tbuckley/cabot-search huggingface dataset:
Phase II feasibility study of adjuvant S-1 plus docetaxel for stage III gastric cancer patients after curative D2 gastrectomy (OGSG 0604).
Authors: Jin Matsuyama, Shigeyuki Tamura, Kazumasa Fujitani, Yutaka Kimura, Takeshi Tsuji, Shohei Iijima, Hiroshi Imamura, Kentaro Inoue, Kenji Kobayashi, Yukinori Kurokawa, Hiroshi Furukawa
Journal: Journal of Clinical Oncology (2012)

108 Background: An adjuvant chemotherapy with S-1 has become the standard treatment for patients (pts) with stage II/III gastric cancer (GC) who have undergone gastrectomy with D2 dissection in Japan, but it is assumed that the survival benefit for stage III pts who received S-1 is modest. S-1 plus docetaxel has shown that the response rate and median overall survival (OS) were 56% and 14.3 months in pts with advanced GC. The aims of this phase II study were to evaluate the feasibility and safety of adjuvant S-1 plus docetaxel in pts with stage III GC with D2 surgery. Methods: Pts with pathological stage III GC who underwent gastrectomy with D2 dissection received oral S-1 (80 mg/m 2 /day) administration for 2 consecutive weeks and intravenous docetaxel (40 mg/m 2 ) on day 1, repeated every 3 weeks (1 cycle). The treatment was started within 45 days after surgery, and repeated for 4 cycles, followed by S-1 administration until 1 year after surgery. The primary endpoint was feasibility of the 4 cycles administration of S-1 plus docetaxel; secondary endpoints were safety, progression-free survival (PFS), OS, and feasibility of S-1 administration until 1 year after surgery. Results: We enrolled 53 pts, 42 males and 11 females with a median age of 65 years (range, 43-78), between May 2007 and August 2008. Pathological stages included IIIA in 36 pts and IIIB in 17 pts. The feasibility of planned 4 cycles of treatment was 77.4% (95% CI 63.8-87.7%, p &lt; 0.001) with 41 pts out of 53 pts. Grade 4 neutropenia was observed in 28% of pts with grade 3 febrile neutropenia in 9%. Non-hematological toxicities of grade 3 or more involved fatigue in 6%, anorexia in 9%, and nausea in 6%. No treatment-related deaths occurred. Reasons for discontinuation were recurrent cancer in 1 pt, adverse events in 10, and miscellaneous in 1, respectively. 3 year overall survival was 78.8% (95% CI 68.4-90.7) and 3 year disease free survival was 50.3% (95% CI 34.4-73.3). Conclusions: Adjuvant S-1 plus docetaxel therapy is feasible and has only moderate toxicity in stage III gastric cancer pts. We believe that this regimen will be a candidate for future phase III trials seeking the optimal adjuvant chemotherapy for stage III gastric cancer patients.
DIGESTION LEUCOCYTOSIS AND CANCER OF THE STOMACH.
Journal: JAMA (1905)

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
“New potential diagnostic biomarkers for pulmonary hypertension.” Svenja L. Tiede, Henning Gall, Oliver Dörr, Marina dos Santos Guilherme, Christian Troidl, Christoph Liebetrau, Sandra Voss, Robert Voswinckel, Ralph T. Schermuly, Werner Seeger, Friedrich Grimminger, Andreas M. Zeiher, Stefanie Dimmeler, Helge Möllmann, Christian W. Hamm, Hossein Ardeschir Ghofrani and Holger M. Nef.<i>Eur Respir J</i>2015; 46: 1390–1396.
Journal: European Respiratory Journal (2016)
Free Clinic in Alexander County
Journal: JAMA (2007)

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
Fluorescent treponemal antibody-absorption (FTA-ABS) test for syphilis
Authors: W. E. Deacon
Journal: JAMA (1966)

The development of the fluorescent treponemal antibody-absorption (FTA-ABS) test<sup>1</sup>has been the result of continued attempts to improve the original FTA procedures,<sup>2,3</sup>in terms of sensitivity and specificity. Test improvement was made possible by the discovery that nonpathogenic treponemes such as<i>Treponema microdentium</i>and the Reiter treponeme share antigens in common with<i>T pallidum</i>, and the corresponding common antibodies are of frequent occurrence in serums from normal individuals. It was found, however, that such antibodies could be removed from test serums by intact Reiter treponeme absorption and that in serums so treated and subsequently examined there was an increased specificity and sensitivity of test results.<sup>4</sup>Later, the use of sonic-disrupted Reiter treponemes in place of intact organisms for absorption was described, the resulting procedure being identified as the FTA-ABS test.<sup>1</sup>At present, a stable water-soluble extract from Reiter treponemes is employed instead of sonicate. This change
Hyponatremic Encephalopathy After Endometrial Ablation
Authors: Daniel S. Seidman
Journal: JAMA (1994)

<h3>To the Editor.</h3> —We read with interest the article by Drs Arieff and Ayus<sup>1</sup>describing severe symptomatic hyponatremia in four patients who underwent endometrial ablation. In two of these patients, the hyponatremic encephalopathy was diagnosed intraoperatively because of hypothermia or hypoxemia. Arieff and Ayus therefore suggested that in patients undergoing general anesthesia during endometrial ablation the possibility of hypo-osmolality should be suspected if, among other symptoms, a decrease in oxygen saturation is diagnosed by pulse oximeter. We have recently reported<sup>2</sup>the occurrence of oxygen desaturation accompanied by a simultaneous increase in blood carbon dioxide levels in six of 46 patients who underwent operative hysteroscopy during a 6-month period. Moderate hyponatremic serum levels (121 and 125 mmol/L) were observed in only two of six patients. However, four of these patients were found to have a significant blood coagulopathy. Arieff and Ayus do not report the coagulation functions of their
A randomized trial of chemoradiation using mitomycin or cisplatin, with or without maintenance cisplatin/5FU in squamous cell carcinoma of the anus (ACT II)
Authors: R. James, S. Wan, R. Glynne-Jones, D. Sebag-Montefiore, L. Kadalayil, J. Northover, D. Cunningham, H. Meadows, J. Ledermann
Journal: Journal of Clinical Oncology (2009)

LBA4009 Background: Chemoradiotherapy (CRT) with 5-fluorouracil (5-FU) and mitomycin-C (MMC) is standard treatment for anal cancer. This trial addresses two questions: whether (i) replacing MMC with cisplatin (CDDP) improves the complete response (CR) rate, and (ii) two cycles of maintenance chemotherapy after CRT reduces recurrence. Methods: Between 2001 and 2008, 940 patients (pts) were recruited to a multicenter, randomized factorial trial. Pts received 5-FU (1,000mg/m2/day on d1–4 and 29–32), radiotherapy (RT) (50.4Gy in 28 fractions), and either MMC (12mg/m2, d1; n=471) or CDDP (60mg/m2 on d1 and 29; n=469). Pts were also randomized to receive maintenance therapy (n=448) 4 weeks after CRT (two cycles of CDDP and 5-FU weeks 11 and 14) or no maintenance (n=446). Maintenance randomization was not considered appropriate in 46 pts. Statistical power was ≥80% to detect a difference in the CR rate of 5% (CDDP vs MMC), and 30% reduction in recurrence (maintenance vs no maintenance). Results: Median age 58 yrs; 62% male, 38% female; tumor site - canal (81%), margin (15%); stage T1-T2 (50%), T3-T4 (43%); node negative (62%), positive (30%). Median follow-up was 3 yrs. The CR rate was 94% MMC and 95% CDDP (p=0.53). MMC pts had more acute grade 3/4 haematological toxicities (25 vs 13%, p<0.001) but this did not result in an increase in neutropaenic sepsis (3.1 vs 3.2%, p=0.93). Non-haematologic grade 3/4 toxicities were similar (61 vs 65%, p=0.22). Preliminary analysis shows no statistically significant difference in recurrence free survival (RFS) (HR 0.89, 95% CI 0.68, 1.18; p=0.42) or overall survival (HR 0.79, 95% CI 0.56,1.12; p=0.19) for the maintenance comparison. The number of pre-treatment colostomies not reversed were similar between treatments (18 MMC vs 14 CDDP, p=0.65, Maint/No maint, p=0.23) and only 9 disease-free pts had colostomies performed (5 MMC, 4 CDDP). Conclusions: ACT II is the largest trial conducted in anal cancer. High CR (95%) and RFS (75% at 3 yrs) rates were achieved with this CRT. This excellent outcome may have been influenced by the absence of a gap in the RT schedule. There was no difference in CR rates between MMC and CDDP or in RFS rates with or without maintenance chemotherapy. 5-FU, MMC with RT remains the standard of care. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Merck-Serono, Pfizer, Roche, sanofi-aventis Merck Serono, Roche, sanofi- aventis AstraZeneca, Merck Serono, Pfizer, Roche
T-Cell Immune Reconstitution in Pediatric Leukemia Patients After Allogeneic Bone Marrow Transplantation With T-Cell–Depleted or Unmanipulated Grafts: Evaluation of Overall and Antigen-Specific T-Cell Repertoires
Authors: Barbara C. Godthelp, Maarten J.D. van Tol, Jaak M. Vossen, Peter J. van den Elsen
Journal: Blood (1999)
Foreword
Authors: E. Ringel, R.C.B. Aitken, P. Pinkerton, G.W.H. Leytham, J.C. Nemiah, F. Askevold, R. Baumann, Helgard Ziprian, I. Demel, J. Gordesch, H. Katschnig, W. Pöldinger, V. Scheiber, P. Sint, W. Gödicke, W. Hartrodt, Erna Naumann, J. Läuter, Edward Stonehill, A.H. Crisp, R.G. Priest, A.H. Crisp, R.G. Priest, M.A. Leibovich, F.H. Frankel, P. Hahn, H. Mayer, Brigitte Stanek, H. Mayer, Brigitte Stanek, P. Hahn, Brigitte Stanek, P. Hahn, F. Antonelli, L. Ancona, R. Pierloot, H. van Coppenolle, H. Mayer, R. Adler, F. Lomazzi, G. Koptagel, F. Reimann, P.D. Slade, G.F.M. Russell, A.J. Forrest, T. von Uexküll, M. Rotmann, W. Schüffel, R. Karstens, K. Köhle, C. Simons, B. Scholich, N. Schäfer, M. Jackson, C.P. Kimball, H. Freyberger, H.H. Wolff, Ida Cermak, P.E. Sifneos, A.H. Crisp, E. Stonehill, G.W. Fenton, P.B.C. Fenwick, C.P. Kimball, D. Quinlan, Florence Osborne, B. Woodward, A. Appels, H. Musaph, R. Kertesz, G.S. Philippopoulos, B. Luban-Plozza, A. Comazzi, C. Simons, K. Köhle, U. Genscher, M. Dietrich, C.L. Cazzullo, G. Invernizzi, R. Ventura, M. Sostero
Journal: Psychotherapy and Psychosomatics (1973)
Comprehensive genomic profiling (CGP) of histologic subtypes of urethral carcinomas (UrthCa).
Authors: Joseph Jacob, Oleg Shapiro, Andrea Necchi, Petros Grivas, Ethan Sokol, Jo-Anne Vergilio, Keith Killian, Douglas I. Lin, Erik Williams, Shakti H. Ramkissoon, Eric Allan Severson, Amanda Hemmerich, Jon Chung, Brian Michael Alexander, Kimberly McGregor, Julia Andrea Elvin, Alexa Betzig Schrock, Natalie Danziger, Jeffrey S. Ross, Gennady Bratslavsky
Journal: Journal of Clinical Oncology (2020)

426 Background: UrthCa is an uncommon GU malignancy that can progress to advanced metastatic disease. Methods: 126 metastatic UrthCa underwent hybrid-capture based CGP to evaluate all classes of genomic alterations (GA). Tumor mutational burden (TMB) was determined on up to 1.1 Mbp of sequenced DNA and microsatellite instability (MSI) was determined on 114 loci. PD-L1 expression was determined by IHC (Dako 22C3). Results: 49 (39%) urothelial (UrthUC), 31 (24%) squamous (UrthSCC), 34 (27%) adenocarcinomas (UrthAC) and 12 (9%) clear cell (UrthCC) were evaluated. UrthUC and UrthSCC were more common in men; UrthAC and UrthCC more common in women. Ages were similar in all groups. GA in PIK3CA were the most frequent potentially targetable GA; mTOR pathway GA in PTEN also identified. GA in other potentially targetable genes were also identified including ERBB2 (6% in UrthUC, 3% in UrthSCC and 12% in UrthAC), FGFR1-3 (3% in UrthSCC), BRAF (3% in UrthAC), PTCH1 (8% in UrthCC) and MET (8% in UrthCC). Possibly reflecting their higher GA/tumor status, potential for immunotherapy benefit associated with higher TMB and PD-L1 staining levels were seen in UrthUC and UrthSCC compared to UrthAC and UrthCC. MSI high status was absent throughout. Conclusions: CGP reveals GA that may be predictive of both targeted and immunotherapy benefit in patients with advanced UrthCa and that could potentially be used in future adjuvant, neoadjuvant and metastatic disease trials.[Table: see text]
The Newborns
Journal: JAMA (2002)

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
BOOK REVIEWS
Authors: D. C. ALLISON
Journal: JNCI Journal of the National Cancer Institute (1992)

BOOK REVIEWS Get access Adjuncts to Cancer Surgery Steven G. Economou , Thomas R. Witt , Daniel J. Deziel , Theodore J. Saclarides , Edgar D. Staren , Steven D. Bines , eds. Philadelphia : Lea & Febiger , 1991 . 703 pp., illus. $85 DAVID C. ALLISON DAVID C. ALLISON Department of Surgery The Johns Hopkins University School of Medicine 600 N. Wolfe St. Baltimore, MD 21205. Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 84, Issue 14, 15 July 1992, Pages 1120–1121, https://doi.org/10.1093/jnci/84.14.1120-a Published: 15 July 1992
Lehrbuch der Nervenkrankheiten für Studierende und praktische Aerzte, in 30 Vorlesungen.
Journal: JAMA (1921)

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
Eighth International Symposium on Carotenoids
Journal: JNCI Journal of the National Cancer Institute (1987)

Journal Article Eighth International Symposium on Carotenoids Get access JNCI: Journal of the National Cancer Institute, Volume 78, Issue 3, March 1987, Page 594, https://doi.org/10.1093/jnci/78.3.594-b Published: 01 March 1987
Editorial: Failure to respond to levodopa.
Journal: BMJ (1973)

and G. Marshak' were stimulated by a report of success in giving zinc sulphate by mouth to try it in six patients.A 220 mg tablet was given three times a day to the five of them who were adults and 50 mg three times a day to a 32-year-old child.The authors say that the treatment should be continued for three or four weeks after the granuloma disappears.They confess ignorance of just how this treatment works, but suggest that it might be given as a prophylactic measure to patients undergoing long operations.No ill effects were reported.As the treatment is simple and apparently harmless it could be tried when surgical endolaryngeal treatment is not available or if for some reason it is considered inadvisable.
Dwarfism following long-term topical corticosteroid therapy
Authors: H. H. Bode
Journal: JAMA (1980)

THE USE of topical glucocorticoids has greatly advanced therapy for several dermatologic conditions. When properly applied, glucocorticoids produce minimal systemic side effects, even though percutaneous absorption of these hormones is sufficient to suppress adrenal cortisol secretion.<sup>1-3</sup>The beneficial effects of prolonged therapy with topical glucocorticoids are, however, outweighed by detrimental side effects, such as adrenal suppression,<sup>1-4</sup>dermal atrophy, axillary and inguinal striae,<sup>5</sup>hyperglycemia,<sup>6</sup>and even multiple gastric ulcers,<sup>7</sup>that have been observed. In this communication, we report a case in which this therapy caused stunted growth and permanent short stature along with adrenal insufficiency unresponsive to adrenocorticotropic hormone (ACTH) stimulation. <h3>Report of a Case</h3> A 13-year-old boy was referred to the Pediatric Endocrine Unit by his physician-father for evaluation of short stature. He was born after a full-term, uncomplicated pregnancy as the fifth of eight children. His birth weight, length, and early infantile development were
SUPPRESSION OF A MEDICAL MEETING.
Journal: JAMA (1904)

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
FOOLISH LEGISLATION.
Journal: JAMA (1903)

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
Clinical crossroads: an invitation
Authors: T. L. Delbanco
Journal: JAMA (1995)

The first live conference created for a journal directed to medical practitioners was published nearly 100 years ago when Dr Richard Cabot introduced the clinical pathologic conference to academic medicine, in the form of the case records of the Massachusetts General Hospital.<sup>1</sup>Borrowing from case-based teaching used in the study of law, Dr Cabot developed the conference to tackle the problem of wrong diagnoses. He created a link between the clinician and the pathologist, and by including real patients in the clinical discussion of specific diseases, he also hoped to create a teaching instrument for students. Diagnostic medicine has moved forward, and today, although misdiagnoses and diagnostic strategies remain a problem, treatment options often present the greatest dilemma for clinicians. Stimulated by Dr Cabot's timeless question to his students—"What is the gist of it all?"<sup>1</sup>—we introduce, in this issue, Clinical Crossroads. See also p 69. Doctors in