tbuckley/cabot-search huggingface dataset:
Complications During Insertion of Narrow-Bore Feeding Tubes
Authors: David M. Alessi
Journal: JAMA (1985)

<h3>To the Editor.—</h3> Hand et al<sup>1</sup>described inadvertent transbronchial insertion of narrow-bore feeding tubes into the pleural space. Schorlemmer<sup>2</sup>was the first to describe this. His three patients all suffered a pneumothorax after the feeding tube was inserted with a wire guide. A depressed gag reflex allowed for easy insertion into the larynx and the wire guide was implicated in perforating the pleura. He suggested immediate radiographic confirmation of tube location before commencement of feedings, and use of the wire guide only for passage of the nasopharynx. Having experienced similar occurrences at our institution (D.M.A., G. Berci, MD, unpublished data, January 1984) we advocate not using the wire guide at all. To pass the tube, we attach the tip of a small-bore feeding tube to the tip of a rigid Levine nasogastric tube with half of a gelatin capsule (as used for encapsulated medicine).<sup>3</sup>The rigid nasogastric
Toward Precision Epidemiology
Authors: Carlos Blanco, Wilson M. Compton, Bridget F. Grant
Journal: JAMA Psychiatry (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 Psychiatry 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 Psychiatry journal
Influence of radiation modality and nodal dissection on survival in high-risk early-stage endometrial cancer.
Authors: J. P. Chino, E. Jones, A. Berchuck, L. Havrilesky
Journal: Journal of Clinical Oncology (2010)

5027 Background: A recent randomized trial (PORTEC 2) reported preliminary equivalence of adjuvant whole pelvic radiotherapy (WPRT) with vaginal brachytherapy (VB) in FIGO stage I endometrial cancer with high risk factors. However grade 3 cancers with > 50% myometrial invasion were excluded from this trial, and no nodal dissections (LND) were performed. We wished to determine, by analysis of the SEER registry, the effect of WPRT, VB and LND had on overall survival (OS) in this highest risk subset of stage I cancers. Methods: The SEER registry was queried for grade 3 endometrial cancers with > 50% myometrial invasion undergoing hysterectomy as primary treatment from 1998-2006; we excluded those for whom information about LND and adjuvant radiotherapy were not recorded. Survival analysis was performed via the Kaplan Meier method and the log rank test. Results: 1,941 patients were identified. Median follow up was 45 months; 5 yr OS was 63.6%. LND was performed in1318 (68%). No RT was delievered in 723 (37%), 145 (7.5%) received VB, 744 (38.3%) WPRT, and 329 (17%) WPRT plus VB. LND was associated with increased 5 yr OS (68.8% vs. 54.1%, p < 0.001). Women who did not undergo LND had higher 5 yr OS when they received adjuvant WPRT (60.6%) or WPRT + VB (59.7%) compared to treatment with VB alone (37.5%) or no RT (48.3%, p ≤ 0.002 for all comparisons). Women who underwent LND had higher 5 yr OS following VB alone (79%), WPRT (70%), or WPRT +VB (71.6%), as compared to no RT (63.7%, p ≤ 0.002 for all comparisons). Conclusions: Adjuvant radiotherapy and lymph node dissection are associated with improved overall survival in grade 3 endometrial cancers with > 50% invasion in the SEER registry. WPRT appears to be superior to VB alone in the setting of no LND; this difference and the improved survival of women who underwent LND are likely related in part to the existence of occult nodal metastases in the group without LND. No significant financial relationships to disclose.
Immune-Stimulatory Effects of Rapamycin Are Mediated by Stimulation of Antitumor γδ T Cells
Authors: Vinh Dao, Yang Liu, Srilakshmi Pandeswara, Robert S. Svatek, Jonathan A. Gelfond, Aijie Liu, Vincent Hurez, Tyler J. Curiel
Journal: Cancer Research (2016)

Abstract The FDA-approved mTOR inhibitor rapamycin mediates important immune effects, but its contributions to the anticancer effects of the drug are unclear. Here we report evidence that rapamycin-mediated cancer protection relies upon stimulation of γδ T cells. In a well-established mouse model of carcinogen and inflammation-driven skin carcinogenesis, IFNγ recruited γδ TCRmid T cells to the epidermis where rapamycin boosted their perforin-dependent antitumor properties. These antitumor cells were mostly Vγ5−Vγ4−Vγ1− in phenotype. IFNγ signals were required in both hematopoietic and nonhematopoietic cells for rapamycin to optimally promote epidermal infiltration of γδ TCRmid T cells, as mediated by CXCR3–CXCL10 interactions, along with the antitumor effects of these cells. In mouse xenograft models of human squamous cell carcinoma, rapamycin improved human γδ T-cell–mediated cancer cell killing. Our results identify immune mechanisms for the cancer prevention and treatment properties of rapamycin, challenging the paradigm that mTOR inhibition acts primarily by direct action on tumor cells. Cancer Res; 76(20); 5970–82. ©2016 AACR.
A first-in-human phase 1 dose-escalating trial of G305 in patients with solid tumors expressing NY-ESO-1.
Authors: Amit Mahipal, Kunle Odunsi, Sacha Gnjatic, Seunghee Kim-Schulze, Richard T. Kenney, Samuel Ejadi
Journal: Journal of Clinical Oncology (2015)

3073 Background: A major way to expand in vivo tumor antigen-specific CD8 cytotoxic T cells (CTLs) is to induce and enhance the presence of CD4 helper T cells that are specific for the same antigen. G305 is recombinant full-length NY-ESO-1 protein mixed with a proprietary formulation of the synthetic TLR4 agonist, glucopyranosyl lipid A (GLA). GLA, when administered with other recombinant antigens in healthy volunteers, induces antigen-specific CD4 T and B cells and activates innate immunity. Methods: Adults with advanced or metastatic melanoma, sarcoma, ovarian, breast, bladder, or NSCLC expressing NY-ESO-1 by IHC were enrolled using a 3+3 dose-escalation design. Patients were dosed i.m. every three weeks for three doses. NY-ESO-1 was fixed at 250 µg and GLA was increased from 2 to 5 to 10 µg. Safety, immunogenicity, and clinical responses were assessed prior to, during, and at the end of therapy. Results: 12 patients were treated; mild local reactogenicity was most common (92%) and all related adverse events were CTCAE Grade 1 or 2, with no DLTs or related SAEs. Serology results show that G305 was immunogenic at all doses; 8 of 12 patients had preexisting antibody titers at baseline, 5 of which increased with treatment, and 3 of 4 with no baseline titer seroconverted. 4 of 6 patients tested to date had high baseline CD4 T cells that increased in 2 with G305 treatment; 1 of 8 tested developed antigen-specific CD8 T-cell responses. 6 of 12 patients (50%) have had SD for 2.5 to 8+ months and 6 patients progressed after a mean of 99 days with no relationship between dose, reciprocal antibody titers, or efficacy. One patient had decreasing CA125 titers and SD for 8 months, and subsequently developed brain metastases. Conclusions: G305 was shown to be safe and well-tolerated at doses up to 10 µg GLA and was associated with a satisfactory clinical response. Anti-NY-ESO-1 titers suggest that a 5 µg dose of G305 is suitable for subsequent trials. The immunogenicity results support the mechanism of action for G305, which is planned to complement LV305, a hybrid novel DC-tropic viral vector expressing NY-ESO-1, in a sequential prime-boost regimen to generate and expand NY-ESO-1-specific CTLs that target solid tumors. Clinical trial information: NCT02015416.
RETRACTED: Impact of Rotor Ablation in Nonparoxysmal Atrial Fibrillation Patients Results From the Randomized OASIS Trial [J Am Coll Cardiol 2016;68:274–82]
Authors: Sanghamitra Mohanty, Carola Gianni, Prasant Mohanty, Philipp Halbfass, Tamara Metz, Chintan Trivedi, Thomas Deneke, Gery Tomassoni, Rong Bai, Amin Al-Ahmad, Shane Bailey, John David Burkhardt, G. Joseph Gallinghouse, Rodney Horton, Patrick M. Hranitzky, Javier E. Sanchez, Luigi Di Biase, Andrea Natale
Journal: Journal of the American College of Cardiology (2016)
Prévalence, distribution et risque des polypes/adénomes festonnés au sein d’un centre présentant un taux de détection d’adénome élevé et des anatomopathologistes expérimentés
Journal: Endoscopy (2016)

Les lésions festonnées apparaissent comme une des hantises des hépato-gastroentérologues car elles sont difficiles à détecter, d’analyse histologique délicate et responsables de 15 à 30 % des cancers colo-rectaux et probablement en cause dans la survenue d’une partie des cancers coliques d’intervalle.
Colour coded warnings on how medicines affect driving do not work, study shows
Authors: Susan Mayor
Journal: BMJ (2016)

Colour coded warnings on the labels of drugs for anxiety and insomnia to alert users to their potential adverse effects on driving have not reduced road traffic crashes associated with these medicines, data from a French national programme have shown.1

Ten years ago France introduced a national system of colour coding medicines to highlight their effects on driving performance, having found that benzodiazepines …
Resident Duty Hour Reform and Mortality in Hospitalized Patients—Reply
Authors: David O. Meltzer, Vineet M. Arora
Journal: JAMA (2007)

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
Toll-like receptor signaling-deficient mice are easy mobilizers: evidence that TLR signaling prevents mobilization of hematopoietic stem/progenitor cells in HO-1-dependent manner
Authors: M Adamiak, A Abdelbaset-Ismail, M Kucia, J Ratajczak, M Z Ratajczak
Journal: Leukemia (2016)

Toll-like receptor signaling-deficient mice are easy mobilizers: evidence that TLR signaling prevents mobilization of hematopoietic stem/progenitor cells in HO-1-dependent manner
BCL2L10 Quantification Is a Predictive Factor of Response to Azacitidine in Myelodysplastic Syndromes (MDS) and Acute Myeloid Leukemia (AML)
Authors: Valerie Vidal, Clemence Ginet, Jean Michel Karsenti, Frederic Luciano, Lauris Gastaud, Georges Garnier, Thorsten Braun, Pierre Hirsch, Emmanuel Raffoux, Anne Marie Nloga, Herve Dombret, Pierre-Simon Rohrlich, Lionel Ades, Christine Chomienne, Pierre Fenaux, Patrick Auberger, Guillaume Robert, Thomas Cluzeau
Journal: Blood (2014)
Clinical efficacy of α4 integrin block with natalizumab in ankylosing spondylitis
Authors: Francesco Ciccia, Aroldo Rizzo, Giuliana Guggino, Rodolfo Bignone, Massimo Galia, Giovanni Triolo
Journal: Annals of the Rheumatic Diseases (2016)

We describe the impact of α4-β1/7 blockade with natalizumab, a recombinant humanised immunoglobulin (Ig) G4κ monoclonal antibody (mAb) targeted to the α4 subunit of the α4β1 and α4β7 integrins, on the gut and spine inflammation in a patient with ankylosing spondylitis (AS) who developed multiple sclerosis after treatment with tumour necrosis factor (TNF)-blocking agents.

A 45-year-old man with human leucocyte antigen (HLA)-B27-positive AS was admitted in January 2007. He had been diagnosed with AS 4 years earlier based on the presence of inflammatory back pain, peripheral arthritis, radiographic bilateral grade 2 sacroiliitis, HLA-B27 positivity. At that time, he had evidence of chronic intestinal inflammation upon histological evaluation of the gut. He was treated with adalimumab for 2 years, achieving a good clinical response. In March 2009, MRI of the brain was performed for the occurrence of …
Unusual cause of localised bronchiectasis
Authors: Wen-Ting Siow, Pyng Lee
Journal: Thorax (2016)

A 49-year-old man presented with 3 months' productive cough. He denied weight loss, fever and haemoptysis. He was an ex-smoker of 10 pack-years and was a pedestrian in a road traffic accident 20 years ago. He sustained an open skull fracture that led to residual hemiparesis and cranial diabetes insipidus. Physical examination revealed a well-nourished man. He had normal vital parameters with a heart rate of 80 bpm, blood pressure of 115/80 mm Hg and oxygen saturation of 96% on room air. Coarse crepitations were auscultated over the lower third of the left hemithorax, and there was no clubbing or cervical lymphadenopathy. Neurological examination showed mild hemiparesis on the left, without cognitive or speech deficits. …
A gram of gadolinium is worth a thousand neurologists
Authors: James Stefaniak
Journal: BMJ (2016)

“So what do you want to specialise in?”

It was a question I’d been dreading from my neurosurgery consultant. I wanted to do neurology, and told him so. His face lit up at the chance to preach his favourite message—I was told, with great pleasure, that neurologists “don’t do anything for patients” and …
The use of opioids in the last month of life in a tertiary cancer center in Jordan.
Authors: Omar M. Shamieh, Sewar S Salmany, Odai Khamash, Stella Dawood, Mustafa Alkhreisat, Mohamamd Ibrahim, Dalia Al-Rimawi, David Hui
Journal: Journal of Clinical Oncology (2015)

54 Background: The low rates of utilization of opioids is a major barrier to optimal pain control in cancer patients in developing countries. The presence of a palliative care service may improve opioid utilization. In our study we assessed opioid utilization in the last month of life for patients admitted to our tertiary care cancer center in Jordan, and compared the use of opioids with and without palliative care involvement. Methods: We conducted a retrospective chart review to examine opioid use for all adult patients who died at King Hussein Cancer Center between January 1st, 2012 until December 31st, 2012. Patient demographics, cancer diagnosis, type of opioid and total daily dose of opioids in morphine oral equivalent (OME) were collected in the last 30 days of life while admitted to the hospital. Results: Among the 297 patients included, the median age was 58 years (range, 19- 95), 134 (45%) were males, and 186 (62.6%) died under the palliative care service. The median admission length was 7 days. The average daily doses of opioids were 187mg, 214mg, 222mg (OME) in the last 24 hours, 48 hours, and 30 days of life, respectively, In the last 24 and 48 hours before death, 140 (47%) and 228 (77%) patients were on opioids, respectively. Younger age was associated with higher doses of opioids (P= 0.0001). We found no significant differences in patient characteristics between palliative and non-palliative care patients; however, patients under palliative care received significantly higher doses of opioids compared to non-palliative care patients in the last 30 days of life, the average daily dose of opioids (OME) was 249.4mg vs. 11.2mg (P&lt; 0.001). There was no survival difference between palliative and non-palliative patients (P= 0.2244), or between patients who were on opioids or patients who were not (p= 0.57). Conclusions: A large minority of patients did not receive opioids at the end-of-life. Palliative care service was associated with higher utilization of opioids. Palliative care service may assist in pain management at the end-of-life.
Clinical Indications for Use of Reflectance Confocal Microscopy for Skin Cancer Diagnosis
Authors: Stefania Borsari, Riccardo Pampena, Aimilios Lallas, Athanassios Kyrgidis, Elvira Moscarella, Elisa Benati, Margherita Raucci, Giovanni Pellacani, Iris Zalaudek, Giuseppe Argenziano, Caterina Longo
Journal: JAMA Dermatology (2016)

<h3>Importance</h3> Reflectance confocal microscopy (RCM) improves diagnostic accuracy in skin cancer detection when combined with dermoscopy; however, little evidence has been gathered regarding its real impact on routine clinical workflow, and, to our knowledge, no studies have defined the terms for its optimal application. <h3>Objective</h3> To identify lesions on which RCM performs better in terms of diagnostic accuracy and consequently to outline the best indications for use of RCM. <h3>Design, Setting, and Participants</h3> Prospectively acquired and evaluated RCM images from consecutive patients with at least 1 clinically and/or dermoscopically equivocal skin lesion referred to RCM imaging, from January 2012 to October 2014, carried out in a tertiary referral academic center. <h3>Main Outcomes and Measures</h3> A total of 1279 equivocal skin lesions were sent for RCM imaging. Spearman correlation, univariate, and multivariate regression models were performed to find features significantly correlated with RCM outcome. <h3>Results</h3> In a total of 1279 lesions in 1147 patients, RCM sensitivity and specificity were 95.3% and 83.9%, respectively. The number of lesions needed to excise to rule out a melanoma was 2.4. After univariate and multivariate regression analysis, head and neck resulted as the most appropriate body location for confocal examination; RCM showed a high diagnostic accuracy for lesions located on sun-damaged skin (adjusted odds ratio [aOR], 2.13; 95% CI, 1.37-3.30;<i>P</i>=.001) and typified by dermoscopic regression (aOR, 2.13; 95% CI, 1.31-3.47;<i>P</i>=.002) or basal-cell carcinoma specific criteria (aOR, 9.35; 95% CI, 1.28-68.58;<i>P</i>=.03). <h3>Conclusions and Relevance</h3> Lesions located on the head and neck, damaged by chronic sun-exposure, and dermoscopically typified by regression represent best indications for the use of RCM.
Orientation-specific RAG activity in chromosomal loop domains contributes to <i>Tcrd</i> V(D)J recombination during T cell development
Authors: Lijuan Zhao, Richard L. Frock, Zhou Du, Jiazhi Hu, Liang Chen, Michael S. Krangel, Frederick W. Alt
Journal: The Journal of Experimental Medicine (2016)

T cell antigen receptor δ (Tcrd) variable region exons are assembled by RAG-initiated V(D)J recombination events in developing γδ thymocytes. Here, we use linear amplification–mediated high-throughput genome-wide translocation sequencing (LAM-HTGTS) to map hundreds of thousands of RAG-initiated Tcrd D segment (Trdd1 and Trdd2) rearrangements in CD4−CD8− double-negative thymocyte progenitors differentiated in vitro from bone marrow–derived hematopoietic stem cells. We find that Trdd2 joins directly to Trdv, Trdd1, and Trdj segments, whereas Trdd1 joining is ordered with joining to Trdd2, a prerequisite for further rearrangement. We also find frequent, previously unappreciated, Trdd1 and Trdd2 rearrangements that inactivate Tcrd, including sequential rearrangements from V(D)J recombination signal sequence fusions. Moreover, we find dozens of RAG off-target sequences that are generated via RAG tracking both upstream and downstream from the Trdd2 recombination center across the Tcrd loop domain that is bounded by the upstream INT1-2 and downstream TEA elements. Disruption of the upstream INT1-2 boundary of this loop domain allows spreading of RAG on- and off-target activity to the proximal Trdv domain and, correspondingly, shifts the Tcrd V(D)J recombination landscape by leading to predominant V(D)J joining to a proximal Trdv3 pseudogene that lies just upstream of the normal boundary.
Doctor of Pharmacy
Authors: Gerald D. Griffin
Journal: JAMA (1983)

<h3>To the Editor.—</h3> Drs Biles and Lundberg as well as the American Medical Association are to be congratulated on their timely and lucid comments concerning the "Doctor of Pharmacy" and "Clinical Pharmacist" (1983; 249:1157 and 1983;249:1193). The basis of the enhancement of patient care by both clinical pharmacy and medicine is a historical one, and it seems only a natural progression to welcome the clinical pharmacist as a permanent professional member in active patient care. I would like to caution the medical profession, however, that there are some basic facts to be aware of. First of all, not every PharmD is a clinical pharmacist with the abilities as given by Dr Biles. It depends on where the pharmacist received his doctorate, whether it is his first professional degree or granted as a graduate degree, and whether the pharmacist has an interest in being a clinical pharmacist. In other words, it
Life-Threatening Childhood Obesity and Legal Intervention
Authors: Susan Z. Yanovski, Jack A. Yanovski, Mary Horlick
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