tbuckley/cabot-search huggingface dataset:
Child's needs should be central
Authors: A F Mellon
Journal: BMJ (1996)

EDITOR,—I am concerned about some of the issues raised in the case discussed in the ethical debate about child protection.1 Given the nature of the case, it is entirely appropriate that social workers should have investigated it, as it was indeed an abuse of parental responsibility towards a child. I am not surprised at the child claiming that she must have slept through anything that happened. I have seen a teenage girl who denied the …
Patient safety took second place to research needs at NIH hospital, says report
Authors: Michael McCarthy
Journal: BMJ (2016)

A special working group assigned to look into lapses in safety practices at the US National Institutes of Health’s (NIH) Clinical Center has found that in many cases patient safety had been treated as secondary to research needs.1

“While there were certain risks inherent in leading edge research conducted by the NIH,” the report said, “failing to take appropriate steps to minimize those risks was a disservice to both the patients and the quality of the research itself.”

The center, located on the NIH campus in Bethesda, Maryland, …
Systematic evaluation of pembrolizumab dosing in patients with advanced non-small-cell lung cancer
Authors: M. Chatterjee, D.C. Turner, E. Felip, H. Lena, F. Cappuzzo, L. Horn, E.B. Garon, R. Hui, H.-T. Arkenau, M.A. Gubens, M.D. Hellmann, D. Dong, C. Li, K. Mayawala, T. Freshwater, M. Ahamadi, J. Stone, G.M. Lubiniecki, J. Zhang, E. Im, D.P. De Alwis, A.G. Kondic, Ø. Fløtten
Journal: Annals of Oncology (2016)
Genetic association of ankylosing spondylitis with<i>TBX21</i>influences T-bet and pro-inflammatory cytokine expression in humans and SKG mice as a model of spondyloarthritis
Authors: Max C Lau, Patricia Keith, Mary-Ellen Costello, Linda A Bradbury, Kelly A Hollis, Ranjeny Thomas, Gethin P Thomas, Matthew A Brown, Tony J Kenna
Journal: Annals of the Rheumatic Diseases (2016)

Ankylosing spondylitis (AS) is a highly heritable immune-mediated arthropathy. Inflammation in AS is poorly understood. TBX21 encodes T-bet, a transcription factor, lying within a locus with genome-wide significant association with AS. T-bet is implicated in innate and adaptive immunity. However, the role of T-bet in AS pathogenesis is unclear.We assessed the importance of T-bet in disease development and progression in peripheral blood mononuclear cells from 172 AS cases and 83 healthy controls carrying either risk or protective alleles of the peak AS-associated TBX21 single nucleotide polymorphism. Kinetics and localisation of T-bet expression in the SKG mouse model of spondyloarthropathy was examined, along with the impact of Tbx21 knockout on arthritis development in SKG mice.Patients with AS had higher T-bet expression than healthy individuals, driven predominantly by natural killer and CD8+ T cells, with expression levels in CD8+ T cells completely distinguishing AS cases from healthy controls. T-bet expression was increased in AS cases carrying risk compared with protective alleles of rs11657479. In curdlan-treated SKG mice, T-bet expression increased early after disease initiation and persisted throughout the course of disease. There was marked reduction in gut and peripheral joint inflammation, and less IFNγ-producing and IL-17-producing CD8+ T cells, in Tbx21-/- compared with wild-type SKG mice.AS-associated variants in TBX21 influence T-bet expression. T-bet+ innate and adaptive immune cells have altered IL-17 and IFNγ, and early activation marker CD69 expression than T-bet cells. This indicates that T-bet is a major component of inflammatory pathways of spondyloarthropathy in humans and mice.
Pathologic downstaging with taxane-based neoadjuvant chemotherapy correlates with increased survival in patients with locally advanced esophageal cancer
Authors: M. K. Gibson, M. Brock, E. Montgomery, J. Herman, S. Baylin, E. Heath, R. Heitmiller, A. A. Forastiere
Journal: Journal of Clinical Oncology (2005)

4039 Background: We previously reported the effect of neoadjuvant chemoradiotherapy on pathologic stage and survival in patients with locally advanced esophageal cancer treated with concurrent cisplatin, 5-FU and radiotherapy (RT) followed by surgery. This study aimed to evaluate these outcomes in patients treated with taxane-based neoadjuvant chemoradiotherapy. Methods: Patients (n=67) received taxane-based induction chemoradiotherapy followed by esophagectomy. Survival calculated from time of surgery was stratified by pathologic stage and controlled for clinical factors. Results: Characteristics included: age (range 40 to 76 years); gender (64 male; 3 female); and histology (59 adeno; 8 squamous cell). Pre-treatment stages were: IIA (n=2); IIB (n=8); III (n=49) and IVa (n=8). Treatment led to downstaging in 54 patients, and 19 patients achieved a pathologic complete response. Post-treatment (pathologic) stages were: 0 (n=19); I (n=6); IIA (n=26); IIB (n=7); III (n=6); IV (n=3). The number of interval stage reductions (pre versus post treatment) was: none (n=13); 1 (n=6); 2 (n=21); 3 (n=9); 4 (n=17); and 5 (n=1). Median survival is 47.5 months with minimum follow up of 5 months for surviving patients. Number of stage reductions did not correlate with survival (p = 0.83 by chi2), and 6/13 patients with no downstaging are alive. Median survivals for each pathologic stage were: 0 (not reached); I (31 months); IIA (35 months); IIB (17 months); III (11 months); and IV (4 months) [p < 0.01 by logrank test]. In a Cox multivariate model adjusted for age, gender and histology, higher pathologic stage correlated with worse survival (HR 1.44; 95% CI 1.12–1.86). Conclusions: Taxane-based neoadjuvant chemoradiotherapy for resectable esophageal cancer leads to pathologic downstaging in most patients, and lower pathologic stage correlates with better survival. These results are similar to those achieved with cisplatin and 5-FU. No significant financial relationships to disclose.
Physical activity and exercise capacity in patients with moderate COPD exacerbations
Authors: Ayedh D. Alahmari, Beverly S. Kowlessar, Anant R.C. Patel, Alex J. Mackay, James P. Allinson, Jadwiga A. Wedzicha, Gavin C. Donaldson
Journal: European Respiratory Journal (2016)

Little is known about changes in physical activity during moderate (out-patient managed) exacerbations.6-min walking distance (6MWD) was measured during 50 exacerbations when the patients were stable, and at 3 and 7 days post-exacerbation presentation. At similar time points, quadriceps maximum voluntary contraction (QMVC) was measured during 47 different exacerbations. Physical activity (SenseWear; Bodymedia Inc., Pittsburgh, PA, USA) was recorded over 2 consecutive-week periods post-presentation.6MWD fell from a median 422 m when stable to 373 m on day 3 (p=0.001). Similarly, QMVC fell from 32.6 versus 29.7 kg (p=0.026). Falls in 6MWD were associated with a rise in C-reactive protein (r= -0.364; p=0.041) and increased Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) (r= -0.44; p=0.013). Light physical activity was 2.18 h·day(-1) during the first week post-exacerbation and was less over week 2 (1.98 h·day(-1); p=0.009). Patients who had attended pulmonary rehabilitation had smaller changes in 6MWD than those who had not attended (-35.0 versus -114.9 m; p=0.013). Falls in physical activity were correlated with higher depression scores (rho= -0.51; p=0.006).These findings indicate that exercise capacity and muscle strength fall at exacerbation in chronic obstructive pulmonary disease patients who are treated at home and are free to maintain normal activity.
Reconsidering Bias: A Hermeneutic Perspective
Authors: Suzanne Metselaar, Gerben Meynen, Guy Widdershoven
Journal: The American Journal of Bioethics (2016)

In “Biases and Heuristics in Decision Making and their Impact on Autonomy,” Blumenthal-Barby (2016) rightfully draws attention to the relevance of cognitive science findings for ethical concepts su...
Deep T-Wave Inversions After Pacemaker Adjustment
Authors: Ersilia M. DeFilippis, David D. Berg, Donna M. Polk
Journal: JAMA Internal Medicine (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 Internal Medicine 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 Internal Medicine journal
Hysteria — The Stability and Usefulness of Clinical Criteria
Authors: Michael J. Perley, Samuel B. Guze
Journal: New England Journal of Medicine (1962)

A COMPLETE concept of the clinical characteristics of hysteria is of practical importance to the physician since he must often evaluate the significance of symptoms that have not been explained by physical examination and laboratory studies. The danger of haphazard and unwarranted dismissal of symptoms as manifestations of hysteria is obvious. Nevertheless, there is surprisingly little quantitative information in the literature about the clinical manifestations and prognosis of hysteria. Studies of the natural history of this disease have been limited primarily to descriptions of the isolated occurrence and prognosis of specific hysterical symptoms, such as transient blindness, paralysis and aphonia, . . .
324P Aloe vera: an ancient herb for radiation induced xerostomia and oral fibrosis
Authors: J.K. Acharya, D.R. Garg, R. Mathur, S.L. Jakhar, N.L. Mahawar, R. Mathur, A. Kwatra, R.K. Mathur, R.N. Purohit
Journal: Annals of Oncology (2015)
‘Benign Thoracic Pain’ Syndrome: Role of Magnetic Resonance Imaging in the Detection and Localization of Thoracic Disc Disease
Authors: F E Bruckner, A Greco, A W L Leung
Journal: Journal of the Royal Society of Medicine (1989)

The syndrome of 'benign thoracic pain' is seen in young women who have pain and tenderness in the mid-thoracic spine radiating around the chest and aggravated by spinal movement. Ten consecutive patients with this syndrome and 15 controls were evaluated with magnetic resonance imaging (MRI). This showed thoracic intervertebral disc dehydration with no associated prolapse in 90% of the patients and 13% of the controls. We postulate that the clinical features are due to impaired shock absorption of these degenerate discs rather than direct compression of surrounding structures. MRI is non-invasive and does not use ionizing radiation; it allows direct visualization of the entire thoracic spine and cord, and accurate detection of early disc degeneration. Thus, it is the imaging modality of choice for defining the subtle intervertebral disc abnormalities that characterize the 'benign thoracic pain' syndrome.
Defective Regulation of Inflammatory Mediators in Hodgkin's Disease
Authors: Peter A. Ward, Jeffrey L. Berenberg
Journal: New England Journal of Medicine (1974)

Elevated levels of the chemotactic-factor inactivator, a naturally occurring regulator of inflammatory mediators, were found in the serums of nine patients with Hodgkin's disease. When these same serums were activated with the yeast particle zymosan, so as to generate chemotactic activity, considerably less chemotactic activity was found in the specimens from patients with Hodgkin's disease than in four similarly treated normal serums. Inactivator isolated from either serum of the patients or normal serum inactivated monocyte as well as neutrophil chemotactic factors. Inactivator in patients' serum was qualitatively similar to that isolated from normal human serum, but may not be functionally homogeneous. The elevated levels in serum of patients, together with inactivation of leukotactic factors that are complement-derived, complement-independent and lymphocyte-derived, suggest that patients with Hodgkin's disease have a generalized defect in the ability to mobilize inflammatory cells. (N Engl J Med 290:76–80, 1974)
Pre-treatment cognitive functioning of older prostate cancer patients (PCa): Baseline data from a prospective study of androgen ablation and health status
Authors: S. Gupta, M. Lacy, K. Kuball, W. Stadler, M. Rodin
Journal: Journal of Clinical Oncology (2005)

8175 Background: Although higher endogenous testosterone levels and testosterone supplementation have been linked to better cognitive functioning and health status, few studies have investigated potential effects of androgen ablation on cognition and functional status. Methods: PCa pts >50 yrs initiating LHRH agonist therapy for > 2 yrs, who were not on chemotherapy, and had a baseline Mini-Mental State Exam (MMSE) > 21 were enrolled. Pts completed baseline functional measures (basic/instrumental activities of daily living (A/IADLs) and Berg Balance Score (BBS)) and underwent a comprehensive neuropsychological assessment including Delayed Verbal Learning (HVLT), Delayed Visual Memory (BVMT), Working Memory (LNS), Phonemic Fluency, and Semantic Fluency. Repeat assessments are planned at 6 and 24 mths following androgen ablation initiation. Results: To date, 20 pts completed a baseline evaluation and 11 have undergone 6-mth follow-up testing. Pt characteristics include 37% African-American with a mean age of 70 and mean education of 12 yrs. At baseline, there were no deficits in ADLs or IADLs. However, 47% were at risk for falls (<40/56 on BBS). No declines in function were found at 6-mths. At baseline, 26% of pts scored between 22–26 on the MMSE suggestive of cognitive impairment. Eight of the 20 initial pts (40%) were rated cognitively impaired based on scoring > 1.5 standard deviations below the mean on 2 or more neuropsychological tests. When comparing test scores standardized for age and education, these pts were significantly more impaired than the non-impaired group across the test battery: HVLT p = .005; BVMT p =.000; LNS p=.000; Phonemic Fluency p = .028; Semantic Fluency p =.019. At 6-mth follow-up, there were no significant declines of test scores in either group. Conclusions: 40% of older men with PCa exhibit neurocognitive deficits prior to starting treatment. Follow-up to determine whether pts with pre-treatment impairment are more vulnerable to the cognitive effects of androgen ablation (e.g. dementia) is ongoing. Comparison of studies investigating the cognitive effects of androgen ablation must take baseline functioning into account. No significant financial relationships to disclose.
AB0363 Traditional Cardiovascular Risk Factors in Rheumatoid Arthritis: Table 1.
Authors: L. Riancho, A. Corrales, M. Santos-Gόmez, J. Rueda-Gotor, R. Blanco, M.A. González-Gay
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Patients with rheumatoid arthritis have an increased risk of cardiovascular disease. <h3>Objectives</h3> To evaluate the influence of the classic cardiovascular risk factors in the development of premature atherosclerosis. <h3>Methods</h3> A set of 592 consecutive RA patients from a single university hospital without history of cardiovascular (CV) events were studied. Both traditional cardiovascular risk factors and the Systematic Coronary Risk Evaluation (SCORE) modified according to the EULAR recommendations (mSCORE) were assessed. Carotid ultrasonography was performed in patients and controls by a MyLab 70 scanner (Esaote; Genoa, Italy), equipped with 7–12 MHz linear transducer and the <i>automated software guided technique radiofrequency</i> – <i>Quality Intima Media Thickness</i> in <i>real</i>-<i>time</i> (<i>QIMT</i>, <i>Esaote</i>, <i>Maastricht</i>, <i>Holland</i>) to determine carotid intima-media thickness (cIMT) and plaques, according to Mannheim consensus. After the univariate analysis, multivariate regression models were fitted to adjust for potential confounders. <h3>Results</h3> 592 patients (456 women, 136 men) with a mean age of 59±13 years were studied. Among them, 85% presented at least one classic cardiovascular risk factor; dyslipidemia (DLP) (43%), hypertension (HT) (42%), tobacco use (26%), hypertriglyceridemia (16%), diabetes mellitus (DM) (10%) and chronic kidney disease (CKD) (3%). In the univariate analysis, the cIMT was significantly associated with age, sex, DLP, HTA, DM, CKD and hypertriglyceridemia. Carotid plaques were associated with age, as well as with DLP, HTA and DM. A positive correlation between the mSCORE and cIMT was found (r=0,50; p&lt;0.001). The frequency of carotid plaques among patients classified as mild, moderate, and high CV risk according to mSCORE was 25%, 67% and 86%, respectively (p&lt;0,001). In the multivariate analysis, factors that were independently associated with cIMT were the age, male sex, DM, and smoking (p&lt;0.002 in all cases). Carotid plaques were significantly associated with age and tobacco use (TABLE). <h3>Conclusions</h3> Our study demonstrates a close relationship between carotid ultrasonography findings (plaques and increased cIMT) and classic CV risk factors in RA patients. This could explain, at least partially, the increased risk of CV disease in these patients. <h3>Disclosure of Interest</h3> None declared
Glucose Tolerance and Ageing
Authors: Robert W Stout
Journal: Journal of the Royal Society of Medicine (1994)

Hyperglycaemia, impaired glucose tolerance and noninsulin dependent diabetes become progressively more common with advancing age. The mechanism is insensitivity to the actions of insulin at the postreceptor level. Inadequate secretion of insulin and decreased hepatic sensitivity to insulin's action in suppressing glucose output also occur. The age-related changes may be made worse by obesity, renal failure or the ingestion of certain drugs, or may be lessened by increased physical activity.
TCTAP A-023 Long-Term Clinical Outcomes After Primary and Delayed Percutaneous Coronary Interventions for STEMI
Authors: Nino V. Tsereteli, Tamara Dzhordzhikia, Dzhamil Arif Asadov, Pavel S. Vasiliev, David G. Iosseliani
Journal: Journal of the American College of Cardiology (2016)
IMPS-34INNATE IMMUNOLOGICAL COMPENSATORY CONTROL OF GLIOMAGENESIS AND MALIGNANT TRANSFORMATION IN MURINE CD8α KNOCKOUT MODELS
Authors: Ganesh Rao, Xiaoyang Ling, Tiffany Doucette, Yuhui Yang, Ling-Yuan Kong, Jun Wei, Gregory Fuller, Felix Nwajei, Shouhao Zhou, Hillary Caruso, Richard Vile, Amy Heimberger
Journal: Neuro-Oncology (2015)

BACKGROUND: The extent of CD8+ T cell infiltration has been shown to correlate with improved survival in patients with high-grade glioma. However, it is unknown how the CD8 effector cells influences gliomagenesis or the progression from low- to high-grade glioma. In this study we eliminated CD8 T cells in an otherwise immunocompetent model of glioma to study their effect on the initiation and malignant progression of glioma. METHODS: We backcrossed CD8α KO mice into the Ntv-a background and then induced endogenous gliomas in CD8α−/−/Ntv-a and CD8+/+/Ntv-a mice using co-expression of PDGFB and STAT3. Immune compensatory mechanisms were studied using ex vivo immune functional assays, immunohistochemistry, and flow cytometry. RESULTS: We verified the absence of CD8α T cells in CD8−/−/Ntv-a mice in peripheral blood, spleen and brain. Mice lacking CD8α T cells demonstrated no increase in glioma formation or grade compared to wild-type mice. The lack of CD8α T cells did not impact symptom free survival or the incidence of malignant degeneration. A compensatory increase of cytotoxic CD4+ T cells, CD19+ B cells, and NK 1.1+ cells was found systemically but did not traffic to the glioma microenvironment. In contrast, in the glioma-bearing CD8α−/−/Ntv-a mice, CD11b+ monocytes and Iba1+ macrophages were found to be over represented in the tumor microenvironment relative to glioma-bearing CD8 wild-type mice (P = 0.0001). The macrophages in the tumors from CD8α−/−/Ntv-a mice demonstrated increased TNF-alpha expression compared to those from wild-type mice indicating they are polarized to the M1 phenotype. CONCLUSIONS: Absence of the CD8α T cell population does not influence glioma formation or survival in an immunocompetent model. A compensatory increase in M1 macrophages was identified in tumor-bearing mice. These results indicate that the innate immune system effector response may play a key role in the control of gliomagenesis and the process of malignant degeneration.
Case 15-1997
Authors: N. Paul Rosman, Drucilla J. Roberts
Journal: New England Journal of Medicine (1997)

Presentation of CaseA newborn boy was admitted to an intensive care unit because of respiratory depression.The infant was born to a 28-year-old woman (gravida 2) at 38 weeks' gestation, after an uneventful pregnancy. The parents were from the Cape Verde Islands. The mother's blood group was O, Rh-positive. A test for antirubella antibodies was positive; tests for antibodies to hepatitis B surface antigen and the human immunodeficiency virus, a serologic test for syphilis, and vaginal cultures for chlamydia and gonococci were negative. A healthy daughter had been delivered three years earlier. The mother had eight siblings and seven . . .
Novel association between thymomas and T-cell Non-Hodgkin's lymphomas: Evaluation of 5 cases
Authors: D. A. Vaena, M. Czader, E. Van Hook, K. Ganjoo, P. Loehrer
Journal: Journal of Clinical Oncology (2004)

7326 Background: Thymomas are often accompanied by a variety of paraneoplastic syndromes and have been associated with abnormal intra-thymic T-cell development, as well as oligoclonal T-cell populations in the bone marrow of certain patients. Prior series have shown an increased incidence of secondary malignancies in patients with thymoma. Recently, Engels et al. (Int. J. Cancer: 105, 546–551) demonstrated an excessive occurrence of Non-Hodgkin's lymphomas (NHL) after a thymoma diagnosis, identifying 7 cases among 9 SEER registries; however, only B-cell NHL cases were found. We report the association between thymomas and T-cell NHLs and examine its possible causal relationship to abnormal T-cell maturation within the thymus, employing immunohistochemical stains and assessment of T-cell clonality. Methods: Five patients with thymoma and T-cell NHL (both biopsy-proven) were identified through the Thymoma Clinic database at Indiana University. The T-NHL diagnosis could precede, concur or be subsequent to the thymoma. Original thymic samples are being stained for CD2, CD3, CD5, CD4, CD8, CD25, CDK6, p53 and compared to NHL samples. Thymic T-lymphocytes and original T-NHL lymphocytes are being subjected to T-cell receptor gene rearrangement studies by PCR. Results: Median age at the time of thymoma diagnosis was 38 years (range, 28–56). Patient characteristics are summarized in the table. All patients had cortical thymoma. Two patients (cases 4 and 5) presented with the T-NHL in the setting of persistent thymoma. Conclusions: We describe a novel clinical association between thymomas and T-cell NHLs. Abnormal T-cell maturation induced by thymomas may play a role in T-NHL pathogenesis in these patients. Correlative studies will be available for presentation at the time of the Annual Meeting. No significant financial relationships to disclose.
Epstein-Barr virus genome in non-Hodgkin's lymphomas occurring in immunocompetent patients: highest prevalence in nonlymphoblastic T-cell lymphoma and correlation with a poor prognosis. Danish Lymphoma Study Group, LYFO
Authors: F d'Amore, P Johansen, A Houmand, DD Weisenburger, LS Mortensen
Journal: Blood (1996)