tbuckley/cabot-search huggingface dataset:
Choice, Transparency, Coordination, and Quality Among Direct-to-Consumer Telemedicine Websites and Apps Treating Skin Disease
Authors: Jack S. Resneck, Michael Abrouk, Meredith Steuer, Andrew Tam, Adam Yen, Ivy Lee, Carrie L. Kovarik, Karen E. Edison
Journal: JAMA Dermatology (2016)

Evidence supports use of teleconsultation for improving patient access to dermatology. However, little is known about the quality of rapidly expanding direct-to-consumer (DTC) telemedicine websites and smartphone apps diagnosing and treating skin disease.To assess the performance of DTC teledermatology services.Simulated patients submitted a series of structured dermatologic cases with photographs, including neoplastic, inflammatory, and infectious conditions, using regional and national DTC telemedicine websites and smartphone apps offering services to California residents.Choice of clinician, transparency of credentials, clinician location, demographic and medical data requested, diagnoses given, treatments recommended or prescribed, adverse effects discussed, care coordination.We received responses for 62 clinical encounters from 16 DTC telemedicine websites from February 4 to March 11, 2016. None asked for identification or raised concerns about pseudonym use or falsified photographs. During most encounters (42 [68%]), patients were assigned a clinician without any choice. Only 16 (26%) disclosed information about clinician licensure, and some used internationally based physicians without California licenses. Few collected the name of an existing primary care physician (14 [23%]) or offered to send records (6 [10%]). A diagnosis or likely diagnosis was proffered in 48 encounters (77%). Prescription medications were ordered in 31 of 48 diagnosed cases (65%), and relevant adverse effects or pregnancy risks were disclosed in a minority (10 of 31 [32%] and 6 of 14 [43%], respectively). Websites made several correct diagnoses in clinical scenarios where photographs alone were adequate, but when basic additional history elements (eg, fever, hypertrichosis, oligomenorrhea) were important, they regularly failed to ask simple relevant questions and diagnostic performance was poor. Major diagnoses were repeatedly missed, including secondary syphilis, eczema herpeticum, gram-negative folliculitis, and polycystic ovarian syndrome. Regardless of the diagnoses given, treatments prescribed were sometimes at odds with existing guidelines.Telemedicine has potential to expand access to high-value health care. Our findings, however, raise concerns about the quality of skin disease diagnosis and treatment provided by many DTC telemedicine websites. Ongoing expansion of health plan coverage of these services may be premature. Until improvements are made, patients risk using health care services that lack transparency, choice, thoroughness, diagnostic and therapeutic quality, and care coordination. We offer several suggestions to improve the quality of DTC telemedicine websites and apps and avoid further growth of fragmented, low-quality care.
Macrophage Migration Inhibitory Factor Regulates Multiple Myeloma Bone Marrow Homing
Authors: Yuhuan Zheng, Qiang Wang, Jianfei Qian, Yi Li, Yong Lu, Enguang Bi, Mingjun Zhang, Tianshu Li, Maojie Yang, Yu Wu, Frederic J. Reu, Zhen Cai, Qing Yi
Journal: Blood (2014)
OP18NEURO ONCOLOGY PARENT'S AWARENESS DAY
Authors: Louise Robinson, Emily Bennett, Emily Talbot, Katie Bohane, Margaret Parr, Nicola Webb, Tamsin Hancox, David Walker, Kathy Dickinson
Journal: Neuro-Oncology (2015)

INTRODUCTION: An awareness day was developed in response to feedback from parents/carers of children and young people (CYP) with brain tumours. Objectives of the day were; increased understanding of the ongoing implications of having a brain tumour, providing information on accessing support and opportunities to meet other families. METHOD: The day was developed by a multi-professional team working with CYP diagnosed with a brain tumour at a regional centre. A series of presentations were delivered covering the following topics: learning/education, rehabilitation, practical and financial support, and psychosocial issues. Time was also allocated for discussion, questions and opportunities to meet other parents. All parents/carers of children diagnosed within the previous year were invited to attend. Feedback was solicited on the relevance and content at the end of the day. RESULTS: 13 parents/carers from 7 families attended the awareness day. All but one completed the feedback questionnaire. Overall, the majority of parents (5 out of 6) felt the content was ‘very helpful', and all parents felt the session relevance was either ‘helpful' or ‘very helpful'. The most helpful session was reported to be ‘brain tumours and learning'. Parents valued the opportunity to meet other families, although two felt more time could have been allocated for this. All appreciated the discussion and question time. CONCLUSION: Provision of an awareness day for parents/carers offered a well-received opportunity for families to engage with a range of professionals to receive information and support around their child's brain tumour. Parents also valued the opportunity to share experiences with other families.
Epilepsy, Antiepileptic Drugs, and Aggression: An Evidence-Based Review
Authors: Martin J Brodie, Frank Besag, Alan B Ettinger, Marco Mula, Gabriella Gobbi, Stefano Comai, Albert P Aldenkamp, Bernhard J Steinhoff
Journal: Pharmacological Reviews (2016)

Antiepileptic drugs (AEDs) have many benefits but also many side effects, including aggression, agitation, and irritability, in some patients with epilepsy. This article offers a comprehensive summary of current understanding of aggressive behaviors in patients with epilepsy, including an evidence-based review of aggression during AED treatment. Aggression is seen in a minority of people with epilepsy. It is rarely seizure related but is interictal, sometimes occurring as part of complex psychiatric and behavioral comorbidities, and it is sometimes associated with AED treatment. We review the common neurotransmitter systems and brain regions implicated in both epilepsy and aggression, including the GABA, glutamate, serotonin, dopamine, and noradrenaline systems and the hippocampus, amygdala, prefrontal cortex, anterior cingulate cortex, and temporal lobes. Few controlled clinical studies have used behavioral measures to specifically examine aggression with AEDs, and most evidence comes from adverse event reporting from clinical and observational studies. A systematic approach was used to identify relevant publications, and we present a comprehensive, evidence-based summary of available data surrounding aggression-related behaviors with each of the currently available AEDs in both adults and in children/adolescents with epilepsy. A psychiatric history and history of a propensity toward aggression/anger should routinely be sought from patients, family members, and carers; its presence does not preclude the use of any specific AEDs, but those most likely to be implicated in these behaviors should be used with caution in such cases.
Imatinib Inhibits SCF-Induced Development Of Human Mast Cells In Vitro and Induces Profound and Selective Mast Cell Deficiency In Patients With Ph+ CML
Authors: Sabine Cerny-Reiterer, Anja Rabenhorst, Gabriele Stefanzl, Susanne Herndlhofer, Katharina Blatt, Gregor Hoermann, Leonhard Muellauer, Sigrid Baumgartner, Christine Beham-Schmid, Wolfgang R Sperr, Werner Linkesch, Christine Mannhalter, Michel Arock, Karin Hartmann, Peter Valent
Journal: Blood (2013)
Abstract 18775: Longterm Follow-Up After Surgical Ablation Therapy for Atrial Fibrillation Using an Implantable Cardiac Rhythm Monitoring Device
Authors: Anke Kowert, Bruno Reichart, Gerd Juchem
Journal: Circulation (2013)

Objectives: After ablation, intermittent and symptom-based monitoring of the heart rhythm may not be reliable in identifying patients with ongoing atrial fibrillation (AF). For accuracy of rhythm surveillance after surgical ablation leadless implantable cardiac rhythm monitoring devices (ICM) were implanted. Methods: Surgically ablation of AF was accomplished following the Cox-Maze technique modified after Damiano. Lines were produced with bipolar radiofrequency using the AtriCure ® clamp. Continuity near the AV-valves was achieved applying the unipolar Isolator ® Pen. In each case concomitant cardiovascular procedures were necessary. At the end of the interventions the ICMs were implanted. Amiodaron was given for six and phenprocoumon for twelve postoperative months. Patient follow-up was conducted by means of transtelephonic transmission on a monthly basis. The attending physician in private practice got access to the remote monitoring. Results: A group of 27 patients were continuously monitored over a period of three years. Preoperatively, 15% of the patients had paroxysmal, 59% persistent and 26% permanent AF. Mean postoperative AF burden as indicated by ICM declined continuously over twelve months: From 35 to 7% (preoperative paroxysmal), 60 to 25% (preoperative persistent) and 83 to 64% (preoperative permanent). ). The treatment is less effective for patients with permanent AF and severe heart failure. Atrial flutter was detected in two patients. Symptomatic bradycardia necessitated two permanent pacemakers. Conclusion: Continuous heart rhythm monitoring with an ICM detected AF burden higher then expected. The duration of AF decreases significantly in the course of the first year only. After this period of time, anticoagulation could be reconsidered. Intensified heart rhythm follow-up and local medical networking can improve cardiac therapy.
Chemotherapy-Induced Oral Mucositis: 11 SNPs Implicated In GWAS Of 972 Patients With Multiple Myeloma
Authors: Elizabeth Ann Coleman, Jeannette Y Lee, Stephen Erickson, Julia Goodwin, Marjorie Beggs, Naveen Sanathkumar, Daohong Zhou, Kent McKelvey, Vinay Raj, Senu Apewokin, Owen Stephens, Carol Enderlin, Annette Juul Vangsted, Patty Reed, Elias J. Anaissie
Journal: Blood (2013)
Progression-Free Survival, Response Rate, and Disease Control Rate as Predictors of Overall Survival in Phase III Randomized Controlled Trials Evaluating the First-Line Chemotherapy for Advanced, Locally Advanced, and Recurrent Non–Small Cell Lung Carcinoma
Authors: Kentaro Nakashima, Nobuyuki Horita, Kenjiro Nagai, Saki Manabe, Shuji Murakami, Erika Ota, Takeshi Kaneko
Journal: Journal of Thoracic Oncology (2016)
Sex and Racial Differences in the Management of Acute Myocardial Infarction, 1994 through 2002
Authors: Viola Vaccarino, Saif S. Rathore, Nanette K. Wenger, Paul D. Frederick, Jerome L. Abramson, Hal V. Barron, Ajay Manhapra, Susmita Mallik, Harlan M. Krumholz
Journal: New England Journal of Medicine (2005)

Although increased attention has been paid to sex and racial differences in the management of myocardial infarction, it is unknown whether these differences have narrowed over time.
The need for a revised staging system of metastatic (M) colorectal cancer (CRC): Evidence from a national perspective on survival following surgically treated (HPX) liver metastases
Authors: E. Morris, J. Thomas, D. Forman, P. Quirke, B. Cottier, G. J. Poston
Journal: Journal of Clinical Oncology (2009)

4099 Background: AJCC V.6 (2002) places all patients with MCRC beyond the lymph node basin of the primary tumor in a homogenous Stage 4. Patients with inoperable hepatic MCRC can be made operable with curative intent with chemotherapy yet remaining in Stage 4. Via the linkage of routine health datasets across England this population-based study sought to determine the impact of HPX for MCRC on stage-matched survival at initial presentation. Methods: All patients between 1998–2001 undergoing surgery for CRC in England were identified via the national-linked cancer registry HES dataset. All care episodes in the 3 years following initial colorectal surgery were examined to determine the frequency of subsequent HPX. Kaplan-Meier curves and log- rank tests were used to examine 5-year survival following HPX for MCRC compared to all Stage 3 and Stage 4 at presentation. Survival was calculated from the date of resection of each patient's primary colorectal tumor. Results: 68,307 individuals were identified as undergoing surgery for primary CRC over the study period. 20,298 were Stage 3 at presentation. 1,483 (2.2%) subsequently underwent HPX &lt;3 years of their colorectal operation. 55 patients died within 30 days of HPX (mortality rate: 3.7%). Crude 5-year survival of patients who underwent HPX was 41.6% (95%CI 39.0–44.1%) from time of initial colectomy. This survival rate was significantly better than that for both Stage 3 (38.6% (95%CI 37.9%-39.2%, P&lt;0.01) and 4 (6.1% 95%CI 5.3–6.9%, P&lt;0.01) overall. Conclusions: 5-year survival following HPX for MCRC is better than that seen overall for all Stage 3 patients (with MCRC confined to the regional draining lymph node basin) following initial colectomy. Our data support the hypothesis that all MCRC that is potentially resectable with curative intent should be stratified within Stage 3, and Stage 4 should only contain those MCRC patients for whom surgery is not an option. If further evidence emerges to support this theory then a revision of the current staging system will be required. [Table: see text]
Rift Valley fever in kidney transplant recipient returning from Mali with viral RNA detected in semen up to four months from symptom onset, France, autumn 2015
Authors: Fatiha Haneche, Isabelle Leparc-Goffart, Fabrice Simon, Maxime Hentzien, Valérie Martinez-Pourcher, Eric Caumes, Marianne Maquart
Journal: Eurosurveillance (2016)

A 29-year-old kidney transplant recipient returning from Mali was diagnosed with Rift Valley fever (RVF) in France in autumn 2015. The patient was immunosuppressed due to his renal transplant. IgM and IgG specific to RVF virus (RVFV) were detected in cerebrospinal fluid and blood up to two months after symptom onset, whereas in urine, RVFV genomic RNA was detected by RT-PCR up to three months, and in semen up to four months post symptom onset.
Randomized Summer Camp Crossover Trial in 5- to 9-Year-Old Children: Outpatient Wearable Artificial Pancreas Is Feasible and Safe
Authors: Simone Del Favero, Federico Boscari, Mirko Messori, Ivana Rabbone, Riccardo Bonfanti, Alberto Sabbion, Dario Iafusco, Riccardo Schiaffini, Roberto Visentin, Roberta Calore, Yenny Leal Moncada, Silvia Galasso, Alfonso Galderisi, Valeria Vallone, Federico Di Palma, Eleonora Losiouk, Giordano Lanzola, Davide Tinti, Andrea Rigamonti, Marco Marigliano, Angela Zanfardino, Novella Rapini, Angelo Avogaro, Daniel Chernavvsky, Lalo Magni, Claudio Cobelli, Daniela Bruttomesso
Journal: Diabetes Care (2016)

OBJECTIVE The Pediatric Artificial Pancreas (PedArPan) project tested a children-specific version of the modular model predictive control (MMPC) algorithm in 5- to 9-year-old children during a camp. RESEARCH DESIGN AND METHODS A total of 30 children, 5- to 9-years old, with type 1 diabetes completed an outpatient, open-label, randomized, crossover trial. Three days with an artificial pancreas (AP) were compared with three days of parent-managed sensor-augmented pump (SAP). RESULTS Overnight time-in-hypoglycemia was reduced with the AP versus SAP, median (25th–75th percentiles): 0.0% (0.0–2.2) vs. 2.2% (0.0–12.3) (P = 0.002), without a significant change of time-in-target, mean: 56.0% (SD 22.5) vs. 59.7% (21.2) (P = 0.430), but with increased mean glucose 173 mg/dL (36) vs. 150 mg/dL (39) (P = 0.002). Overall, the AP granted a threefold reduction of time-in-hypoglycemia (P &amp;lt; 0.001) at the cost of decreased time-in-target, 56.8% (13.5) vs. 63.1% (11.0) (P = 0.022) and increased mean glucose 169 mg/dL (23) vs. 147 mg/dL (23) (P &amp;lt; 0.001). CONCLUSIONS This trial, the first outpatient single-hormone AP trial in a population of this age, shows feasibility and safety of MMPC in young children. Algorithm retuning will be performed to improve efficacy.
Regulation of bronchial epithelial barrier integrity by type 2 cytokines and histone deacetylases in asthmatic patients
Authors: Paulina Wawrzyniak, Marcin Wawrzyniak, Kerstin Wanke, Milena Sokolowska, Kreso Bendelja, Beate Rückert, Anna Globinska, Bogdan Jakiela, Jeannette I. Kast, Marco Idzko, Mübeccel Akdis, Marek Sanak, Cezmi A. Akdis
Journal: Journal of Allergy and Clinical Immunology (2016)
Bronchoscopic “Resection”of Small Cell Carcinoma
Authors: S W Watkin, A J Soorae, J A Green
Journal: Endoscopy (1989)

Small cell carcinoma of the bronchus frequently presents as a widely disseminated tumor with a large central primary lesion. A patient with peripheral shadowing on a chest radiograph is reported in whom bronchoscopy revealed endobronchial tumor of the small cell type. The patient underwent lobectomy, but residual carcinoma could not be identified in the operative specimen, and the patient has remained disease-free for 2.5 years post-resection.
Altering the tumor microenvironment: A phase II study of copper depletion using tetrathiomolybdate (TM) in patients (pts) with breast cancer (BC) at high risk for recurrence.
Authors: Eleni Nicole Nackos, Naomi Kornhauser, Maureen M. Ward, Tessa Cigler, Anne Moore, Eleni Andreopoulou, Nancy Chan, Veronica Fitzpatrick, Sarah E. Schneider, Alysia Wiener, J. David Warren, Anna Rubinchik, Amy Willis, Sharrell Lee, Maureen E. Lane, Vivek Mittal, Linda T. Vahdat
Journal: Journal of Clinical Oncology (2015)

11008 Background: Bone marrow derived endothelial progenitor cells (EPCs) and copper-dependent pathways are critical components to remodeling the tumor microenvironment and creating the pre-metastatic niche. Copper depletion (CD) inhibits tumor metastases in preclinical models. We hypothesized that TM-associated CD would reduce EPCs and other copper dependent processes in the pre-metastatic niche in BC pts at high risk for relapse. We investigated the relationship between CD and its effect on EPCs and other components of the tumor microenvironment including lysyl oxidase (LOX). Methods: In this single arm, phase II study, BC pts at high risk for recurrence, defined as node+ triple negative (TN), stage 3 and 4 with no evidence of disease (NED) were enrolled on a trial of CD with TM. We utilized TM to maintain ceruloplasmin (Cp) between 5-17 mg/dl until end of treatment or relapse. The primary endpoint was change in EPCs measured by flow cytometry before and during treatment with TM. Secondary endpoints included tolerability, safety, and its effect on other markers including LOX. Results: We enrolled 75 pts. The study treatment duration was 24 cycles (28 days each). Over 2021 cycles have been administered. The median age is 51 (range 29-66). 45 pts have Stage 2/3 BC and 30 are Stage 4 NED. 48% of pts have TNBC, and 40% of pts are Stage 4 NED. Median Cp level decreased from 28 at baseline to 16 (p < 0.0001) after one cycle. Copper depletion was most efficient in TNBC. TM was well tolerated and the only grade 3/4 toxicities were reversible neutropenia (2.5%) and anemia (0.04%). CD was associated with a significant decrease in EPCs (p < 0.001) and LOX (p < 0.001) in the 2 year analysis; the 5 year analysis is ongoing. The PFS for all 75 pts from the start of TM treatment was 81% including a PFS of 94% for all stage 2/3 pts with TNBC at median f/u of 5.6 yrs. The hazard ratio for relapse is zero at two years. Conclusions: TM is safe, well tolerated and appears to affect multiple components of the tumor microenvironment creating an inhospitable environment for tumor progression. This seems to be most striking in TNBC. Further phase III trials are warranted. Clinical trial information: NCT00195091.
HHS Called to Implement Law to Prevent Cyber Attacks
Authors: Rita Rubin
Journal: JAMA (2016)

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
High level of scrutiny is crushing innovation in NHS, say hospital bosses
Authors: Gareth Iacobucci
Journal: BMJ (2016)

NHS hospital bosses have warned that a culture of bullying from “oppressive” regulators has been harming innovation efforts and motivating experienced leaders to leave the NHS.

The warnings came in a new report by the health policy think thank the King’s Fund and NHS Providers, the membership organisation for providers of NHS services. In the report 12 NHS chief executives who were either leaving or had recently left the health service were interviewed.1

While interviewees spoke positively about making a difference to patients and staff, the report said that “the sense of pressure and constraint, in some cases bordering on bullying, is also palpable.”

A number of chief executives said that scrutiny levels had worsened during recent years and warned that pressure from the many system regulators was harming attempts to innovate.

In the report Mark Newbold, a former hospital doctor turned …
Preliminary analysis of the pandemic H1N1 influenza on Réunion Island (Indian Ocean): surveillance trends (July to mid-September 2009)
Authors: F Thouillot, C Do, E Balleydier, E Rachou, F Staikowsky, P Morbidelli, Y Jacques-Antoine, A Bourde, M Lagrange-Xélot, P Poubeau, A Winer, B A Gauzere, A Michault, M C Jaffar-Bandjee, G Henrion, L Filleul, E D’Ortenzio
Journal: Eurosurveillance (2009)

First infections with the 2009 pandemic H1N1 influenza virus were identified on Réunion Island in July 2009. By the end of July, sustained community transmission of the virus was established. Pandemic H1N1 influenza activity peaked during week 35 (24 to 30 August), five weeks after the beginning of the epidemic and has been declining since week 36. We report preliminary epidemiological characteristics of the pandemic on Réunion Island in 2009 until week 37 ending September 13.
Global perceptions of food allergy thresholds in 16 countries
Authors: M. J. Marchisotto, L. Harada, J. A. Blumenstock, L. A. Bilaver, S. Waserman, S. Sicherer, Y. Boloh, L. Regent, M. Said, S. Schnadt, K. J. Allen, A. Muraro, S. L. Taylor, R. S. Gupta
Journal: Allergy (2016)

Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
Metchnikoff in Messina
Authors: Manfred L. Karnovsky
Journal: New England Journal of Medicine (1981)

IN late September of 1980 an international meeting was held in Sicily to mark the centenary of Metchnikoff's discovery of the role of phagocytosis in the maintenance of health. His experiments were conducted in Messina, Sicily, and they brought revolutionary concepts into the arena of our understanding of the ways in which the body controls infections. An arena indeed it was, with many acrimonious exchanges between the "cellularists," led by Metchnikoff, and the "humoralists," the early immunologists who espoused soluble serum components rather than cells as the key to antimicrobial action. Of course, both factions were ultimately proved right; this . . .