tbuckley/cabot-search huggingface dataset:
Villanelle in Honor of American Hospitals
Authors: Jack Coulehan
Journal: Annals of Internal Medicine (2022)

Ad LibitumFebruary 2022Villanelle in Honor of American HospitalsJack Coulehan, MDJack Coulehan, MDCenter for Medical Humanities, Compassionate Care, and Bioethics at Stony Brook University, Stony Brook, New YorkSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M21-3920 Audio Reading - “Villanelle in Honor of American Hospitals” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads “Villanelle in Honor of American Hospitals” by Jack Coulehan, MD Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail There was a time when hospitals were shy.It wasn't right to advertise or claimto be the most compassionate, or any lie.Without a marketing plan, without a guyin charge of building the corporation's name,there was a time when hospitals were shy.The major signs were, Quiet, please. A spywho dug deeply within, would come out dry.No most compassionate. No other lie.Then the vicious tide came in and with it highproduction medicine and slogans that exclaim,My hospital—although quite shy—has the biggest new machine. That's whywe're best! And for those who like to namecompassion their concern, they easily liewith ... Author, Article, and Disclosure InformationAuthors: Jack Coulehan, MDAffiliations: Center for Medical Humanities, Compassionate Care, and Bioethics at Stony Brook University, Stony Brook, New YorkCorresponding Author: Jack Coulehan, MD; e-mail, john.[email protected].edu. PreviousarticleNextarticle Advertisement Audio Reading - “Villanelle in Honor of American Hospitals” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads “Villanelle in Honor of American Hospitals” by Jack Coulehan, MD Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics February 2022Volume 175, Issue 2Page: 304 ePublished: 15 February 2022 Issue Published: February 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
How Dermatologists Can Address the Structural and Social Determinants of Health—From Awareness to Action
Authors: Jazzmin Williams, Erin H. Amerson, Aileen Y. Chang
Journal: JAMA Dermatology (2022)

This Viewpoint considers the structural and social determinants of health in dermatology and suggests ways that dermatologists can use their roles as clinicians, advocates, researchers, and educators to improve health equity.
SPLENOMEGALY
Authors: E. R. Carling
Journal: BMJ (1936)

Splenomegalv affords the surgeon some of his most striking trophies, and very big spleens look imposing when mounted with their colour preserved ; but the symptom of which the patient complains at the outset of his disorder may take him, with or without the concurrence of his own doctor, to the exponent of almost any special- ism: to the dermatologist for bronzing of the skin, or for lymphomatous masses in and under the skin of hands or face, for purpuric rashes, and so on; to the ophthalmo- logist for thickening of the conjunctiva, for retinal changes, for intraocular haemorrhages, or for proptosis; to the gynaecologist, the proctologist, or the urologist for haemor- rhages from the orifices in their respective territories ; to the laryngologist for glossitis, pharyngitis, or gingivitis and spreading oedema; to the neurologist for combined de- generation or for cramps ; to the psychiatrist or the psycho-analyst for depression ; and of course to the inter- nist for indigestion, haematemesis, cirrhosis, ascites, and, in particular, anaemia.I-cterus, exhaustion, and aching back, haemoglobinuria, an acute abdominal emergency, such as a torsion (and that may fall to the gynaecologist), obstruction, cholelithiasis with colic-all these and many more may necessitate an investigation of the palpability of the spleen.
A single-arm, open-label, phase 2 study evaluating pacritinib for patients with biochemical recurrence after definitive treatment for prostate cancer: Blast study.
Authors: Deepak Kilari, Aniko Szabo, William A. Hall, Ariel Ann Nelson, Scott Johnson, Thomas A. Giever, John Burfeind, Parag Tolat, Kathryn A. Bylow, Kenneth Iczkowski, Yunguang Sun, Hallgeir Rui, James P. Thomas, Marja Nevalainen
Journal: Journal of Clinical Oncology (2022)

TPS220 Background: Androgen deprivation therapy (ADT) achieved with gonadotropin releasing hormone (GnRH) agonist or antagonist is considered the standard of care for men with prostate cancer (PC) who develop biochemical recurrence (BCR) after definitive treatment. ADT is associated with significant adverse effects in this asymptomatic population, and hence there is an unmet need for alternate non-hormonal options. Androgen receptor (AR) and its variants (AR-V) are persistently expressed in the majority of the cells in recurrent PCs and drives PC growth. Jak2-Stat5 signaling has been shown to sustain PC cell viability and is critical for PC tumor growth. Stat5 activation in PC at the time of surgery predicts early PC recurrence. Our investigation of the molecular targets downstream of Jak2-Stat5 signaling have revealed the AR gene as a critical target, and the Jak2-Stat5 pathway represents a target to inhibit expression of diverse AR and AR-V species and thereby control of PC growth. Pacritinib (PAC) is a novel JAK2 inhibitor that suppresses wild-type Jak2 in cell-based assays and has demonstrated promising antitumor activity in myelofibrosis. We hypothesize that PAC inhibition of Jak2-Stat5 signaling will induce biochemical responses in men with recurrent PC by depleting AR and AR-V. Methods: BLAST (NCT04635059) is a single arm, open-label, phase 2 study of PAC (200mg BID) for patients with PC who underwent definitive treatment and developed BCR. Eligibility criteria include histologically confirmed PC, BCR with a PSA doubling time ≤ 9 months, PSA &gt; 0.5 ng/mL, and serum testosterone &gt; 150 ng/dL. 46 subjects will be enrolled with a primary objective to assess the effect of PAC on time to PSA progression. The primary endpoint is six-month PSA progression free survival per PCWG3 criteria. The null hypothesis that the median PSA-progression-free survival is six months will be tested against a one-sided alternative for the six-month PSA-progression-free survival probability exceeding 50%. Secondary endpoints include time to subsequent therapy, safety and toxicity. Exploratory endpoints include effect of PAC on geriatric domains. An interim analysis will be performed when 10 patients have been treated and followed for six months. Accrual began in July 2021. Clinical trial information: NCT04635059.
Abu Khaled Muhammed Akramul Haq
Authors: Mohammed Wajed, Shabana Haque, Noel Haque
Journal: BMJ (2022)

<h3>Rationale</h3> A better understanding of the mechanism of action of mesenchymal stromal cells (MSCs) and their extracellular vesicles (EVs) is needed to support their use as novel therapies for acute respiratory distress syndrome (ARDS). Macrophages are important mediators of ARDS inflammatory response. Suppressor of cytokine signalling (SOCS) proteins are key regulators of the macrophage phenotype switch. We therefore investigated whether SOCS proteins are involved in mediation of the MSC effect on human macrophage reprogramming. <h3>Methods</h3> Human monocyte-derived macrophages (MDMs) were stimulated with lipopolysaccharide (LPS) or plasma samples from patients with ARDS (these samples were previously classified into hypo-inflammatory and hyper-inflammatory phenotype) and treated with MSC conditioned medium (CM) or EVs. Protein expression was measured by Western blot. EV micro RNA (miRNA) content was determined by miRNA sequencing. In vivo: LPS-injured C57BL/6 mice were given EVs isolated from MSCs in which miR-181a had been silenced by miRNA inhibitor or overexpressed using miRNA mimic. <h3>Results</h3> EVs were the key component of MSC CM responsible for anti-inflammatory modulation of human macrophages. EVs significantly reduced secretion of tumour necrosis factor-α and interleukin-8 by LPS-stimulated or ARDS plasma-stimulated MDMs and this was dependent on SOCS1. Transfer of miR-181a in EVs downregulated phosphatase and tensin homolog (PTEN) and subsequently activated phosphorylated signal transducer and activator of transcription 5 (pSTAT5) leading to upregulation of SOCS1 in macrophages. In vivo, EVs alleviated lung injury and upregulated pSTAT5 and SOCS1 expression in alveolar macrophages in a miR181-dependent manner. Overexpression of miR-181a in MSCs significantly enhanced therapeutic efficacy of EVs in this model. <h3>Conclusion</h3> miR-181a-PTEN-pSTAT5-SOCS1 axis is a novel pathway responsible for immunomodulatory effect of MSC EVs in ARDS.
Growth kinetics and progression rates of cystic renal masses on active surveillance.
Authors: Justin Tse, Luyao Shen, Luke Yoon, Aya Kamaya
Journal: Journal of Clinical Oncology (2022)

298 Background: The Bosniak classification is used to risk stratify the probability of cancer among cystic renal masses using CT or MRI and assigns a class ranging from I-IV. Bosniak III and IV masses have the highest probabilities of cancer and are treated similarly to solid renal masses per 2021 American Urological Association (AUA) Guidelines. The purpose of this study was to determine the growth kinetics and progression rates of unresected Bosniak III and IV masses defined by Bosniak Classification, version 2019 (v2019). Methods: In this retrospective and IRB-approved study, CT and MRI images of 107 cystic renal masses from 100 patients (34 women, 66 men; range 28-92 years) with unresected Bosniak III and IV masses from 2005-2021 were reviewed. Cystic renal masses on baseline imaging were assigned a category based on v2019 by two abdominal radiologists, with discrepancies resolved by a third, such that each mass had a single Bosniak class assignment. Mass dimensions over serial imaging were measured using orthogonal planes by a radiologist with 3D laboratory training. Linear growth rate (mm/year) and volumetric growth rate (mL/year) were calculated. “Progression” off of active surveillance was defined as any of the following: linear growth rate &gt; 5 mm a year, volume doubling rate ≤ 1 year, or increased stage based on TNM. Results: 107 cystic renal masses were categorized as 51 Bosniak III and 56 Bosniak IV masses on baseline exam. Median follow-up time was 406 days. Linear growth rate for Bosniak III masses was 0.4 ± 4.3 mm/year while linear growth rate for Bosniak IV masses was 2.3 ± 4.9 mm/year (p = 0.036; Student’s t-test). 12/51 (24%) Bosniak III masses progressed based on above definitions while 26/56 (46%) Bosniak IV masses progressed (p = 0.016; Fisher’s exact test). 13 masses upgraded from a Bosniak III to IV during surveillance, but category upgrades were not associated with progression (p = 0.131; Fisher’s exact test). 2 patients developed lung metastases; both masses were Bosniak IV and were biopsy proven papillary and clear cell renal cell carcinomas. Conclusions: Although currently treated similarly by AUA Guidelines, unresected Bosniak IV masses grow faster than Bosniak III masses and are more likely to progress off of active surveillance.
Personal View
Authors: J. Cohen
Journal: BMJ (1987)

From his perspective as a physician and as the son of an elderly, mentally incapacitated nursing home patient, the author discusses his conflicting feelings about active, voluntary euthanasia. He weighs the relief of suffering and the maintenance of dignity against religious beliefs that condemn suicide and euthanasia, the criminal status of euthanasia in Britain, and the difficulty of providing adequate safeguards against its misuse. Cohen concludes that it may be safer to combine a complete prohibition on ending life with improved care that maintains the dignity of the chronically ill and provides all reasonable relief of pain and suffering.
Book Review Periodontal Diseases: Diagnosis and treatment . By Arthur H. Merritt, D.D.S., M.S., F.A.C.D., F.A.A.P. Second edition. 8°, cloth, 205 pp., with 44 illustrations and 1 chart. New York: Macmillan Company, 1939. $3.50.
Journal: New England Journal of Medicine (1940)
Annals Graphic Medicine - Kindness
Authors: Stefan Tigges
Journal: Annals of Internal Medicine (2020)

Web Exclusives3 March 2020Annals Graphic Medicine - KindnessFREEStefan Tigges, MDStefan Tigges, MDEmory University School of Medicine, Atlanta, Georgia (S.T.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/G19-0024 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: Emory University School of Medicine, Atlanta, Georgia (S.T.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=G19-0024.Author/Illustrator Information: Stefan Tigges, MD (e-mail, [email protected]edu).This article was published at Annals.org on 25 February 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 3 March 2020Volume 172, Issue 5Page: W73-W79KeywordsConflicts of interestDisclosureHealth care ePublished: 25 February 2020 Issue Published: 3 March 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Annals Graphic Medicine - Silence
Authors: Michael S. Shen
Journal: Annals of Internal Medicine (2020)

Web Exclusives6 October 2020Annals Graphic Medicine - SilenceFREEMichael S. Shen, MDMichael S. Shen, MDNYU Langone Medical Center, New York, New York (M.S.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/G20-0013 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Download figure Download PowerPoint Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: NYU Langone Medical Center, New York, New York (M.S.S.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=G20-0013.Author/Illustrator Information: Michael S. Shen, MD, is an artist and internal medicine resident at NYU Langone and Bellevue Hospital in New York, New York. His art explores communication in serious illness. You can find more of his work at mshen.org or on Instagram @hilomilos.This article was published at Annals.org on 22 September 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 6 October 2020Volume 173, Issue 7Page: W127 ePublished: 22 September 2020 Issue Published: 6 October 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Genital herpes.
Authors: C. S. Goodwin, J. V. Gostling, P. J. Pead, E. H. Sims
Journal: BMJ (1970)

were inserted into the fossa navicularis, approximately 10 mm. from the exterior.It may be significant that the swabs were transported in our mycoplasma transport medium, which contains yeast extract and 20% unheated horse serum,3 and were not frozen.We have frequently isolated H.S.V. from cervical swabs transported in nutrient broth, but it is possible that a higher number of isolations of H.S.V. might be achieved by using a transport medium enriched with serum.-Weare, etc.,
New Names for Salts and Esters
Journal: JAMA (1973)

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
THEODOR KOCHER (1841-1917) BERNESE BURGHER
Journal: JAMA (1967)

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
Pembrolizumab (pembro) plus abiraterone acetate (abi) and prednisone (p) in patients with chemotherapy-naive metastatic castration-resistant prostate cancer (mCRPC): Results from KEYNOTE-365 cohort D.
Authors: Cristiano Ferrario, Josep M. Piulats, Mark David Linch, Michael Stoeckle, Brigitte Laguerre, José A. Arranz, Tilman Todenhöfer, Peter C.C. Fong, William R. Berry, Urban Emmenegger, Loic Mourey, Nataliya Mar, Leonard Joseph Appleman, Anthony M. Joshua, Henry Jacob Conter, Xin Tong Li, Charles Schloss, Christian Heinrich Poehlein, Johann S. De Bono, Evan Y. Yu
Journal: Journal of Clinical Oncology (2022)

118 Background: Abi + p is a standard of care for mCRPC. Cohort D of the phase 1b/2 KEYNOTE-365 study (NCT02861573) was used to evaluate safety and efficacy of the PD-1 inhibitor pembro + abi and p in patients (pts) who had not received chemotherapy for mCRPC. Methods: Chemotherapy-naive pts who had not previously used next-generation hormonal agents (NHAs) for mCRPC or were intolerant to enzalutamide or for whom enzalutamide was ineffective for mCRPC, whose disease progressed ≤6 months before screening, and who had ECOG PS score 0/1 were eligible. Enrolled pts received pembro 200 mg IV Q3W + abi 1000 mg PO QD and p 5 mg PO BID. Primary end points were PSA response rate (PSA decrease ≥50% from baseline), confirmed ORR per RECIST v1.1 by blinded independent central review, and safety. Secondary end points included rPFS per PCWG3-modified RECIST v1.1, DCR (CR + PR + SD or non-CR/non-PD ≥6 mo), DOR, OS, time to symptomatic skeletal-related event, radiographic bone progression, and radiographic soft tissue progression. Results: Of 103 treated pts, 35.9% had RECIST-measurable disease and 26.2% had previously received enzalutamide. Median (range) time from enrollment to data cutoff was 17.6 (9.7-27.0) months. Confirmed PSA response rate in all 103 pts was 56.3%. Overall, 78.6% of pts had a reduction in PSA level from baseline (confirmed and unconfirmed). For 37 pts with RECIST-measurable disease, ORR was 16.2% (1 CR; 5 PRs) overall, 7.7% for those who previously received enzalutamide (n = 13) and 21.7% for those who had not previously received NHAs (n = 23). Two pts with RECIST-nonmeasurable disease had a CR. DOR was not reached (NR; range, 2.1+ to 19.4+ mo); 4 pts had a response ≥12 months. DCR was 44.7% overall, 11.1% in pts who previously received enzalutamide (n = 27), and 57.3% in pts who had not previously used NHAs (n = 75). Additional analyses are listed in the table. Treatment-related AEs (TRAEs) were experienced by 90.3% of pts; 36.9% experienced grade 3-5 TRAEs. Overall, 18.4% of pts had a grade 3/4 ALT laboratory elevation and 12.6% had a grade 3/4 AST elevation. Five pts died of AEs; 1 was treatment-related (myasthenic syndrome). Conclusions: Pembro + abi and p showed antitumor activity in chemotherapy-naive pts with mCRPC. Safety was generally consistent with individual profiles of each agent, although there was an increased incidence of grade 3/4 ALT/AST laboratory elevations than reported for the individual treatments. Clinical trial information: NCT02861573. [Table: see text]