tbuckley/cabot-search huggingface dataset:
Ophthalmology
Authors: F. C. Blodi
Journal: JAMA (1979)

As both a medical and surgical specialty, ophthalmology has continued to advance. From an organizational point of view, the most notable event of the past year was the incorporation of a new and independent American Academy of Ophthalmology. The new organization is certain to become the rallying point of ophthalmologists and ophthalmic endeavors. Clinically, the year was marked by continued work on diabetic retinopathy, new findings that may affect the treatment of choroidal melanomas, new instrumentation for counting corneal endothelial cells, another method for measuring vision, and a new method for the treatment of malignant lid tumors. <h3>Diabetic Retinopathy</h3> Last year we reported the first results of the diabetic retinopathy collaborative study organized by the National Eye Institute. This study is being continued, and the indications for treatment have been refined. Certain risk factors (including retinal hemorrhages, neuvascularization of the disk, and neovascularization elsewhere) have been isolated and delineated. What
Abstract 174: Cost-Utility Analysis of Extracorporeal Cardiopulmonary Resuscitation in Patients With Cardiac Arrest
Authors: Murtaza Bharmal, Joseph Venturini, Rhys Chua, Willard Sharp, David Beiser, Corey Tabit, Taishi Hirai, Jonathan R Rosenberg, Janet Friant, John E Blair, Jonathan D Paul, Sandeep Nathan, Atman P Shah
Journal: Circulation (2018)

Introduction: Extracorporeal cardiopulmonary resuscitation (ECPR) provides cardiac and respiratory support and serves as a bridge to definitive therapy or to recovery. However, ECPR is resource intensive and evidence of clear survival benefit is lacking. In this study, we investigated the cost-utility of ECPR (cost/QALY) in cardiac arrest patients treated at our institution. Methods: We performed a retrospective review of ECPR patients who suffered cardiac arrest at our institution between 2012 and 2017. Charges for all medical care associated with ECPR and subsequent hospital care were recorded, including direct costs, indirect costs, operating costs and payer charges. The quality-of-life status of survivors was assessed with the Health Utilities Index Mark II. Results: ECPR was instituted in 24 patients (54% in-hospital [13 of 24]), mean age 49.8 ± 17.3 years, 71% male (17 of 24), and 58% African American (14 of 24). The mean and median duration of ECMO support was 3.2 and 2.7 days, respectively. The mean and median of total length of stay was 13.4 and 7.5 days, respectively. Survival to hospital discharge and 1-year survival were 17% (4 of 24) and 13% (3 of 23), respectively. The mean score of the Health Utilities Index Mark II at discharge for the survivors was 0.53 ± 0.23 (range, 0.32-0.84). The average operating cost for patients undergoing ECMO was $188,197 per patient. The calculated cost-utility for ECPR was $59,449/QALY gained. Conclusions: The calculated cost-utility for ECPR is within the threshold considered cost-effective in the United States (&lt;$100,000/QALY gained). These results are comparable to the cost-effectiveness of orthotopic heart transplantation for end-stage heart failure. Larger studies are needed to assess the cost-utility of ECPR and to identify whether other factors, such as patient characteristics and type of cannula, may affect the cost-utility benefit.
Association of Treatable Health Conditions During Adolescence With Accelerated Aging at Midlife
Authors: Kyle J. Bourassa, Terrie E. Moffitt, Antony Ambler, Ahmad R. Hariri, HonaLee Harrington, Renate M. Houts, David Ireland, Annchen Knodt, Richie Poulton, Sandhya Ramrakha, Avshalom Caspi
Journal: JAMA Pediatrics (2022)

Biological aging is a distinct construct from health; however, people who age quickly are more likely to experience poor health. Identifying pediatric health conditions associated with accelerated aging could help develop treatment approaches to slow midlife aging and prevent poor health in later life.To examine the association between 4 treatable health conditions in adolescence and accelerated aging at midlife.This cohort study analyzed data from participants in the Dunedin Study, a longitudinal investigation of health and behavior among a birth cohort born between April 1, 1972, and March 31, 1973, in Dunedin, New Zealand, and followed up until age 45 years. Participants underwent an assessment at age 45 years and had data for at least 1 adolescent health condition (asthma, smoking, obesity, and psychological disorders) and outcome measure (pace of aging, gait speed, brain age, and facial age). Data analysis was performed from February 11 to September 27, 2021.Asthma, cigarette smoking, obesity, and psychological disorders were assessed at age 11, 13, and 15 years.The outcome was a midlife aging factor composite score comprising 4 measures of biological aging: pace of aging, gait speed, brain age (specifically, BrainAGE score), and facial age.A total of 910 participants (459 men [50.4%]) met the inclusion criteria, including an assessment at age 45 years. Participants who had smoked daily (0.61 [95% CI, 0.43-0.79] SD units), had obesity (0.82 [95% CI, 0.59-1.06] SD units), or had a psychological disorder diagnosis (0.43 [95% CI, 0.29-0.56] SD units) during adolescence were biologically older at midlife compared with participants without these conditions. Participants with asthma were not biologically older at midlife (0.02 [95% CI, -0.14 to 0.19] SD units) compared with those without asthma. These results remained unchanged after adjusting for childhood risk factors such as poor health, socioeconomic disadvantage, and adverse experiences.This study found that adolescent smoking, obesity, and psychological disorder diagnoses were associated with older biological age at midlife. These health conditions could be treated during adolescence to reduce the risk of accelerated biological aging later in life.
Presidential Address
Authors: None The Prince Philip
Journal: BMJ (1959)

It was a great disappointment to me that I was unable to attend the Joint Meeting of the British Medical Association and the Canadian Medical Association in Edinburgh in July.I realize, of course, that the whole point of my being invited to become Joint President this year was so that I could preside at Edinburgh; and, in fact, planning towards that end had been going on for some time.As you know, other arrangements had to be made.Although not ideal, they seemed to suit most people but left
Collagenous colitis.
Authors: J G Kingham, D A Levison, B C Morson, A M Dawson
Journal: Gut (1986)

Clinical and pathological aspects of six patients with collagenous colitis are presented. These patients have been observed for between four and 15 years and the evolution of the condition is documented in three (cases 1, 3 and 5). Management and possible pathogenetic mechanisms of this enigmatic condition are discussed.
Personal View
Authors: F. H. Staines
Journal: BMJ (1968)

My introduction to Australia in July 1964 started with the flaming orange, blues, greens, and purple-browns of a jet-high sunrise over Caernarvon; continued with the soft greens and greys of a damp breakfast-time in Perth; and ended with the inevitable and international jet-age wait for delayed luggage in Sydney after lunch.The sun was shining, and this was the new world of the Holden and the Gum-tree.The purpose of the trip was to study group practice and general health-care organization under the generous sponsorship of the Nuffield Foundation.I'd learned already elsewhere on the trip that words of my own language such as "general practice," ".hospital," and ""National Health" didn't mean the same thing when spoken in another country, and this lesson continued in Australia.Soon after landing I also learned that it doesn't pay to have a party at the end of 7,500 miles non-stop--every face of that evening is still clear and sharp, but nothing whatsoever of what we talked about now remains.From a few days later the words stay sharp, though some of the faces have faded-" How many caesars have your group done this year ?"; " How can you possibly call yourself a G.P. if you haven't got a hospital to work in ?"; "We had to give her four pints before I got the bleeder"; "Would you give the pill to an unmarried girl, tell me, would you ?"; " This place cost us £16,000 four years ago, and it'll be paid off clear in another four". . .
A phase I does-escalation and expansion study of epidiolex (cannabidiol) in patients with biochemically recurrent prostate cancer.
Authors: Zin Myint, William H. St.Clair, Stephen Strup, Peng Wang, Andrew Callaway James, Donglin Yan, Carleton Scott Ellis, Danielle E. Otto, Robert S. DiPaola, Susanne M. Arnold, Jill Kolesar
Journal: Journal of Clinical Oncology (2022)

257 Background: There is a need for a low toxicity option for men with prostate cancer with biochemical recurrence (BCR) following primary curative therapy. Cannabinoids (CBD) have anti-tumor activity in preclinical studies, but products may vary in activity without clear standardization. As epidiolex is a standardized FDA approved oral CBD solution for treatment of certain types of seizures, we studied epidiolex in patients with BCR of prostate cancer to determine safety and dosing of this therapy to support future studies. Methods: We present an open-label, single center, phase I dose escalation study followed by a dose expansion. Patients with BCR prostate cancer after primary definitive local therapy (prostatectomy +/- salvage radiotherapy or primary definitive radiotherapy) were eligible. Majority of our patients’ prostate-specific antigen (PSA) doubling time was ≤ 12 months. All patients were screened for urine tetrahydrocannabinol (THC) prior to enrollment. With use of a Bayesian optimal interval design, patients received escalating doses of epidiolex starting at 600mg daily and up to 800mg daily. All patients were treated for 90 days followed by a 10 day taper. The Primary endpoints were safety and tolerability. Patients were monitored for both acute (30 days) and chronic (90 days) treatment-related toxicities. Secondary endpoints included change in PSA levels and testosterone levels from baseline throughout the treatment period. Results: A total of 21 patients were enrolled but four withdrew from the study (one patient was hospitalized with COVID-19 and three patients requested to stop due to grade 2 adverse events (AEs). There were seven patients included in the dose escalation phase. Four patients received 600mg daily; two of the four in this phase did not finish the first 30 days (one with COVID-19 and one withdrew). The other three patients received 800 mg daily. No dose-limiting toxicities were observed at any dose level so an additional 14 patients were enrolled at the 800mg dose. Treatment-related chronic AEs occurring in &gt;10% of patients were grade 1 or 2 diarrhea (47.6%), grade 1 or 2 nausea (23.8%) and grade 1 or 2 fatigue (19%). The mean PSA at baseline was 2.9 ng/ml. One patient developed oligo-metastasis disease, two patients progressed after the study period, and one patient died from a non-treatment or disease-related cause. Conclusions: Epidiolex at a dose of 800mg daily appears to be safe and tolerable in patients with BCR of prostate cancer, supporting a safe dose for future studies to determine if there is clinical activity to delay development of hormone refractory metastatic disease. Clinical trial information: NCT04428203.
Osimertinib Called “Home Run” for EGFR-Mutant NSCLC
Journal: Cancer Discovery (2020)

Adjuvant treatment with the tyrosine kinase inhibitor osimertinib will likely become a new standard of care in patients with EGFR-mutant non-small cell lung cancer. In the phase III ADAURA trial, 90% of patients with stage II-IIIA disease who received osimertinib were alive and free of cancer at 2 years, compared with 44% who received a placebo-results considered so striking that researchers unblinded the trial early.
Osteoarthritis.
Authors: V. Wright
Journal: BMJ (1989)

exercise must-probably for ever-remain controversial.'9But this is a sterile debate: who would deny that stopping smoking, taking more exercise, controlling high blood pressure, and having nutritional counselling to reduce excess body weight and needlessly high cholesterol concentrations are reasonable strategies in pursuing a healthier lifestyle?What of those who already have evidence of coronary heart disease?Aspirin, thrombolysis, 3 blockers, angiotensin con- verting enzyme inhibitors, risk stratification by cardiological investigation, revascularisation by surgery or angioplasty, and transplantation are some of the factors that have generated justifiable optimism in cardiology during the past decade.20Yet with resources scarce and under pressure there can be no complacency about the monumental problem of managing coronary heart disease not just in Scotland but world wide.The cost ofthese techniques and treatments is the greatest stimulus to invest more modest resources in a healthier future.Without doubt, preventive strategies must be strengthened for those already known to have coronary heart disease, with the aim of preventing the progression of atheroma or even inducing regression,2 22 especially since the results of trials of secondary prevention have been encouraging."2-25And primary prevention?We have to acknowledge that the
Strengthening a Study of Diabetes Progression After Statins Use
Authors: Vincent Rigalleau, Kamel Mohammedi, Ninon Foussard
Journal: JAMA Internal Medicine (2022)

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 Journals 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
PTU-072 Evaluation of the Impact of different Commercially available DNA Extraction Kits and Laboratories for Assessing Bacterial Community Structure in Faecal Samples – Implications for IBD Research
Authors: N Kennedy, A Walker, S Berry, S Duncan, F Farquharson, P Louis, J Satsangi, H Flint, C Lees, G Hold
Journal: Gut (2013)

<h3>Introduction</h3> Determining faecal sample bacterial community structure through sequence analysis of DNA has become a very important facet of inflammatory bowel disease (IBD) research. The possible impact of different commercially available DNA extraction kits and the influence of different lab environments on the data generated has however received relatively little attention. The study compared bacterial communities in faecal samples extracted using commercial DNA kits in established gastrointestinal research laboratories. <h3>Methods</h3> Faecal samples from 2 healthy volunteers and 2 IBD patients with relapse were investigated. DNA extraction was undertaken using MoBio and Fastprep DNA extraction kits in two established labs. Two protocols were followed for processing samples using the Fastprep kit. Each DNA sample was then split and an aliquot transferred to the other lab. Pyrosequencing PCR of bacterial 16S rRNA genes was performed in both labs on all samples. Quantitative PCR analysis (q-PCR) to validate sequencing data was also performed. Hierarchical clustering was done using the Jaccard and Theta Yue &amp; Clayton similarity coefficients on the pyrosequencing data. <h3>Results</h3> DNA extracted using methods FastPrep1, FastPrep2 and the MoBio kit yielded median DNA concentrations of 476 (interquartile range 290–518), 453 (IQR 228–689) and 22 (IQR 9–36) ng/µL respectively. Those obtained with MoBio were significantly lower than FastPrep (p &lt; 0.0001). Hierarchical clustering of sequence data revealed four clusters, with samples clustering by patient. Within each patient cluster, samples clustered by DNA extraction kit. Linear modelling of the effect of patient and kit on relative abundance of common bacterial classes revealed significant differences between MoBio and FastPrep. <i>Ruminococcaceae</i> and Bacteroidetes were significantly increased in MoBio extracted samples, while<i>Lachnospiraceae</i> and <i>Enterobacteriaceae</i> were significantly reduced (p &lt; 0.05 in each case). Q-PCR revealed good correlation with sequencing data, with R2 of 0.94, 0.82, 0.69 and 0.57 for <i>Enterobacteriaceae</i>, <i>Bacteroides</i>, <i>Ruminococcaceae</i> and <i>Lachnospiraceae</i> respectively. <h3>Conclusion</h3> This study demonstrates significant differences in DNA yield and bacterial DNA composition seen when comparing DNA extracted from the same faecal sample with different extraction kits. This highlights the importance of ensuring that all samples to be analysed together are prepared with the same DNA extraction method, and the need for caution when comparing studies that have used different methods. <h3>Disclosure of Interest</h3> None Declared
<i>HSD3B1</i> polymorphism in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC) treated with abiraterone acetate and prednisone (AAP): Pharmacodynamics and therapeutic implications.
Authors: Diogo Assed Bastos, Anamaria Aranha Camargo, Ricardo Zylberberg, Denis Leonardo Fontes Jardim
Journal: Journal of Clinical Oncology (2022)

140 Background: AAP prolongs survival in pts with mCRPC. Although it is widely used for mCRPC, no predictive biomarker for response has been identified so far. Methods: This study evaluated HSD3B1 genetic polymorphism and pharmacodynamic parameters from serum samples of mCRPC pts with disease progression after diethylstilbestrol (DES) treated with AAP in the AAP-DES study (NCT02217566). Peripheral blood samples were collected before initiating AAP therapy, after 12 weeks, and at disease progression. Sample analysis included HSD3B1 genotyping, abiraterone acetate (AbA) and D4-abiraterone serum levels, testosterone and dehydroepiandrosterone sulfate (DHEA-S) ultrasensitive analysis. Clinical characteristics, overall survival (OS), progression-free survival (PFS) and the rate of PSA decline ≥ 50% were assessed considering homozygous wild-type (AA) versus heterozygous variant (AC) + homozygous variant (CC) HSD3B1 genotypes. Results: Serum samples of 42 pts were analyzed. AA and AC + CC HSD3B1 genotypes were 50.0% each (95% CI:34.2-65.8). Mean ages at baseline was significantly higher in the AA group (71.1 years) compared to the AC+CC group (66.3 years) (p=0.047). Gleason score ≥8 was observed for 38.1% and 47.6% of AA and AC+CC genotypes, respectively (p&lt;0.001). No statistically significant difference was observed between AA and AC+CC groups related to testosterone and DHEA-S level at baseline, week 12, and PSA progression. Serum levels of AbA and D4-abiraterone were similar, throughout treatment despite HSD3D1 genotype. Median OS was 21.3 months (95% CI: 14.8 - ; 14 events) for the AA genotype, and it was not reached at the AC+CC genotype group (9 events) (p=0.154). Regarding PFS, median estimates were 7.3 months (95% CI: 4.6 – 9.4; 16 events) for AA genotype and 7.9 months (95% CI: 5.6 – 14.4; 16 events) for AC+CC genotype (p=0.519). PSA decline ≥ 50% was 71.4% for AA genotype and 42.9% for AC+CC genotypes and the chance of PSA response in patients with AA genotype is 3.33 (95% CI: 0.93; 12.11) times greater than that in patients with AC or CC genotypes, despite not statistically significant differences (p=0.0614). Conclusions: In our study, the presence of HSD3B1 (1245C) was not significantly associated with clinical response during AAP treatment, as well as testosterone, DHEA-S, AbA and D4-abiraterone levels. The role of HSD3B1 polymorphism to predict clinical outcome of AR blockade for mCRPC patients still needs to be further analyzed in larger translational studies. [Table: see text]
Re: Keiichiro Mori, Mohammad Abufaraj, Hadi Mostafaei, et al. The Predictive Value of Programmed Death Ligand 1 in Patients with Metastatic Renal Cell Carcinoma Treated with Immune-checkpoint Inhibitors: A Systematic Review and Meta-analysis. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2020.10.006
Authors: Johanna Noel, Olivier Huillard, Francois Goldwasser
Journal: European Urology (2021)
Abstracts of the Annual Meeting of the “Societé de Réanimation de Langue Française”, Paris, 26–29 November 1981
Authors: J Viale~, I Bui, Xua~ Ghari~, D Benzoni~, Hedj Aissa, J Moti~ ~ervice De R~animation, Hspital Herriot, J Kopferschmitt, A Jaeger, M Ledig, A Warter, M Sauoer, J Ziessel
Journal: Intensive Care Medicine (1982)
Mononuclear phagocytes.
Authors: M J Auger
Journal: BMJ (1989)

address, remain with the same general practitioners,3 but do not notify them of the change.Problems also arise with practices that fail to update their records or fail to notify the family practitioner committee of changes.One study found that family practitioner committees are notified in only about a quarter of casesi' Computerisation of family practitioner committee records highlights rather than solves these problems.8Between three quarters and nine tenths of people consult their general practitioners in a year.Consultation rates are higher among women and elderly people-the target populations for current screening programmes and case finding.9If receptionists routinely checked patients' addresses as they consulted the practice and immediately notified changes to the family practitioner committee then addresses could be updated for most patients at little cost.Given the capitation fee system on which general practice is based the potential savings to the Treasury from regularly updated lists of patients would be substantial.If these savings were released to family practitioner committees they might be used to employ clerical staff specifically to check addresses and death returns at regular intervals.The breast screening programme, like the cervical screening programme before it, will fail unless this problem is solved.
Retrospective Address, delivered at the Ninth Anniversary of the Provincial Medical and Surgical Association, held at York, August 4 and 5, 1841
Journal: BMJ (1842)

A feeling of delicacy has hitherto prevented us from bestowing upon Dr. Streeten's Retrospective Address that notice which the annual retrospective reports of the Provincial Association have promptly obtained from us.We cannot, however, avoid trans- ferring to our pages the following remarks from the pen of the editor of the Gateshead Observer, one of the most ably conducted provincial newspaper.. in the United Kingdom.]Among the advantages which attend such inistitu-