tbuckley/cabot-search huggingface dataset:
The growth and development of the allied health schools
Authors: D. J. Mase
Journal: JAMA (1968)

With the mandate of society to extend comprehensive health care to all of our citizenry, it becomes essential to update our procedures for preparing the health manpower needed. Health is our third largest industry and shall soon become the largest. In 1900 there was one supportive person for each physician. It is estimated that today the ratio is 13 to 1. By 1975 it is expected that this ratio will be 20 or 25 to 1. These supportive personnel are most commonly referred to as those in the allied or health related professions and/or occupations. This estimate in no way implies a lessening of the current projections for more physicians and dentists. Historically many of these supportive personnel were trained in hospitals. With the extension of education beyond high school for the masses, it becomes essential to prepare those for the health professions and occupations in our junior colleges, colleges,
Impact of cytoreductive nephrectomy (CN) on survival in metastatic renal cell cancer (mRCC) treated with immune checkpoint inhibitors (ICI).
Authors: Stuthi Perimbeti, Changchuan Jiang, Lei Deng, Arya Roy, Keerthy Gopalakrishnan, Gurkamal S. Chatta, Saby George, Dharmesh Gopalakrishnan
Journal: Journal of Clinical Oncology (2022)

359 Background: The advent of ICIs has dramatically changed the treatment paradigm in mRCC. Although CN was demonstrated to improve survival in combination with cytokine-based therapies, its role is not well-defined in the ICI era. We aimed to compare survival outcomes of patients treated with ICIs, based on their CN status. Methods: The National Cancer Database was queried to identify all patients older than 18 years with mRCC who received ICIs from 2015 to 2018. Chi-Square and Mann-Whitney U tests were used to compare frequency distributions. Cox proportional hazards regression was employed for multivariate analysis of factors associated with overall survival (OS). Results: A total of 4,369 patients were identified- 36.4% (n=1589) had undergone CN. Among patients who got CN, 85.3% were treated with upfront surgery while 13.8% received prior systemic therapy ( P = 0.001). The study population was predominantly Caucasian (89.2%) and male (70.6%). Patients who underwent CN were younger (median age 61 vs. 65 years, P = &lt;0.001). Large primary tumors and clinically node-negative status were associated with higher odds of CN (T4 disease - odds ratio (OR) for 1.49, 95% CI 1.13-3.44, P = 0.03; cN0 disease - OR 1.56, 95% CI 1.23-4.56, P = 0.04). OS after 1 year was significantly higher in patients who underwent CN (66.8% vs 33.2%. P &lt;0.001). On multivariate analysis, CN was independently predictive of improved OS with a hazard ratio (HR) of 0.53 and 95% CI 0.41-0.68, P &lt;0.001. Conclusions: In this large retrospective analysis, CN was associated with improved OS among patients with mRCC receiving ICI-based therapies. Our findings suggest that despite recent advances in systemic therapies for mRCC, CN retains an important role in carefully selected patients.[Table: see text]
SOX11 Inhibitors Are Cytotoxic in Mantle Cell Lymphoma
Authors: Shashidhar S. Jatiani, Stephanie Christie, Violetta V. Leshchenko, Rinku Jain, Abhijeet Kapoor, Paola Bisignano, Clement Lee, H. Ümit Kaniskan, Donna Edwards, Fanye Meng, Alessandro Laganà, Youssef Youssef, Adrian Wiestner, Lapo Alinari, Jian Jin, Marta Filizola, Aneel K. Aggarwal, Samir Parekh
Journal: Clinical Cancer Research (2021)

Abstract Purpose: Mantle cell lymphoma (MCL) is a fatal subtype of non–Hodgkin lymphoma. SOX11 transcription factor is overexpressed in the majority of nodal MCL. We have previously reported that B cell–specific overexpression of SOX11 promotes MCL pathogenesis via critically increasing BCR signaling in vivo. SOX11 is an attractive target for MCL therapy; however, no small-molecule inhibitor of SOX11 has been identified to date. Although transcription factors are generally considered undruggable, the ability of SOX11 to bind to the minor groove of DNA led us to hypothesize that there may exist cavities at the protein–DNA interface that are amenable to targeting by small molecules. Experimental Design: Using a combination of in silico predictions and experimental validations, we report here the discovery of three structurally related compounds (SOX11i) that bind SOX11, perturb its interaction with DNA, and effect SOX11-specific anti-MCL cytotoxicity. Results: We find mechanistic validation of on-target activity of these SOX11i in the inhibition of BCR signaling and the transcriptional modulation of SOX11 target genes, specifically, in SOX11-expressing MCL cells. One of the three SOX11i exhibits relatively superior in vitro activity and displays cytotoxic synergy with ibrutinib in SOX11-expressing MCL cells. Importantly, this SOX11i induces cytotoxicity specifically in SOX11-positive ibrutinib-resistant MCL patient samples and inhibits Bruton tyrosine kinase phosphorylation in a xenograft mouse model derived from one of these subjects. Conclusions: Taken together, our results provide a foundation for therapeutically targeting SOX11 in MCL by a novel class of small molecules.
DR. SAMUEL D. GROSS.
Journal: JAMA (1892)

We are in receipt of the following circular which is self explanatory: A monument to the late Samuel David Gross, M.D., LL.D., D. C. L., Oxon; LL.D., Cantab.; LL.D., Edinburgh; LL.D., Univ. Penn., etc. "American Medicine and Surgery has had no abler exponent than Samuel David Gross! "There has been no man in our profession more honored by scientific associations and learned institutions, both abroad and at home, than Dr. Gross; none who have been more admired by their fellow practitioners, or revered by former pupils! "A boy of studious habits, ambitious promptings, integrity of purpose, and purity of character; without the prestige of a name, or the influence of family or fortune, he rose, unaided, to the highest position in the profession of his selection. A man of marked personal character, with great acquirements, he made an impress upon American Surgery, which has served to dignify American Medicine! "His
PRIMERA trial (NCT04188275), early survival results from a prospective trial exploring impact of circulating tumor cell detection in castrate resistant prostate cancer patients undergoing abiraterone or enzalutamide I line treatment.
Authors: Giulio Francolini, Mauro Loi, Lucia Pia Ciccone, Monica Mangoni, Beatrice Detti, Vanessa Di Cataldo, Michele Aquilano, Andrea Allegra, Pamela Pinzani, Francesca Salvianti, Cecilia Cerbai, Luca Burchini, Giulio Frosini, Chiara Mattioli, Viola Salvestrini, Barbara Guerrieri, Giulia Salvatore, Mariangela Sottili, Isacco Desideri, Lorenzo Livi
Journal: Journal of Clinical Oncology (2022)

137 Background: Circulating tumor cells (CTC) detection and androgen receptor splice variant 7 (ARV7) expression have been shown to be associated with worse clinical outcomes in metastatic castration resistant prostate cancer (mCRPC) patients undergoing androgen receptor targeted agents (ARTA) treatment, paving the way for alternative treatment options for patients with negative predictive factors. Full-length androgen receptor (ARFL), prostate specific membrane antigen and prostate specific antigen (PSA) may further help to refine prognostic models. In our institution, a prospective observational trial testing CTC detection in mCRPC undergoing ARTA treatment (PRIMERA trial, NCT04188275) terminated the planned enrollment in 2020. Here we present early results of the overall cohort. Methods: PRIMERA (NCT04188275) is a prospective, observational trial enrolling mCRPC patients undergoing ARTA treatment. All patients were treated with either abiraterone or enzalutamide in I line setting. Blood samples to detect CTCs were taken before starting ARTA treatment. Reverse transcription - quantitative real-time PCR (RT-qPCR) was used to determine the CTC expression of PSA, PSMA, AR and ARV7. PSA drop (defined as difference between baseline PSA at ARTA treatment start and PSA at nadir under treatment), progression free and overall survival (PFS and OS) and their correlation with CTC detection were reported. Explorative analysis about AR, PSA and PSMA expression in CTC+ patients were conducted. Results: Overall, 44 patients were included. CTC were detected at treatment start in 19 patients (43,2%), of whom 3(15,78%), 9(63,15%), 15(78,94%) and 14 (73.68%) patients expressed ARV7, ARFL, PSA and PSMA, respectively. Biochemical response was significantly improved in CTC+ vs. CTC- patients, with median PSA drop values of 18.5 vs 2.5 ng/ml (p=0.03). After a median follow up of 18 months, 22 (50%) patients progressed. PFS was significantly longer in CTC- patients (not reached vs 16 months, respectively, p=0.02). Eight (18.2%) patients died, a non-significant trend in terms of overall survival was detected in favor of CTC- patients (not reached vs 29 months, respectively, p=0.05). AR, PSA and PSMA expression in CTC+ had no significant impact on PSA drop, PFS or OS. Conclusions: PRIMERA trial confirmed the CTC detection predictive importance in mCRPC patients. Adequately powered studies will be needed to further explore CTC profiling in this setting. Clinical trial information: NCT04188275.
Somatic Mutation
Authors: P. Armitage, R. Doll, M. C. Pike
Journal: BMJ (1965)

SIR,-By using a new method, recently referred to in your columns1 by Sir Macfarlane Burnet, we find that suspected idiopathic autoimmune disorders can be classified by statistical criteria into two categories.This division also corresponds, interestingly enough, to a fundamental anatomical distinction regarding the location of the target tissue.are, etc.,
Clinical Lectures on Mental and Cerebral Diseases
Authors: J. C. Browne
Journal: BMJ (1874)

think any school of doctors ever proclaimed it; if they did, they would be allopaths.But a notorious person named Hahnemann, taking advantage of the fact that doctors, who proceed according to common sense, do not save everybody from dying, rose against common sense, and said like cures like-similiaiz simizilibuis curantur.Then was seen how unhappy it is that this idea of like is left at school in such undiscipline; for a whole crowd, ready for something new, go after him, not knowing how to deal with so manifold a thing as likeness, and not caring what it means.But if you examine the proposition " likes cures like", you see its puerility, so far as it has any apprehensible meaning.We have seen that like-
Mycoplasma pneumoniae.
Authors: M C Jones
Journal: Thorax (1969)

JOHN WRIGHT This has been evolved with a modified pulse duplicator and the use of a hot film probe for measuring velocity, direction, and turbulence.Many of the commercially available mitral valve prostheses are being investigated for their flow characteristics.In addition, efficiency is being examined and some unusual findings point to the possibility of a hydraulic ram effect in the normal mitral valve that allows opening to commence before the end of ventricular systole.TRIAL OF A NEW ANTI-MYXOVIRUS COMPOUND J. E. STARK Two hundred and sixty-four male students
Infectious Diseases: Epidemiology and Clinical Practice.
Journal: Annals of Internal Medicine (1988)

Reviews 1323 surprising inclusions.Several drawings are in- accurate, and too small and fussy.Greater integration in the text would have avoided omissions of clinically important biomechanical studies of the trunk, as yet undescribed in any textbook.Salutary criticism from nonspecialists makes for brevity and clarity, but pruning is for experts.Collaboration of both throughout the next edition would make for better balance and an even more coherent synthesis.Good plates, type, paper and binding make for easy reading.The index is useful.The addition of more references to original papers and brief reviews would encourage students to explore the literature.
<i>QuickStats:</i> Percentage* of Residential Care Communities† Engaged in Selected End-of-Life and Bereavement Care Practices§ — National Study of Long-Term Care Providers, United States, 2018
Journal: MMWR Morbidity and Mortality Weekly Report (2021)

Documented preferences Discussed spiritual needs Publicly honored deceased O ered bereavement services Percentage End-of-life and bereavement care practices Abbreviation: RCC = residential care community.* 95% confidence intervals indicated with error bars.† RCCs and similar assisted living communities are state-regulated, provide services in noninstitutional home-like settings, and are staffed around the clock to provide supervision and assistance with personal care to adults.§ Based on RCCs that answered "often" or "almost always" to the question, "How often do you engage in the following practices when a resident is dying or has died: rarely, sometimes, often, or almost always?"In 2018, when a resident was dying or died, 82% of RCCs documented residents' family, religious, or cultural preferences in their care plans, 79.9% discussed residents' spiritual needs with them, 65.1% publicly honored deceased residents in the RCC, and 59.5% offered bereavement services to staff members and residents.
Table Inversion Error
Authors: Kenton Johnston, Jason Hockenberry, Karen Maddox
Journal: JAMA (2021)

In Reply We agree with Dr Rathi's main observation about our recent article 1 that the financial incentives were small in the MIPS 2019 performance year, and the performance threshold for avoiding a payment penalty was low.In fact, the performance threshold was so low in 2019 that only clinicians who did not comply with the MIPS (did not report any performance measures to the CMS) received payment penalties. 2 We also agree with Rathi that performance measures will change in future years as the CMS reacts to program results and clinician behavior.Given the importance of the MIPS as the largest outpatient value-based purchasing program in the US, it was nonetheless important to assess it during the first year.More research will be needed in future years as the program changes and evolves.It is important to note that both the financial incentives and performance thresholds of the MIPS will increase over time.Thus, clinicians must obtain a MIPS performance score of at least 15 to avoid a payment penalty in the 2020 performance year, although the score threshold of 70 for an exceptional performance bonus remains the same. 3 In addition, by 2022, clinicians are scheduled to receive financial penalties or bonuses under the MIPS of up to 9% of their total Medicare reimbursement. 4 Due to the planned increases in performance thresholds and financial incentives, we believe that our findings for the 2019 performance year provide evidence of a competitive advantage of health system affiliation for clinicians participating in administratively complex value-based payment programs.This raises a concerning possibility that the MIPS may end up rewarding clinicians for obtaining the organizational infrastructure and administrative sophistication that reflects better reporting of existing activities rather than spurring change that improves the quality of patient care.Policy makers at the CMS should also rethink the broad inclusiveness of quality-related activities from the array of nearly 400 measures included in the MIPS.The current performance measurement system appears to reward physicians more for suffering through administrative complexity rather than actually improving patient care. 5 If a reconsideration of the MIPS measures is not taken, savvy reporting behavior on the part of large group practices will render the current measures indiscriminate on performance and simply further concentrate the physician group market, which could have substantial economic consequences. 6 Clinicians will continue to make their own decisions about where they practice medicine based on their value systems and priorities.However, if the shift to value-based payment requires clinicians to possess a sophisticated management and information infrastructure to navigate the system successfully, then it is likely to lead to further consolidation of clinicians within health systems in the future.
Anthrax.
Authors: R Lamb
Journal: BMJ (1973)

perception of light) and was later extracted, along with the delivery, by magnet, of a small metal fragment.The final vision was 6/24 with correction.This case was exceptional in that the visual result was relatively poor.In contrast the remaining patients recovered good vision, as shown in the table.Final Visual Acuity of the 20 Patients Visual acuity * 6/5 6/6 6/9 6/12 6/24 No. of patients .. 6 11 1 1 1Such excellent results depend in part on prompt referral, since a retained intraocular foreign body may lead to siderosis if the iron content is sufficiently high.The following case illustrates this, as well as re-emphasizing that the patient may regard the initial injury as trivial.A 46-year-old man complained of failing vision of his left eye.Two years earlier he had been adjusting some part of his car with a steel hammer when he felt something hit the eye.It was a bit red the next day and he saw spots for some four days.The eye settled down sufficiently, however, for him not to seek advice at that time.For a year the vision worsened progressively.There was a small scar in the left cornea with an associated nodule in the iris, in which an x-ray film showed a foreign body.The iris was brown, in contrast to the blue iris in the other eye, and there was a cataract, reducing the vision to hand movements.The foreign body was removed with forceps and later the cataract was extracted, leaving 6/6 vision with a contact lens.This patient was exceptionally fortunate in retaining such good vision 12 years after the injury despite his presenting the classical signs of siderosis initially.We have great pleasure in thanking the surgeons of Moorfields Eye Hospital (High Holborn Branch) for allowing us to make this report on patients under their care.
Annals of Internal Medicine, Philadelphia
Journal: JAMA (1966)

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
Medicolegal
Journal: JAMA (1934)

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
Plant Dermatitis
Authors: A. Rook
Journal: BMJ (1960)

congenital disability, trauma, or any other catastrophe.In one case the emphasis may be on the shape of tissue, in the other upon the subjective experience of the particular patient; on form and contour, or feelings and confidence; but, fundamentally, both these aspects are part of the whole human being and deserve the shared and balanced attention of experts in the respective fields.Summary A plea is made for more active co-operation between plastic surgeon and psychiatrist.A provisional and basic classification of mental reactions to disfigurement is provided.An attempt is made to outline the groups which are particularly amenable to combined plastic and psychiatric treatment.While the traditionally cautious or conservative approach to the problem has been avoided, we emphasize the dangers that can follow imperfect or inadequate selection of psychiatric patients for plastic surgery.
Radiology of Bone Diseases
Authors: H. L. Steinbach
Journal: JAMA (1975)

Within recent years, several excellent textbooks on skeletal radiology have been published to fill a void that had existed previously. The various skeletal lesions were usually discussed under topics of disease entities, and much pertinent information was included in regard to roentgen changes and significant clinical laboratory and pathologic features. Professor Greenfield has departed from this standard presentation and has oriented this second edition to the analytical approach for identifying unknown or suspected disease entities. This analysis is based primarily on the roentgenographic appearance and is supplemented by brief discussions of clinical and laboratory data. When indicated, pathophysiologic mechanisms are discussed. To accomplish this task, the book has been divided into the following nine sections: the analytical approach to bone radiology; loss of bone density; alterations of bone texture; the epiphyseal region; changes in size and shape of bone; the cardinal roentgen features; the solitary lesion; conditions of bone and