tbuckley/cabot-search huggingface dataset:
BMA annual representative meeting, Llandudno, 28 June to 1 July: More patients could be treated in the UK if associate specialists' skills were recognised
Authors: Zosia Kmietowicz
Journal: BMJ (2004)

Thousands of patients who are being sent abroad for surgery could be treated in their local hospital if the skills of staff and associate specialist doctors working throughout the NHS were properly recognised, the BMA's annual conference heard.

Mr Mohib Khan, chairman of the Staff and Associate Specialists Committee, said that the doctors he represents have been treated as an underclass, often bullied and harassed by colleagues and frustrated and demoralised by their lack of progression and recognition.

Despite years of experience the careers of many of the 12 500 specialist doctors in the United Kingdom are being blocked. These doctors are prevented from applying for consultant posts because their experience does not count towards inclusion on the specialist register, even though legislation to allow them to do so was passed last year.

“Patients are losing out because highly skilled specialists are being prevented from offering their full expertise,” Mr Khan told delegates.

In a video broadcast at the conference Miss Pushpa Dudani, a breast surgeon in Rotherham, recounted how patients questioned her right to treat them when they saw the words “associate specialist” on her badge despite the fact that she had 15 years' experience in the specialty.

“As an associate specialist, I can do the same things consultants do, but I'm not allowed to become one because the royal colleges don't recognise all my years of experience. They have tunnel vision, and unless they change their attitude, we're not going to move forward at all,” she said.

Another doctor, Mr Vijay Kumar, who now works in Yorkshire, held a senior post in a teaching hospital in Saudi Arabia and had trained many doctors who now practised as consultants in the NHS. However, his experience is not recognised by the Royal College of Surgeons, which prevents him from qualifying as a consultant and limits the amount of responsibility he can take.

“It's frustrating that so many patients waiting for operations are being sent overseas or to independent sector treatment centres staffed by surgeons from countries like South Africa. I fail to understand why they can't be treated by someone like me,” said Mr Kumar.

Associate specialists also lose out financially. At the top of their grade, associate specialists can earn around £60000 ($110000; €90000) whereas their consultant colleagues doing the same work can expect to earn more than £101500.

Mr Khan complained about delays in negotiating a new contract for staff and associate specialist doctors, which was due to start in April this year.

“The pay differential is ever increasing between SAS [staff and associate specialist] doctors and their medical colleagues in the NHS, and we are tired of waiting,” he said.

Delegates voted unanimously for the BMA to tackle the delayed new contract as a matter of urgency to secure better conditions and pay for these grades.
Erratum to ‘Bilateral gluteal advancement flap for treatment of recurrent sacrococcygeal pilonidal disease: A prospective cohort study’ [Int. J. Surg. 29 (2016) 1–8]
Authors: Khaled Elalfy, Sameh Emile, Ahmed Lotfy, Mohamed Youssef, Hossam Elfeki
Journal: International Journal of Surgery (2016)
Delirium, opioid regulation, and pathological gambling
Authors: D. Kamerow
Journal: BMJ (2007)

Don't believe everything you read. That's the message from several articles in this week's BMJ.

Neill Adhikari and colleagues systematically reviewed the results of 12 clinical trials of nitric oxide in the treatment of acute respiratory distress syndrome (doi: 10.1136/bmj.39139.716794.55). A selective vasodilator, nitric oxide has been widely used in intensive care units because of its demonstrated beneficial effects on oxygenization in critically ill patients. But this meta-analysis of small trials totaling more than 1200 patients found no significant effect on hospital mortality and an increased risk of renal dysfunction. In an accompanying editorial, Niall Ferguson discusses the theoretical advantages of nitric oxide in catastrophic respiratory failure (doi: 10.1136/bmj.39168.568692.BE). Unfortunately this seems to be a case when physiological improvements do not lead to better clinical outcomes, which Ferguson calls a “recurring theme in critical care.”

A more general but less obvious point is made by Ignacio Ferreira-Gonzalez et al in a systematic review of cardiovascular trials using composite end points (doi: 10.1136/bmj.39136.682083.AE). “Composite end points” is journal speak for the creation in a clinical trial of an outcome measure from several presumably related end points, in order to increase the trial's efficiency. Thus the investigators might combine death and myocardial infarction rates in a cardiovascular drug trial or several measures of cognitive impairment in an Alzheimer's disease study. Using composite end points allows a smaller sample size and can better capture the overall impact of a therapeutic intervention.

This works well when the combined end points are of similar importance and similar frequency and if they are not subject to important biases. But it can be misleading if, for example, death is a rare outcome and the other end points are subject to bias, such as revascularization rate or admissions to intensive care. This study found that in some of the trials many of the most important components of the composite end points had smaller treatment effects than the less important ones when they were reported separately. And many trials did not report the component outcomes separately.

In an editorial (doi: 10.1136/bmj.39176.461227.80), Nick Freemantle and Mel Calvert agree with this paper's findings and express concern that the misleading use of composite end points may lead to approval by regulators of inappropriate claims for drugs. They advocate clear language specifying which outcomes have been shown to be affected by the drug in question.
LMI-11TWO-YEAR EXPERIENCE WITH BRAIN TUMORS DIAGNOSED AND TREATED IN HOSPITAL INFANTIL TELETON DE ONCOLOGIA (HITO), THE FIRST PEDIATRIC ONCOLOGY-DEVOTED HOSPITAL IN MEXICO
Authors: Gabriela Escamilla-Asiain, Rafael Ruvalcaba-Sanchez, Lourdes Romero-Rodriguez, Montserrat Hernandez-Garcia, Pilar Cubria-Juarez, Vanesa Peralta-Velazquez, Lourdes Vega-Vega, Andrea Ellis-Irigoyen
Journal: Neuro-Oncology (2016)
The inherence heuristic: A basis for psychological essentialism?
Authors: Susan A. Gelman, Meredith Meyer
Journal: Behavioral and Brain Sciences (2014)

Abstract Cimpian &amp; Salomon (C&amp;S) provide evidence that psychological essentialism rests on a domain-general attention to inherent causes. We suggest that the inherence heuristic may itself be undergirded by a more foundational cognitive bias, namely, a realist assumption about environmental regularities . In contrast, when considering specific representations, people may be more likely to activate attention to non-inherent, contingent, and historical links.
Variations in Histologic Pattern and Functional Effects of a Transplantable Adrenal Cortical Carcinoma in Intact, Hypophysectomized, and Newborn Rats
Authors: Katharine C. Snell, Harold L. Stewart
Journal: JNCI Journal of the National Cancer Institute (1959)

A transplantable adrenal cortical carcinoma of the rat is described. During 7 generations of transplantation into intact, mature, male and female Osborne-Mendel rats, this tumor line, designated Adrenal cortical carcinoma 494, maintained a consistently similar histologic pattern of cords of uniform, polygonal cells. All tumor-bearing rats developed polyuria, polydipsia, and degenerative changes in the distal convoluted tubules of the kidney. They also showed atrophy of the adrenal glands, sex organs, lymphatic tissue, and pituitary gland. A subline, tumor 494H, developed after transplantation of tumor 494 into hypophysectomized rats. It differed in histologic pattern from tumor 494 in that it contained large, bizarre cells in addition to the uniform, polygonal cells of tumor 494. When tumor 494H was returned to intact, adult, male and female rats, it retained its own distinctive histologic pattern, yet it also induced polyuria, polydipsia, and renal tubular degeneration. Rats of both sexes inoculated with tumor 494H developed hyperplastic mammary glands filled with milky secretion. In the females, the uterine horns were enlarged and the vaginal epithelium mucified; in the males, the testes and accessory sex organs were extremely atrophied. A second subline, tumor 494NB, similar in histologic pattern to tumor 494H, developed when tumor 494 was transplanted to newborn rats. This subline was like subline 494H in biologic behavior, and it produced a similar effect on the organs of tumor-bearing male and female rats.
Boys should receive HPV vaccination, doctors urge government
Authors: Anne Gulland
Journal: BMJ (2016)

The UK government has been urged to speed up deliberations over whether to extend the human papillomavirus (HPV) vaccination programme to cover teenage boys as well as girls.

The vaccine, which prevents most types of cervical cancer, is routinely offered to secondary school girls aged 12 and 13. But a group of 13 doctors—including Elizabeth Carlin, president of the British Association for Sexual Health and HIV, and Saman Warnakulasuriya, emeritus professor of oral medicine and experimental pathology at King’s College, London—have written to England’s health secretary, Jeremy Hunt, urging him to “expedite a decision” to extend the national HPV vaccination programme, to help …
EPT-13RAPIRI I – PHASE I STUDY OF DAILY ORAL RAPAMYCIN AND INTRAVENOUS IRINOTECAN IN CHILDREN WITH A RECURRENT/REFRACTORY MALIGNANT SOLID TUMOR: GOOD TOLERANCE AND PROMISING RESULTS IN BRAIN TUMORS - A REPORT FROM THE SOCIÉTÉ FRANÇAISE DES CANCERS ET LEUCÉMIES DE L'ENFANT ET DE L'ADOLESCENT (SFCE)
Authors: Sarah Jannier, Veronique Kemmel, Meriam Koob, Françoise Farace, Erwan Pencreach, Birgit Geoerger, Isabelle Aerts, Cecile Faure-Conter, Pierre Leblond, Nicolas Andre, Yves Perel, Nadège Corradini, Anne Isabelle Bertozzi, Natacha Entz-Werlé
Journal: Neuro-Oncology (2016)
From latent to active TB: are IGRAs of any use?: Table 1
Authors: Wei Shen Lim
Journal: Thorax (2016)

In May 2014, the World Health Assembly approved the WHO End TB Strategy which set ambitious targets for the elimination of tuberculosis (TB), including a 95% reduction in TB deaths and a 90% reduction in TB incidence by 2035.1 In December 2015, WHO Guidelines for low-TB-burden countries for the management of latent Mycobacterium tuberculosis (MTB) infection (LTBI) were published in support of the WHO End TB Strategy.2 A major focus of these guidelines is the identification of people with LTBI and the provision of chemoprophylaxis to prevent the development of active TB in those infected.

Latent TB infection is defined as a state of persistent bacterial viability, immune control and no clinical evidence of active TB.3 ,4 There is no direct test to diagnose LTBI. Instead, LTBI is recognised by the presence of measurable immune sensitisation to MTB as identified by a positive result to either tuberculin skin testing or an interferon-γ release assay (IGRA).5 In many high-income and upper-middle-income countries with low TB incidence, IGRAs currently play an integral part in screening programmes for LTBI. A clear understanding of the predictive value of IGRAs for the development of active TB disease is therefore necessary.

In 2012, Rangaka et al 6 published a meta-analysis of longitudinal studies that assessed the positive and negative predictive values (PPVs and NPVs) of IGRAs for future active TB. Fifteen studies (6 from Europe) with a combined sample …
Systemic therapy for small-cell lung cancer: old themes replayed, new ones awaited.
Authors: J Viallet, D C Ihde
Journal: Journal of Clinical Oncology (1989)

Article Tools Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1989.7.8.985 Journal of Clinical Oncology - published online before print September 22, 2016 PMID: 2547029 Systemic therapy for small-cell lung cancer: old themes replayed, new ones awaited. J VialletxJ VialletSearch for articles by this author , D C IhdexD C IhdeSearch for articles by this author Show More National Cancer Institute Bethesda, MD. https://doi.org/10.1200/JCO.1989.7.8.985 First Page PDF © 1989 by American Society of Clinical Oncology
Less frequent lithium administration and lower urine volume
Authors: R C Bowen, P Grof, E Grof
Journal: American Journal of Psychiatry (1991)

This study was designed to determine whether patients maintained on a regimen of lithium on a once-per-day schedule have lower urine volumes than do patients receiving multiple doses per day.This was a cross-sectional study of 85 patients from a lithium clinic who received different dose schedules. Patients were admitted to the hospital for measurement of lithium level, creatinine clearance, urine volume, and maximum osmolality.Multiple daily doses of lithium were associated with higher urine volumes. The dosing schedule, duration of lithium treatment, and daily dose of lithium did not affect maximum osmolality or creatinine clearance.Urine volume can be reduced by giving lithium once daily and/or by lowering the total daily dose. Lithium-induced polyuria seems to be related to extrarenal as well as to renal effects.
Mediastinoscopy: A Method of Biopsy in the Superior Mediastinum
Authors: F G PEARSON
Journal: JAMA (1963)

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
THE PHYSICIAN AND THE PHARMACOPEIA.
Authors: W T SALTER
Journal: JAMA (1905)

from a Spanish bullfight as much as a game of bean-bag dif¬ fers from a college football game.There is no bloodshed, nothing repugnant, but plenty of hilarity, and frequently great athletic ability is displayed by men, horses and bulls.On the short horns of the latter are placed large rubber balls.
Exploratory analysis of a prognosis predictive formula for metastatic colorectal cancer treated with chemotherapy.
Authors: Mamoru Tanaka, Hitoshi Kusaba, Satomi Mukaide, Junji Kishimoto, Hozumi Kumagai, Akitaka Makiyama, Tsuyoshi Shirakawa, Hisanobu Oda, Masato Komoda, Kenji Mitsugi, Koichi Akashi, Eishi Baba
Journal: Journal of Clinical Oncology (2015)

757 Background: Progression free survival (PFS) has been recognized as a surrogate outcome in the therapy for metastatic or recurrent colorectal cancer (mCRC). As molecular targeted therapies have become to be widely used, new surrogate outcome such as early tumor shrinkage (ETS; the relative change in the sum of longest diameters of target lesions at week 8 compared to baseline) and deepness of response (DpR; the relative change in the sum of longest diameters of target lesions at the nadir compared to baseline) are proposed. However, their validity has not been fully proven. We conducted to develop a new prognosis predictive formula consisting of the three factors, DpR, ETS and PFS, in the first-line chemotherapy of mCRC. Methods: We retrospectively evaluated mCRC patients who started any chemotherapy from 2005 to 2010. Estimated ETS (eETS), instead of ETS, was defined as the estimated relative change of target lesions at week 8 calculated from first image assessment. DpR was defined as above. Predictive formulae of prognosis were examined by single and multiple regression analysis. Results: 63 patients were enrolled. KRAS status were as follows; wild type; 33, mutant; 17, unknown; 13. Chemotherapies were performed as follows; oxaliplatin-based plus bevacizumab; 34, irinotecan-based plus bevacizumab; 6, oxaliplatin-based plus anti-EGFR antibody; 2, oxaliplatin-based; 17, irinotecan-based; 4. Median of DpR, eETS, PFS and overall survival (OS) were 26.5%, 15.4%, 236 days and 571 days, respectively. PFS showed a correlation with OS (r 2 = 0.434), while DpR and eETS were less correlated with OS (r 2 = 0.228, 0.082). PFS and eETS were thus chosen as variables for the prediction formula of prognosis. However, the present formula did not show an apparent increased R 2 value compared with the formula consisted of PFS alone (adjusted R 2 = 0.442 vs 0.425), indicating that the present formula could not provide more accurate prediction. In the stratified subgroups according to treatment regimen and KRAS status, the formula did not show remarkable change in R 2 value. Conclusions: The present formulae including DpR and eETS does not have superior predicting potential to PFS alone for prognosis of the whole mCRC patients.
PNR-08NEWLY DISCOVERED ONCOGENES DRIVING AND MAINTAINING CHOROID PLEXUS CARCINOMA PROVIDE POTENTIALLY DRUGGABLE TARGETS
Authors: Yiai Tong, Diana Merino, Birgit Nimmervoll, Kirti Gupta, David Finkelstein, David W. Ellison, Jinghui Zang, David Malkin, Richard Gilbertson
Journal: Neuro-Oncology (2016)
&lt;emph type="ital"&gt;Midnight Vigil&lt;/emph&gt;
Authors: Harriet O. Kelley
Journal: JAMA (2008)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Progress and perspectives on targeting nanoparticles for brain drug delivery
Authors: Huile Gao
Journal: Acta Pharmaceutica Sinica B (2016)

Due to the ability of the blood–brain barrier (BBB) to prevent the entry of drugs into the brain, it is a challenge to treat central nervous system disorders pharmacologically. The development of nanotechnology provides potential to overcome this problem. In this review, the barriers to brain-targeted drug delivery are reviewed, including the BBB, blood–brain tumor barrier (BBTB), and nose-to-brain barrier. Delivery strategies are focused on overcoming the BBB, directly targeting diseased cells in the brain, and dual-targeted delivery. The major concerns and perspectives on constructing brain-targeted delivery systems are discussed.
HG-05DIFFERENTIAL EXPRESSION OF PARP1/2 AS A BIOMARKER OF DIPG MALIGNANT PROGRESSION: RELATIONSHIP TO TGF-β/BMP SIGNALING AND EZH2 GLOBAL METHYLATION
Authors: Uday Bhanu Maachani, Uma Shankavaram, Melanie Schweitzer, Yue Linda Wu, Kevin Camphausen, Mark Souweidane
Journal: Neuro-Oncology (2016)

HG-05. DIFFERENTIAL EXPRESSION OF PARP1/2 AS A BIOMARKER OF DIPG MALIGNANT PROGRESSION: RELATIONSHIP TO TGF-b/BMP SIGNALING AND EZH2 GLOBAL METHYLATION Uday Bhanu Maachani1, Uma Shankavaram2, Melanie Schweitzer1, Yue Linda Wu1, Kevin Camphausen2, and Mark Souweidane1; Weill Cornell Medicine, New York, NY, USA; National Cancer Institute-NIH, Bethesda, MD, USA Diffuse intrinsic pontine gliomas (DIPG) which occur in the brain stem are the most malignant inoperable and hard to treat brain tumors in children. Many reports indicate DIPG as being unique in terms of the molecular process that drives their malignancy. Recently, Poly (ADP-ribose) polymerase 1 & 2 (PARP1/2) have gained much attention as potential promising therapeutic targets for the treatment of solid tumors including DIPG. In this study, we defined molecular landscape of DIPG tumor samples by using a large public retrospective gene expression data set (n 1⁄4 53) and performed detailed bio-informatics analysis to generate hypotheses regarding potential mechanisms associated with PARP expression. Different associations between PARP and TGF-b/BMP, EZH2 signaling pathway genes were observed (low vs high). We found a negative co-relation between PARP expression and TGBRII, BMP2 and BMP2K genes, with much stronger correlation in patients with H3F3A mutation (present in 65-75% of tumors) suggesting negative role of PARP on TGF-b/BMP signaling. We noticed significant positive correlation of PARP with EZH2 and UHRF1BP1 genes knownto regulate global methylation and their increased expression is recognized to inhibit genes responsible for suppressing tumor development. Further patients with highPARPexpression along with high EZH2 and lowBMP signaling were correlated with poor prognosis to survival. In conclusion, these results reveal potential biological role of PARP in regulating TGF-b/BMP signaling and global methylation driving DIPG tumorigenesis. Moreover, these findings delineate pathways of susceptibility that could be disrupted to confer strong sensitivity to PARP inhibitors. Neuro-Oncology 18:iii48–iii77, 2016. doi:10.1093/neuonc/now073.4 #The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
LG-61DEVELOPING RISK-BASED SELECTION CRITERIA FOR THE NEXT SIOP TRIAL OF “SIGHT-SAVING THERAPY” FOR CHILDREN WITH NF1-ASSOCIATED OPTIC PATHWAY GLIOMA (NF1-OPG) - A MULTI-DISCIPLINARY CONSENSUS WORKSHOP
Authors: David Walker, Astrid Sehested, Enrico Opocher, Tim Jaspan, Jo-Fen Liu, Amedeo Azizi, Ian Simmons, Rosalie Ferner, Jacques Grill
Journal: Neuro-Oncology (2016)
A case of fluoxetine-induced serum sickness
Authors: L G Miller, R C Bowman, D Mann, A Tripathy
Journal: American Journal of Psychiatry (1989)

After 3-4 weeks of taking fluoxetine for depression, a 27-year-old man developed fever, skin eruptions, arthralgia, and lymphadenopathy. His clinical symptoms and results of laboratory assessment were consistent with a diagnosis of serum sickness reaction to the fluoxetine.