tbuckley/cabot-search huggingface dataset:
What We Don’t Talk About When We Talk About Preventing Type 2 Diabetes—Addressing Socioeconomic Disadvantage
Authors: Gabriela Spencer Bonilla, Rene Rodriguez-Gutierrez, Victor M. Montori
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
Abstract 17516: Use of an Infrared Probe Enhances Esophageal Temperature Monitoring during Left Atrial Radiofrequency Ablation
Authors: Leon M Ptaszek, E. Kevin Heist, Ryan Caulfield, Kevin Cordaro, Jeremy N Ruskin, Moussa Mansour
Journal: Circulation (2012)

Introduction: Atrial-esophageal fistula is a rare but potentially fatal complication of esophageal heating during catheter ablation for atrial fibrillation. Currently available esophageal temperatu...
Sugar and fructose consumption and the risk of cancer.
Authors: Peter Boyle, Mathieu Boniol, Alice Koechlin, Maria Bota, Cécile Pizot, Philippe Autier
Journal: Journal of Clinical Oncology (2015)

e12586 Background: Some observational studies have suggested links between the consumption of sugar or fructose consumption and cancer. A meta-analysis was performed of prospective studies on sugar and fructose intakes and cancer. Methods: A systematic search was made of the literature published until July 2014. Sugar was defined as any mono or disaccharide. We considered total amounts of sugar and of fructose present in all consumed solid foods, sugar-sweetened beverages (SSB) and fruit juices. Only the SSB and fruit juices marketed in the USA were included in calculations of fructose intakes. Meta-analyses were carried out when four or more studies were available for the studied cancer site. Summary relative risks (SRR) and (95% confidence intervals) were calculated using random effect meta-analysis. Results: For sugars from solid foods, in 11 studies including 3,451 cases of pancreatic cancer, the relative risk associated with an increase of 25 g/day of sugar intake was 1.03 (0.93; 1.15) with large heterogeneity (I² = 55%) but no evidence of publication bias. In 6 studies including 14,165 cases of breast cancer, the SRR for 25 g sugar/day from solid foods was 0.99 (0.96; 1.03). There was no heterogeneity between studies (I² = 0%) and no evidence of publication bias. In 4 studies including 2,789 cases of endometrial cancer, the SRR for 25 g sugar/day from solid foods was 1.07 (0.99; 1.15). There was no heterogeneity between studies (I² = 0%) and no evidence of publication bias. For SSB, the meta-analysis using highest vs. lowest intake and including 4,552 cases of pancreatic cancer obtained a SRR of 1.15 (95%CI: 0.84; 1.59) for 8 studies in women, and 1.26 (95%CI: 0.87; 1.82) for 10 studies in men. Heterogeneity was moderate (I2 = 26% in men and 10% in women) and there was no evidence of publication bias. For fructose from solid foods and from beverages, in 7 studies including 3,412 cases of pancreatic cancer, the SRR was 1.07 (95% CI: 0.95; 1.20) per 25g/d increment in consumption. Heterogeneity between studies was low (I2 = 9%) and there was no indication for publication bias. Conclusions: Prospective studies provide no evidence for an association between amounts of sugar, SSB or fructose intake and pancreatic, breast and endometrial cancer. Source of funding: Coca-Cola Company.
Identification of embryonic precursor cells that differentiate into thymic epithelial cells expressing autoimmune regulator
Authors: Nobuko Akiyama, Nobukazu Takizawa, Maki Miyauchi, Hiromi Yanai, Ryosuke Tateishi, Miho Shinzawa, Riko Yoshinaga, Masaaki Kurihara, Yosuke Demizu, Hisataka Yasuda, Shintaro Yagi, Guoying Wu, Mitsuru Matsumoto, Reiko Sakamoto, Nobuaki Yoshida, Josef M. Penninger, Yasuhiro Kobayashi, Jun-ichiro Inoue, Taishin Akiyama
Journal: The Journal of Experimental Medicine (2016)

Medullary thymic epithelial cells (mTECs) expressing autoimmune regulator (Aire) are critical for preventing the onset of autoimmunity. However, the differentiation program of Aire-expressing mTECs (Aire+ mTECs) is unclear. Here, we describe novel embryonic precursors of Aire+ mTECs. We found the candidate precursors of Aire+ mTECs (pMECs) by monitoring the expression of receptor activator of nuclear factor-κB (RANK), which is required for Aire+ mTEC differentiation. pMECs unexpectedly expressed cortical TEC molecules in addition to the mTEC markers UEA-1 ligand and RANK and differentiated into mTECs in reaggregation thymic organ culture. Introduction of pMECs in the embryonic thymus permitted long-term maintenance of Aire+ mTECs and efficiently suppressed the onset of autoimmunity induced by Aire+ mTEC deficiency. Mechanistically, pMECs differentiated into Aire+ mTECs by tumor necrosis factor receptor-associated factor 6-dependent RANK signaling. Moreover, nonclassical nuclear factor-κB activation triggered by RANK and lymphotoxin-β receptor signaling promoted pMEC induction from progenitors exhibiting lower RANK expression and higher CD24 expression. Thus, our findings identified two novel stages in the differentiation program of Aire+ mTECs.
Local rectal portal hypertension in the absence of a patent superior rectal vein
Authors: Joel Leroy, Arthur Wijsmuller, Edris Wedi, Catherine Roy, Didier Mutter, Juergen Hochberger
Journal: Endoscopy (2016)

A 16-year-old girl was referred to our unit for recurrent anemia caused by rectal bleeding that had required regular blood transfusions since her birth. The patient's history did not reveal any other abnormalities such as inflammatory disease or perinatal complications. Physical examination revealed the presence of grade III hemorrhoids and abnormal enlargement of the clitoris ([Fig. 1]). Colonoscopy showed diffuse submucosal venous dilatation in the perianal region, rectum, and low sigmoid colon ([Fig. 2]). Magnetic resonance imaging (MRI) with angiography demonstrated dilatation mainly of the venous mesorectal network and multiple opacifications in the soft tissues that showed uptake of contrast agent before there was uptake in the systemic venous system ([Fig. 3]). The iliac veins showed a normal blood flow, while the patency of the superior rectal vein could not be clearly distinguished.
Tumor Suppressor HIPK2 Regulates Malignant Growth via Phosphorylation of Notch1
Authors: Eun-Jung Ann, Mi-Yeon Kim, Ji-Hye Yoon, Ji-Seon Ahn, Eun-Hye Jo, Hye-Jin Lee, Hyun-Woo Lee, Hyeok-Gu Kang, Dong Wook Choi, Kyung-Hee Chun, Ji Shin Lee, Cheol Yong Choi, Adolfo A. Ferrando, Keesook Lee, Hee-Sae Park
Journal: Cancer Research (2016)

The receptor Notch1 plays an important role in malignant progression of many cancers, but its regulation is not fully understood. In this study, we report that the kinase HIPK2 is responsible for facilitating the Fbw7-dependent proteasomal degradation of Notch1 by phosphorylating its intracellular domain (Notch1-IC) within the Cdc4 phosphodegron motif. Notch1-IC expression was higher in cancer cells than normal cells. Under genotoxic stress, Notch1-IC was phosphorylated constitutively by HIPK2 and was maintained at a low level through proteasomal degradation. HIPK2 phosphorylated the residue T2512 in Notch1-IC. Somatic mutations near this residue rendered Notch1-IC resistant to degradation, as induced either by HIPK2 overexpression or adriamycin treatment. In revealing an important mechanism of Notch1 stability, the results of this study could offer a therapeutic strategy to block Notch1-dependent progression in many types of cancer. Cancer Res; 76(16); 4728-40. ©2016 AACR.
Breast cancer survivorship programming at four NCI designated cancer centers: Our experiences and lessons learned.
Authors: Jennifer R. Klemp, Tara Beth Sanft, Anne Hudson Blaes, Mary E Sesto, Amye Tevaarwerk
Journal: Journal of Clinical Oncology (2015)

e20605 Background: National accreditation standards encourage the development and delivery of a comprehensive treatment summary and survivorship care plan (SCP). No published studies have demonstrated either the benefits of a SCP to patient outcomes or the real-world experience of practices trying to implement the SCP into clinical workflow. We describe the efforts of 4 NCI Comprehensive Cancer Center’s efforts to implement breast cancer (BrCa) survivorship care and SCPs. Methods: BrCa survivorship clinics at 4 NCI designated cancer centers have been developed independently over the past 9 years. Collaboration between these institutions has been established to share best practices and establish key variables for clinical care and outcomes measures. Initial steps included ongoing in-person and tele-conferences, sharing of data collection tools, and discussions of selected outcomes. Variables include type and structure of the breast cancer survivorship clinic, patient demographics, type and delivery of survivorship care plan, services offered, and key patient outcomes. Results: Survivorship clinics in this study ranged from 1-9 years in practice and included both physicians and advanced practice providers in the delivery of survivorship care and a SCP. All four clinics offer both consultation and continuity of care clinics and see patients any time after diagnosis, immediately following treatment, and for long-term follow-up care. Sites have integrated SCPs within the electronic health record. Key outcomes include percentage of survivors with SCPs and care planning sessions, survivor, cancer and treatment demographics, resources required and utilized, referrals generated, recommendations on preventive health, lifestyle modification, and major risk for late effects including cardio-toxicity, bone health, and menopausal side effects. Conclusions: Similarities and differences existed among the development and structure of 4 independently developed BrCa survivorship clinics. A common element includes development of a clinic where survivors received a SCP and care planning. This collaboration provides a framework for ongoing BrCa survivorship health services research.
Use existing staff to drive integrated care, says report
Authors: Gareth Iacobucci
Journal: BMJ (2016)

NHS and local government leaders should not automatically create new roles to deliver integrated care as there is “limited evidence” to support the creation of these jobs, a new report has advised.

The report1 by the King’s Fund examined the evidence for creating new positions to help drive integration across health and social care in line with national government policy.

It analysed new roles ranging from co-ordinators and case managers—specifically appointed to drive integrated care—to extended support workers or personal assistants—appointed to build on existing …
Relationships Between Lymphocytic Choriomeningitis Virus, Amethopterin, and an Amethopterin-Resistant Lymphocytic Neoplasm in Mice
Authors: Michael Potter, Victor H. Haas
Journal: JNCI Journal of the National Cancer Institute (1959)

Amethopterin resistance was developed in the tetraploid lymphocytic neoplasm P288 by serial transfer of cells of the amethopterin-sensitive stem line through amethopterin-treated mice. The character of amethopterin resistance remained stable and heritable following the transfer of cells, for many transfer generations, through untreated mice. Lymphocytic choriomeningitis (LCM) virus did not influence this resistance since it was never found in the sensitive stem line or in the amethopterin-resistant sublines. However, the resistant subline (P288/AmR-II) was infected intentionally with the virus of LCM in a single exposure in vitro and carried it, as a passenger, through 39 successive transfers. Passage of this contaminated tumor through mice immune to LCM caused the virus to disappear, insofar as the tests were capable of detecting it, but virus did not disappear from amethopterin-treated immune mice bearing the tumor. It was also found that the resistant subline (free of LCM) of neoplasm P288 could grow progressively and kill certain mice of foreign strains when such mice were treated with amethopterin.
Massachusetts Medical Society
Authors: John Figgis Jewett
Journal: New England Journal of Medicine (1976)

A 37-year-old gravida 9 died at 32 weeks from a ruptured uterus without operative intervention.Previous pregnancies, except in number, were unremarkable. Seen earlier at a free-standing satellite clinic, the patient had been told that she was pregnant and had either cirrhosis or "fatty liver," attributable to her severe alcoholism. If there was any other prenatal care, it could not be identified, since she had apparently had no follow-up observation. Three weeks before death, she had been brought to the emergency floor because of an automobile accident, but left before being examined. On the afternoon before admission, she had been . . .
Evaluating goals of care meetings for hospitialized cancer patients at risk for critical care.
Authors: Colleen C. Apostol, Julie Waldfogel, Elizabeth Pfoh, Donald C. List, Lynn Billing, Suzanne A. Nesbit, Sydney Morss Dy
Journal: Journal of Clinical Oncology (2014)

134 Background: Communication about care preferences is vital for care of cancer patients with advanced and refractory disease, particularly when they become ill enough to be at risk for critical care interventions potentially inconsistent with their preferences. It is vital to describe the use of goals of care discussions in patients with advanced/refractory cancer at risk for critical care and evaluate associations between these discussions and outcomes. Methods: Cohort study describing patient/families’ perceptions of goals of care meetings and comparing health care utilization outcomes of patients who did and who did not have discussions. Inpatient units of an academic cancer center included patients who had metastatic solid tumors or relapsed/refractory lymphoma or leukemia and were at risk for critical care (defined as requiring supplemental oxygen and/or a cardiac monitor). Results: Of 86 patients enrolled, 34 (39%) had a reported goals of care discussion. Patients/families reported their needs and goals were addressed moderately to quite a bit during the meetings. Patients with reported discussions were less likely to receive critical care (0% vs 22%, p=0.003) and more likely to be discharged to hospice (48% vs 30%, p=0.04). Only one patient with a goals of care discussion died during the index hospitalization (on comfort care) (3%) compared with 9% among those without discussions (p=0.08). Conclusions: Goals of care meetings should be incorporated into usual care for cancer patients with advanced or refractory disease at risk for critical care during a hospitalization, in order to improve concordance between care received and patient and family preferences. Goals of care meetings for advanced/refractory cancer inpatients at risk for critical care can address patient and family goals and needs and improve health care utilization outcomes. These meetings should be part of routine care in this patient population.
Notes from the Field: Acute Sulfuryl Fluoride Poisoning in a Family — Florida, August 2015
Authors: Prakash R. Mulay, Grethel Clark, William L. Jackson, Geoffrey M. Calvert
Journal: MMWR Morbidity and Mortality Weekly Report (2016)

On August 19, 2015, the Florida Department of Health (FDOH) was notified by the Florida Poison Information Center Network and a local hospital of possible sulfuryl fluoride poisonings affecting a family in Martin County, in southeastern Florida. Sulfuryl fluoride is a highly toxic (toxicity category I) gas fumigant used for termite control of homes and buildings.* FDOH personnel in Martin County commenced an investigation and identified a family of five (a grandmother, mother, father, son, and daughter) exposed to sulfuryl fluoride after their house was fumigated. The Florida Department of Agriculture and Consumer Services (FDACS), and the U.S. Environmental Protection Agency (EPA) Criminal Investigation Division also conducted an investigation after being notified by FDOH. Medical records were reviewed, and the father was interviewed by FDOH.
Does the Derived Neutrophil Lymphocyte Ratio Predict Benefit from Cisplatin and Gemcitabine Compared with Gemcitabine Alone in Advanced Biliary Cancer? an Exploratory Study of the Abc-02 Trial
Authors: T. Grenader, Y. Plotkin, J.W. Valle, J.A. Bridgewater
Journal: Annals of Oncology (2014)
United States Health Care Reform
Authors: Barack Obama
Journal: JAMA (2016)

<h3>Importance</h3> The Affordable Care Act is the most important health care legislation enacted in the United States since the creation of Medicare and Medicaid in 1965. The law implemented comprehensive reforms designed to improve the accessibility, affordability, and quality of health care. <h3>Objectives</h3> To review the factors influencing the decision to pursue health reform, summarize evidence on the effects of the law to date, recommend actions that could improve the health care system, and identify general lessons for public policy from the Affordable Care Act. <h3>Evidence</h3> Analysis of publicly available data, data obtained from government agencies, and published research findings. The period examined extends from 1963 to early 2016. <h3>Findings</h3> The Affordable Care Act has made significant progress toward solving long-standing challenges facing the US health care system related to access, affordability, and quality of care. Since the Affordable Care Act became law, the uninsured rate has declined by 43%, from 16.0% in 2010 to 9.1% in 2015, primarily because of the law's reforms. Research has documented accompanying improvements in access to care (for example, an estimated reduction in the share of nonelderly adults unable to afford care of 5.5 percentage points), financial security (for example, an estimated reduction in debts sent to collection of $600-$1000 per person gaining Medicaid coverage), and health (for example, an estimated reduction in the share of nonelderly adults reporting fair or poor health of 3.4 percentage points). The law has also begun the process of transforming health care payment systems, with an estimated 30% of traditional Medicare payments now flowing through alternative payment models like bundled payments or accountable care organizations. These and related reforms have contributed to a sustained period of slow growth in per-enrollee health care spending and improvements in health care quality. Despite this progress, major opportunities to improve the health care system remain. <h3>Conclusions and Relevance</h3> Policy makers should build on progress made by the Affordable Care Act by continuing to implement the Health Insurance Marketplaces and delivery system reform, increasing federal financial assistance for Marketplace enrollees, introducing a public plan option in areas lacking individual market competition, and taking actions to reduce prescription drug costs. Although partisanship and special interest opposition remain, experience with the Affordable Care Act demonstrates that positive change is achievable on some of the nation's most complex challenges.
Uveitis Associated with Zika Virus Infection
Authors: João M Furtado, Danillo L Espósito, Taline M Klein, Tomás Teixeira-Pinto, Benedito A da Fonseca
Journal: New England Journal of Medicine (2016)

An adult patient recovered from acute Zika virus infection, but ocular symptoms subsequently developed. Anterior uveitis was diagnosed, and Zika virus was identified in the aqueous humor.
Case 21-1978
Authors: Richard C. Cabot, Robert E. Scully, James J. Galdabini, Betty U. McNeely, James H. Nelson, Jaime Prat
Journal: New England Journal of Medicine (1978)

Presentation of CaseAn 84-year-old woman was admitted to the hospital because of an abdominal mass.She was well until four months previously, when anorexia and fatigue developed, accompanied by weight loss of unknown amount. A physician found an abdominal mass and referred her to this hospital. There was a long history of uterine prolapse, for which she had worn a pessary in the past. She had been constipated for an unknown interval but had not observed melena.The temperature was 37°C, the pulse 80, and the respirations 16. The blood pressure was 130/70 mm Hg.On examination she appeared . . .
John Brian Taylor
Authors: Peter Taylor
Journal: BMJ (2015)

John Brian Taylor was the first in his family to study medicine. His father was an Ulsterman working in Liverpool, and his mother was from Shropshire. After initial schooling in England, John and his family moved back to Londonderry. As an undergraduate he was triple blue in Queens University, Belfast. He had particular success as a mile runner, coming second in the open all-Ireland final in 1944. He held the surgical resident post at the Royal Victoria Infirmary, Belfast, before signing up as a ship’s doctor with the Blue Funnel Line, voyaging to Japan and back in 1950. He spent national service years with the Royal Army Medical Corps in Catterick …
Brain Metastases from NSCLC: Radiation Therapy in the Era of Targeted Therapies
Authors: Jonathan Khalifa, Arya Amini, Sanjay Popat, Laurie E. Gaspar, Corinne Faivre-Finn
Journal: Journal of Thoracic Oncology (2016)

Brain metastases (BMs) will develop in a large proportion of patients with NSCLC throughout the course of their disease. Among patients with NSCLC with oncogenic drivers, mainly EGFR activating mutations and anaplastic lymphoma receptor tyrosine kinase gene (ALK) rearrangements, the presence of BM is a common secondary localization of disease both at the time of diagnosis and at relapse. Because of the limited penetration of a wide range of drugs across the blood-brain barrier, radiotherapy is considered the cornerstone of treatment of BMs. However, evidence of dramatic intracranial response rates has been reported in recent years with targeted therapies such as tyrosine kinase inhibitors and has been supported by new insights into pharmacokinetics to increase rates of tyrosine kinase inhibitors' penetration of the cerebrospinal fluid (CSF). In this context, the combination of brain radiotherapy and targeted therapies seems relevant, and there is a strong radiobiological rationale to harness the radiosentizing effect of the drugs. Nevertheless, to date, there is a paucity of high-level clinical evidence supporting the combination of brain radiotherapy and targeted therapies in patients with NSCLC and BMs, and there are often methodological biases in reported studies, such as the lack of stratification by mutation status. Moreover, among asymptomatic patients not suitable for ablative treatment, this strategy is challenged by the promising results associated with the administration of targeted therapies alone. Herein, we review the biological rationale to combine targeted therapies and brain radiotherapy for patients with NSCLC and BMs, report the clinical data available to date, and discuss future directions to improve outcome in this group of patients.