tbuckley/cabot-search huggingface dataset:
Where Does It Hurt?
Authors: Neil Chanchlani
Journal: BMJ (2010)

The junior doctor is back. But this time he’s traded in the stethoscope and white coat for a prescription pad and ripped T shirt. Making the transition from the ward as a first year foundation programme doctor to a drug and rehabilitation outreach officer was no easy move for Dr Max Pemberton, author of the best selling novel Trust Me, I’m a (Junior) Doctor. 

Max has taken on the streets of London—one rent boy, drug addict, and prostitute at a time. After a stressful year of getting yelled at by consultants and finding no time for sleep let alone time do his laundry, Max has opted to work in the suburbs for a year at the Phoenix Outreach Project in London. Here Max’s role is twofold: …
How easy is it to change foundation schools halfway through the foundation programme?
Authors: Sophia Bourne
Journal: BMJ (2017)

Dear Sophia

How easy is it to change foundation schools halfway through the foundation programme?

Kimberley Harland-Mears, final year medical student, Hull York medical school

Most junior doctors are happy with the foundation schools they have been allocated for the two year training programme. If you become unhappy during the programme, however, discuss the situation with your programme education supervisor or foundation programme director. It is unlikely you will be able to switch foundation schools part way through for anything other than extenuating circumstances.

An inter-foundation school transfer (IFST) may be granted on the following …
Abstract 17275: Evaluating the Convergent and Discriminant Validity of Four Frailty Instruments in Adults With Heart Failure: Results From the Frame-HF Study
Authors: Julee McDonagh, Yenna Salamonson, Roslyn Prichard, Sunita R Jha, Caleb Ferguson, Peter S Macdonald, Patricia M Davidson, Phillip J Newton
Journal: Circulation (2018)

Introduction: Frailty assessment has become increasingly common in those with heart failure. The most frequently used frailty instrument is the Frailty Phenotype (FP). The validity of this instrument in those with heart failure is yet to be determined. Aim: To examine the convergent and discriminant validity of four frailty instruments: i) the FP ii) a Questionnaire-only version of FP [q-FP]; iii) St. Vincent’s Frailty [SVF]; and iv) the Frailty Instrument for Primary Care of the Survey of Health, Ageing and Retirement in Europe [SHARE-FI] for assessing the frailty status of adults with heart failure. Methods: Using a cross-sectional survey design, individuals aged ≥ 18 years, diagnosed with heart failure were recruited from the inpatient cardiology ward and outpatient heart failure clinic of a metropolitan academic hospital. In addition to assessing all items of the frailty instruments, other data collected included: a) NYHA classification; b) quality of life and health status using the EQ-5D-5L; c) physical status using the Australian-modified Karnofsky Performance Scale (AKPS); and d) 10-item Depression in Medically Ill (DMI) measure. Results: A total of 131 participants were recruited and included in the analyses, there were wide variations in frailty status across the four frailty instruments (Figure 1). Inter-correlations were highest between SVF and SHARE-FI instruments ( r = 0.62). The NYHA classification were correlated with SVF ( r = 0.46) and SHARE-FI ( r = 0.42). Similarly, all EQ-5D-5L dimensions were correlated with both SVF and SHARE-FI but not with FP or q-FP. The SVF differentiated between high and low AKPS scores (χ 2 = 11.70, df : 2, p = 0.003) and DMI scores (χ 2 = 7.28, df : 2, p = 0.026). Similarly, the SHARE-FI also had good discriminant validity using AKPS scores (χ 2 = 9.25, df : 2, p = 0.010) and DMI scores (χ 2 = 14.32, df : 2, p = 0.001). Conclusions: The SVF and SHARE-FI demonstrated good convergent and discriminant validity. Both instruments provide a valid alternative to the FP for the assessment of frailty in those with heart failure. Figure 1: Classification of frailty categories: FP, Questionnaire-only FP, SVF and SHARE-FI
Abbv-621 Is a Novel and Potent TRAIL Receptor Agonist Fusion Protein That Induces Apoptosis Alone and in Combination with Navitoclax and Venetoclax in Hematological Tumors
Authors: Stephen Kenneth Tahir, Morey L Smith, Larry R Solomon, Haichao Zhang, John C Xue, Yu Xiao, Dong Cheng, Greg Buchanan, Susan Morgan-Lappe, Darren C. Phillips
Journal: Blood (2017)
Efforts to Improve Mammography Highlight Breast Density
Authors: Rebecca Voelker
Journal: JAMA (2019)

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
Timeline of the junior doctors contract dispute
Authors: Matthew Billingsley, George Gillett
Journal: BMJ (2015)

The outcome of the junior doctor contract negotiations could have a major impact on current medical students’ pay and working conditions. Below is a timeline of the major flashpoints, and an overview of the changes being proposed.

October 2013 —Talks begin between NHS Employers and the BMA

NHS Employers, acting on behalf of the government, and the BMA, the trade union for doctors in the United Kingdom, start discussing the terms of the new contract, with a view to implementing it by April 2015.

October 2014 —BMA walks away from the negotiation table

After a year of negotiations the BMA pulls out of talks citing concerns about patient safety, doctors’ welfare, and a lack of evidence underpinning the changes. Kitty Mohan, co-chair of the junior doctors’ committee at the time said the contract proposals lack a “fundamental grasp” of the way in which NHS staff work and that doctors are “upset and frustrated” with how their work was not being “valued, noticed and recognised.”

November 2014 —DDRB steps in

After the breakdown of talks, the government commissioned the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) to review the contract proposals.

July 2015 —DDRB report published

The DDRB report says that the current contract is no longer fit for purpose and is hindering the achievement of the NHS’s goals to improve patient care and outcomes, and is unaffordable in the current financial climate. The report includes several recommendations that upset junior doctors (box 1). NHS Employers in England agreed that the DDRB report should be the basis for finalising new contractual arrangements. NHS Northern Ireland, Scotland, and Wales all rejected the new contract and have decided not to enforce it. …
Abstract SY31-04: Metabolic regulation of tumor cells survival
Authors: Tak W. Mak
Journal: Cancer Research (2010)

Abstract Today's targeted therapeutics exert their anti-cancer effects mainly by blocking molecular signals that promote tumor cell proliferation, obstruct cell death, hamper cellular differentiation, or facilitate angiogenesis. However, the molecular pathways that underlie these cellular processes are multifaceted and often redundant, allowing tumor cells to escape these drugs. Another approach may be to target tumor cell metabolism. In the 1920s, Warburg noted that cancers exhibit increased rates of glycolysis even in the presence of oxygen, a phenomenon known as aerobic glycolysis or the ‘Warburg effect’. The switch from oxidative phosphorylation to glycolysis that underlies the Warburg effeect represents an alteration to tumor cell metabolism that permits cancer cells to adapt and thrive in conditions that kill normal cells Such adaptations may include upregulated or altered molecular pathways to increase energy production, expansion of the cell's biosynthetic capacity, and/or adoption of an enhanced redox state to cope with elevated levels of deleterious reactive oxygen species. Understanding the energy sources and metabolic pathways utilized by cancer cells to survive should allow the exploitation of this knowledge to design more effective anti-cancer drugs. Citation Format: Tak W. Mak. Metabolic regulation of tumor cells survival [abstract]. In: Proceedings of the AACR 101st Annual Meeting 2010; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr SY31-04
Abstract P5-03-14: Not presented
Authors: Z Xu, J Tang
Journal: Cancer Research (2019)

Abstract This abstract was not presented at the conference. Citation Format: Xu Z, Tang J. Not presented [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-03-14.
Costs of mandatory training must also be considered
Authors: Bridget K MacDonald
Journal: BMJ (2019)

Gerada raises the important issue of how training is delivered as well as its relevance.1 I would like to add two further points.

When reviewing my mandatory and statutory training requirements recently, I calculated that I need to devote at least 12 hours a year to this activity. Colleagues have said that this seems optimistic. Extrapolating this …
Inserting a catheter into a male patient
Authors: Catherine Riley, Tim Briggs
Journal: BMJ (2011)

Every junior doctor will need to insert a urinary catheter Every junior doctor will need to insert a urinary catheter during their practice, and 26% of inpatients are estimated to have an indwelling catheter during their admission.1 The procedure is not without its dangers. A one year study found that 6% (51/864) of urological consultations during the study were related to male urethral catheterisation. Of these 51 cases of catheter related morbidity, 38 (74%) resulted from junior doctors performing urethral catheterisation; 28 of these (73%) occurred during the first six months of internship.2 Part of the problem might be junior doctors’ inexperience. A questionnaire sent to final year medical students and recent graduates of Oxford medical school found that 92% had been taught how to catheterise male patients as a medical student, but 48% of students had done fewer than two catheterisations on qualification. Also, 68% of house officers had received no additional instruction even though 69% of house officers said they were “very confident” in their ability to perform male urethral catheterisation.3 The choice of catheter depends on the indication for catheterisation. The most common indications are close monitoring of the patient’s fluid balance and acute urine retention. Foley catheters are the most suitable in these situations. Box 1 lists which type of catheter is used for which indication. #### Box 1: Indication for urethral catheterisation
A man with lower back pain
Authors: Louis Koizia, Zofia Zielicka, Philippa Berman, Pranav H Patel
Journal: BMJ (2013)

A 66 year old man presented to his general practitioner with lower back pain, worsening over a three month period, which radiated into his abdomen. His history included hypertension and hypercholesterolaemia, and he was a long term smoker.

He was afebrile with a blood pressure of 132/84, heart rate 84, and oxygen saturations 96%. His GP requested a lumbar spine radiograph (figure⇓) and blood tests—haemoglobin was 12.8g/dL, white cell count 6.4, Na+ 138, K+ 3.9, Cr 121, and Ur 6.6 mmol/L (the GP performed the radiograph as a firstline investigation for back pain. It is worth noting, however, that guidelines from the National Institute for Health and Clinical Excellence recommend against ordering a radiograph of the lumbar spine in lower back pain).





(1) The radiograph shows evidence of spondylotic changes at multiple levels of the lumbar spine, but no vertebral collapses or evidence of sacroiliitis. There is opacification centrally, however, with a …
In Vivo HSC Transduction and Selection Results in Long-Term, High-Level Expression of Human Gamma Globin in Peripheral Blood Erythrocytes of Mice
Authors: Andre Lieber, Hongjie Wang, Nikoleta Psatha, Chang Li, Kevin G Haworth, Anja Ehrhardt, Zsuzsanna Izsvak, Hans-Peter Kiem, George Stamatoyannopoulos, Thalia Papayannopoulou
Journal: Blood (2017)
Abstract P2-08-50: Elevated levels of serum tumor marker p53 is a prognostic parameter and a monitoring biomarker for patients who had undergone surgical resection in breast cancer
Authors: M Arai, T Nagata, S Sekine, H Baba, M Moriyama, I Hashimoto, T Fujii
Journal: Cancer Research (2019)

Abstract Background Elevated levels of serum tumor maker p53 antibody is expected as an indicator of early diagnosis and a parameter of recurrence in breast cancer. P53 mutation accounts for 20% to 35% in all breast cancer patients. Preoperative high level of anti-p53 antibody in breast cancer patients tend to associate with worse prognosis. This study investigated the prognostic value of preoperative serum p53 levels, and the significance as a biomarker to evaluate a recurrence after surgical resections in breast cancer. Methods Preoperative serum p53 concentration levels were measured in total of 259 breast cancer patients, who had undergone either a total mastectomy or a partial mastectomy, through 2010 to 2015 in our facility. Patients with elevated levels of p53 (29 patients) and normal levels of p53 (230 patients) were compared to analyze the association of a marker level with the prognosis and the indication to diagnose recurrence in breast cancer. Results Elevated serum level of p53 mutation was identified in 29 (11%) patients. The size of tumor, staging, and pathology did not associate with the level of p53. Patients with elevated serum level of p53 correlated to the high score of nuclear grade (NG2 and NG3) and the high percentage of Ki-67 (&amp;gt;14%), which leading to the worse prognosis. Triple negative breast cancer was the major molecular subtype in the group of high level of p53 comparing with the group of low level of p53. Survival analysis using the Kaplan-Meier method were performed to examine DFS and OS of high serum level of p53 patients. Patients with high level of p53 were significantly showed worse DFS than a normal p53 group. Serum level of p53 was also reflected to the recurrence and metastasis of postoperative breast cancer. There were three patients, who had local recurrences and metastasis, in the group of high levels of p53. Their serum levels of p53 were re-elevated as emerging the local recurrence and metastasis once they had gotten the normal serum levels of p53 after surgical resections. It showed that the increasing of the level of p53 was reflected to the recurrence and metastasis of tumors after surgical resections in breast cancer. Conclusions This study suggests that preoperative serum level of p53 can be an independent prognostic parameter and a monitoring biomarker for breast cancer. Citation Format: Arai M, Nagata T, Sekine S, Baba H, Moriyama M, Hashimoto I, Fujii T. Elevated levels of serum tumor marker p53 is a prognostic parameter and a monitoring biomarker for patients who had undergone surgical resection in breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-50.
Warburg Effects in Cancer and Normal Proliferating Cells: Two Tales of the Same Name
Authors: Huiyan Sun, Liang Chen, Sha Cao, Yanchun Liang, Ying Xu
Journal: Genomics Proteomics & Bioinformatics (2019)

It has been observed that both cancer tissue cells and normal proliferating cells (NPCs) have the Warburg effect. Our goal here is to demonstrate that they do this for different reasons. To accomplish this, we have analyzed the transcriptomic data of over 7000 cancer and control tissues of 14 cancer types in TCGA and data of five NPC types in GEO. Our analyses reveal that NPCs accumulate large quantities of ATPs produced by the respiration process before starting the Warburg effect, to raise the intracellular pH from ∼6.8 to ∼7.2 and to prepare for cell division energetically. Once cell cycle starts, the cells start to rely on glycolysis for ATP generation followed by ATP hydrolysis and lactic acid release, to maintain the elevated intracellular pH as needed by cell division since together the three processes are pH neutral. The cells go back to the normal respiration-based ATP production once the cell division phase ends. In comparison, cancer cells have reached their intracellular pH at ∼7.4 from top down as multiple acid-loading transporters are up-regulated and most acid-extruding ones except for lactic acid exporters are repressed. Cancer cells use continuous glycolysis for ATP production as way to acidify the intracellular space since the lactic acid secretion is decoupled from glycolysis-based ATP generation and is pH balanced by increased expressions of acid-loading transporters. Co-expression analyses suggest that lactic acid secretion is regulated by external, non-pH related signals. Overall, our data strongly suggest that the two cell types have the Warburg effect for very different reasons.
Quelle concordance de l'histologie avec l'endoscopie dans la maladie coeliaque?: expérience d'un service universitaire
Authors: FZ Chabib, I Benelbarhdadi, FZ Ajana
Journal: Endoscopy (2019)

La maladie coeliaque, est une entéropathie chronique auto-immune caractérisée sur le plan histologique par une atrophie villositaire. Des aspects caractéristiques de la maladie coeliaque peuvent être observés au niveau du bulbe et du duodénum. néanmoins, un duodénum endoscopiquement sain n'élimine pas la maladie, d'où l'intérêt de notre étude qui est d'étudier la corrélation entre l'existence d'anomalies endoscopiques et la sévérité de l'atrophie villositaire.
A Novel FVIIa Variant with Increased Potency and Duration of Effect Compared to Wildtype FVIIa. A Study in a Dog Model of Hemophilia A
Authors: Debra Pittman, Stacey Weston, Kathleen Shields, Chuenlei Parng, Steven Arkin, Ed Madison, Timothy C. Nichols, Joachim Fruebis
Journal: Blood (2011)
Dynamic nuclear polarization magnetic resonance imaging and the oxygen-sensitive paramagnetic agent OX63 provide a noninvasive quantitative evaluation of kidney hypoxia in diabetic mice
Authors: Yoshimi Kodama, Fuminori Hyodo, Mayumi Yamato, Keiji Yasukawa, Yohei Minami, Noriyuki Sonoda, Yoshihiro Ogawa, Kazuhiro Ichikawa, Toyoshi Inoguchi
Journal: Kidney International (2019)
Abstract 16972: Patients With Human Immunodeficiency Virus Treated With Highly Active Antiretroviral Therapy Have Increased Intra-Myocardial Triglyceride Accumulation by 3-Tesla Cardiac Magnetic Resonance Spectroscopy
Authors: Lidia S Szczepaniak, Troy LaBounty, Michael D Nelson, Edward Szczepaniak, Laura Smith, David Ramirez, John Hsih, Lawrence St. John, Gregg Sannes, Rohan Dharmakumar, Roya Yumul, Debiao Li, W. D Hardy, Antonio Hernandez Conte
Journal: Circulation (2013)

Introduction: Approximately 34 million people worldwide are living with HIV disease, and 55,000 new HIV infections occur annually in the U.S. alone. Highly-active anti-retroviral therapy (HAART) fo...
Use of Bortezomib-Containing Regimens in the Frontline Treatment of Patients with Plasmablastic Lymphoma: A Multicenter Retrospective Analysis
Authors: Thomas Guerrero, Michele Bibas, Franco Baldini, Guillaume Cartron, Kate Cwynarski, Daan Dierickx, Frederick Lansigan, Yevgeniy A Linnik, Renzo Mogollon, Jose Tomas Navarro, Slavisa Ninkovic, Adam J Olszewski, John L. Reagan, Emmanuelle Tchernonog, Thomas Tousseyn, Jorge J. Castillo
Journal: Blood (2017)
INVASIVE RECURRENCE RATE AND CLINICOPATHOLOGICAL FEATURES AFTER ENDOSCOPIC RESECTION FOR 591 T1 COLORECTAL CANCERS
Authors: K Kawashima, Y Saito, Y Mizuguchi, H Takamaru, SYS Wu, M Sekiguchi, M Yamada, T Sakamoto, T Matsuda
Journal: Endoscopy (2019)

Recent studies reported that invasion depth only has no clinical impact to lymph node metastasis (LNM) of colorectal cancer (CRC). Several recurrent cases have been reported, however, after endoscopic resection for T1b (SM deep) CRC without any unfavorable histological factors. We, therefore, aim to investigate the recurrence rate and clinicopathological features associated with invasive recurrence after endoscopic resection for T1 CRC.
Hereditary breast and ovarian cancer syndrome: Descriptive analysis of a familial cancer clinic
Authors: S.R. Amaral, T. Cunha Pereira, A.R. Monteiro, A.R. Garcia, L. Pinto, V. Gonçalves, M. Mariano, S. Broco, T. Carvalho, G. Sousa
Journal: Annals of Oncology (2019)

Background: Germline mutations in the high-penetrance susceptibility genes BRCA1 and BRCA2 are associated with inherited predisposition for breast and ovarian cancer. Pattern of mutations varies considerably among different populations, and there are groups with high prevalence of particular mutations according to geographical area, as the c.156_157insAlu BRCA2 rearrangement, a founder mutation of Portuguese origin and one of the most frequent BRCA2 mutations described to date. In this study we review the clinical and pathological characteristics of the patients with Hereditary Breast and Ovarian Cancer Syndrome (HBOC), the BRCA1 and BRCA2 mutation spectrum and evaluate its relation with clinical outcomes. Methods: Retrospective analysis of families with HBOC of our clinic between January 2007 and December 2017. Myriad or BRCAPRO model was applied and individuals with score ≥ 10% were tested for BRCA1/2 mutations, using PCR sequencing and MLPA technique. Data was analyzed with SPSS statistics software. Results: Ninety-four families with 378 members were evaluated. BRCA1 mutation was identified in 182 individuals, and BRCA2 in 111 individuals. In BRCA1 population, 42 individuals (40 females, 2 males) with cancer (affected individuals – AI) were identified, mainly with triple-negative breast cancer (BC) (57%). The most frequently detected mutations were exon 16_17del, c.1121_1123delCACinsT and c.2037delGinsCC which together represented 31% of total pathogenic mutations. In BRCA2 population, 62 AI were identified (55 females, 6 males), mainly with luminal BC (71.4%). The c.156_157insAlu BRCA2 rearrangement represented 61% of total pathogenic mutations. Rate of risk reducing surgeries was similar in both groups. Five-year overall survival was 82.5% in BRCA1 AI vs 86.4% in BRCA2 AI. Conclusions: Our results are consistent with literature in terms of genotype-phenotype relation and frequency of founder mutations. Identify the most frequent mutations in each population is crucial for a personalized approach of patients and to define strategies of surveillance for patients and relatives at risk. Prognostic impact of these mutations in outcomes in BC has not been fully determined to date. Further studies including this population are warranted. Legal entity responsible for the study: Susana Amaral. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.