. R. Chen, and J. L. Shi present the very recent exciting progresses on the elaborate design and fabrication of organic, inorganic and organic/inorganic hybrid nanoparticles for enhancing the HIFU ablation efficiency against tumor tissues.
Senior house officers in medicine: postal survey of training and work experience
Authors: P. J Baldwin, R. W Newton, G. Buckley, M. A Roberts, M. Dodd
Journal: BMJ (1997)

<h3>Abstract</h3> <b>Objectives:</b> To describe working conditions for senior house officers in medicine in Scotland and to relate these to the quality of clinical training they receive. <b>Design:</b> Postal questionnaire survey. <b>Subjects:</b> All senior house officers in medicine and related specialties in post in Scotland in October 1995 (n=437); 252 (58%) respondents. <b>Main outcome measures:</b> Questionnaires covered hours, working patterns, measures of workload, an attitudes to work scale, and experience of education and training. <b>Results:</b> In the week before the questionnaire, doctors on rotas had worked a mean of 7.4 (95% confidence interval 5.8 to 9.0) hours in excess of their contracts, compared with 3.7 (2.0 to 5.5) hours for those on partial shifts. The most common reason for this was "the needs of the patients or the service." Those on partial shifts reported significantly less continuity of care with patients than those on rotas (Mann-Whitney U test, z=-4.2, P&lt;0.0001) or full shifts (z=-2.08, P=0.03). Doctors in general medicine reported significantly higher measures of workload (number of acute admissions, number of times called out, and fewest hours9 uninterrupted sleep) than those in subspecialties. Consultants9 clinical teaching and style of conducting a ward round were significantly related to factors extracted from the attitudes to work scale. <b>Conclusions:</b> The quality of senior house officers9 training is detrimentally affected by a variety of conditions, especially the need for closer support and supervision, the need for greater feedback, and the lack of time that consultants have to dedicate to clinical training. Efforts should be made to improve these conditions and to reinforce a close working relationship between trainee and supervising consultant. <h3>Key messages</h3> Many senior house officers continue to work long hours in excess of their contracts Senior house officers see partial shifts as detrimental to their own health, patient care, and clinical training Acute general medicine has a higher intensity of work than the allied specialties The quality of consultant feedback has an important influence on perception of learning, ability to cope, and relationships between junior and senior staff
Activating ESR1 mutations in hormone-resistant metastatic breast cancer
Authors: Dan R Robinson, Yi-Mi Wu, Pankaj Vats, Fengyun Su, Robert J Lonigro, Xuhong Cao, Shanker Kalyana-Sundaram, Rui Wang, Yu Ning, Lynda Hodges, Amy Gursky, Javed Siddiqui, Scott A Tomlins, Sameek Roychowdhury, Kenneth J Pienta, Scott Y Kim, J Scott Roberts, James M Rae, Catherine H Van Poznak, Daniel F Hayes, Rashmi Chugh, Lakshmi P Kunju, Moshe Talpaz, Anne F Schott, Arul M Chinnaiyan
Journal: Nature Genetics (2013)
Hürthle Cell Tumors of the Thyroid Gland
Authors: Robert H. Caplan
Journal: JAMA (1984)

We reviewed the pathology and clinical follow-up of 26 patients with H urthle cell adenomas and three patients harboring H urthle cell carcinomas, who were treated at our medical center from 1950 to 1979. Although benign lesions could not be distinguished from malignant tumors by cytologic features alone, other pathologic features allowed differentiation. A total thyroidectomy was performed in only one patient; the remaining patients were treated by less extensive operations. None of the patients with benign adenomas, including those with tumors greater than 2 cm in diameter, experienced recurrent or metastatic disease. The period of observation varied from two to 22 years (mean, 8.5 +/- 7.7 years). We conclude that lobectomy is a satisfactory operation for removal of benign H urthle cell tumors, and reserve total or near-total thyroidectomy for cases displaying pathologic evidence of malignancy.
Factors Influencing the Radiological Attack Rate of Progressive Massive Fibrosis
Authors: A. L. Cochrane, W. E. Miall
Journal: BMJ (1956)

Progressive massive fibrosis (P.M.F.) is the more serious form of coal-workers' pneumoconiosis.It causes serious disability (Gilson and Hugh-Jones, 1955; Gilson and Carpenter, 1956), probably causes excessive mortality (Carpenter and Cochrane, 1956), and has a surprisingly high prevalence among miners and ex-miners in
Abstract 4454: Modulation of the early cytotoxic effects of Irvalec® by zinc and DIDS in lung tumor cells
Authors: José M. Molina-Guijarro, Victoria Moneo, Juan F. Martínez-Leal, Carmen Cuevas, Luis F. Garcia-Fernandez, Carlos M. Galmarini
Journal: Cancer Research (2010)

Abstract Irvalec®, a marine-derived depsipeptide, has showed potent cytotoxic activity in vitro against a wide variety of human tumors, including breast, colon, pancreas, lung and prostate. Irvalec® is currently undergoing phase II clinical studies in non-small lung cancer. Exposure of tumor cells to Irvalec® induces necrotic cell death, a process associated with rapid loss of membrane integrity and subsequent cell permeabilization. In dose-response experiments using different tumor cell lines, very similar IC50 values were obtained after short (30 min) and long (72 h) exposure times to the drug, suggesting that the compound exerts its cytotoxic effect immediately after drug treatment. Tumor cells exposed to effective concentrations of Irvalec® underwent rapid and dramatic morphological changes, including cell blebbing, severe swelling, and plasma membrane permeabilization (as detected by propidium iodide (PI) uptake and LDH release) that irrevocably lead to cell lysis. Interestingly, membrane damage was observed only after reaching a threshold concentration of around 1-5 µM and only in the continuous presence of the compound in the culture medium. Compounds acting at the cell membrane have been reported to have similar cellular effects than those observed with Irvalec®. The activity of these compounds was inhibited by the use of different cell membrane protectors. To test if these protectors exert some effect against the cytotoxic activity of Irvalec® we exposed A549 cells to a panel of 20 different compounds and then treated with Irvalec®. The cytotoxic activity of the drug was evaluated by PI nuclear staining by fluorescence microscopy, time-lapse videomicroscopy and plate fluorimetry. Among the compounds tested, only DIDS (dihydro-4,4′ diisothiocyanostilbene-2,2′-disulphonic acid) and zinc salts resulted in a drastic reduction of the early effects of Irvalec® in A549 cells. In the presence of DIDS or zinc, a 70% and 90% decrease was observed, respectively, in the cytotoxicity of the drug. Altogether, these results suggest that Irvalec® induces a rapid hydroelectrolitic disbalance in tumor cells, causing severe alterations that lead to a necrotic cell death. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4454.
Review: Antibiotic prophylaxis on removal of urinary catheters reduces symptomatic urinary tract infections
Authors: Dennis G. Maki
Journal: Annals of Internal Medicine (2013)

Source Citation Marschall J, Carpenter CR, Fowler S, Trautner BW; CDC Prevention Epicenters Program. Antibiotic prophylaxis for urinary tract infections after removal of urinary catheter: meta-analysis. BMJ. 2013;346:f3147. 23757735
Intrauterine Transmission of Cytomegalovirus to Infants of Women with Preconceptional Immunity
Authors: Suresh B. Boppana, Lisa B. Rivera, Karen B. Fowler, Michael Mach, William J. Britt
Journal: New England Journal of Medicine (2001)

Preconceptional immunity against cytomegalovirus (CMV) provides only partial protection against intrauterine transmission of the virus. Whether congenital CMV infection in the offspring of women who are seropositive for CMV can occur after maternal reinfection with a different strain of CMV is unknown.Serum specimens from 46 women with preconceptional immunity against CMV that were obtained during the previous pregnancy and the current pregnancy were analyzed for antibodies against the strain-specific epitopes of CMV glycoprotein H. Virus-neutralizing activity in maternal serum samples was measured against the AD169 laboratory strain of CMV and the CMV isolates available from seven infected infants. In addition, the nucleotide sequences of the glycoprotein H gene from the seven CMV isolates were determined.Eleven of the 16 mothers with infected infants (69 percent) had antibodies against the glycoprotein H epitopes present on two laboratory strains of CMV, AD169 and Towne. Ten of the 16 mothers with infected children (62 percent) acquired new antibody specificities against glycoprotein H, as compared with only 4 of the 30 mothers of uninfected infants (13 percent, P<0.001). The samples obtained at the time of the current delivery from four of the seven mothers contained at least twice as many neutralizing antibodies against the CMV isolated from their infants as were present in the samples obtained at the previous delivery. The specificity of the newly acquired maternal antibodies reflected the amino acid sequence of the glycoprotein H epitope of CMV from these four infants.In women who are seropositive for CMV, reinfection with a different strain of CMV can lead to intrauterine transmission and symptomatic congenital infection.