tbuckley/cabot-search huggingface dataset:
Should we reconsider the use of self-expandable metal stents as a bridge to surgery in malignant colorectal obstruction?
Authors: Emo van Halsema, Jeanin van Hooft
Journal: Endoscopy (2015)

A major concern of self-expandable metal stent (SEMS) placement as a bridge to elective surgery for malignant colonic obstruction is the impact of stent placement on the oncological outcome of the patient with a potentially curable cancer. The short term postoperative outcomes of SEMS as a bridge to surgery have been studied in several trials. The most recent meta-analysis of seven randomized controlled trials showed that preoperative stent placement in patients with malignant left-sided colonic obstruction did not reduce the postoperative mortality, but did show less overall morbidity, a higher primary anastomosis rate, and a lower permanent stoma rate compared with emergency resection [1]. So far, it has been difficult to balance these short term benefits against the long term oncological outcomes of preoperative stent placement, because data are scarce. Given the oncological uncertainty, SEMS placement as a bridge to surgery is not recommended as standard treatment in the new European Society of Gastrointestinal Endoscopy (ESGE) guideline [2]. However, preoperative SEMS placement is recommended for consideration in patients over the age of 70 years and/or American Society of Anesthesiologists (ASA) score of ≥ 3, because in this subgroup the risk of short term mortality caused by emergency surgery may well outweigh the oncological risk of stent placement [2].
Psychiatric records: variations based on discipline and patient characteristics, with implications for quality of care
Authors: B B Perlman, A H Schwartz, M Paris, J C Thornton, H Smith, R Weber
Journal: American Journal of Psychiatry (1982)

In this study of the delivery of outpatient psychiatric care to Medicaid patients at all 29 free-standing psychiatric clinics and at six hospital clinics in New York City, the authors found that nonphysician mental health workers provided much direct patient care: diagnosis and identifying data, necessary for reimbursement, were always included in records whereas mental status and medical history were poorly documented; and nonphysicians in hospitals generally surpassed physicians in the latter two areas. An additional observation was that attitudes of mental health workers toward certain diagnostic and ethnic groups may be inferred from the selective completeness of their psychiatric record keeping.
A phase I study of sunitinib in combination with sirolimus in adults with advanced refractory malignancies
Authors: J. Li, H. Kluger, M. W. Saif, J. R. Murren, J. J. Lee, W. K. Kelly, L. Rink, L. Devine, M. Sznol
Journal: Journal of Clinical Oncology (2009)

3554 Background: Sirolimus, a commercially available oral mTOR inhibitor, may complement the anti-angiogenic and anti-tumor activity of sunitinib, an oral small molecule inhibitor of multiple receptor tyrosine kinases (RTKs), by vertical disruption of VEGFr signaling, by reducing the compensatory production of VEGF in sunitinib-treated patients, and also by directly inhibiting tumor cell proliferation. Methods: Sunitinib was given at 50 mg daily (d) x 28 q6w. The dose of sirolimus was escalated in cohorts of 3–6 beginning at 4 mg weekly until the MTD was determined. The first cohort received sunitinib alone 50mg d x 14 followed by 14 days off in cycle #1. After the 4mg sirolimus dose cohorts, sunitinib dose was reduced in subsequent cohorts to 37.5mg, and dose escalation of sirolimus was re-initiated at 4mg. Results: 18 patients (pts) with ECOG PS &lt;2 were enrolled, median age 57yo (r:24–76), M:F: 11:7. Median # of prior treatments (Rx): 2(r:0–5), 6 had no prior systemic Rx. Disease primary sites: GI-5 (28%), renal cell- 4 (22%), melanoma-2, soft tissue sarcoma (STS)-2, adenoca unknown 1 0 -2, breast-1, H&amp;N-1, NSCLC-1. At the 50/4 dose level, 4 of 8 required dose reduction (DR) or early discontinuation (ED) of Rx in cycle #1. At the 37.5/4 and 37.5/8 dose levels, 3/9 required DR or ED in cycle #1 or starting cycle #2. Several pts able to complete 1–2 cycles at full dose had significant toxicities including fatigue and hand-foot syndrome. 1 pt developed interstitial pneumonitis, 1 pt died on day 8 due to progressive disease. Four pts received &gt;4 cycles (5-STS, 5-renal papillary, 13-neuroendocrine pancreas, 17-renal clear cell). Among 16 pts undergoing restaging, there was no CR or PR. 5 other pts demonstrated transient central necrosis or size reduction in some tumors. There was no apparent PK interaction at the 4mg sirolimus dose level, and no clear effect on sunitinib-induced increase in circulating VEGF levels. Conclusions: Toxicity precluded dose escalation of weekly sirolimus in combination with a standard sunitinib dose/schedule. These results suggest caution when combining targeted agents lacking specificity for tumor signaling or vasculature. [Table: see text]
A study of crying in medically and surgically hospitalized patients
Authors: R L Green, T W McAllister, J L Bernat
Journal: American Journal of Psychiatry (1987)

In a prospective study of hospitalized patients referred to a psychiatry consultation service, 46 patients were referred for a presumed diagnosis of depression because crying was a prominent symptom. Psychiatric consultation determined that 20% had a psychiatric disorder only, 33% had a neurological disorder only, 43% had both psychiatric and neurological disorders, and 4% had a previously undescribed entity, "essential" crying. The most common neurological disorder in these crying patients was bilateral hemispheric dysfunction associated with dementia or delirium; the most common psychiatric disorder was major depression. Effective therapy for patients who cry depends on proper identification of the cause of crying.
MDSINE: Microbial Dynamical Systems INference Engine for microbiome time-series analyses
Authors: Vanni Bucci, Belinda Tzen, Ning Li, Matt Simmons, Takeshi Tanoue, Elijah Bogart, Luxue Deng, Vladimir Yeliseyev, Mary L. Delaney, Qing Liu, Bernat Olle, Richard R. Stein, Kenya Honda, Lynn Bry, Georg K. Gerber
Journal: Genome biology (2016)

Predicting dynamics of host-microbial ecosystems is crucial for the rational design of bacteriotherapies. We present MDSINE, a suite of algorithms for inferring dynamical systems models from microbiome time-series data and predicting temporal behaviors. Using simulated data, we demonstrate that MDSINE significantly outperforms the existing inference method. We then show MDSINE's utility on two new gnotobiotic mice datasets, investigating infection with Clostridium difficile and an immune-modulatory probiotic. Using these datasets, we demonstrate new capabilities, including accurate forecasting of microbial dynamics, prediction of stable sub-communities that inhibit pathogen growth, and identification of bacteria most crucial to community integrity in response to perturbations.
Microfluidics‐Based Biosensors: A Microfluidic Paper‐Based Origami Nanobiosensor for Label‐Free, Ultrasensitive Immunoassays (Adv. Healthcare Mater. 11/2016)
Authors: Xiao Li, Xinyu Liu
Journal: Advanced Healthcare Materials (2016)

The first microfluidic paper-based origami nano-biosensor featuring zinc oxide nanowires and an electrochemical impedance spectroscopy biosensing mechanism, for label-free, ultrasensitive immunoassays is reported by X. Li and X. Liu on page 1326. The sensor consists of cellulose paper, a carbon ink electrode, and zinc oxide nanowires directly grown on the top. Possible parallelization of assays and high storage stability render the sensor promising for clinical diagnostics applications.
Ruxolitinib for Myelofibrosis
Authors: Ibrahim C Haznedaroglu
Journal: New England Journal of Medicine (2012)

The aim of the present study was to assess the beneficial and harmful effects of ruxolitinib in patients with myelofibrosis (MF).The Cochrane databases, PubMed and Embase were searched for studies published up to October 2012.Randomised controlled trials assessing ruxolitinib versus a placebo or the best available therapy in patients with MF were included.Two trials randomised 528 patients with MF to ruxolitinib versus a placebo or ruxolitinib versus the best available therapy.Compared with the placebo, ruxolitinib had a significant beneficial effect on the proportion of patients that had a reduction in spleen volume of ≥35% at 24 weeks [odds ratio (OR), 109.78;95% confidence interval (CI), 14.97-804.78]or an increased overall survival rate (OR, 2.02; 95% CI, 0.99-4.12).Ruxolitinib significantly increased the risk of several non-haematological or haematological adverse events, but not the risk of treatment discontinuations (OR, 1.04; 95% CI, 0.50-2.14).Compared with the best available therapy, ruxolitinib had a significant beneficial effect on the proportion of patients that had a reduction in spleen volume of ≥35% at 24 (OR, 68.45; 95% CI, 4.15-1129.19)or 48 weeks (OR, 56.20; 95%CI,.Ruxolitinib once again significantly increased the risk of several non-haematological adverse events, serious adverse events and dose reductions or interruptions (OR, 9.60; 95% CI,, but not the risk of treatment discontinuations (OR, 1.54; 95% CI, 0.48-4.97).In conclusion, based on the trials included in the present study, the use of ruxolitinib is beneficial in the treatment of MF.
Gripenet: an internet-based system to monitor influenza-like illness uniformly across Europe
Authors: S P van Noort, M Muehlen, H Rebelo de Andrade, C Koppeschaar, J M Lima Lourenço, M GM Gomes
Journal: Eurosurveillance (2007)

Gripenet has been monitoring the activity of influenza-like-illness (ILI) with the aid of volunteers via the internet in the Netherlands and Belgium since 2003 and in Portugal since 2005. In contrast with the traditional system of sentinel networks of mainly primary care physicians coordinated by the European Influenza Surveillance Scheme (EISS), Gripenet obtains its data directly from the population. Any resident of the three countries can participate in Gripenet by completing an application form on the appropriate websites (http://www.gripenet.pt), which contains various medical, geographic and behavioural questions. Participants report weekly on the website any symptoms they have experienced since their last visit. ILI incidence is determined on the basis of a uniform case definition.In the 2006/2007 season, 19,623 persons participated in Gripenet in the Netherlands, 7,025 in Belgium and 3,118 in Portugal. The rise, peak and decline of ILI activity occurred at similar times according to Gripenet and EISS. However, ILI attack rates in the Netherlands (6.6%), Belgium (6.1%) and Portugal (5.6%) were remarkably more similar in Gripenet than in EISS (0.8%, 3.9%, and 0.6% respectively).Monitoring ILI activity with the direct participation of volunteers provides similar incidence curves compared to the traditional system coordinated by EISS. Whereas EISS provides an established system whose data is validated by virology tests, Gripenet is a fast and flexible monitoring system whose uniformity allows for direct comparison of ILI rates between countries. A current objective of Gripenet is to engage more European countries.
FRI0205 Analysis of the Characteristics of Patients with Chronic Back Pain Referred from Primary Care to a Rheumatology Service: Table 1
Authors: C. Lόpez Medina, J. Calvo Gutiérrez, R. Jiménez Gasco, M.C. Castro Villegas, R. Ortega Castro, P. Font Ugalde, A. Escudero Contreras, E. Collantes Estévez
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> In recent years it has become increasingly important to design strategies for the detection of patients with Axial Spondyloarthritis (axial SpA), thus allowing us to prescribe appropriate medication to avoid structural damage. However, some studies have shown a lack of agreement on the appreciation of back pain characteristics by Primary Care specialists. Because of this, sometimes the derivation to a Rheumatology Service is not adequate. <h3>Objectives</h3> To analyse the clinical, analytical and radiographical characteristics of patients with chronic back pain (CBP) and younger than 45 years old referred from Primary Care (PC) to a Rheumatology service. <h3>Methods</h3> A descriptive analysis which included 95 patients referred from Primary Care with chronic back pain and younger than 45 years old who underwent a full clinical and analytical examination which aimed to determine Spondyloarthritis criteria (sacroiliac joints X-ray, HLAB-27) in each patient. The patients also answered an anamnesis undertaken by a specialist clinician in Rheumatology, the aim of which was to determine in each patient the presence of items which define the inflammatory back pain (IBP) by ASAS. In this way, patients were classified in two different groups: a) those that meet IBP criteria, and b) those that do not meet IBP criteria (non-IBP). An analysis of the connection between the two groups of patients with different variables took place. <h3>Results</h3> Out of the 95 patients, 35 of them (38.9%) were classified as IBP and 55 (61.1%) as non-IBP. Table 1 represents the most important clinical and analytical characteristics from DLI patients, compared with non-DLI patients. Also, the table shows the results of the bivariate and multivariate logistic regression. The multivariate logistic regression model showed that patients with pathologic SI joints X-ray have a 78.78 higher risk of having IBP as well as a 4.19 increased probability in patients with a positive result in HLA-B27. Out of the 35 IBP patients, 27 of them (77.14%) met the ASAS criteria for axial SpA, with a 19.82 higher risk of having IBP. <h3>Conclusions</h3> This research suggests that IBP is the most distinctive clinical characteristic of axial SpA and it is defined as an accurate criterion for referring patients with chronic back pain to a Rheumatology service. <h3>Disclosure of Interest</h3> None declared
Molecular Diagnosis
Authors: Bruce Korf
Journal: New England Journal of Medicine (1995)

Most of the mutations responsible for genetic disease are remarkably subtle, considering the dramatic effects they may have on the phenotype. A change in just one of many thousand bases in a gene can be sufficient to disrupt and thus alter or eliminate the expression of a protein product. On the other hand, genetic variation is common from person to person and is usually of no phenotypic consequence. Benign changes may occur in regions that do not encode protein or do alter the properties of the protein encoded by a gene. The challenge in the molecular diagnosis of gene mutations . . .
Feasibility of a thumb-controlled device in double-balloon enteroscopy-assisted ERCP
Authors: Tetsuo Tamura, Daisuke Kikuchi, Tsunao Imamura, Yuko Koizumi, Rikako Koyama, Mitsuru Kaise, Kazuo Takeuchi
Journal: Endoscopy (2015)

In recent years, patients with common bile duct calculi and Roux-en-Y anatomy have been treated using double-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (DBE-ERCP). It is known that cannulation in this procedure is difficult [1] [2] [3]. We hypothesized that a thumb-controlled device (Smart shooter, TOP corporation, Tokyo, Japan [4]) ([Fig. 1]) would be useful for DBE-ERCP. The device enables the operator to control the endoscopic instruments while keeping both hands on the scope. Herein, we present three patients with Roux-en-Y anatomy who underwent DBE-ERCP using the Smart shooter for common bile duct stones. This is the first report of the use of the Smart shooter in actual practice since it became commercially available.
The Emergency Treatment of Cardiac Arrest
Authors: R M HOSLER
Journal: JAMA (1963)

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
TUBERCULOSIS OF THE MAMMARY GLAND.
Authors: A DELLIVENNERI, D DELASCIO, C GIORDANO, V T AMARAL
Journal: JAMA (1898)

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
Measuring diagnostic accuracy in the absence of a "gold standard"
Authors: S V Faraone, M T Tsuang
Journal: American Journal of Psychiatry (1994)

As the nation debates issues of national health care reform, psychiatrists seek equal status with other medical colleagues. To defend psychiatry in the national arena, the accuracy of psychiatric diagnoses must be measured. Indexes of accuracy such as sensitivity and specificity provide valuable information, yet they are rarely computed because there is no "gold standard" with which to compare them. The goal of this article is to show how this problem can be overcome and to encourage nosologists to use accuracy statistics in assessing the adequacy of psychiatric diagnoses.The authors reviewed the literature on medical decision making to find methodological approaches to assessing diagnostic accuracy in the absence of gold standards.A lack of such standards is not unique to psychiatry and has been addressed with a variety of novel analytic procedures. Although these methods differ in many respects, each recognizes that the conventional 2 x 2 table of interrater agreement does not provide enough data for estimating diagnostic accuracy. After defining the data needed, each method provides a mathematical model that estimates accuracy statistics and the prevalence of a disorder. Most of these methods are variants of latent class analysis. The authors reanalyzed data from one of the reviewed papers to show that similar inferences about accuracy of diagnoses could be drawn from a conventional latent class analysis.There are potential pitfalls in using latent structure methods, but their cautious use would provide valuable information for psychiatric nosology. These methods supplement, but do not replace, data about outcome, family history, laboratory studies, and other validating criteria in making accurate diagnoses.
PTH-119 Differences between radiology and histopathology: are we judging wrong? should we lower alpha-fetoprotein cut-off in the selection criteria?
Authors: S Onali, D Al-Nujaidi, F Al-Rubaish, E Tsochatzis, J O’Beirne, A Marshall, D Yu, T Meyer, T Luong, M Pinzani, P Manousou
Journal: Gut (2015)

<h3>Introduction</h3> Current UK selection criteria for liver transplantation (LT) in patients with hepatocellular carcinoma (HCC) are based on pre-LT imaging and aFP values &lt;1000 IU/ml. <h3>Aim</h3> Aim of the study was to identify potential discrepancies between radiology and histopathology in patients undergoing LT for HCC and identify predictors of outcome with HCC recurrence as endpoint. <h3>Method</h3> All consecutive patients transplanted for HCC between 1997–2014 were retrospectively evaluated: demographic and clinical data, aetiology, pre-LT aFP levels and HCC treatment, radiological staging of HCC, histological tumour characteristics. Cox regression was used to assess factors associated with HCC recurrence and AUROC and Youden index to access cut-offs. <h3>Results</h3> 185 patients: male 150(81%); mean age 55(27–68) years; aetiology HCV (54%), HBV (19%), ALD (15%). 126 (68%) underwent pre-LT treatment for HCC. Discrepancy between histopathological and radiological findings regarding the number of HCC nodules was found in 104/185(56%) patients: 78 were underestimated and 26 overestimated by radiology. 10/40 (25%) patients, who fell within radiological Milan criteria, resulted outside Milan criteria according to the explant due to discrepancy in the number of nodules. Considering the diameter of the biggest nodule on explant, discrepancy was observed in 158/182(85%) patients: 93 were underestimated, 65 overestimated. 20/40 (50%) patients fulfilling Milan criteria based on radiology, exceeded these criteria due to discrepancy in the size of the largest tumour. Recurrence was observed in 29/185(16%) patients post-LT in a median of 37 months (4–157 months). Cox regression showed that pre-LT factors associated with HCC recurrence post-LT were: aFP &gt;100 IU/l (p = 0.007, OR=0.28, 95% CI=0.113–0.707) and radiological size of the largest nodule &gt;3 cm (p = 0.001, OR=0.8, 95% CI = 0.78–0.97). Combined together the two parameters showed the best sensitivity (77%) and specificity (70%): AUROC=0.72, p = 0.0001, 95% CI=0.62–0.82. <h3>Conclusion</h3> In patients transplanted for HCC there is an important discrepancy between radiological findings and pathological description of the explant. The best predictors of HCC recurrence was the combination of pre-LT aFP &gt;100 IU/l and diameter of the biggest nodule &gt;3 cm. <h3>Disclosure of interest</h3> None Declared.