tbuckley/cabot-search huggingface dataset:
Avoiding overtreatment in rectal cancer when the benefit of adjuvant chemotherapy is unclear.
Authors: Jonathan M. Loree, Hagen F. Kennecke, Howard John Lim, Daniel John Renouf, Michael M. Vickers, Caroline Speers, Winson Y. Cheung
Journal: Journal of Clinical Oncology (2015)

6572 Background: Adjuvant chemotherapy (AC) is intended for early stage cancers that pose a high risk of recurrence, but its use is frequently generalized to cases in which the probability of recurrence is low and absolute benefit is small. Using a cohort of stage II rectal cancer (RCa)patients (pts), we aimed to examine population-based outcomes stratified by receipt of AC and to characterize pts in whom AC provides benefit. Methods: Prospectively collected data from pts referred to 5 cancer centers in British Columbia for pathologic stage II RCa from 1998 to 2009 were reviewed. Overall (OS), disease-specific (DSS) and relapse-free (RFS) survival were assessed with Kaplan-Meier methods. Cox regression models that adjusted for age, ECOG, gender and high risk features were constructed. Results: Of 851 pts reviewed, 469 who received neoadjuvant radiotherapy were analyzed. Median age was 67, 63% were men, 73% were ECOG 0/1, 70% underwent short course radiotherapy and 43% received AC. Those treated with AC were younger (P< 0.001), had better ECOG (P< 0.001) and had more high risk features (P <0.001). In univariate analyses, AC contributed to superior OS (HR 0.46 95%CI 0.35-0.62, P< 0.001), DSS (HR 0.63 95% CI 0.43-0.92, P =0.02), and a trend to improved RFS (HR 0.70 95%CI 0.49-1.01, P= 0.055). In multivariate analyses, however, AC correlated with better OS (HR 0.61 95%CI 0.42-0.90, P< 0.001), but not DSS (P= 0.25) or RFS (P =0.46). Subgroup analysis revealed that AC correlated with improved OS (HR 0.22 95%CI 0.07-0.70, P= 0.011), DSS (HR 0.25 95%CI 0.07-0.89, P= 0.033) and RFS (HR 0.24 95%CI 0.07-0.85, P= 0.03) only in selected pts who received short course radiotherapy and had ≥ 2 high risk features (n = 49, 12% of pts), such as T4 lesion, poor differentiation, inadequate lymph node sampling or obstruction/perforation. Outcomes in other subgroups were similar regardless of receipt of AC. Conclusions: In this population-based cohort of stage II RCa pts, the majority do not appear to benefit from AC. Risk factors conventionally used to guide AC decisions in early colon cancer should be considered in early RCa. Incorporating molecular tests into future risk stratification may further minimize unnecessary use of AC and potential over-treatment of pts.
Body dysmorphic disorder in the DSM-IV field trial for obsessive- compulsive disorder
Authors: D Simeon, E Hollander, D J Stein, L Cohen, B Aronowitz
Journal: American Journal of Psychiatry (1995)

This study investigated the prevalence and phenomenology of body dysmorphic disorder in patients with obsessive-compulsive disorder.The authors studied 442 patients who participated in the DSM-IV field trial for obsessive-compulsive disorder.Twelve percent (N = 51) of the patients had a lifetime comorbid diagnosis of body dysmorphic disorder. Patients with and without body dysmorphic disorder did not differ in demographic characteristics of obsessive-compulsive symptoms. Patients with obsessive-compulsive disorder and body dysmorphic disorder had more anxious, impulsive, and schizotypal features than patients with obsessive-compulsive disorder alone. Age at onset was similar for the two disorders, and severity correlated. However, insight was significantly more impaired for body dysmorphic disorder than for obsessive-compulsive disorder.As previously thought, these findings suggest that the two disorders are strongly related but also have differences that require further investigation.
Potassium Perchlorate in Management of Thyrotoxicosis
Authors: B T DAVE
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 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
AB0327 Five-Year Clinical, Functional and Radiological Outcomes of Early Rheumatoid Arthritis
Authors: Y.A. Ermakova, D.E. Karateev, E.L. Luchikhina, N.V. Demidova, A.V. Smirnov, E.L. Nasonov
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> The study of the clinical course of rheumatoid arthritis (RA), it functional and radiological changes is especially important for a long time. These data give an understanding of the main outcomes of this disease. <h3>Objectives</h3> To study the dynamics of disease activity, radiological course and the development of functional disorders in patients with early RA. <h3>Methods</h3> We used the data of long-term Russian project "RADICAL" (Rheumatoid Arthritis: Diagnostic, Outcomes, Criterions, Aggressive Treatment). 200 patients with early RA (diagnosed for less than two year) according to American College of Rheumatology criteria included in the study from 2003 to 2007 (67,5% RF (+); 57% ACCP (+), 86,5% women, age of 49 [40-58]). Patients followed for 5 years. They were treated by DMARDs including the biologic therapy (24%) according the "tight-control" principle. The radiological investigation of hands and feet, DAS28, HAQ and functional class evaluated every 12 months. <h3>Results</h3> With the passage of time have observed a decrease in the level of activity of RA. Baseline median [25th percentile, 75th percentile] DAS28 was 5,1 [4,49-5,85]. In the period from 1 to 5 years - 3,05 [2,25-4,43], 3,04 [2,07-4,23], 2,55 [1,86-3,74], 2,48 [1,78-3,77], 3,12 [1,86-4,32], respectively, p&lt;0,01. The same trend applies to HAQ. Baseline median HAQ was 1,125 [0,625-1,75]. After 1, 2, 3, 4 and 5 years - 0,5 [0,125-1,0], 0,5 [0-1,0], 0,5 [0-1,0], 0,5 [0-1,0] and 0,75 [0,125-1,125], respectively, p&lt;0,01. From 1 to 5 years the erosive arthritis was in 27,5%, 38,5%, 49,5%, 58%, 73% of cases, respectively, p&lt;0,001. Baseline median of Sharp/van der Heijde erosions score was 0 [0-0]. After 1, 2, 3, 4 and 5 years it grew to 0 [0-1], 0 [0-4], 1 [0-8], 3 [0-12], 6 [0-14] respectively, p&lt;0,01. <h3>Conclusions</h3> During the first five years was noted stabilization of the RA. DAS28 and HAQ decrease. RA radiological progression was found, however the most of patients showed only minor deterioration of structural damage. <h3>Disclosure of Interest</h3> None declared
Childhood Exposure to Ambient Air Pollutants and the Onset of Asthma: An Administrative Cohort Study in Québec
Authors: Louis-Francois Tétreault, Marieve Doucet, Philippe Gamache, Michel Fournier, Allan Brand, Tom Kosatsky, Audrey Smargiassi
Journal: Environmental Health Perspectives (2016)

Although it is well established that air pollutants can exacerbate asthma, the link with new asthma onset in children is less clear.
If overuse injury is a ‘training load error’, should undertraining be viewed the same way?
Authors: Tim J Gabbett, Steve Kennelly, Joe Sheehan, Richard Hawkins, Jordan Milsom, Enda King, Rod Whiteley, Jan Ekstrand
Journal: British Journal of Sports Medicine (2016)

Inappropriately high training loads cause overuse injuries.1 However, it has recently been proposed that overuse injuries should be considered in terms of both ‘overloading’ and ‘underloading’.2 The rationale is that increased injury risk is associated with ‘spikes’ in workload (ie, overloading) and low chronic workloads (ie, underloading), which may leave an athlete predisposed to a ‘spike’ in workload.3 Given that workload is both modifiable and controllable, it has been suggested that ‘overuse injuries’ be considered as ‘training load errors’.2 ,4

Anecdotally, strength and conditioning staff are viewed as the practitioners who ‘break’ the athlete, while medical staff ‘fix’ them. Conversely, conditioning staff may indeed decrease the probability of athletes sustaining an injury by increasing chronic workloads, whereas medical staff may inadvertently increase injury risk by reducing workloads. Given that all coaching staff as well as the performance team (eg, strength and conditioning, sport scientists and physiotherapists) are involved to varying degrees in the training process, an effective solution needs to be multidisciplinary in nature. Periods of underloading and overloading can occur anywhere, from rehabilitation through to game-specific skills and competition, hence communication between athlete, manager …
Cholesterol Crystals
Authors: P J DeMarco, R M Keating
Journal: New England Journal of Medicine (1995)

Figure 1. A 70-year-old man presented with a history of rheumatoid arthritis, insulin-dependent diabetes mellitus, chronic renal insufficiency, and hypertension. He had had rheumatoid arthritis for 17 years, was seropositive for rheumatoid factor, and had destructive arthritis documented by plain radiographs of the hands. His olecranon bursa was chronically swollen but had never been injected with a corticosteroid preparation.The aspirate of an effusion from the olecranon bursa reveals cholesterol crystals (×400). These crystals are characterized by broad plates with a notched corner, created by their propensity to adhere to one another's surfaces. They are variably and mildly birefringent. The . . .
Paterson-Brown Kelly syndrome.
Authors: O A Ogunbiyi, M I El Tahir
Journal: BMJ (1967)

Over a five-year period (September 1987 to August 1992), eight patients, one male and seven females, with a characteristics history of dysphagia due to cervical esophageal webs (Paterson-Brown Kelly syndrome) were encountered. The patients, all Arabs, comprised six Saudi females, one Yemeni female and an Eygptian male. All the patients, except two, were in middle age. The webs, single in five patients and multiple in three, and present at the levels of the 5th, 6th and 7th cervical vertebrae, were located in the anterior wall of the esophagus in four patients, circumferential-producing stenosis in three patients, while one patient with multiple webs had both types of location. Associated iron-deficiency anemia was present in all patients, three of them with evident koilonychia. One patient had associated nodular goiter and rheumatoid arthritis while another had a fatal complicating postcricoid carcinoma. The only male patient had associated ulcerative protocolitis. All seven patients without malignant complication of their webs had marked or total resolution of their dysphagia with iron therapy, pharyngoscopy/esophagoscopy, and dilatation. The Paterson-Brown Kelly syndrome of postcricoid dysphagia is discussed briefly.
Laboratory Guide for the Bacteriologist.
Journal: JAMA (1895)

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
AB0713 Botulinum Toxin-A for the Treatment of Severe Raynaud's Phenomenon
Authors: L. Ruiz Gutiérrez, A. Pérez Gόmez, N. Valdeolivas Casillas, A. Movasat, E. Cuende Quintana, A. Sánchez Atrio, A. Turriόn Nieves, C. Bohόrquez Heras, F. Albarrán Hernández, H. Moruno Cruz, M.L. Romero Bogado, S. Medina Montalvo, M. Άlvarez de Mon
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Raynaud9s phenomenon (RP) is characterized by transient episodes of vasoconstriction of the arteries and arterioles of the extremities in response to cold or emotional stimuli. Depending on the severity of the vascular insult, it can cause superficial ulceration or deep-tissue necrosis. Pharmacological treatments aim to enhance blood flow but their efficacy is not uniform. <h3>Objectives</h3> To evaluate the efficacy of botulinum toxin-A in the treatment of severe RP. <h3>Methods</h3> We present a series of 7 patients with RP with bad response to conventional pharmacological therapy that have been treated with local botulinum neurotoxin-A. Exclusion criteria included botulinum toxin allergy, active infection at the site of injection, previous digital sympathectomy and pregnancy. 4 to 8 units of botulinum toxin-A were administered per point of injection depending on the degree of severity. Points of injection were located on the lateral and medial aspect of the base of the fingers, except the thumb. Prior to infiltration, obstructive pathology was ruled out by Doppler ultrasound; also, a nailfold capillaroscopy test was performed before and after the infiltration. Variables such as the number of episodes per day, pain during the episodes, recuperation time, finger color and presence of digital ulceration or necrosis have been studied baseline, 30 minutes, one week and one month after the infiltration. Follow up of 6 patients was performed with a 9 weeks median, being 18 weeks the maximum time registered. Patient 1 died due to a peritonitis 3 days after the study started. <h3>Results</h3> 30 minutes after infiltration, three patients felt no improvement, two assessed slight improvement and two very important improvement. At the patients9 one-week and thirty-days follow-up visits two patients did not perceive any change and four experienced great amelioration. Patients that did not register any change where those with fewer subjective clinical complaints and normal Doppler ultrasound and capillaroscopy tests. The variable with the most remarkable response was pain, with important pain decrease in all of the cases. Three patients presented digit ulcers at baseline visit; ulceration healing was noted in all of them, two of them one week after the injection and the other one, one month after. Three patients reported mild "weakness" after being injected and one reported slight thenar-eminence pain that lasted a few days. None of the patients suffered any systemic complications related to the toxin. <h3>Conclusions</h3> Botulinum toxin-A is a safe and effective therapeutic option for patients with severe RP that have failed to conventional treatment. <h3>Disclosure of Interest</h3> None declared
More on Melanoma with Transdifferentiation
Authors: Michael A Panzara, Carmen Bozic, Alfred W Sandrock
Journal: New England Journal of Medicine (2008)

Children’s Hospital Boston Boston, MA 02115 orah.platt@childrens.harvard.edu Chaine B, Neonato MG, Girot R, Aractingi S. Cutaneous ad­ 1. verse reactions to hydroxyurea in patients with sickle cell disease. Arch Dermatol 2001;137:467­70. Kersgard C, Osswald MB. Hydroxyurea and sickle cell leg 2. ulcers. Am J Hematol 2001;68:215­6. Loukopoulos D, Voskaridou E, Kalotychou V, Schina M, Lou­ 3. tradi A, Theodoropoulos I. Reduction of the clinical severity of sickle cell/beta­thalassemia with hydroxyurea: the experience of a single center in Greece. Blood Cells Mol Dis 2000;26:453­66. de Montalembert M, Begue P, Bernaudin F, Thuret I, Bachir 4. D, Micheau M. Preliminary report of a toxicity study of hydroxy­ urea in sickle cell disease. Arch Dis Child 1999;81:437­9.
Computed Body Tomography.
Authors: R J Alfidi, J R Haaga
Journal: Annals of Internal Medicine (1983)

Only the surface of the diagnostic possibilities inherent in CT imaging has been scratched. Solic organ pathology is readily visible in most instances by computed tomography. With further extension of present knowledge and development of newer contrast agents, the ability of computed body tomography to image a wide range of diseases appears almost limitless.
Continuing importation of falciparum malaria from Goa into Europe
Authors: T Jelinek, None on behalf of the European Network o
Journal: Eurosurveillance (2008)

A case of falciparum malaria acquired in Goa, India, has recently been reported to the European Network on Imported Infectious Disease Surveillance (TropNetEurop, http://www.tropnet.net). The report relates to a Swedish woman in her fifties who had spent two weeks in Goa (Candolim beach) and Kerala in India without taking malaria chemoprophylaxis. In mid-December 2007, approximately two weeks after returning to Sweden, she fell ill with fever and a mild cough. Ten days after the onset of symptoms, thick and thin films were done and an infection with Plasmodium falciparum with a parasitaemia of 1.8% was diagnosed. The patient was admitted to hospital, uneventfully treated with a standard dose of mefloquine and discharged four days later.
The American Health Care System
Authors: J J Alpert
Journal: New England Journal of Medicine (1999)

on samples ofthe narcotics have failed to find any evidence of C. tetani.At present, the cause of the tetanus outbreak in Hong Kong is still unknown.I would like to suggest a possible cause for this epidemic tetanus.C. tetani are commonly found in soil and street dust, therefore contamination of wounds with the spores are very common.In spite of the ubiquity of tetanus bacilli, tetanus is relatively rare, even among those who had no immunity to the disease.This is because a very complex environment is required for the germination of tetanus spores4.In fact, C tetani are frequently isolated from unimmunized patients who do not have tetanus2.Therefore, the frequency of occurrence oftetanus probably depends more on the availability ofthe tetanus-prone wounds than on the incidence of wounds contaminated with C tetani.The sudden increase in the incidence of tetanus may be due to an alteration of the adulterants or the bacterial content in the street heroin producing more tetanus-prone wounds.Alteration in the constituents of the adulterants may result in a lower oxygen tension and redox potential at sites of injection and thus favours the growth of the anaerobes.Changes in the bacterial content of the heroin5, especially with an increase of bacteria resistant to quinine6, may lead to multiplication of aerobic or facultative organisms in devitalized tissue.This may diminish oxygen concentration and develops a better habitat that supports growth of tetanus bacilli.
The Epigenetic Regulators CBP and p300 Facilitate Leukemogenesis and Represent Therapeutic Targets In Acute Myeloid Leukemia (AML)
Authors: George Giotopoulos, Wai-In Chan, David Ruau, Paolo Gallipoli, Alexis Fowler, Berthold Göttgens, Jan Van Deursen, Philip Cole, Brian Huntly
Journal: Blood (2013)
Cardiovascular and antidepressant effects of imipramine in the treatment of secondary depression in patients with ischemic heart disease
Authors: M Raskind, R Veith, R Barnes, G Gumbrecht
Journal: American Journal of Psychiatry (1982)

The authors report on 12 men with ischemic heart disease who developed secondary depression following myocardial infarction or coronary artery bypass-graft surgery and were treated with imipramine hydrochloride for 4 weeks. Imipramine had an antiarrhythmic effect, manifested by reduction in premature ventricular contractions during treatment. This drug did not produce clinically significant disturbances in cardiac conduction, but orthostatic hypotension led to early termination of the drug treatment in 1 subject. Imipramine treatment was associated with significant improvement in both observer-rated and patient-rated depression scales.
PTU-272 Prehabilitation programmes in patients undergoing abdominal surgery within enhanced recovery: a systematic review
Authors: N Francis, A Luther, G Gullick
Journal: Gut (2015)

<h3>Introduction</h3> Enhanced recovery after surgery (ERAS) involves preoperative optimisation in order to reduce surgical stress response. However, extended preoperative prehabilitation programmes are gaining popularity, particularly in patients with reduced functional capacity. The actual impact of prehabilitation programmes within ERAS is not fully explained. The aim of this study was to systematically review the available literature regarding prehabilitation interventions in patients undergoing abdominal surgery within ERAS and to examine the effect of the interventions on recovery. <h3>Method</h3> Relevant studies were identified through a search on MEDLINE, EMBASE, AMED, CINAHL and pubmed. All randomised controlled trials (RCT) and non-RCT studies in abdominal surgery that had prehabilitation intervention (s) within ERAS were included. Descriptive characteristics such as participants characteristics, study design, speciality, type and mode of the intervention, outcome measure and follow up were extracted. Methodological evaluation of the studies was performed using Jadad score. <h3>Results</h3> 11 studies were included consisting of 1105 patients (680 had some form of intervention) from 7 RCT and 4 non-RCT across four different specialities (colorectal, gastric, liver and bladder surgery). There was a wide variation in the mode, type, duration, outcome measure and follow up period of the interventions. Five studies included structured aerobic programme and two studies included only nutritional enhancing regimes while four had combined modalities. Median duration of the intervention was 4 weeks prior to surgery and four studies extended the intervention to the postoperative period. Outcome measures included functional recovery and quality of life (4); clinical outcomes (4) and cardiopulmonary fitness (3). Seven studies showed improvement in the functional capacity and/or clinical outcomes due to the intervention, particularly in patients with low initial fitness. <h3>Conclusion</h3> Addition of prehabilitation programme to ERAS may offer additional benefits to traditional ERAS. Further research is required to investigate the optimum intervention of rehabilitation within ERAS. <h3>Disclosure of interest</h3> None Declared. <h3>References</h3> Li C, <i>et al</i>. Trimodal prehabilitation program improves functional recovery in colorectal cancer surgery: A pilot study. <i>Surg Endosc Other Intervent Tech.</i>2012;<b>26</b>(S243):0930-2794 Kaibori M, <i>et al</i>. Perioperative exercise for chronic liver injury patients with hepatocellular carcinoma undergoing hepatectomy. Am J Surg. 2013;206(2):202–9 Gillis C, <i>et al</i>. Prehabilitation versus rehabilitation: A randomized control trial in patients undergoing colorectal resection for cancer. Anesthesiology 2014;121(5):937-47