tbuckley/cabot-search huggingface dataset:
PTH-049 The Split Clinic – A Prescription For Efficiency In The Gastroenterology Outpatient Clinic
Authors: MF Jaboli, M Grimes, H Palmer, C Clayman, T Rayne, C Durcan, I Mason, O Epstein
Journal: Gut (2014)

<h3>Introduction</h3> Worldwide, healthcare providers are striving to balance escalating costs with the patient’s expectation of efficient access to specialist opinion, rapid investigation and treatment. Over the past 65 years, the NHS gastroenterology outpatient journey has remained unchanged. Patients are assessed at the first visit, followed by one or more hospital visits for gastrointestinal investigations and a return hospital visits for final assessment. The split clinic has been designed, wherever possible, to condense the journey from weeks or months to hours. <h3>Methods</h3> Over a period of three months, each gastroenterology referral letter was previewed four to six weeks prior to the outpatient appointment, and each patient was triaged as “Solution” and “Complex”. For the solution cohort, investigations were predicted and booked for the same day as the outpatient visit. The patients were asked to attend clinic starved and told to expect one or more same day gastrointestinal investigations. On the appointment day, “Solution” patients attended the split clinic for an initial assessment, then proceeded to investigation, returning thereafter to the clinic for feedback. <h3>Results</h3> Of 174 referrals, 95 patients were triaged from the referral letter as “Solution” patients, and 81 attended the split clinic (7 did not arrive, 4 postponed, 3 direct to surveillance colonoscopy). In those who attended, 46 same day tests were performed (14 upper endoscopies, 11 sigmoidoscopies, 5 barium swallows, 6 Eso Capsule endoscopies, 5 ultrasound scans, 1 electrogastrogram, 2 CT abdomen and 2 CT colonoscopy). Twenty-seven patients (34%) were discharged, and twenty-two (27%) were discharged after a single follow up telephone consultation. Overall, 49 patients designated as “Solution” patients (60%) required only a single hospital visit. Sixteen patients (17%) were re-designated as “Complex” requiring further tests and 3 (3%) were referred elsewhere. Overall, 95 (46 same day tests and 49 return to follow up clinic in old system) return hospital visits were avoided and the attended to discharged ratio was 81:27 (1:0.3). <h3>Conclusion</h3> Analytical triage of GP referral information allows identification of most gastroenterology “Solution” patients. This facilitates pre-emptive investigation planning and scheduling which, in turn, supports a split clinic designed to condense weeks or months of investigation and follow up into a few hours. The well planned split clinic meets the patient’s expectation for an efficient journey, quick diagnosis and reduced number of hospital visits. <h3>Disclosure of Interest</h3> None Declared.
Surgery
Journal: JAMA (2001)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
JOHN HUGHLINGS JACKSON
Journal: JAMA (1964)

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Books and Pamphlets.
Journal: JAMA (1900)

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Policlinico, Sezione Pratica, Rome
Journal: JAMA (1964)

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Queries and Minor Notes
Journal: JAMA (1946)

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A phase II study of afatinib in patients (pts) with metastatic human epidermal growth factor receptor (HER2)-positive trastuzumab-refractory esophagogastric (EG) cancer.
Authors: Yelena Yuriy Janjigian, Marinela Capanu, Tooba Imtiaz, David Paul Kelsen, Geoffrey Yuyat Ku, Mark Schattner, Karen T. Brown, David H. Ilson, David B. Solit, Michael F. Berger, Efsevia Vakiani
Journal: Journal of Clinical Oncology (2014)

52 Background: Trastuzumab (T) combined with chemotherapy has been the standard of care for pts with HER2+ EG cancer. Resistance to T is now emerging in this population. Afatinib (A), a potent ErbB Family Blocker, induced nearly complete tumor regression in MSKCC HER2+ patient derived xenografts (PDX). We report the initial results of a phase II study of afatinib in patients with T refractory EG cancer. Methods: Pts with HER2+ (IHC 3+ or FISH&gt;2.0) EG adenocarcinoma –progressive on trastuzumab -received A 40 mg. Archival pre-T tissue, tumor biopsy after progression on T and after 1 week on A mandated on protocol. The primary endpoint-overall clinical benefit at 4 months: stable disease (SD) or partial response (PR). Results: 14 pts treated with A; median duration 5.1 mos (1.7 to 12.1 mos). Median age 62, KPS 80, median 2 (1 to 4) prior T containing regimens, 64% of tumors IHC3+; 36% IHC2+/FISH&gt;2.2. Adverse events included: diarrhea (Grade 1/2:69%), fatigue (Grade 1/2:54%), rash (Grade 1/2:54%), mucositis (Grade 1:23%), paronychia (Grade 1/2:15%). To date, 13 pts evaluable for response, 3 of 13 pts (23%) had disease stabilization (PR or SD); 1 pt with confirmed PR - a durable 75% regression of biopsy proven metastases. Median OS 6.6 mos (1.9 to NR). PDXs established from biopsies of T refractory tumors of 5 pts. Next generation sequencing of matched pre-T and post-T progression tumors from 6 pts was performed and results will be reported. Conclusions: Afatinib shows clinical efficacy in patients with T refractory EG cancer. The study has been expanded to accrue additional patients. Efforts to elucidate the mechanisms of T resistance including validation of potential drivers of T resistance using HER2+ PDXs are ongoing. Updated molecular and clinical data will be presented. Clinical trial information: NCT01522768.
P1.13-03 Lung Adenocarcinomas Manifesting as Radiological Part-Solid Nodules Define a Special Clinical Subtype
Authors: T. Ye, L. Deng, S. Wang, J. Xiang, Y. Zhang, H. Hu, Y. Sun, Y. Li, L. Shen, L. Xie, W. Gu, Y. Zhao, F. Fu, W. Peng, H. Chen, Y. Shen
Journal: Journal of Thoracic Oncology (2019)
Results of a Large Prospective Study On the Use of Defibrotide (DF) in the Treatment of Hepatic Veno-Occlusive Disease (VOD) in Hematopoietic Stem Cell Transplant (HSCT). Early Intervention Improves Outcome – Updated Results of a Treatment IND (T-IND) Expanded Access Protocol
Authors: Paul G. Richardson, Angela Smith, Nancy A. Kernan, Stephan A. Grupp, Sally Arai, Brandon M. Triplett, Paul R. Haut, Kawah Chan, Heather J. Symons, Biljana N. Horn, Alfred P. Gillio, Michael Boyer, Amrita Krishnan, Leslie E. Lehmann, Paul L. Martin, Shin Mineishi, Tsiporah B. Shore, Tiffany Simms-Waldrip, Joseph H. Antin, Alison L. Hannah, Robin Hume, Elena Tudone, Carin Heringa, Robert J. Soiffer
Journal: Blood (2012)
Frustration and foundation. Management of pneumonia before antibiotics
Authors: H. F. Dowling
Journal: JAMA (1972)

" T he only use of a knowledge of the past is to equip us for the present," said Alfred North Whitehead,<sup>1</sup>and Herbert Muller<sup>2</sup>put it even more succinctly: "The past answers only to a present interest." In the past 60 years, man has gradually gained some degree of control over pneumonia. In the process, clinicians and investigators were often frustrated and discouraged, yet many of the frustrations opened the door to new methods of diagnosis and therapy. I believe the story is worth telling because it is filled with lessons that we can use profitably today. Medical history can be written in terms of important discoveries or their practical application. In no disease are these more closely intertwined than in pneumonia, and I shall discuss both. However, because popular writers have dwelt at length, and often with hyperbole, upon how the discoveries occurred, I shall pay particular
LONDON
Journal: JAMA (1952)

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MORITZ SCHIFF (1823-1896) EXPERIMENTAL PHYSIOLOGIST
Journal: JAMA (1968)

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Systemic Lupus Erythematosus
Authors: Marianthi Kiriakidou, Cathy Lee Ching
Journal: Annals of Internal Medicine (2020)

Systemic lupus erythematosus (lupus) is characterized by aberrant activity of the immune system, leading to variable clinical symptoms. Lupus is more prevalent in African American women and women in other ethnic minority groups. Diagnosing, treating, and identifying novel therapies for lupus is challenging because of its genetic and phenotypic heterogeneity. Lupus nephritis is the most common target-organ manifestation and requires individualized care to minimize toxicity. A multidisciplinary approach to caring for pregnant patients with lupus is essential to optimize outcomes.
Highlights
Journal: JAMA Oncology (2018)

Optimal Treatment in Lymph Node-Positive Penile Cancer 643Penile cancer is rare, with little guidance on optimal treatment.Joshi et al identified 1123 patients in the US National Cancer Database with lymph node-positive nonmetastatic penile cancer and compared outcomes of those who did or did not receive lymph node dissection, chemotherapy, or radiotherapy.On multivariable analysis, only lymph node dissection was associated with better overall survival.These data thus lay a foundation for prospective trials.Pettaway and McCormick provide an Invited Commentary.
Management of hyperlipidemias
Authors: B. F. Murphy
Journal: JAMA (1974)

The treatment of hyperlipidemia is desirable, especially in patients with a family history of premature ischemic heart disease, but only after the specific type of hyperlipoproteinemia has been determined. Secondary causes of hyperlipoproteinemia should be sought and eliminated. Dietary regulation remains the primary therapeutic approach; adjunctive chemotherapy is indicated only when dietary control is unsuccessful. Several drugs will reduce lipid levels, but the long-term effects of these drugs are unknown. (<i>JAMA</i>230:1683-1691, 1974)
State-Specific Prevalence of Current Cigarette Smoking Among Adults, and Policies and Attitudes About Secondhand Smoke—United States, 2000
Journal: JAMA (2002)

Tobacco use, particularly cigarette smoking, is the leading preventable cause of death in the United States, but the health consequences extend beyond smokers to nonsmokers involuntarily exposed to environmental tobacco smoke or secondhand smoke (SHS). Each year, an estimated 3,000 lung cancer deaths and 62,000 deaths from coronary heart disease in adult nonsmokers are attributed to SHS. Among children, SHS causes sudden infant death syndrome, low birthweight, chronic middle ear infections, and respiratory illnesses (e.g., asthma, bronchitis, and pneumonia). Two national health objectives for 2010 are to reduce cigarette smoking among adults to 12% (objective 27-1) and the proportion of nonsmokers exposed to environmental tobacco smoke to 45% (objective 27-10). To characterize state-specific prevalence of cigarette smoking among adults, exposure to SHS at home, smoke-free workplace policies, and attitudes toward smoke-free policies by state, CDC analyzed data from the 2000 Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of that analysis and indicates that in 2000, state-specific adult smoking prevalence ranged from 12.9%-30.5%, and high levels of public support exist, even among smokers, for smoke-free policies in many settings. States should implement comprehensive programs to reduce tobacco use and adopt clean indoor air policies to reduce involuntary exposure to SHS.
AUTHORS' REPLY
Authors: P. Ormerod
Journal: Thorax (1996)

Letters to the Editor drug.We consider that this leaves insufficient time for reliable identification ofthe offending drug or drugs.We agree that the drugs should probably be re-introduced in this order.A further difficult problem is the re-in- troduction of chemotherapy after an episode of acute liver failure.Certainly it is our policy, as discussed by Mitchell et al,' to change to drugs with no history of hepatotoxicity in patients fortunate enough to have survived this complication.
California of the South.
Journal: JAMA (1897)

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
DOMESTIC CORRESPONDENCE.
Authors: Myrix J. Crouch
Journal: JAMA (1893)

<h3>To the Editor of the Journal of the American Medical Association:</h3><h3>Dear Sir:</h3> —I did not intend to say more than to put myself on record in favor of what I honestly believed to be right for the good of the profession at large, and the future prosperity of the American Medical Association. Since my communication a number of letters have appeared, and some of such a nature as to require amendments to my letter. I make these amendments very freely for the sake of first named principles, and in response to an earnest appeal from that letter. I stated in that letter, April 22,1893, that " I saw nothing in the demand for revision save a down-grade movement on the part of a few in a single State." I am sorry that recent letters prove a few in more than a "single State," "who are dissatisfied and fail to give
Drug export activity of the human canalicular multispecific organic anion transporter in polarized kidney MDCK cells expressing cMOAT (MRP2) cDNA.
Authors: R Evers, M Kool, L van Deemter, H Janssen, J Calafat, L C Oomen, C C Paulusma, R P Oude Elferink, F Baas, A H Schinkel, P Borst
Journal: Journal of Clinical Investigation (1998)

The canalicular (apical) membrane of the hepatocyte contains an ATP-dependent transport system for organic anions, known as the multispecific organic anion transporter (cMOAT). The deduced amino acid sequence of cMOAT is 49% identical to that of the human multidrug resistance- associated protein (MRP) MRP1, and cMOAT and MRP1 are members of the same sub-family of adenine nucleotide binding cassette transporters. In contrast to MRP1, cMOAT was predominantly found intracellularly in nonpolarized cells, suggesting that cMOAT requires a polarized cell for plasma membrane routing. Therefore, we expressed cMOAT cDNA in polarized kidney epithelial MDCK cell lines. When these cells are grown in a monolayer, cMOAT localizes to the apical plasma membrane. We demonstrate that cMOAT causes transport of the organic anions S-(2,4-dinitrophenyl)-glutathione, the glutathione conjugate of ethacrynic acid, and S-(PGA1)-glutathione, a substrate not shown to be transported by organic anion transporters previously. Transport is inhibited only inefficiently by compounds known to block MRP1. We also show that cMOAT causes transport of the anticancer drug vinblastine to the apical side of a cell monolayer. We conclude that cMOAT is a 5'-adenosine triphosphate binding cassette transporter that potentially might be involved in drug resistance in mammalian cells.