tbuckley/cabot-search huggingface dataset:
T-Lymphocyte Infiltration to Islets in the Pancreas of a Patient Who Developed Type 1 Diabetes After Administration of Immune Checkpoint Inhibitors
Authors: Sho Yoneda, Akihisa Imagawa, Yoshiya Hosokawa, Megu Yamaguchi Baden, Takekazu Kimura, Sae Uno, Kenji Fukui, Kunihito Goto, Motohide Uemura, Hidetoshi Eguchi, Hiromi Iwahashi, Junji Kozawa, Iichiro Shimomura
Journal: Diabetes Care (2019)

Type 1 diabetes is a disease characterized by destruction of the β-cells in the pancreatic islets. The inhibitory receptor programmed cell death-1 (PD-1) and its ligands, programmed cell death ligand-1 (PD-L1) and PD-L2, have been shown to play an important role in regulating T-cell activation and peripheral tolerance. Inhibitors targeting PD-1 or PD-L1 are especially advantageous in the treatment of cancer. There are several reports where type 1 diabetes developed after administration of anti–PD-1 antibody (1). However, there is no report containing an immunohistochemical study of the pancreas.

At the age of 55 years, a male patient underwent left radical nephrectomy for kidney cancer. At age 60, he was diagnosed with type 2 diabetes. Under the administration of vildagliptin, his hemoglobin A1c was maintained at ∼6% (41 mmol/mol). He was diagnosed with gallbladder metastasis of renal carcinoma at age 61 and underwent a cholecystectomy. Thereafter, he was diagnosed with renal carcinoma pancreatic metastasis, which increased in size, whereupon anti–CTLA4 antibody (ipilimumab) and anti–PD-1 antibody (nivolumab) combination therapy was started. Ipilimumab and nivolumab were administered four times over 2 months and nine times over 5 months, respectively. At age 63, 5 months after the start of administration, he developed diabetic ketoacidosis, his serum C-peptide was 1.8 ng/mL at that time, and insulin treatment was started. Anti–glutamic acid decarboxylase, anti–IA-2, and anti-IAA antibodies were negative, and his HLA haplotype was DRB1\*11:01-DQB1\*03:01 and DRB1\*09:01-DQB1\*03:03 . Two weeks after hospitalization, his serum C-peptide was <0.1 ng/mL. Thereafter, the combination …
Medical students will be recruited on their compassion, says Health Education England
Authors: Emilie Green
Journal: BMJ (2013)

In response to the Francis Inquiry into the Mid Staffordshire NHS trust, Health Education England has said that it will require universities to assess medical school applicants on the basis of their values and behaviours.

Ian Cumming, chief executive of Health Education England (HEE), the health authority with responsibility for medical education, said: “HEE will be talking to universities to ensure that every student we directly or indirectly fund to study nursing, medicine, physiotherapy, or any other health related course should be interviewed prior to being offered a place and they should also be subject to an assessment of their values and behaviours. If potential students cannot demonstrate the right values and behaviours to work in healthcare, why should tax payers spend tens or hundreds of thousands …
Raised troponin: non-invasive cardiac investigations
Authors: Sukhjinder S Nijjer, Gayle F Appleby, Simon W Dubrey
Journal: BMJ (2010)

The first of a two part series looking at troponin and cardiac investigations A borderline troponin result is a potential minefield for the student and junior doctor alike. Similarly, patients with chest pain but without a rise in troponin concentration (“a negative troponin”) need further investigations to assess their cardiac risk. This first part of these two articles covers the non-invasive investigations that may be ordered if troponin concentrations are raised. Part two will look at invasive investigations. Patients who attend hospital with chest pain are common and account for 700 000 emergency department attendances (6% of total) and as many as a quarter of acute admissions in England and Wales.1 The principal differential diagnoses have cardiac, respiratory, and gastrointestinal causes. The key diagnosis of concern is myocardial infarction, and this depends on a history of cardiac sounding chest pain, electrocardiographic features, and changes in troponin concentration above the 99th centile of the upper recommended limit. Myocardial infarction is part of the umbrella term of the acute coronary syndromes (ACS). These consist of ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI; raised troponin), and unstable angina (normal troponin) (box 1).2 ACS represent unstable coronary atheroma that may be acutely enlarging because of rupture and platelet activation (unstable angina) or because of acute total occlusion of a vessel (STEMI). STEMI and NSTEMI are generally a type 1 myocardial infarction, but there is substantial overlap with types 2 and 3 myocardial infarction. The universal definition of myocardial infarction (the five types) is used mainly in research, but clinically most doctors use STEMI and NSTEMI. #### Box 1: Classification of myocardial infarction2
From bandages to the bends
Authors: Andrew Cumpstey
Journal: BMJ (2011)

Dealing with multiple casualties that have a range of traumas is difficult for any medical person. If you take into account that I’m still a student, and then take away the comfort of being in a teaching hospital resuscitation room with equipment and specialist support, and the situation looks even worse. Luckily, this was an exercise, and I was observing. For the 50 or more doctors participating the pressure was on though. The Great North Air Ambulance was about to land to pick up the “injured.”

This exercise is the final part of the expedition and wilderness medicine course, which is run …
Films portraying diabetes mellitus need to get their facts right
Authors: Stephanie Hill
Journal: BMJ (2015)

We’ve all shouted from the sofa, “Why would you go down to the basement? At least take a weapon with you.” You don’t need any medical knowledge to know not to go into the basement when there’s a killer loose. “That’s not how hypoglycaemia works,” however, is a comment less often heard on film night, unless you’re a frustrated healthcare professional wondering how the film industry got diabetes so wrong.

I was enjoying the re-enactment of Zimbardo’s famous prison experiment in Paul Scheuring’s film, The Experiment, until one of the prisoners fell ill. He had type 1 diabetes mellitus. Apparently, because he had not had his insulin, he was hypoglycaemic. To treat him, another prisoner correctly gave him a piece of white bread to increase his blood sugar level, but the prisoner also, incorrectly, waited for his insulin injection, which would have the opposite effect and bring his sugar back down. This film, like several others, perpetuates inaccuracies about a condition that affects one in every 430-530 people under the age of 19 in the United Kingdom.1

In the 2013 film Hansel and Gretel: Witch Hunters , Hansel had a deadly disease (“the sugar sickness”) caused by eating too many sweets as a child. He had to inject himself every few hours. When he missed his injection, his symptoms were similar to the …
Warnings over rise in prescriptions for methylphenidate, as use of cognitive enhancers becomes common among students
Authors: Isabella Laws
Journal: BMJ (2013)

Increased prescribing of methylphenidate has led the Care Quality Commission (CQC) to warn that supplies of the drug might be being diverted and misused as cognitive enhancers.

The drug is commonly used to treat attention deficit hyperactivity disorder, but the CQC warned about potential misuse of the drug in its annual report on controlled drugs.1

The report says that the CQC is “aware of the possibility that methylphenidate could be diverted and …
Enhanced Recovery After Surgery—Knowing, Not Guessing
Authors: Olle Ljungqvist
Journal: JAMA Surgery (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 Surgery 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 Surgery journal
How to apply a cast for forearm fractures
Authors: Patrick G Robinson, A R M Macey, I S Johnston, A C Macey
Journal: BMJ (2017)

The forearm bones (radius and ulna) are the two most commonly broken bones in the body.1 Immediate management of these injuries includes applying a plaster cast—called a back slab—to the dorsal aspect of the forearm. These casts are a simple and effective way of providing temporary stabilisation of the fracture and pain relief. All medical students and junior doctors should know how to apply a dorsal back slab.2 It is usually applied in the emergency department or orthopaedic theatre, but it might also be required during expeditions or in remote settings on elective placement.

The back slab bridges the gap in treatment until definite fracture fixation takes place—that is, an operation is planned within a few days or a full circumferential cast is applied once swelling has settled. In both cases, a fracture of a forearm bone will take about six weeks to heal.

It is important that a back slab does not encircle the limb to allow for some expansion secondary to swelling, and it should be easy to remove. A back slab can be applied with or without manipulation of the fracture, and it can play an important part in managing a fracture conservatively.

However, application of the back slab is not without its risks. Circulatory or nerve impairment can occur if a back slab is applied too tightly, and pressure ulcers can develop if padding at bony prominences is not applied appropriately.23 Practice is all that is required to become proficient in applying a cast, and the fracture clinic or emergency department plaster room can be a source of training and support. The principles learnt from casting the forearm can be applied to other parts of the body. The British Orthopaedic Association’s patient liaison group states that they expect that anyone who requires …
A simple echocardiographic estimate of right ventricular-arterial coupling to assess severity and outcome in pulmonary hypertension on chronic lung disease
Authors: Khodr Tello, Hossein A. Ghofrani, Charlotte Heinze, Karsten Krueger, Robert Naeije, Christina Raubach, Werner Seeger, Natascha Sommer, Henning Gall, Manuel J. Richter
Journal: European Respiratory Journal (2019)

<b>The ratio of tricuspid annular plane systolic excursion to systolic pulmonary artery pressure is a simple echocardiographic parameter that reflects haemodynamic severity and predicts survival in pulmonary hypertension due to lung diseases.</b>http://bit.ly/2KgLAbR
Abstracts of the 4th European Congress on Intensive Care Medicine, Baveno-Stresa, Italy, June 14–18, 1988
Authors: I V~is~nen, J Tahvanainen, A §kel §inen, T Miqhelsen', A Yl~-Jarkko, P Nikki, Gajdos I°}{, Verceen Jb, Raphael Jc, B Schlemmar, Le ~11 -, Max Zio Solca, ~ Koldxm, ~ Pesmyci, Y David, D Myerberg, T Ebling, % Herry, J Boldt, D Kling, G Hempelmann
Journal: Intensive Care Medicine (1988)
Useful apps for radiology on surgical rotations
Authors: Maximilian Stephens
Journal: BMJ (2012)

Surgical rotations often place an emphasis on abdominal and pelvic computed tomography interpretation. However, interpretation by students is often poor, especially as the skill is rarely taught in medical school. Radiology 2.0: One Night in the ED is a useful educational app, although it is relatively undiscovered. The app features 65 surgical cases that are easy to browse. Selecting a case presents the reader with a fully scrollable computed tomogram …
Tips for the childhood immunisation OSCE
Authors: Karolina Kapeller, Neil Chanchlani
Journal: BMJ (2019)

A guide on how to structure your consultation and answer common questions #### Box 1: OSCE scenario You are a final year medical student in general practice. The practice nurse has asked you to speak to the mother of a 1 year old boy who has not had any of his vaccinations. The mother seems reluctant for her son to have the vaccinations and has cancelled multiple appointments. You have 8 minutes to deal with her concerns. Communicating with parents about the benefits of childhood immunisation and addressing their concerns is a common objective structured clinical examination (OSCE) station at medical schools in the United Kingdom. The goal of this station is to assess your communication skills—how you elicit and respond to parents’ concerns, rather than bombarding them with information in order to encourage vaccine uptake. In this article we give advice on how to structure your consultation and how to answer common questions you might be asked at this type of OSCE station. The ICE acronym (ideas, concerns, expectations) is a useful tool for structuring your opening conversations in any communications based OSCE station. Using ICE can help you to gauge a parent’s level of understanding and pitch your response accordingly. Adverse events to vaccines do occur, so you must empathise and validate parental concerns rather than dismissing them. If you do not acknowledge their concerns, you risk losing their confidence and failing the station by showing a lack of empathy and communication skills. Box 2 offers a structure around which you can base your consultation, with useful tips for opening the station, how to signpost your discussion and bring it to a close.1 #### Box 2: Sample structure for consultation, with examples
An interim report on the investigator-initiated phase 2 study of pembrolizumab immunological response evaluation (INSPIRE)
Authors: Derek L. Clouthier, Scott C. Lien, S. Y. Cindy Yang, Linh T. Nguyen, Venkata S. K. Manem, Diana Gray, Michael Ryczko, Albiruni R. A. Razak, Jeremy Lewin, Stephanie Lheureux, Ilaria Colombo, Philippe L. Bedard, David Cescon, Anna Spreafico, Marcus O. Butler, Aaron R. Hansen, Raymond W. Jang, Sangeet Ghai, Ilan Weinreb, Valentin Sotov, Ramy Gadalla, Babak Noamani, Mengdi Guo, Sawako Elston, Amanda Giesler, Sevan Hakgor, Haiyan Jiang, Tracy McGaha, David G. Brooks, Benjamin Haibe-Kains, Trevor J. Pugh, Pamela S. Ohashi, Lillian L. Siu
Journal: Journal for ImmunoTherapy of Cancer (2019)

<h3>Background</h3> Immune checkpoint inhibitors (ICIs) demonstrate unprecedented efficacy in multiple malignancies; however, the mechanisms of sensitivity and resistance are poorly understood and predictive biomarkers are scarce. INSPIRE is a phase 2 basket study to evaluate the genomic and immune landscapes of peripheral blood and tumors following pembrolizumab treatment. <h3>Methods</h3> Patients with incurable, locally advanced or metastatic solid tumors that have progressed on standard therapy, or for whom no standard therapy exists or standard therapy was not deemed appropriate, received 200 mg pembrolizumab intravenously every three weeks. Blood and tissue samples were collected at baseline, during treatment, and at progression. One core biopsy was used for immunohistochemistry and the remaining cores were pooled and divided for genomic and immune analyses. Univariable analysis of clinical, genomic, and immunophenotyping parameters was conducted to evaluate associations with treatment response in this exploratory analysis. <h3>Results</h3> Eighty patients were enrolled from March 21, 2016 to June 1, 2017, and 129 tumor and 382 blood samples were collected. Immune biomarkers were significantly different between the blood and tissue. T cell PD-1 was blocked (≥98%) in the blood of all patients by the third week of treatment. In the tumor, 5/11 (45%) and 11/14 (79%) patients had T cell surface PD-1 occupance at weeks six and nine, respectively. The proportion of genome copy number alterations and abundance of intratumoral 4-1BB+ PD-1+ CD8 T cells at baseline (<i>P</i>&nbsp;&lt; 0.05), and fold-expansion of intratumoral CD8 T cells from baseline to cycle 2–3 (<i>P</i>&nbsp;&lt; 0.05) were associated with treatment response. <h3>Conclusion</h3> This study provides technical feasibility data for correlative studies. Tissue biopsies provide distinct data from the blood and may predict response to pembrolizumab.
Abstract P3-11-06: HRD (homologous recombination deficiency) score and its clinicopathological features in neoadjuvant chemotherapy treated sporadic breast cancers
Authors: S Imanishi, Y Naoi, K Shimazu, M Shimoda, N Kagara, T Tanei, T Miyake, SJ Kim, S Noguchi
Journal: Cancer Research (2019)

Abstract [Purpose]Homologous Recombination Deficiency (HRD) score has been developed to evaluate the DNA double-strand break repair function. BRCA1/2 germline mutation-associated breast cancers are known to show a high HRD score and a high sensitivity to platinum-based chemotherapy as well as PARP inhibitor. HRD can be theoretically induced by not only the dysfunction of BRA1/2 but also the dysfunction of the other molecules involved in homologous recombination, and, actually, high HRD score is reported to be seen in a significant proportion of sporadic breast tumors without BRCA1/2 mutation. The aim of the present study was to elucidate the clinicopathological characteristics of sporadic breast tumors with high HRD score as well as their sensitivity to sequential paclitaxel and FEC chemotherapy (P-FEC). [Methods]Tumor tissues obtained by Mammotome from 132 sporadic breast cancer patients (stage II-III) before neoadjuvant chemotherapy with P-FEC were subjected to assay for HRD score using Oncoscan CNV kit®. HRD score was a simple sum of NtAI, LOH, and LST (cutoff, 42), and were also subjected to the gene expression analysis using the Affymetrix microarray (U133 plus 2.0). BRCA1 promoter methylation was assayed by methylation specific real-time PCR. [Result]Of the 132 breast tumors, 32% showed a high HRD score which were significantly associated with high histological grade (P=0.001), negative progesterone receptor (P=0.023) and high Ki67 index (P=0.004). Triple negative breast cancer (TNBC)(n=19) showed a significantly (P&amp;lt;0.001) higher HRD score than the other subtypes (HR+/HER2-(n=73), HR+/HER2+(n=12), HR-/HER2+(n=18)). BRCA1 promoter methylation was significantly associated with a high HRD score. There was no significant correlation between HRD score and pCR to P-FEC when all tumors were considered but tumors with a high HRD score showed a significantly (P=0.020) lower pCR rate when only TNBC were considered. In TNBC, majority of tumors showed a high HRD score in five subtypes (BL1, BL2, IM, M, MSL) but no tumor showed a high HRD score in LAR (luminal androgen receptor) subtype. [Conclusion]Approximately one third of sporadic breast tumors show a high HRD score, indicating the presence of homologous recombination dysfunction, and they are most often seen in TNBC with BRCA1 promoter methylation and never in LAR subtype. Interestingly, breast tumors with a high HRD score were less sensitive to P-FEC. Citation Format: Imanishi S, Naoi Y, Shimazu K, Shimoda M, Kagara N, Tanei T, Miyake T, Kim SJ, Noguchi S. HRD (homologous recombination deficiency) score and its clinicopathological features in neoadjuvant chemotherapy treated sporadic breast cancers [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 P3-11-06.
Abstract 20018: Increased Blood Stasis in the LV of Patients With Atrial Fibrillation
Authors: Lucia Real-Valdés, Victor Antón de Zafra, Pablo Martinez-Legazpi, Candelas Pérez del Villar, Lorenzo Rossini, Raquel Yotti, Yolanda Benito, Gerard Loughlin, Antonia Delgado-Montero, Francisco Fernandez-Aviles, Juan Carlos del Alamo, Javier Bermejo
Journal: Circulation (2016)

Recent studies have shown that atrial stasis may not be the unique source of cardioembolism in patients with atrial fibrillation (AF). In the healthy left ventricle (LV), the intraventricular flow ...
Abstract 16456: Enhanced Cardiac Stem Cell Engraftment with Magnetic Gadonanotubes
Authors: Lesa A Tran, Mayra Hernandez-Rivera, Luiz Sampaio, Yi Zheng, Christina Bove, Lon J Wilson, Guilherme Silva, Emerson C Perin
Journal: Circulation (2012)

Adult bone marrow-derived mesenchymal stem cells (MSCs) are attractive for cellular cardiomyoplasty because of their multipotent nature and immunomodulatory properties. However, low engraftment and...
Immune microenvironment controls the outcome of PD‐1 blockade in cutaneous immune response
Authors: Tatsuya Ogawa, Yosuke Ishitsuka, Akimasa Saito, Yoshiyuki Nakamura, Rei Watanabe, Naoko Okiyama, Yasuhiro Fujisawa, Manabu Fujimoto
Journal: Allergy (2019)

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Xpert® BCR-ABL Ultra, a High Sensitivity Assay, Demonstrates a Limit of Detection Reaching MR4.5 and below
Authors: Christophe Ferrand, Marina Deschamps, Alba Levitas, Christina Lockwood, Jacqueline E. Payton, Geoffrey L. Uy, Charles A. Schiffer, Gerald Feldman, Aaron Bossler, Julie Woolworth, Alice S. Mims, Krupa Shridhar, Natalie Wu, Sandy Huang, Huilin Wei, Chris Lykke, Michael P. Bates, Wendy Wong, Gwo-Jen Day
Journal: Blood (2017)
BMJ Group Awards 2011
Authors: Harriet Vickers
Journal: BMJ (2011)

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