tbuckley/cabot-search huggingface dataset:
Hepatitis C nonresponders: Re-treat or retreat?
Authors: Michael Leise, Ray W. Kim, Kris Kowdley, Geoffrey McCaughan, Christian Trautwein
Journal: Hepatology (2009)

BACKGROUND: Many patients with chronic hepatitis C have not responded to therapy with pegylated interferon plus ribavirin. OBJECTIVE: To evaluate use of peginterferon-α2a plus ribavirin to re-treat nonresponders to peginterferon-α2b plus ribavirin. DESIGN: Randomized, parallel-group trial conducted between September 2003 and February 2007. Patients and researchers were not blinded to intervention assignment. Random assignment was centralized, computer-generated, and stratified by geographic region, hepatitis C virus (HCV) genotype, and histologic diagnosis. SETTING: 106 international centers. PATIENTS: 950 nonresponders to 12 or more weeks of therapy with peginterferon-α2b plus ribavirin. INTERVENTION: Peginterferon-α2a, 360 μg/wk, for 12 weeks, then 180 μg/wk to complete 72 weeks (group A) or 48 weeks (group B), or peginterferon-α2a, 180 μg/wk for 72 weeks (group C) or 48 weeks (group D). All patients received ribavirin, 1000 or 1200 mg/d. MEASUREMENTS: Sustained virologic response (SVR), defined as undetectable (<50 IU/mL) HCV RNA levels 24 weeks after the end of treatment. RESULTS: The SVR rates in groups A (n = 317), B (n = 156), C (n = 156), and D (n = 313) were 16%, 7%, 14%, and 9%, respectively (relative risk [RR] for group A vs. group D [the primary comparison], 1.80 [95% CI, 1.17 to 2.77]; P = 0.006). Extended treatment duration increased SVR rates (16% for 72 weeks [groups A and C] vs. 8% for 48 weeks [groups B and D]; RR, 2.00 [CI, 1.32 to 3.02]; P < 0.001). Complete viral suppression (HCV RNA level <50 IU/mL) at week 12 was achieved in 21% of patients in groups A and B and 13% of those in groups C and D. Rates of SVR were 49% (77 of 157 patients) and 4% (32 of 719 patients) among those with and without complete viral suppression at week 12, respectively. LIMITATIONS: Nonresponders to peginterferon-α2a plus ribavirin were not evaluated. CONCLUSION: Re-treating nonresponders to therapy with peginterferon-α2b plus ribavirin for 72 weeks significantly increases SVR rates compared with re-treating them for 48 weeks. The overall SVR rate was low, but patients who are most likely to respond to re-treatment can be identified at week 12.
Uncertainty in Prostate Cancer Care
Authors: Timothy J. Wilt
Journal: JAMA (2000)

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
Reviews and Notes: Ethics: Life Choices: A Hastings Center Introduction to Bioethics
Authors: Robert Lyman Potter
Journal: Annals of Internal Medicine (1995)

Literature of Medicine15 November 1995Reviews and Notes: Ethics: Life Choices: A Hastings Center Introduction to BioethicsRobert Lyman Potter, MD, PhDRobert Lyman Potter, MD, PhDMidwest Bioethics Center Kansas City, MO 64105Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-123-10-199511150-00041 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail JH Howell and WF Sales; eds. 560 pages. Washington, DC: Georgetown Univ Pr; 1995. $28.95. ISBN 0-87840-577-1. Order phone 410-516-6995.The editors have framed 39 carefully selected articles, previously published in the Hastings Center Report, with succinct introductions and questions useful for stimulating discussion. Thus, the text appears to be most suitable for use in a bioethics course.The articles have been skillfully arranged in five general categories of bioethical issues: decision making, reproduction, termination of treatment, transplantation, and genetics. The articles have various publication dates and authors, which display a cross-section of the last decade of the bioethics movement.... Author, Article, and Disclosure InformationAffiliations: Midwest Bioethics Center Kansas City, MO 64105 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 November 1995Volume 123, Issue 10Page: 816-816KeywordsBioethicsChartsDecision makingEmbryosEmotionsGeneticsLibrariesResuscitationTransplantation ePublished: 15 August 2000 Issue Published: 15 November 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Jenner's Evergreen Valley
Authors: Henry R. Viets
Journal: New England Journal of Medicine (1967)

DRIVING down the highway, straight as an arrow, from Gloucester to Bristol one lovely English midsummer day, I turned right some 15 miles south of Gloucester and, topping a rise over a spur of the Cotswold Hills, came to a dead halt, so enchanting was my first view of the Vale of Berkeley. Below me the land fell softly away to the Severn leaving a watershed of unmistakable charm. Jenner called it "our evergreen valley," and no one ever knew it better than he. But what caught my eye, as it had with so many before me, was a tuft . . .
Pernicious anaemia and mucosal endocrine cell proliferation of the non-antral stomach.
Authors: J Rode, A P Dhillon, L Papadaki, R Stockbrugger, R J Thompson, E Moss, P B Cotton
Journal: Gut (1986)

There is a recognised association between pernicious anaemia and the development of gastric carcinoma, endocrine cell hyperplasia, and carcinoid tumour. Multiple endoscopic biopsies from the body mucosa of seven patients with pernicious anaemia showed small intestinal metaplasia with varying degrees of inflammation, fibrosis, and expansion of the lamina propria. Using conventional silver and lead stains, endocrine cells were inconspicuous. Staining for the general neural and neuroendocrine markers NSE and PGP 9.5 revealed a proliferation of endocrine cells in the epithelium and isolated clumps of endocrine cells in the lamina propria. The clumps were composed of two cell types, either small or large. Some of these endocrine cells showed gastrin, 5HT, VIP and substance P immunoreactivity of varying intensity. Ultrastructurally nine morphologically distinct types of granules were found some of which correlated with the immunohistochemistry. Some separate islands were composed solely of endocrine cells while others had a definite neural component, suggesting that the former arise from 9budding off9 of enteroendocrine cells and the latter originate from the neuroendocrine cells of the lamina propria plexus. Thus there may be a dual origin of carcinoid tumours. Carcinoid tumours associated with pernicious anaemia tend to be multifocal and are infrequent. Less than 50 such cases have hitherto been reported. Our findings of endocrine cells proliferations in seven cases of pernicious anaemia indicate that this may be an adaptive change that occurs frequently and provides the basis on which carcinoids, less frequently, develop.
Is a Minimally Invasive Approach the Solution for Reducing Surgical Site Infections?
Authors: Simon P. Kim, Marc C. Smaldone
Journal: JAMA Surgery (2014)

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 Surgery 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 Surgery journal
A Manual of Echoencephalography
Authors: Ronald P. Pawl
Journal: JAMA (1971)

As indicated in the preface, this brief monograph is primarily intended as a training aid in the operational aspects and interpretation of echoencephalography. After a short historical sketch, the fundamental principles and the practical applications of echo are discussed. Following this, the authors discuss the normal patterns and some of the more commonly seen abnormalities. The remainder of the book is mainly devoted to the authors' experiences with echo in head trauma, brain tumor, cerebrovascular accident, inflammatory diseases, and epilepsy, although separate chapters are devoted to determination of ventricular size, transdural echo, and some additional clinical aspects and statistics. The manner of text construction and some discrepancies in the figures could cause the neophyte considerable confusion. For instance, in Fig 7, the examiner has the probe on the left side of the patient's head, but the text describes the machine set at mode "right" (p 15). Additionally, this particular chapter
The importance of context information in the diagnostic rating of digital images of patch test reactions
Authors: W. Uter, P.J. Frosch, D. Becker, A. Schnuch, A. Pfahlberg, O. Gefeller
Journal: British Journal of Dermatology (2009)

Patch test (PT) guidelines recommend classifying PT reactions based on morphological criteria only, i.e. irrespective of context information such as substance, concentration and vehicle.To analyse reclassification of PT reactions after revelation of context information subsequent to an initial blinded reading.One hundred and twenty-two participants (experienced dermatologists and researchers) rated 20 digital images of different PT reactions twice, first blinded, then unblinded regarding substance, concentration and vehicle. Agreement between both ratings was quantified with Cohen's kappa, and systematic differences statistically examined with tests for marginal homogeneity.Mostly, ratings remained stable, e.g. in > 90% of cases of images showing typical strong or extreme positive PT reactions. Reclassification was comparatively often observed in images depicting irritant reactions. Conversely, 16 of 122 participants re-rated doubtful reactions to thiuram mix and dichromate, respectively, as 'allergic' (weak or strong positive) after knowing the substance.The considerable proportion of participants who choose an 'allergic' rating, despite a morphological presentation definitely not justifying this, points to a conceptual problem of the PT reading scale: the mixing up of morphological classification and interpretation. We therefore suggest amending the scale. Moreover, standardization of PT reading can be improved by continual PT training sessions.
Migratory Pulmonary Infiltrates Secondary to Aspirated Foreign Body
Authors: James L. Hargis
Journal: JAMA (1978)

IF AN aspirated foreign body is not expelled by cough, the patient may become totally asymptomatic, and a diagnosis may not be made until complications arise later.<sup>1</sup>A chest roentgenogram usually shows a radiopaque foreign body; however, the diagnosis of a small or a radiolucent foreign body requires a high index of suspicion and careful bronchoscopy. Situations have been described in which the presence of a foreign body was not diagnosed until part of the lung was removed as treatment for abscess, bronchiectasis, or a suspected tumor.<sup>2</sup> We describe an unusual presentation of an aspirated foreign body. Although the object was radiopaque, its presence on the initial chest roentgenograms was not detected. <h3>Report of a Case</h3> In May 1977, a 58-year-old mentally retarded man had a persistent cough, and a chest roentgenogram showed a right upper lobe infiltrate. He was treated with penicillin G procaine, and a repeated
Glucose Levels Predict Hospitalization for Congestive Heart Failure in Patients at High Cardiovascular Risk
Authors: C. Held, H.C. Gerstein, S. Yusuf, F. Zhao, L. Hilbrich, C. Anderson, P. Sleight, K. Teo
Journal: Circulation (2007)

Background— Patients with diabetes mellitus (DM) are at high risk of developing congestive heart failure (CHF). However, the relationships between glucose levels and CHF in people with or without a history of DM have not been well characterized. Methods and Results— We evaluated the associations between fasting plasma glucose and risk of hospitalization for CHF during follow-up in patients at high cardiovascular risk and without CHF enrolled in a large-scale clinical trials program. Baseline fasting plasma glucose levels were assessed in 31 546 high-risk subjects with ≥1 coronary, peripheral, or cerebrovascular disease or DM with end-organ damage who are participating in 2 ongoing parallel trials evaluating the effects of telmisartan, ramipril, or their combination (Ongoing Telmisartan Alone and in Combination With Ramipril Global Endpoint Trial [ONTARGET]; n=25 620) and the effects of telmisartan against placebo in angiotensin-converting enzyme–intolerant patients (Telmisartan Randomized Assessment Study in ACE Intolerant Subjects With Cardiovascular Disease [TRANSCEND]; n=5926). Interim analyses blinded for randomized treatment were performed to compare baseline fasting plasma glucose with the adjusted CHF event rate at a mean follow-up of 886 days. Multivariable Cox regression models were performed, and associations were reported as hazard ratios and 95% confidence intervals. Among all subjects (mean age, 67 years; 69% men), of whom 11 708 (37%) had known DM and 1006 (3.2%) had newly diagnosed DM at baseline, 668 patients were hospitalized for CHF during follow-up. After adjustment for age and sex, a 1-mmol/L-higher fasting plasma glucose was associated with a 1.10-fold-increased risk of CHF hospitalization (95% confidence interval, 1.08 to 1.12; P &lt;0.0001). The association persisted after adjustment for age, sex, smoking, previous myocardial infarction, hypertension, waist-to-hip ratio, creatinine, DM, and use of aspirin, β-blockers, or statins (hazard ratio, 1.05; 95% confidence interval, 1.02 to 1.08; P &lt;0.001). Conclusions— Fasting plasma glucose is an independent predictor of hospitalization for CHF in high-risk subjects. These data provide theoretical support for potential direct beneficial effects of glucose lowering in reducing the risk of CHF and suggests the need for specific studies targeted at this issue.
PULMONARY TUBERCULOSIS AFTER SUNBATHS
Authors: A. H. Gosse, G. S. Erwin
Journal: BMJ (1934)

Bacteriological NotesMicroscopical.-On three separate occasions, the first on the fourteenth day, the urine was examined for spirochaetes, and these were found.The specimens were centri- fuged, and the deposit examined under dark-ground illuminatIon, and also stained by Fontana's silver method.It was found necessary to obtain a very fresh specimen in order to observe the movements, which consisted of rotation and undulation.In stained preparations the spirochaetes were not very numerous, but about a dozen or so of these were seen, and one (the first) preparat,on was photographed.There was a distinct hook-like tendency at the termination of the spirochaete, but the textbook well-marked hooking was only obvious in a few specimens.It must be remembered that the urine has an action on the morphological appearances, and tends to make the organism appear somewhat atyp:cal.Biological.-Rather late in the disease animal inocula- tion of the centrifuged deposit was tried, and a guinea-pig was injected intraperitoneally.No effects were observed, the animal being killed a fortnight after injection.A. D. Gardner' states that the organism occurs both in fresh and in sea water, and can be cultivated therefrom.Dr. R. A. O'Brien very kindly consented to test to serological agglutination against the leptospira with a specimen of the patient's serum, but suitable strains are not for the moment available.
Dietary Salt Intake and Blood Pressure-Reply
Authors: Belding H. Scribner
Journal: JAMA (1984)

In Reply.—  I agree with most of the points in Dr Kaplan's excellent letter. Indeed, he does a better job of making the key points than I did in my editorial. I especially like his modification of my Figure of the saturation effect and will use it in future presentations.  My only point of disagreement is that I still believe it is easy to identify the high-risk groups and that it is more important to concentrate on lowering sodium intake in these groups and not force the entire population to worry about sodium.
Eligibility of non-residents for NHS treatment: Failed asylum seekers should not be denied access to free NHS care
Authors: Roman Romero-Ortuno
Journal: BMJ (2004)

EDITOR—I agree with Pollard and Savulescu that failed asylum seekers should not be denied access to free NHS health care.1

Firstly, as Williams argues in the previous issue,2 evidence shows that failed asylum seekers are desperate and needy from a …
Low rate of calreticulin mutations in refractory anaemia with ring sideroblasts and marked thrombocytosis
Authors: J Broséus, E Lippert, A S Harutyunyan, S Jeromin, E Zipperer, L Florensa, J D Milosevic, T Haferlach, U Germing, E Luño, S Schnittger, R Kralovics, F Girodon
Journal: Leukemia (2014)
What doctors and managers can learn from each other
Authors: R. Smith
Journal: BMJ (2003)

Doctors and managers have different cultures, which opens up possibilities not only of fruitless fighting but also of rich learning. I've belonged to both cultures. In 1989 I went to the Stanford Business School in California with a typical doctor's view of management: boring, uncreative, and best left to those incapable of doing anything better. I came back thinking the opposite. To be able to mix together ideas, people, and resources to makes things happen is creative, difficult, and a privilege. Generally, there is even more uncertainty in management than medicine. Having now inhabited both cultures it's clear that they have much to learn from each other—and where better to do that than within healthcare systems, where they work alongside each other?

Not everything is different between the two cultures. Both professions are full of highly committed people who work extremely hard—often to the point of damaging themselves and their families. The training of both is long, hard, and never ends. Contrary to what doctors may believe, managers think about ethics. Shocked by the scandals of the 1980s, business schools have been teaching ethics for as long as medical schools. This is not to say that all managers behave ethically any more than all doctors do.

Both professions respond to financial incentives. Doctors like to fool themselves that they don't, but there is overwhelming evidence that they do—just like everybody …
Blackout at PFI hospital forces surgeon to operate by torchlight
Authors: B. Christie
Journal: BMJ (2012)

One of Scotland’s biggest hospitals is considering legal action against the company that runs its non-medical services under the private finance initiative (PFI) after repeated problems that have endangered patients.

The latest incident at the Edinburgh Royal Infirmary meant that a surgeon had to complete an operation by torchlight after the power supply to the theatre was disconnected. In December the private company Consort Healthcare was fined £100 000 (€120 000; $160 000) when a similar blackout forced a father to search for his newborn son in a birthing pool using the light from his mobile phone.

The NHS Lothian health board is now consulting lawyers to examine its options in relation …
Pelvic Phleboliths
Authors: D.P. Burkitt, C. Latto, S.B. Janvrin, B. Mayou
Journal: New England Journal of Medicine (1977)

Few meical phenomena are more readily recog-nized yet regularly relegated to a position of inconsequence as the presence of pelvic phleboliths. Over a century has passed since Rokitansky1 confirmed the presence of calcified masses attached to pelvic veins, and it is nearly 70 years since these masses were identified radiologically.2 Phleboliths are now agreed to be calcified blood clots in pelvic veins. They are frequently multiple, and, since they are usually observed near the line of the ureters, their only recognized importance is their liability to be mistaken for ureteric calculi.Geographical DistributionAs with many other characteristically Western diseases, . . .
Glucagonoma and Dacarbazine
Authors: LEWIS A. DUNCAN
Journal: Annals of Internal Medicine (1982)

Letters and Corrections1 December 1982Glucagonoma and DacarbazineLEWIS A. DUNCAN, M.D., SAMUEL P. MARYNICK, M.D.LEWIS A. DUNCAN, M.D.Search for more papers by this author, SAMUEL P. MARYNICK, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-97-6-930_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In the September 1980 issue (1) we reported a case of glucagonoma metastatic to liver that had been in remission clinically after dacarbazine (DTIC) chemotherapy for 18 months. At the time of the report the patient was still in remission. This patient was the third reported to have malignant glucagonoma that had responded to DTIC. Our patient had not responded to streptozocin as a single agent given before DTIC therapy.Alternate-month DTIC maintenance chemotherapy, 200 mg/m2body surface area · d for 5 days, was continued from September to December 1980. In December 1980 the patient developed...Reference1. MARYNICKFAGADAUDUNCAN SWL. Malignant glucagonoma syndrome: response to chemotherapy. Ann Intern Med. 1980;93:453-4. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: LEWIS A. DUNCAN, M.D.; SAMUEL P. MARYNICK, M.D.Affiliations: Baylor University Medical Center Dallas, TX 75246 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byLow dose DTIC is effective and safe in pretreated patients with well differentiated neuroendocrine tumorsNeuroendocrine TumorsSerum Gastrin in Zollinger-Ellison SyndromeA Case of Glucagonoma with Liver Metastasis: Complete Response to DacarbazineCurative resection for malignant glucagonomaGlucagonoma syndrome. Rapid response following arterial embolization of glucagonoma metastatic to the liver 1 December 1982Volume 97, Issue 6Page: 930-930KeywordsBody surface areaChemotherapyLiver ePublished: 1 December 2008 Issue Published: 1 December 1982 PDF downloadLoading ...