tbuckley/cabot-search huggingface dataset:
Clinical Lectures on the Diagnosis of Carcinoma of the Breast in its Early Stages: (Delivered at St. George's Hospital.)
Authors: A. M. Sheild
Journal: BMJ (1896)

THE frequency of mammary cancer is very serious and remark- .able,yet in comparison with other breast maladies cancer, on account of its gravity, is admitted into hospitals far more frequently than mastitis, abscess, or the more simple growths.Accordingly when we find that cancer of the breast forms nearly one-half of all hospital cases of breast disease we are {probably a little overstating the mark.Out of 1,017 cases of -all sorts of diseases of the breast I have collected from the Middlesex Hospital Reports, 790, or over one-half, were those of cancer.At this hospital, however, cancer cases are un- usually numerous, owing to the special provision for their Telief.At St. George's Hospital, out of 750 cases of all kinds of breast diseases between the years 1875 and 1895, 353, about one-half, were carcinomatous.These figures and facts, sub- ject to the above criticism, are sufficiently accurate to war- rant you in giving very serious attention to a malady as fre- quent as it is formidable. MODE OF EXA1MINATION.The thorax should be quite undressed and covered loosely with a towel or handkerchief.Look critically at the affected organ, at the amount of retraction of the nipple, at the presence or absence of dimples in the skin over the supposed growth, at the colour of the integument, the presence or ab- sence of enlarged veins.Examine the pectoral regions closely to see if there be any " fulness," as though the muscles were pushed forwards by glands beneath them.You will at the same time glance at the patient, and vou will do well to dismiss from your minds any preconceived ideas as to typical facial appearance.Some of the patients may look florid, others emaciated, and, as may be expected, many of them appear " anxious," but in my judgment the majority are much like women of their age, whether they have breast affections or not.When handling the part always observe the utmost gentleness, and examine with the flat of the
Differential restoration of functional hyperemia by antihypertensive drug classes in hypertension-related cerebral small vessel disease
Authors: Masayo Koide, Osama F. Harraz, Fabrice Dabertrand, Thomas A. Longden, Hannah R. Ferris, George C. Wellman, David C. Hill-Eubanks, Adam S. Greenstein, Mark T. Nelson
Journal: Journal of Clinical Investigation (2021)

Dementia resulting from small vessel diseases (SVDs) of the brain is an emerging epidemic for which there is no treatment. Hypertension is the major risk factor for SVDs, but how hypertension damages the brain microcirculation is unclear. Here, we show that chronic hypertension in a mouse model progressively disrupts on-demand delivery of blood to metabolically active areas of the brain (functional hyperemia) through diminished activity of the capillary endothelial cell inward-rectifier potassium channel, Kir2.1. Despite similar efficacy in reducing blood pressure, amlodipine, a voltage-dependent calcium-channel blocker, prevented hypertension-related damage to functional hyperemia whereas losartan, an angiotensin II type 1 receptor blocker, did not. We attribute this drug class effect to losartan-induced aldosterone breakthrough, a phenomenon triggered by pharmacological interruption of the renin-angiotensin pathway leading to elevated plasma aldosterone levels. This hypothesis is supported by the finding that combining losartan with the aldosterone receptor antagonist eplerenone prevented the hypertension-related decline in functional hyperemia. Collectively, these data suggest Kir2.1 as a possible therapeutic target in vascular dementia and indicate that concurrent mineralocorticoid aldosterone receptor blockade may aid in protecting against late-life cognitive decline in hypertensive patients treated with angiotensin II type 1 receptor blockers.
Treatment efficacy and safety of tofacitinib versus methotrexate in Takayasu arteritis: a prospective observational study
Authors: Xiufang Kong, Ying Sun, Xiaojuan Dai, Li Wang, Zongfei Ji, Huiyong Chen, Xuejuan Jin, Lili Ma, Lindi Jiang
Journal: Annals of the Rheumatic Diseases (2021)

To compare the treatment efficacy and safety of tofacitinib (TOF) versus methotrexate (MTX) in Takayasu arteritis (TAK).Fifty-three patients with active disease from an ongoing prospective TAK cohort in China were included in this study. Twenty-seven patients were treated with glucocorticoids (GCs) and TOF, and 26 patients were treated with GCs with MTX. The observation period was 12 months. Complete remission (CR), inflammatory parameter changes, GCs tapering and safety were assessed at the 6th, 9th and 12th month. Vascular lesions were evaluated at the 6th and 12th month, and relapse was analysed during 12 months.The CR rate was higher in the TOF group than in the MTX group (6 months: 85.19% vs 61.54%, p=0.07; 12 months: 88.46% vs 56.52%, p=0.02). During 12 months' treatment, patients in the TOF group achieved a relatively lower relapse rate (11.54% vs 34.78%, p=0.052) and a longer median relapse-free duration (11.65±0.98 vs 10.48±2.31 months, p=0.03). Average GCs dose at the 3rd, 6th and 12th month was lower in the TOF group than that in the MTX group (p<0.05). A difference was not observed in disease improvement or disease progression on imaging between the two groups (p>0.05). Prevalence of side effects was low in both groups (3.70% vs 15.38%, p=0.19).TOF was superior to MTX for CR induction, a tendency to prevent relapse and tapering of the GCs dose in TAK treatment. A good safety profile for TOF was also documented in patients with TAK.
David Walter Millard
Authors: Sheila Millard, Peter Agulnik
Journal: BMJ (2021)

David Walter Millard can be regarded as an unsung hero of psychiatry, who applied his interest in the social aspects of psychiatry in a number of influential ways. After qualifying and a short service commission as a doctor in the Royal Armey Medical Corps, he embarked on psychiatric training at Rubery Hill Hospital in Birmingham. There he experienced the therapeutic community run by John Yarborough, which shaped his future interests and career choices. He moved to Sir William Trethowan’s professorial unit at the Queen Elizabeth Hospital in Birmingham., where he established a therapeutic community on Ward North 5A. He returned to Rubery as a young consultant, where he was instrumental with others in building a third therapeutic community. After …
Peter Kopelman: medical academic, educator, and obesity medicine expert
Authors: Penny Warren
Journal: BMJ (2021)

Credit: University of London

Peter Kopelman, who has died aged 70, rose from being a medical student at St George’s Hospital in London to become its principal, and made a prodigious contribution to obesity medicine and medical education. He was interim vice chancellor of the University of London in 2018-19. The role encompassed managing 17 member institutions and a huge overseas distance learning programme, as well as engaging with all kinds of situations—from a strike by cleaning staff to visits from royalty and billionaire donors. He took it all in his stride. Bill Abraham, the university’s director of development said: “Peter could master a brief and know what questions to ask; he put people at their ease and had great credibility and respect. He was magnificent.”

Born on 23 June 1951, Kopelman grew up in Epping, Essex, with his elder brother Michael (later a professor of neuropsychiatry). Their father, Harry, was a consultant physician, and their mother, Joan (“Hazel”), a nursing sister who later …
Rock inhibitor may compromise human induced pluripotent stem cells for cardiac differentiation in 3D
Authors: Bin Jiang, Wenquan Ou, James G. Shamul, Hao Chen, Sarah Van Belleghem, Samantha Stewart, Zhenguo Liu, John P. Fisher, Xiaoming He
Journal: Bioactive Materials (2021)

Cardiomyocytes differentiated from human induced pluripotent stem cells (iPSCs) are valuable for the understanding/treatment of the deadly heart diseases and their drug screening. However, the very much needed homogeneous 3D cardiac differentiation of human iPSCs is still challenging. Here, it is discovered surprisingly that Rock inhibitor (RI), used ubiquitously to improve the survival/yield of human iPSCs, induces early gastrulation-like change to human iPSCs in 3D culture and may cause their heterogeneous differentiation into all the three germ layers (i.e., ectoderm, mesoderm, and endoderm) at the commonly used concentration (10 μM). This greatly compromises the capacity of human iPSCs for homogeneous 3D cardiac differentiation. By reducing the RI to 1 μM for 3D culture, the human iPSCs retain high pluripotency/quality in inner cell mass-like solid 3D spheroids. Consequently, the beating efficiency of 3D cardiac differentiation can be improved to more than 95 % in ~7 days (compared to less than ~50 % in 14 days for the 10 μM RI condition). Furthermore, the outset beating time (OBT) of all resultant cardiac spheroids (CSs) is synchronized within only 1 day and they form a synchronously beating 3D construct after 5-day culture in gelatin methacrylol (GelMA) hydrogel, showing high homogeneity (in terms of the OBT) in functional maturity of the CSs. Moreover, the resultant cardiomyocytes are of high quality with key functional ultrastructures and highly responsive to cardiac drugs. These discoveries may greatly facilitate the utilization of human iPSCs for understanding and treating heart diseases.
Remodeling the matrix: doxycycline modulates tuberculosis immunopathology
Authors: Jason D. Simmons, Thomas R. Hawn
Journal: Journal of Clinical Investigation (2021)

Pulmonary cavitation is a hallmark of Mycobacterium tuberculosis (Mtb) infection that provides an immune-privileged niche for extracellular bacillary replication, which associates with increased transmission rates, drug resistance, and chronic lung dysfunction following antituberculous therapy (ATT). Inhibitors of matrix metalloproteinases (MMPs), which are induced by Mtb infection, have shown efficacy in preclinical models and improved microbiologic and immunopathologic outcomes. In this issue of the JCI, Hao Miow et al. performed a double-blind, randomized controlled trial exploring host-directed effects of the MMP inhibitor doxycycline versus placebo when added to standard ATT for pulmonary tuberculosis. Doxycycline treatment over two weeks durably modulated host blood transcription profiles, including the resolution of inflammatory gene programs. Reduced immunopathology markers in doxycycline-treated participants also included improved lung cavity volumes and lower MMP levels in blood and sputum. These findings provide mechanistic insight and momentum for using experimental medicine trials to develop host-directed therapies for tuberculosis.
UTILITY OF DEEP LEARNING ALGORITHMS IN DIAGNOSING AND AUTOMATIC PROGNOSTICATION OF PULMONARY ARTERIAL HYPERTENSION BASED ON ROUTINE ECHOCARDIOGRAPHIC IMAGING
Authors: Maria Luisa Benesch Vidal, Gerhard-Paul Diller, Aleksander Kempny, Wei Li, Konstantinos Dimopoulos, Stephen J. Wort, Michael Gatzoulis
Journal: Journal of the American College of Cardiology (2021)
First clinical evaluation of the QIAreachTM QuantiFERON-TB for tuberculosis infection and active pulmonary disease
Authors: K. Fukushima, K. Akagi, A. Kondo, T. Kubo, N. Sakamoto, H. Mukae
Journal: Pulmonology (2021)

1) to compare the QIAreachTM QuantiFERON-TB (QIAreach QFT) vs. QuantiFERON®-TB Gold Plus assay (QFT-Plus) to detect tuberculosis (TB) infection; 2) to evaluate diagnostic sensitivity of QIAreach QFT using active TB as surrogate for TB infection; 3) to preliminarily evaluate QIAreach QFT in immunocompromised individuals. QIAreach QFT measures the level of interferon-γ (IFN-γ) in plasma specimens from blood stimulated by ESAT-6 and CFP-10 peptides in one blood collection tube (equivalent to the TB2 tube of the QFT-Plus). QIAreach QFT was applied to plasma samples from 41 patients with pulmonary TB and from 42 healthy or low-TB-risk individuals. Sensitivity and specificity of QIAreach QFT vs. QFT-Plus were 100% (41/41) and 97.6% (41/42), respectively; overall concordance was 98.8% (82/83). All samples were measured within 20 min. The time to result of each sample was significantly correlated with IFN-γ level with a natural logarithmic scale (r = -0.913, p < 0.001). Seven cases in the active TB group were immunocompromised (CD4 <200/μL) and tested positive by QIAreach QFT. QIAreach QFT provides an objective readout with a minimum blood sample volume (1 mL/subject), potentially being a useful point-of-care screening test for TB infection in high-TB-burden, low-resource countries and for immunocompromised patients.
Nationwide Trends in Cardiac Risk and Mortality in Patients With Incident Type 2 Diabetes: A Danish Cohort Study
Authors: Christine Gyldenkerne, Jakob S. Knudsen, Kevin K.W. Olesen, Henrik T. Sørensen, Hans E. Bøtker, Reimar W. Thomsen, Michael Maeng
Journal: Diabetes Care (2021)

OBJECTIVE Trends in cardiac risk and death have not been examined in patients with incident type 2 diabetes and no prior cardiovascular disease. Therefore, we aimed to examine trends in cardiac risk and death in relation to the use of prophylactic cardiovascular medications in patients with incident type 2 diabetes without prior cardiovascular disease. RESEARCH DESIGN AND METHODS In this population-based cohort study, we included patients with incident type 2 diabetes between 1996 and 2011 through national health registries. Each patient was matched by age and sex with up to five individuals without diabetes from the general population. All individuals were followed for 7 years. RESULTS We identified 209,311 patients with incident diabetes. From 1996–1999 to 2008–2011, the 7-year risk of myocardial infarction decreased from 6.9 to 2.8% (adjusted hazard ratio [aHR] 0.39 [95% CI 0.37–0.42]), cardiac death from 7.1 to 1.6% (aHR 0.23 [95% CI 0.21–0.24]), and all-cause death from 28.9 to 16.8% (aHR 0.68 [95% CI 0.66–0.69]). Compared with the general population, 7-year risk differences decreased from 3.3 to 0.8% for myocardial infarction, from 2.7 to 0.5% for cardiac death, and from 10.6 to 6.0% for all-cause death. Use of cardiovascular medications within ±1 year of diabetes diagnosis, especially statins (5% of users in 1996–1999 vs. 60% in 2008–2011), increased during the study period. CONCLUSIONS From 1996 to 2011, Danish patients with incident type 2 diabetes and no prior cardiovascular disease experienced major reductions in cardiac risk and mortality. The risk reductions coincided with increased use of prophylactic cardiovascular medications.
Abstract 19041: H19/EZH2 Axis: A New Biomarker and Therapeutic Target in Right Ventricular Failure Associated With Pulmonary Arterial Hypertension
Authors: Junichi Omura, Karima Habbout, Tsukasa Shimauchi, Sandra Breuils-Bonnet, Eve Tremblay, Sandra Martineau, Valerie Nadeau, Kassandra Gagnon, Francois Potus, Stephen L Archer, Roxane Paulin, Steeve Provencher, Olivier Boucherat, Sebastien Bonnet
Journal: Circulation (2019)

Background: Right ventricular (RV) function is the major prognostic factor in patients with pulmonary arterial hypertension (PAH). RV hypertrophy triggered by pressure overload is initially adaptiv...
Menopausal hormone therapy and women’s health: An umbrella review
Authors: Guo-Qiang Zhang, Jin-Liang Chen, Ying Luo, Maya B. Mathur, Panagiotis Anagnostis, Ulugbek Nurmatov, Madar Talibov, Jing Zhang, Catherine M. Hawrylowicz, Mary Ann Lumsden, Hilary Critchley, Aziz Sheikh, Bo Lundbäck, Cecilia Lässer, Hannu Kankaanranta, Siew Hwa Lee, Bright I. Nwaru
Journal: PLoS Medicine (2021)

There remains uncertainty about the impact of menopausal hormone therapy (MHT) on women's health. A systematic, comprehensive assessment of the effects on multiple outcomes is lacking. We conducted an umbrella review to comprehensively summarize evidence on the benefits and harms of MHT across diverse health outcomes.
SO-9 Analysis of the immune-related endpoints of the mismatch repair–deficient non-endometrial solid cancers cohort from the GARNET study
Authors: T. André, D. Berton, G. Curigliano, H. Arkenau, J. Trigo, S. Ellard, V. Moreno, C. Abdeddaim, A. Antón, S. Kumar, W. Guo, E. Im, N. Starling
Journal: Annals of Oncology (2021)
CD19-Targeted CAR T Cells in Refractory Systemic Lupus Erythematosus
Authors: Dimitrios Mougiakakos, Gerhard Krönke, Simon Völkl, Sascha Kretschmann, Michael Aigner, Soraya Kharboutli, Sebastian Böltz, Bernhard Manger, Andreas Mackensen, Georg Schett
Journal: New England Journal of Medicine (2021)

To the Editor: Systemic lupus erythematosus (SLE) is a severe autoimmune disease that predominantly affects young women.SLE is characterized by the formation of autoantibodies and immune complex-mediated inflammation and organ damage.Although autoreactive B cells play a key role in the pathogenesis of SLE, B-cell depletion by antibodies has only limited therapeutic efficacy. 1This paradox has been attributed to the inaccessibility and persistence of autoreactive B cells within lymphatic organs and inflamed tissues 2 or the pathologic role of CD20-negative plasma cells, which may act as an additional source of autoantibodies in patients with SLE. 3 Chimeric antigen receptor (CAR)-modified T cells that have been genetically engineered to recognize CD19 and other B-cell surface antigens have emerged as a powerful tool for the treatment of relapsed or refractory B-cell cancers. 4This technological breakthrough, together with recent convincing data on the role of B cells in disease pathogenesis derived from preclinical lupus models, 5 provides a rationale for the use of CAR T-cell therapies in patients with SLE.We report here on the use of autologous CD19 CAR T cells in the treatment of an autoimmune disease.A 20-year-old woman with severe and refractory SLE presented with active lupus nephritis (World Health Organization class IIIA, indicating focal proliferative disease with active lesions), nephrotic syndrome, pericarditis, pleurisy, rash, arthritis, and a history of Libman-Sacks endocarditis.Previous treatments with hydroxychloroquine, high-dose glucocorticoids, cyclophosphamide, mycophenolate mofetil, and tacrolimus, as well as the B-cell-targeting therapies belimumab and rituximab, did not control symptoms, deplete B cells, or abrogate autoimmunity (Fig. S1 in the
Initial viral load and decay kinetics of SARS-CoV-2 lineage B.1.1.7 in the upper respiratory tract of adults and children
Authors: Rosa Costa, Felipe Bueno, Estela Giménez, Alma Bracho, Eliseo Albert, Diego Carretero, Paula de Michelena, Cecilia Martínez-Costa, Fernando González-Candelas, David Navarro
Journal: Journal of Infection (2021)
O-7 FOLFIRI ± napabucasin in patients with previously treated metastatic colorectal cancer: Overall survival results from the phase 3 CanStem303C study
Authors: M. Shah, T. Yoshino, N. Tebbutt, A. Grothey, J. Tabernero, R. Xu, J. Taieb, A. Cervantes, S. Oh, K. Yamaguchi, M. Fakih, A. Falcone, C. Wu, V. Chiu, J. Tomasek, J. Bendell, M. Fontaine, M. Hitron, B. Xu, E. Van Cutsem
Journal: Annals of Oncology (2021)
Primum Non Nocere—Avoiding Harm to Populations at Social Risk in the Design and Implementation of Value-Based Payment Programs
Authors: Margaret C. Tracci, Karen Woo, Matthew Sideman
Journal: JAMA Surgery (2021)

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
Mobile Technology-Based (mLearning) Intervention to Enhance Breast Cancer Clinicians' Communication About Sexual Health: A Pilot Trial
Authors: Jennifer Barsky Reese, Lauren A. Zimmaro, Sharon L. Bober, Kristen Sorice, Elizabeth Handorf, Elaine Wittenberg, Areej El-Jawahri, Mary Catherine Beach, Antonio C. Wolff, Mary B. Daly, Brynna Izquierdo, Stephen J. Lepore
Journal: Journal of the National Comprehensive Cancer Network (2021)

Background: Most breast cancer clinicians lack training to counsel patients about sexual concerns. The purpose of this study was to assess the feasibility, acceptability, and preliminary effects of a mobile learning (mLearning) intervention (improving Sexual Health and Augmenting Relationships through Education [iSHARE]) aimed at enhancing breast cancer clinicians’ knowledge of, beliefs about, and comfort with discussing patients’ sexual health concerns. Methods: Clinicians listened to a 2-part educational podcast series offering information on breast cancer–related sexual health concerns and effective communication on the topic, which consisted of interviews with expert guests. Intervention feasibility was assessed through rates of enrollment, retention, and intervention completion, with benchmarks of 40%, 70%, and 60%, respectively. Acceptability was assessed through program evaluations, with 75% of clinicians rating the intervention favorably (eg, relevance, satisfaction) signifying acceptability. Clinicians self-reported their knowledge about breast cancer–related sexual health concerns, beliefs (ie, self-efficacy for discussing sexual health concerns), and comfort with discussing sexual concerns measured at preintervention and postintervention. Qualitative analysis examined clinicians’ perceptions of lessons learned from the intervention. Results: A total of 32 breast cancer clinicians enrolled (46% of those invited; 97% of those who responded and screened eligible), 30 (94%) completed both the intervention and study surveys, and 80% rated the intervention favorably, demonstrating feasibility and acceptability. Results showed positive trends for improvement in clinician knowledge, beliefs, and comfort with discussing sexual health concerns. Clinicians reported key lessons learned, including taking a proactive approach to discussing sexual health concerns, normalizing the topic, addressing vaginal health, sending the message that help is available, and assessing sexual health concerns with patients from different backgrounds. Conclusions: Breast cancer clinicians were amenable to participating in the iSHARE intervention and found it useful. iSHARE showed promise for improving clinician’s knowledge and comfort discussing patients’ sexual health concerns. A larger trial is required to demonstrate efficacy. Future studies should also examine whether iSHARE can improve patient–clinician communication and address patients’ sexual concerns.
Abstract 13646: Higher Perceived Stress Levels are Associated With an Increased Long-Term Mortality Risk: A Landmark Analysis in Patients With Peripheral Artery Disease
Authors: Ali O Malik, Poghni A Peri-Okonny, Kensey Gosch, Merrill Thomas, Carlos Mena, William R Hiatt, Phillip Jones, Jeremy Provance, Clementine Labrosciano, John Spertus, Kim Smolderen
Journal: Circulation (2019)

Background: It is unknown whether perceived stress in patients with PAD is linked to an increased long-term mortality risk. Methods: The PORTRAIT study enrolled 797 patients presenting with new or ...