tbuckley/cabot-search huggingface dataset:
Soundings: Why seeing a patient after the counsellor is so difficult
Authors: Kevin Barraclough
Journal: BMJ (2000)

“I know now that I haven't resolved my inner conflicts. I have to come to terms with the emotional violence I've suffered and learn to do what I want to do.” The “I” is always italicised in the inflection. “My counsellor says that I am far too generous and must learn to live life on my terms.”

Why is it that we feel such profound fatigue when faced with the regurgitated views of the counsellor? It is not because the statements are necessarily wrong or invalid, merely that, repeated so frequently to hordes of moderately dissatisfied people, they seem to become almost totally devoid of meaning. It is as though the counsellor has dipped his or her hand into the cookie jar of aphorisms labelled “dissatisfied housewife” and come out with a series of brightly coloured platitudes.

The difficulty is that once we have subscribed to a particular, usually simplified version of reality, it is often impossible to experience the world without those blinkered preconceptions. I am reminded of something that John Mortimer wrote in his autobiographical Clinging to the wreckage. As the curtain fell on the opening night of his play about his father, he realised that he had lost something. In the process of creating lines for the stage character he found that he could no longer remember what his father had actually said, and what he had created for him. Something is always lost in the process of articulation. In talking about ourselves, we risk creating fiction.

It seems to me that talking about yourself, in any way, with anyone, is actually rather hazardous, and that perhaps we do too much of it now. My parents came from a generation to whom discussion of their feelings was something for which they had almost no vocabulary. But perhaps because they couldn't articulate their feelings they also did not degrade them. They did not pulverise their emotions in order to fit them into the same shaped boxes as some celebrity in Hello magazine.

The trouble is that the words we use to describe the world ultimately constrain the way we feel about it and the way we see it. Before embarking on a voyage of self discovery, or helping another on the same path, I would be mindful of Einstein's aphorism: “You should strive to make things as simple as possible, but no simpler.”
Cold urticaria vasculitis
Authors: R.A.J. Eady, C.B. Bentley-Phillips, T.M. Keahey, M.W. Greaves
Journal: British Journal of Dermatology (1978)

Journal Article Cold urticaria vasculitis Get access R.A.J. Eady, R.A.J. Eady Institute of Dermatology, St John's Hospital for Diseases of the Skin, Homerton Grove, London E9 6BX Search for other works by this author on: Oxford Academic Google Scholar C.B. Bentley‐Phillips, C.B. Bentley‐Phillips Institute of Dermatology, St John's Hospital for Diseases of the Skin, Homerton Grove, London E9 6BX Search for other works by this author on: Oxford Academic Google Scholar T.M. Keahey, T.M. Keahey Institute of Dermatology, St John's Hospital for Diseases of the Skin, Homerton Grove, London E9 6BX Search for other works by this author on: Oxford Academic Google Scholar M.W. Greaves M.W. Greaves Institute of Dermatology, St John's Hospital for Diseases of the Skin, Homerton Grove, London E9 6BX Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 99, Issue s16, 1 December 1978, Pages 9–10, https://doi.org/10.1111/j.1365-2133.1978.tb15201.x Published: 01 December 1978
In vivo biologic effects of PIXY321, a synthetic hybrid protein of recombinant human granulocyte-macrophage colony-stimulating factor and interleukin-3 in cancer patients with normal hematopoiesis: a phase I study
Authors: S Vadhan-Raj, HE Broxmeyer, M Andreeff, JC Bandres, ES Buescher, RS Benjamin, NE Papadopoulos, A Burgess, S Patel, C Plager
Journal: Blood (1995)
Diuretics
Authors: Laurence E. Earley
Journal: New England Journal of Medicine (1967)

Responsiveness to Diuretic AgentsAs indicated in the first part of this discussion, each of the useful diuretic agents exerts its net effect to increase the excretion of sodium by blocking ubular reabsi rption at sites distal to the proximal tubule.5 Therefore, the maximal effect of any one of the drugs will depend upon the amount of sodium delivered to the distal tubular site where the agent blocks sodium reabsorption, and the extent to which the rejected sodium may escape reabsorption at a more distal site where the diuretic agent exerts no effect. The capacity of thiazides to diminish . . .
Sugaring—Modern Revival of an Ancient Egyptian Technique for Hair Removal
Authors: Victoria Lim, Brian J. Simmons, Eric L. Maranda, Ladan Afifi, Penelope J. Kallis, Joaquin Jimenez
Journal: JAMA Dermatology (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 Dermatology 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 Dermatology journal
PWE-079 Clinical assessment of operative fitness can identify patients at risk of complications after hepatectomy for malignant disease, but does not correlate with long-term survival
Authors: S Ulyett, M Wiggans, M Bowles, S Aroori, C Briggs, G Minto, D Stell
Journal: Gut (2015)

<h3>Introduction</h3> Liver resection is associated with significant morbidity and mortality, and accurate pre-operative assessment of risk is an important part of the pre-operative consultation. Numerous scoring systems exist to assess operative risk, which are rarely used in routine practice. All patients, however, are assessed in out-patient clinic and a subjective assessment of risk is made. Patients thought to be at higher risk of operative complications in our hospital are referred for CPX testing. We wished to establish if clinicians are able to predict patients at greater risk of complications after liver resection. <h3>Method</h3> Prospectively collected data on patients undergoing hepatectomy were retrieved from the HPB unit database. From February 2008 to November 2013 patients subjectively anticipated to be at high-risk were selectively referred for CPX. The study group excluded patients with chronic liver disease and biliary obstruction. Operative complications were classified according to the Clavien-Dindo system. Outcomes between the group referred for CPX was compared with control group. <h3>Results</h3> During the study period 405 resections were performed on 368 individuals. CPX testing was carried out prior to 101 resections. Median age was 72 and 64 in CPX and non-CPX groups, respectively (P &lt; 0.001). Men accounted for 68% and 46% of CPX and non-CPX patients respectively (P &lt; 0.001). There was no difference in the underlying diagnosis or number of resected liver segments between groups. CPX and non-CPX patients suffered 19 (18.8%) and 28 (9.2%) grade 4–5 complications, respectively (P = 0.009). No difference was seen for grade 3 complications. There was no difference in long-term survival between CPX and non-CPX groups (P = 0.63). <h3>Conclusion</h3> This study represents the only attempt to assess clinicians’ ability to identify patients at greater risk of complications following hepatectomy. The confirmation that patients identified in this way have approximately 100% greater risk of grade 4–5 complications demonstrates the value of pre-operative counselling by experienced clinicians. Interestingly, patients identified to be lower operative risk do not have improved long-term survival, suggesting disease recurrence and progression are more important determinants of long-term outcome. <h3>Disclosure of interest</h3> None Declared.
Implementing placebo
Authors: David E Linden
Journal: BMJ (2008)

Pittrof and Rubinstein make the important point that the “placebo effect” is actually an effect—people often do get better on placebo.1 However, most, if not all, of the evidence for placebo effects comes from studies where patients expected to have a reasonable chance (generally 0.5) of receiving the active treatment. There is therefore no evidence base for prescribing placebos in a standard clinical setting, which is what the authors seem to advocate.

We do not know whether placebos will have an effect if patients are aware of what they are receiving. The most likely explanation for the placebo effect, particularly in mental disorders, is that it works as a proto-psychotherapy, using the patients’ conviction that they are being helped and mobilising their own positive resources. We know very little about the brain mechanisms of the placebo response, but the available evidence suggests that, like psychotherapy, it partly operates through the same pathways as the relevant active drugs.2 I would therefore expect the patient’s belief that some aspect of their brain chemistry is actually being changed to be a crucial part of the placebo effect.

There may still be ways in which patients can benefit from placebos, even if they cannot be prescribed like ordinary drugs. Firstly, in a setting that re-creates the original trial, including randomisation to placebo or active treatment, but then the physician would not have control over who receives the “reduced benefits for much reduced risks.”1 Secondly, if physicians were to deceive patients, telling them that they are receiving an active treatment when they are not, but this would face both ethical and practical challenges. Thirdly, by administering placebo-like substances in the context of a quasi-medical model such as homoeopathy, but this will work only if the patient (and probably the doctor as well) believes in this model.
A cholecystocolonic fistula caused by penetration of a double-pigtail plastic stent after endoscopic transpapillary gallbladder stenting
Authors: Itaru Naitoh, Takahiro Nakazawa, Katsuyuki Miyabe, Koji Mizoguchi, Masahiro Kimura, Hiromitsu Takeyama, Takashi Joh
Journal: Endoscopy (2015)

Endoscopic transpapillary gallbladder stenting is currently indicated to treat acute cholecystitis, and a double-pigtail plastic stent is usually placed [1] [2] [3]. No case of cholecystocolonic fistula caused by endoscopic transpapillary gallbladder stenting has been reported.
Relationship Between the Mason-Pfizer Monkey Virus and HeLa Virus: Immunoelectron Microscopy
Authors: Hans Gelderblom, Heinz Schwarz
Journal: JNCI Journal of the National Cancer Institute (1976)

Envelope antigens of the Mason-Pfizer monkey virus (MPMV) and the morphologically similar HeLa virus, which is continuously produced in some HeLa cell lines, were compared by indirect immunoferritin techniques. Antisera raised against MPMV and HeLa virus revealed cross-reacting antigenic specificities on the surfaces of both agents, and cross-absorption and end-point dilution techniques indicated the presence of identical envelope antigens. The results demonstrated a close relationship, if not an identity, between MPMV and HeLa virus.
A Sponge Matrix Method for Tissue Culture. Formation of Organized Aggregates of Cells <italic>in Vitro</italic><xref ref-type="fn" rid="fn1"><sup>2</sup></xref>
Authors: Joseph Leighton
Journal: JNCI Journal of the National Cancer Institute (1951)

Journal Article A Sponge Matrix Method for Tissue Culture. Formation of Organized Aggregates of Cells in Vitro Get access Joseph Leighton Joseph Leighton Pathology Section, National Cancer Institute4Bethesda, Md. Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 12, Issue 3, December 1951, Pages 545–561, https://doi.org/10.1093/jnci/12.3.545 Published: 01 December 1951 Article history Received: 29 August 1951 Published: 01 December 1951
PSRO's
Authors: Bentley P. Colcock
Journal: New England Journal of Medicine (1974)

Surely all physicians will join Welch (page 1319, this issue) in hoping that the American Medical Association, at its annual meeting in June, will make its final decision regarding the Professional Standards Review Legislation (PSRO) "on a basis of reason rather than emotion." The ambivalent resolution of the House of Delegates, at its Anaheim meeting, was approved in an atmosphere highly charged with emotion. The House voted to make a strong effort to repeal the PSRO law and, at the same time, to amend it so as to make it better. This action was taken against the advice of the . . .
American Picnic
Authors: Thomas B. Cole
Journal: JAMA (2013)

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
OC-108 Improving the diagnosis of pancreaticobiliary malignancy by the detection of minichromosome maintenance protein 5 in biliary brushings
Authors: MG Keane, MT Huggett, GJ Johnson, MH Chapman, GJ Webster, D Thorburn, J MacKay, SP Pereira
Journal: Gut (2015)

<h3>Introduction</h3> Biliary brush cytology is the standard method of evaluating a biliary stricture but has a low sensitivity for the detection of malignancy. Minichromosome maintenance (Mcm) replication proteins (Mcm 2–7) are raised in a number of cancers, where the active cycling of malignant cells results in the expression of these licensing proteins on the epithelial surface of the tumour. In pancreaticobiliary malignancies Mcm proteins are dysregulated in the epithelial lining of the bile ducts and in bile samples taken from patients with malignant pancreaticobiliary disease. The aim of this study was to evaluate an automated immunoflurometric assay of Mcm5 as a marker of malignancy in patients with indeterminate biliary strictures. <h3>Method</h3> Biliary brush samples were collected prospectively at endoscopic retrograde cholangiopancreatography from patients with an indeterminate biliary stricture. Following sampling the brush was placed in a buffer solution, agitated and frozen to –80<sup>o</sup>C. On defrosting the sample was placed in a microtitre plate strip of 8 wells coated with a purified mouse monoclonal antibody to Mcm5 and incubated for 2 h. The colour intensity was measured using a plate reader and a cut-off of 1.2 was used to indicate a positive result. Patients also underwent brush cytology and/or biliary biopsy as part of standard practice. <h3>Results</h3> 75 patients were included in the study; median age was 65 years (range 20–94) and 68% (51/75) were male. Mcm5 levels in biliary brush samples were significantly more sensitive than brush cytology (89% <i>vs.</i>18%; <i>P</i>= &lt; 0.05) for the detection of malignancy in patients with an indeterminate stricture. The specificity, PPV and NPV of the Mcm5 assay were 96%, 98% and 84% respectively. <h3>Conclusion</h3> Mcm5 from biliary brush cytology determined by a simple automated test is a more sensitive indicator of pancreaticobiliary malignancy than routine brush cytology. <h3>Disclosure of interest</h3> None Declared.
Journals: Grand Rounds
Authors: Giulio Bognolo
Journal: BMJ (2004)

This online journal aims to collect case reports from surgical and medical specialties in a unique database, providing information and education on new diseases, unusual features, and complications of treatment. Grand Rounds presents cases in a concise but clear manner.

The editors, who claim that the medical literature undervalues the importance of case reports, plan to link presentations to evidence based data already available, but this feature is not fully up and running.

Although Grand Rounds is free to readers, authors are expected to pay a nominal sum to cover the publication costs. It would seem that this is no barrier to authors as there is a good spread of papers already published on subjects from anaesthesia to vascular disease.

Most medical journals commonly publish case reports, but it is this journal's ambition to be comprehensive, collecting cases from all medical and surgical specialties in a single site.

Simply but well designed and user friendly, Grand Rounds has a useful search engine. Articles are easily accessible from a click on list, and they are collected according to field of interest. Some of the references have a URL link, but on some that I tried this feature did not appear to be up to speed. Instead I was taken to an old and no longer functioning web page of the National Center for Biotechnology Information.

These are early days for the journal, and I would expect the archive to grow steadily over the next few months. The site receives more than 45 000 hits from 50 countries every month; the more popular articles are viewed more than 1000 times a month, and all articles are viewed at least 100 times a month, say the editors.

Although entirely web based this is a proper journal, with a two referee peer review system for each article and an ISSN.
PWE-330 Causes for delay in commencing adjuvant chemotherapy in rectal cancer
Authors: HG Jones, P Coyne, M Evans, M Davies, U Khot, T Chandrasekaran, O Hatcher, S Gwynne, J Beynon, D Harris
Journal: Gut (2015)

<h3>Introduction</h3> Adjuvant chemotherapy is routinely recommended for locally advanced colorectal cancer (CRC). Recent guidelines state that adjuvant chemotherapy should be considered for patients with high-risk stage II and all stage III rectal cancer to reduce the risk of local and systemic recurrence (NICE 2014). It is recommended that adjuvant chemotherapy is scheduled to begin within 6 weeks of surgery, as delay has been shown to reduce overall survival (OS) and disease free survival (DFS).<sup>1</sup> <h3>Method</h3> All patients having rectal cancer surgery in a single tertiary centre with curative intent in 2012/13 were included. Patients were excluded if the post-operative MDT decision did not include adjuvant chemotherapy. Data was gathered on patient demographics, staging, length of stay, type of surgery, date of MDT decision and date of commencement of adjuvant chemotherapy. Data on postoperative morbidity (Clavien Dindo Scoring) and mortality was obtained through the patients’ notes, and the Index of Multiple Deprivation (IMD) was calculated using the patient’s postcode. Statistical testing using ANOVA and Pearson’s correlation coefficient were used to determine any risk factors for a delay in starting therapy. <h3>Results</h3> There were 102 patients identified having surgery for rectal cancer in 2012/13. Of these, the MDT decision was for 46 to proceed with adjuvant chemotherapy. The median age was 63 (52–73), with a 2:1 male predominance. The median length of stay was 11 days (IQR 8–17 days), with 50% having non-restorative surgery. The median duration from surgery to commencement of adjuvant chemotherapy was 59.5 days (IQR 50–85 days), with an OS of 755 days (IQR 602–923 days) and DFS of 673 days (IQR 240–912 days). ANOVA confirmed a link between the length of stay in hospital and the delay to commencement of adjuvant chemotherapy (p = 0.001). No other factors were statistically significant, although other factors such as the Clavien Dindo scoring and the IMD approached significance (p = 0.147 and 0.163 respectively).3 <h3>Conclusion</h3> Delay in commencing adjuvant chemotherapy is known to be an adverse factor in OS and DFS. Being able to identify causes of these delays will help health professionals to understand and minimise the risk. This work has demonstrated that longer hospital inpatient stay during the time of the index operation lead to a significant delay in commencing adjuvant therapy. Further, large studies are needed to identify any reversible risk factors that could impact on patient outcomes. <h3>Disclosure of interest</h3> None Declared. <h3>Reference</h3> Biagi JJ, <i>et al</i>. Association between time to initiation of adjuvant chemotherapy and survival in colorectal cancer: a systematic review and meta-analysis. JAMA 2011;305(22):2335–42
In Vitro Growth of Lucké Tumor Cells
Authors: Joseph Zambernard
Journal: JNCI Journal of the National Cancer Institute (1973)

Journal Article In Vitro Growth of Lucké Tumor Cells Get access Joseph Zambernard, Ph.D. Joseph Zambernard, Ph.D. The Albany Medical College of Union UniversityAlbany, New York 12208 Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 51, Issue 3, September 1973, Page 1087, https://doi.org/10.1093/jnci/51.3.1087-a Published: 01 September 1973
Pandemic influenza A(H1N1)2009 in Morocco: experience of the Mohammed V Military Teaching Hospital, Rabat, 12 June to 24 December 2009
Authors: I Lahlou Amine, T Bajjou, H El Rhaffouli, A Laraqui, F Hilali, K Menouar, K Ennibi, M Boudlal, E A Bouaiti, K Sbai, M Rbai, M Hachim, S Zouhair
Journal: Eurosurveillance (2011)

On 12 June 2009, Morocco was the first country in North Africa to report a laboratory-confirmed case of influenza A(H1N1)2009 virus infection. This study describes the epidemiological and clinical characteristics of 240 laboratory-confirmed cases among 594 outpatients with influenza-like illness at the Mohammed V Military Teaching Hospital, Rabat, from 12 June to 24 December 2009. Real-time reverse transcription-PCR was used to confirm the infection. The epidemic peaked in weeks 47 to 49 (16 November to 6 December 2009). The mean age of cases was 23 years (standard deviation: 14 years). Cough was the most common symptom in 200 cases (83%), followed by fever (≥38 °C) in 195 (81%). Diarrhoea or vomiting was reported in 12 (5%) patients. None of the cases developed any complications and no deaths occurred during the study period.