tbuckley/cabot-search huggingface dataset:
Time and Medicine
Authors: William S. Aronstein
Journal: Annals of Internal Medicine (2000)

Letters20 June 2000Time and MedicineWilliam S. Aronstein, MDWilliam S. Aronstein, MDGlendale, OH 45246 (Aronstein)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-132-12-200006200-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The 4 January issue on “Time and Medicine” was thought-provoking. I wish, however, that someone had thought to include, perhaps as a quotation, the following comments from an address given by my revered teacher, the late Philip A. Tumulty, and published as “The Art of Healing” (1): “From a purely practical standpoint, these special characteristics of patients lead to but one conclusion regarding the practice of clinical medicine—it is simply not possible to give excellent care to patients in a quick, easy or offhand fashion, or through the agency of some aid or substitute. … Time personally ...References1. Tumulty PA. The art of healing. Johns Hopkins Medical Journal. 1978;143:140-3. MedlineGoogle Scholar2. Morrison I. The future of physicians' time. Ann Intern Med. 2000;132:80-4. LinkGoogle Scholar3. Clever LH. Some things have not changed. Ann Intern Med. 2000;132:85-9. LinkGoogle Scholar4. Lee RV. Changing times: reflections on a professional lifetime. An interview with Paul Beeson. Ann Intern Med. 2000;132:71-9. LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: William S. Aronstein, MDAffiliations: Glendale, OH 45246 (Aronstein) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Future of Physicians' Time Ian Morrison Some Things Have Not Changed Linda Hawes Clever Changing Times: Reflections on a Professional Lifetime: An Interview with Paul Beeson Richard V. Lee Metrics 20 June 2000Volume 132, Issue 12Page: 1005-1006KeywordsPatients ePublished: 15 August 2000 Issue Published: 20 June 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Legislation governing the US incentive scheme for neglected diseases needs to be amended, urges MSF
Authors: J. Reid, J. Potet, K. Athersuch, M. Grovestock, J. R. Sanjuan
Journal: BMJ (2014)

As a medical humanitarian organisation diagnosing and treating people with neglected diseases for almost 30 years,1 2 Medecins Sans Frontieres (MSF) understands only too well that the dearth of research and development for new tools to treat these diseases3 is directly attributable to insufficient funding and incentives.

Innovative incentive mechanisms for research and development, including “pull” mechanisms, such as the US Food and Drug Administration priority …
Reversible Dementia Due to Thalidomide Therapy for Multiple Myeloma
Authors: Alexander E. Morgan, Wade K. Smith, James L. Levenson
Journal: New England Journal of Medicine (2003)

To the Editor: Thalidomide is used to treat multiple myeloma because of its apoptotic1 and antiangiogenic2 properties. Common side effects of thalidomide in patients with multiple myeloma include s...
Abstract 2772: AT13387, an HSP90 inhibitor, is effective in both vemurafenib-sensitive and -resistant melanoma models
Authors: Ana M. Rodriguez-Lopez, Tomoko Smyth, Jayne Curry, Brent Graham, Rachel McMenamin, John Lyons, Neil Thompson, Nicola Wallis
Journal: Cancer Research (2012)

Abstract Background: Mutations in BRAF are found in approximately 50% of melanomas. Vemurafenib, the selective mutant BRAF inhibitor, is an effective treatment in this disease but is limited by the onset of resistance. A number of mechanisms of resistance to RAF inhibitors have been described, including alternative mechanisms for activating the MEK-ERK and AKT pathways. HSP90 inhibitors affect clients in both these pathways and so it has been suggested that HSP90 inhibition is a potential mechanism for overcoming resistance to RAF inhibitors in melanoma. Results: AT13387 is a fragment-derived, potent HSP90 inhibitor, which is currently being evaluated in clinical trials. AT13387 inhibited cell proliferation in a range of melanoma cell lines, including cell lines with different mechanisms of resistance to vemurafenib (See Table). AT13387 treatment of melanoma cell lines resulted in the induction of HSP70, a marker of HSP90 inhibition, and depletion of HSP90 client proteins including BRAF and AKT. The levels of phospho-ERK, phospho-AKT and phospho-S6 were also depleted in both vemurafenib-sensitive (A375) and vemurafenib-resistant (A2058) lines indicating that the MEK-ERK and AKT signaling pathways were both inhibited. This demonstrates that vemurafenib resistance mediated by upregulation of the AKT pathway can be overcome by HSP90 inhibition. In vivo, AT13387 significantly inhibited growth of an A375 melanoma xenograft. Client proteins, including BRAF, CRAF and AKT were depleted in xenograft tissue and the MEK-ERK and AKT signaling pathways were again inhibited. Conclusions: These results demonstrate the activity of AT13387 in both vemurafenib-sensitive and -resistant models and show that HSP90 inhibition results in downregulation of signaling pathways that may be activated as a result of resistance to RAF inhibitors. These data support further clinical evaluation of AT13387 in melanoma. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2772. doi:1538-7445.AM2012-2772
What’s new in subarachnoid hemorrhage
Authors: M. Smith, G. Citerio
Journal: Intensive Care Medicine (2014)

Aneurysmal subarachnoid haemorrhage (SAH) is a devastating disease first described in the era of Hippocrates. Despite advances in treatment, 1-month case fatality remains as high as 35 %, with around one-third of survivors needing lifelong care and a further third having residual cognitive impairment that affects functional status and quality of life. The immediate and delayed effects of SAH on outcome have recently been reviewed in Intensive Care Medicine [1]. There have been advances in the treatment of this devastating condition aimed at reducing early (mainly re-bleeding) or late complications, particularly delayed cerebral ischemia (DCI). The importance of treatment in high-volume centres by a multidisciplinary team cannot be over-emphasised [2].

Endovascular coiling of intracranial aneurysms represents a major advance in the treatment of SAH and allows minimally invasive and effective treatment. Flow-diverting stents, with or without coils, are an increasingly employed strategy that allows even complex aneurysm to be treated minimally invasively [3]. Clipping of the aneurysm remains an option in the minority of cases that cannot be secured via the endovascular route. Early aneurysm control reduces the risk of re-bleeding and allows maintenance of higher systemic blood pressure to prevent or treat cerebral hypoperfusion. Once the aneurysm is secured, the intensive care management of SAH involves optimization of systemic physiology, and prevention or treatment of DCI and non-neurological complications. Consensus guidelines on the critical care management of SAH have recently been published [2].
Videokeratographic anomalies in familial keratoconus
Authors: David Levy, Helen Hutchings, Jean F Rouland, José Guell, Carole Burillon, Jean L Arné, Joseph Colin, Laurent Laroche, Michel Montard, Bernard Delbosc, Isabelle Aptel, Hervé Ginisty, Hélène Grandjean, Francois Malecaze
Journal: Ophthalmology (2004)
The Association between Polymorphisms of B7 Molecules (CD80 and CD86) and Graves' Ophthalmopathy in a Taiwanese Population
Authors: Wen-Ling Liao, Rong-Hsing Chen, Hui-Ju Lin, Yu-Huei Liu, Wen-Chi Chen, Yuhsin Tsai, Lei Wan, Fuu-Jen Tsai
Journal: Ophthalmology (2010)
The inside story on prison health
Authors: T. Jackson
Journal: BMJ (2013)

The rate of imprisonment in England, Wales, and Scotland—at around 154 per 100 000 people—is one of the highest in western Europe. While dwarfed by that of the United States, the so called “land of the free,” where roughly one in 100 people is behind bars, the number of prisoners in England and Wales has nearly doubled in the past 20 years, even though recorded crime has fallen. In the final article of his five part series on prison health ( BMJ 2013;346:f2216, doi:10.1136/bmj.f2216), Stephen Ginn asks whether prison is the right place for many offenders and whether earlier assistance in the community might prevent a prison sentence. 

As Ginn writes, …
Quantification of left ventricular volumes by two-dimensional echocardiography: a simplified and accurate approach.
Authors: F A Tortoledo, M A Quinones, G C Fernandez, A D Waggoner, W L Winters
Journal: Circulation (1983)

A new and simplified method to determine left ventricular (LV) volumes with two-dimen- sional echocardiography (2-D echo) was developed using the parasternal long-axis and apical four-and two- chamber views.An end-diastolic area (EDA) was derived using the longest minor axis (Dmax) from either of the three views and the major long axis (Lmax) from the apical views, with the formula EDA = Dmax * L Tr/4.LV end-diastolic volumes (EDVs) obtained by single-plane angiograms were correlated with the EDAs derived from 2-D echo in 25 initial patients and the resultant equation, EDV = (EDA x 4.35) -6.44 (r = 0.82, SEE = 34 ml), was applied prospectively to 27 patients (r = 0.95, SEE = 19 ml) and to the 52 combined patients without underestimation according to the equation y = 1.07 x -7.3.Twenty-nine of the 52 patients had coronary artery disease and regional dyssynergy.Ejection fraction (EF) measured with a previously validated method that uses the average of several LV dimensions correlated well with angio- graphic EF in the initial (r = 0.96, SEE = 5%) and prospective (r = 0.87, SEE = 8%) series and in both series combined (r = 0.92, SEE = 7%).End-systolic volume (ESV) was derived by substracting stroke volume (EDV x EF) from EDV. Correlation coefficients for 2-D echo ESV vs angiographic ESV were 0.91, 0.97 and 0.94, with SEES of 25, 12 and 19 ml for the initial, prospective and combined series, respectively.Two-dimensional echo EDV, EF and ESV also correlated well (r = 0.89-0.97)with biplane angiographic results in 15 of 27 prospective patients.Comparisons between two independent observers revealed high r values (0.958-0.965) and mean differences for EDV, EF and ESVof + 3%, 6% and 8%, respectively.Thus, a simplified method of determining LV volumes with 2-D echo without a need for planimetry or computer assistance has been validated.
Abstract 1282: Phase I evaluation of STA-1474, a pro-drug of the novel HSP90 inhibitor STA-9090, in dogs with spontaneous cancer
Authors: Cheryl A. London, Misty D. Bear, Jennifer McCleese, Kevin P. Foley, Reji Paalangara, Takayo Inoue, Weiwen Ying, James Barsoum
Journal: Cancer Research (2011)

Abstract The novel water soluble compound STA-1474 is metabolized to STA-9090, a potent HSP90 inhibitor previously shown to kill canine tumor cell lines in vitro and inhibit tumor growth in the setting of murine xenografts. The purpose of the following study was to extend these observations and investigate the safety and efficacy of STA-1474 in dogs with spontaneous tumors. This was a Phase 1 trial in which dogs with spontaneous tumors received STA-1474 under one of three different dosing schemes. Pharmacokinetics, toxicities, biomarker changes, and tumor responses were assessed. Twenty-five dogs with a variety of cancers were enrolled. Toxicities were primarily gastrointestinal in nature consisting of diarrhea, vomiting, inappetence and lethargy. Upregulation of HSP70 protein expression was noted in both tumor specimens and PBMCs within 7 hours following drug administration. Measurable objective responses were observed in dogs with malignant mast cell disease (n=3), osteosarcoma (n=1), melanoma (n=1) and thyroid carcinoma (n=1), for a response rate of 24% (6/25). Stable disease (&amp;gt;10 weeks) was seen in 3 dogs, for a resultant overall biological activity of 36% (9/25). This study provides evidence that STA-1474 exhibits biologic activity in a relevant large animal model of cancer. Given the similarities of canine and human cancers with respect to tumor biology and HSP90 activation, it is likely that STA-1474 and STA-9090 will demonstrate comparable anti-cancer activity in human patients. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1282. doi:10.1158/1538-7445.AM2011-1282
New Visceral Transplants Invigorate Cancer Victims
Authors: Marsha F. Goldsmith
Journal: JAMA (1989)

TRANSPLANTATION of multiple organs into the abdomen has taken off in a new direction since the failure of the experimental operations on children described in this issue ofThe Journal. Last month, Thomas E. Starzl, MD, PhD, Department of Surgery, University of Pittsburgh (Pa) Health Center, announced that since June, 13 adults near death from hepatic, pancreatic, or duodenal carcinoma have traded their diseased organs for a chance at life via the "organ cluster" transplant procedure he is pioneering. In mid-February, 11 patients were surviving and were apparently free of cancer. All the operations were performed at Pittsburgh's Presbyterian-University Hospital. All but the most recent patient had returned home after receiving a new liver, pancreas, and duodenum. According to Saturo Todo, MD, the surgeon who led the team for many of the procedures, the liver, pancreas, duodenum, stomach, spleen, and right and transverse colon are resected. The superior mesentery artery
Performing Arts Medicine
Authors: Susan Arjmand
Journal: JAMA (2011)

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
Crossover and Self-Controlled Designs in Clinical Research
Authors: Thomas A. Louis, Philip W. Lavori, John C. Bailar, Marcia Polansky
Journal: New England Journal of Medicine (1984)

Crossover studies (clinical trials in which each patient receives two or more treatments in sequence) and self-controlled studies (in which each patient serves as his or her own control) can produce results that are statistically and clinically valid with far fewer patients than would otherwise be required. We investigated the use of the crossover design in the 13 crossover studies that appeared in the Journal during 1978 and 1979. We considered the following important features of design and analysis as they applied to these studies: the method by which patients were assigned to initial treatment (only 7 of 13 studies used random assignment); the determination of when to switch treatments (10 of the 13 used a time-dependent rule, and 3 a less appropriate disease-state-dependent rule); blinding of the crossover point (in only 3 of the 13 studies was the crossover point concealed, but in 4 of the remaining 10 concealment was impossible); assessment of the effects of the order of treatments (included in only 1 of the 13 studies); and the use of at least minimally acceptable statistical analysis (11 of the 13 studies had such an analysis). We also report briefly on 28 additional studies of a single treatment each, in which each patient served as his or her own control before or after treatment or both. The scientific issues were much the same as in crossover studies except that self-controlled comparisons of treatments tended to be less precisely designed and conducted and to focus on clinical problems and patient groups that are especially difficult to study.
The Physician in a Changing Social Structure
Authors: Earle M. Chapman
Journal: New England Journal of Medicine (1971)

Abstract The Social legislation of 1965–66 represented a post-war II adjustment with a shift in ethics from individualism in an agrarian society to a complex organization in a dominantly urban society. Consequently, a reformation in health services confronts physicians, who have long enjoyed a respected position in providing care for those who assumed personal responsibility. Now that society has assumed responsibility, proof of competence is demanded from the physician receiving payment for service. Thus, unless present methods of continuing education are strengthened, government threatens to control their accreditation and to demand licensure of physicians based on periodic re-examination. The profession is responding by exploring several methods of continuous education and is offering specific alternatives to government regulation. The Massachusetts Medical Society is challenged by three specific alternatives to achieve its role in this changing social structure.
Applying Science to Violence Prevention
Authors: Mark L. Rosenberg
Journal: JAMA (1997)

Violence in America runs the risk of becoming endemic at very high levels. Each year, approximately 25500 people die from homicide and 31000 die from suicide in the United States.<sup>1</sup>Violence is the second leading cause of death for Americans between the ages of 15 and 24 years and the leading cause of death for young African Americans in this age group.<sup>2</sup>Adolescents and young adults are disproportionately represented among the victims and perpetrators of violence in our society. The average age of both violent offenders and victims has been growing younger and younger in recent years.<sup>3</sup>Youth interpersonal violence is also closely associated with the problems of child abuse and neglect, dating violence, substance abuse, suicide, and violence against women.<sup>4</sup>Because research suggests that violence is also transmitted from one generation to the next<sup>5</sup>and that aggressive children tend to become violent
Endoscopic Transpapillary Biopsy (ETPB) of Human Extrahepatic Bile Ducts - Light and Electron Microscopic Findings, Clinical Significance
Authors: H. Dancygier
Journal: Endoscopy (1989)

Endoscopic transpapillary biopsy (ETPB) has been performed in 106 patients to investigate the fine structure of human bile ducts, and to assess its clinical significance. Three hundred and twenty-six biopsy specimens obtained from the hepatic and common bile duct and from the ampullary/papillary region were examined by light, transmission and scanning electron microscopy. No complications due to biopsy occurred. The epithelium lining at the bile duct contains 5 different types of cells: the main epithelial cell, endocrine/paracrine cells, tuft cells, immunocompetent cells and goblet cells. Twenty-one ampullary carcinomas, and 26 benign neoplastic ampullary lesions were diagnosed. In 8 of the former, only second-look, follow-up biopsies established the presence of a carcinoma. While the clinical significance of "blind" hepatic duct biopsy is not readily apparent, ETPB is the diagnostic method of choice for ampullary neoplasms, and extensive biopsies from even tiny ampullary lesions are mandatory.
Abstract 2314: Epithelial-mesenchymal transition derived cells exhibit multi-lineage differentiation potential similar to mesenchymal stem cells
Authors: Venkata Lokesh Battula, Kurt Evans, Brett G. Hollier, Yuexi Shi, Frank C. Marini, Ayyakkannu Ayyanan, Cathrin Brisken, Rudy Guerra, Michael Andreeff, Sendurai A. Mani
Journal: Cancer Research (2010)

Abstract The epithelial-to-mesenchymal transition (EMT) is an embryonic process that becomes latent in most normal adult tissues. Recently, we have shown that induction of EMT endows stem cell traits to breast epithelial cells. Mesenchymal stem cells (MSC) have the capacity to self-renew and differentiate into multiple tissue lineages. We hypothesized that the activation of EMT by ectopic expression of Twist, Snail or TGF-β in immortalized human mammary epithelial cells (HMEC) will result in the generation of cells with a phenotype and functionality similar to MSC. We found that the EMT-derived cells not only showed similar morphology but also displayed the typical MSC phenotype i.e. CD44+, CD24− and CD45−. Alternatively, MSC expressed EMT inducing genes such as Twist, Snail and FOXC2. Interestingly, CD140b (PDGFR-β), a marker for naive MSC, was exclusively expressed in EMT-derived cells compared to their epithelial counterparts. Moreover, functional analysis revealed that EMT-derived but not the control cells differentiate into Alizarin Red S-positive mature osteoblasts, Oil Red O-positive adipocytes and Alcian Blue-positive chondrocytes similar to MSC. We also observed that EMT-derived but not control cells invade and migrate towards MDA-MB-231 tumor cells in-vitro similar to MSC, displaying the characteristic tropism of MSC for tumor cells as previously reported by us. In-vivo wound homing assays in nude mice revealed that the EMT-derived cells home to wound sites similar to MSC. In conclusion, we demonstrated that the EMT-derived cells are similar to MSC in gene-expression, multi-lineage differentiation, migration towards tumor cells and their ability to home to wounds. These results also suggest that EMT-derived MSC are active participants in cancer growth and invasion. 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 2314.
Primer of Biostatistics
Authors: Evlin L. Kinney
Journal: JAMA (1987)

This book attempts to achieve a difficult goal: to teach statistics to the novice so as to impart a liking and understanding of statistics. The book is geared toward a medical audience, since most examples are from the medical literature. The structure of the book consists of the following elements in each chapter: a small number of statistical rules of thumb, followed by a nontechnical explanation, a demonstration of how to work through the mechanics of doing the statistical test in question, a summary, and sample problems to be solved by the reader. (The answers, with explanations, are provided in an appendix.) Although a variety of univariate statistics are included, certain topics that are important in medical research are not. For example, there is little or no discussion of multiple regression, life-table techniques, or pooling of studies. These omissions, especially of multiple regression, are unfortunate. The Primer was derived from