tbuckley/cabot-search huggingface dataset:
In acute headache, the Ottawa Subarachnoid Hemorrhage rule had 100% sensitivity and 14% specificity
Authors: Micelle Haydel
Journal: Annals of Internal Medicine (2018)

ACP Journal Club20 March 2018In acute headache, the Ottawa Subarachnoid Hemorrhage rule had 100% sensitivity and 14% specificityMicelle Haydel, MDMicelle Haydel, MDLouisiana State University Health Science Center, New Orleans, Louisiana, USA (M.H.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/ACPJC-2018-168-6-035 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationPerry JJ, Sivilotti ML, Sutherland J, et al. Validation of the Ottawa Subarachnoid Hemorrhage Rule in patients with acute headache. CMAJ. 2017;189:E1379-85. https://pubmed.ncbi.nlm.nih.gov/29133539Clinical Impact RatingsGIM/FP/GP: Emergency Med: Neurology: References1 Carpenter CR, Hussain AM, Ward MJ, et al. Spontaneous subarachnoid hemorrhage: a systematic review and meta-analysis describing the diagnostic accuracy of history, physical examination, imaging, and lumbar puncture with an exploration of test thresholds. Acad Emerg Med. 2016;23:963–1003. [PMID: 27306497] Google Scholar2 Sayer D, Bloom B, Fernando K, et al. An observational study of 2,248 patients presenting with headache, suggestive of subarachnoid hemorrhage, who received lumbar punctures following normal computed tomography of the head. Acad Emerg Med. 2015;22:1267–73. [PMID: 26480290] Google Scholar3 Finnerty NM, Rodriguez RM, Carpenter CR, et al. Clinical decision rules for diagnostic imaging in the emergency department: a research agenda. Acad Emerg Med. 2015;22:1406–16. [PMID: 26567885] Google Scholar Author, Article, and Disclosure InformationAffiliations: Louisiana State University Health Science Center, New Orleans, Louisiana, USA (M.H.)This article was published at Annals.org on 6 March 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 20 March 2018Volume 168, Issue 6Page: JC35KeywordsAneurysmsColony stimulating factorComputed axial tomographyEmergency departmentHeadachesLikelihood ratioLumbar punctureSpecificityStiffnessSubarachnoid hemorrhage ePublished: 20 March 2018 Issue Published: 20 March 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
NHS clinicians to be trained on financial implications of their decisions
Authors: Caroline White
Journal: BMJ (2014)

Doctors across the NHS will be given training to improve their understanding of the financial implications of decisions, as part of a scheme to be launched in January 2015.

The Close Partnering scheme will initially recruit and train NHS finance staff to become “finance educators.” These people will then share their expertise with clinicians on the front line, in exchange for learning more about the thinking behind the decisions they make.

The scheme is one of six workstreams developed under the aegis of Future Focused Finance (www.futurefocusedfinance.nhs.uk), a scheme set up by the chief financial officers of …
GPs face immediate suspension from national performers list if serious safety concerns are raised
Authors: Helen Jaques
Journal: BMJ (2013)

The NHS Commissioning Board will have the power to immediately suspend GPs from the new national performers list if a doctor’s conduct “creates a serious risk to the public,” the Department of Health has revealed.

In its response to the consultation on national performers lists for GPs, dentists, and ophthalmic practitioners, the department said that the current rules—requiring performers to be given 24 hours’ notice of suspension—are not appropriate. 

“In our view, the need to protect patients is paramount,” the department said. …
An EGFRvIII-specific IHC IUO test for patient selection in AMG 595 phase I trial.
Authors: Michael A. Damore, Suzanne K. Coberly, Karen Wakamiya, Scott Webster, Vaishali Tanna, Xiaolei Xu, Ivan Klement, Rosanne Welcher, Panteha Kiaei, Yi Liu, Kimberly Samayoa, Susan Wong, Lisa Shamon-Taylor, Gregory R. Friberg, John S. Hill, Scott D. Patterson
Journal: Journal of Clinical Oncology (2013)

2071 Background: EGFRvIII is a mutant version of EGF receptor resulting from the genomic deletion of exons 2 through 7 and is expressed only in certain tumors. AMG 595 is an experimental therapeutic specifically targeting EGFRvIII and consists of an EGFRvIII-specific antibody conjugated to the maytansinoid antimicrotubule agent DM-1. Due to its specificity, mechanism of action, and pre-clinical activity, AMG 595 is expected to have clinical effect only in tumors expressing EGFRvIII. Since the reported prevalence of EGFRvIII in glioblastoma multiforme (GBM) is ~30%, prospective selection of patients with EGFRvIII positive tumors was desired for clinical development. An immunohistochemical (IHC) assay developed with Dako using a novel EGFRvIII antibody is currently being employed for patient selection for the AMG 595 phase I study in recurrent GBM (NCT01475006). Methods: An appropriate IHC reagent for human tissue was created using the variable region of a novel EGFRvIII-specific antibody developed using Xenomouse technology. Staining conditions were optimized using Dako pharmDx reagents, the Dako Link 48 Autostainer, and FFPE tissue sections. Confirmatory transcript analyses of adjacent sections were conducted using the NanoString platform. Results: Robust and reproducible staining for EGFRvIII was observed using archived GBM resections. Percentage of stained cells correlated with levels of EGFRvIII transcripts, and tumors without staining did not express EGFRvIII transcripts. Although some tumors exhibited homogenous staining, most were heterogeneous with varying distribution and percentages of stained tumor cells similar to literature reports of IHC analysis utilizing other EGFRvIII-specific antibodies. Tumor samples from patients entering into the AMG 595 Phase 1 study analyzed with this IHC test have displayed the predicted staining prevalence. Conclusions: The developed EGFRvIII IHC assay, approved under an Investigational Device Exemption, is currently being successfully employed to prospectively select patients in an ongoing phase I trial. Use of this well characterized IHC test will enable correlation of clinical outcome and staining characteristics to inform subsequent studies.
Many more consultants will be needed to provide seven day service, says BMA
Authors: Abi Rimmer
Journal: BMJ (2014)

The consultant workforce will have to expand significantly to provide cover seven days a week, the chairman of the BMA’s Consultants Committee has said.

Speaking at the association’s annual UK consultants conference in London on Wednesday, Paul Flynn told the audience: “It is unrealistic to expect that current numbers of consultants can support seven day services as well as all our current activity.

“Burnout of consultants is in nobody’s interest, and significant expansion …
The Help Directory
Authors: Rita Pal
Journal: BMJ (2005)

Publisher: G Text, 259 Squires Gate Lane, Blackpool FY4 3RE

printed edition £12.50; CD £12.50 (printed edition plus CD £20.00)

52 pages

ISBN 0 9538246 3 2

Rating: ⋆⋆⋆⋆⋆/5



You can fully assess a tool's usefulness only after extensive testing in the real world. I first came across the Help Directory after a traumatic night's work in the emergency department, during which it would have been incredibly useful to have a list of patient support groups for a wide range of conditions. An internet search led me …
Autophagy in the Tumor or in the Host: Which Plays a Greater Supportive Role?
Authors: Estela Noguera-Ortega, Ravi K. Amaravadi
Journal: Cancer Discovery (2018)

Abstract Summary: Autophagy has been identified as a potential therapeutic target in pancreatic ductal adenocarcinoma, one of the most lethal cancers, with few therapeutic options. Yang and colleagues successfully created a genetically engineered mouse model focused on the autophagy gene Atg4b that allows the study of therapeutic autophagy inhibition in fully formed tumors. Using this tool, they demonstrated that selective autophagy inhibition in either the tumor cells, normal host cells, or both suppresses tumor growth. Cancer Discov; 8(3); 266–8. ©2018 AACR See related article by Yang et al., p. 276.
Differential expressions of MDM2 and TAP73 in cancer and cancer-adjacent tissues in patients with non-small-cell lung carcinoma
Authors: B. Wang, X. Liu, H. Liu, J. Guo, T. Zhang, N. Zhou, Y. Ma, H. Yu, L. Chen, Z. Ren, K. Fan, X. Tian
Journal: Pulmonology (2018)

To investigate the differences in mRNA and protein expressions of MDM2 (mouse double minute 2 homolog) and P73 in cancer and cancer-adjacent tissues in patients with non-small-cell lung carcinoma (NSCLC).
Long‐Term Safety and Efficacy of Belimumab in Patients With Systemic Lupus Erythematosus
Authors: Richard A. Furie, Daniel J. Wallace, Cynthia Aranow, James Fettiplace, Barbara Wilson, Prafull Mistry, David A. Roth, David Gordon
Journal: Arthritis & Rheumatology (2018)

We undertook this US multicenter continuation study (GlaxoSmithKline study BEL112233; ClinicalTrials.gov identifier: NCT00724867) to assess long-term safety and efficacy of belimumab in patients with systemic lupus erythematosus (SLE) who completed the Study of Belimumab in Subjects with SLE 76-week trial (ClinicalTrials.gov identifier: NCT00410384).
Abstract 15217: Differential Impact of Diabetes Mellitus on Antiplatelet Effects of Prasugrel and Clopidogrel
Authors: Satoshi Niijima, Tsukasa Ohmori, Kazuomi Kario
Journal: Circulation (2017)

Introduction:  Although prasugrel exerts stronger antiplatelet effects compared with clopidogrel, the factors affecting platelet reactivity under prasugrel have not been fully determined.   Objectives:  This study aimed to identify the mechanistic differences between prasugrel and clopidogrel.   Methods:  Forty patients with stable angina who underwent elective percutaneous coronary intervention were randomly assigned to receive either prasugrel (20 mg) or clopidogrel (300 mg) as a loading dose. Platelet function (light transmission, laser light scattering, and vasodilator-stimulated phosphoprotein phosphorylation) and plasma active metabolite levels were measured after the loading dose.   Results:  Prasugrel consistently inhibited adenosine diphosphate receptor P2Y 12  signalling, which leads to platelet aggregation. Prasugrel abolished even small platelet aggregates composed of less than 100 platelets(Fig1). Clopidogrel increased small and medium platelet aggregates but inhibited large aggregates. Diabetes was the only independent variable for determining antiplatelet effects and formation of active metabolites of prasugrel, but not clopidogrel(Fig2). Sleep-disordered breathing was significantly correlated with platelet reactivity in patients who had clopidogrel.   Conclusions:  Prasugrel efficiently abolishes residual P2Y 12  signalling that causes small platelet aggregates, but these small aggregates are not inhibited by clopidogrel. Considering the differential effect of diabetes on antiplatelet effects between these two drugs, the pharmacokinetics of prasugrel, other than cytochrome P450 metabolism, might be affected by diabetes.
INDUCT: A risk score to predict relapse in estrogen-receptor–positive breast cancer.
Authors: Steven Buechler, Sunil S. Badve, Yesim Gokmen-Polar
Journal: Journal of Clinical Oncology (2014)

11063 Background: Early stage ER+ breast cancer may be treated with hormone therapy and/or chemotherapy. Currently available prognostic tools (e.g. Oncotype DX, Mammaprint and ProSigna) assess the risk of recurrence and the benefit of hormone and chemotherapy. However, these tests do not outperform traditional parameters such as tumor size, grade and patient age. New assays are needed to improve the prediction of relapse in ER+ patients. Methods: A continuous risk score (INDUCT score) predictive for relapse was developed using integrative analysis of publicly available microarray datasets and FFPE- based qRT-PCR assay. The INDUCT score was validated in (1) Affymetrix datasets consisting of 5 independent patient cohorts and 2) in a cohort of METABRIC dataset. The INDUCT score was further compared to traditional clinico-pathological parameters as well as to current prognostic assays such as Oncotype DX, Mammaprint and Prosigna. Results: The continuous INDUCT score (0-100) was developed to predict relapse in patients with ER+, lymph-node negative (LN-) breast cancer. A low INDUCT score (<42) based the expression of five genes (ESPL1, MKI67, SPAG5, PLK1 and PGR) identified a good prognosis group (8 year relapse-free survival probabilities ≥ 0.93) of 68% patients in both Affymetrix and METABRIC datasets. Importantly, the high expression of more than two genes was needed to achieve a score greater than 42, suggesting that the combinatorial effect of these genes is required to promote metastasis. The INDUCT score is significant in both LN negative [P=1.7x10-4; HR=3.4 (95%CI 1.7-6.9)] and positive [P=2.8x10-5 ; HR=2.5 (95%CI 1.6-4.0)] patients and in the presence [P=1.9x10-5 ; HR=2.7 (95%CI 1.8-4.1)] or absence [P=5.6x10-4; HR=4.0 (95%CI 1.8-9.3)] of tamoxifen therapy INDUCT is not improved by the addition of clinico-pathological parameters in LN- breast cancer and exhibits superior prognostic and predictive ability than Oncotype DX, Mammaprint and ProSigna assays. Conclusions: The five-gene INDUCT score demonstrates superiority to the traditional parameters as well as current prognostic assays in predicting the likelihood of relapse. This may further improve personalized management for patients with ER+ breast cancer.
Time to first-line (1L) therapy discontinuation in metastatic melanoma (MM).
Authors: Jason J. Luke, Sameer Ghate, Raluca Ionescu-Ittu, Briana Ndife, Rebecca Burne, François Laliberté, Mei Sheng Duh
Journal: Journal of Clinical Oncology (2018)

196 Background: Nivolumab or pembrolizumab monotherapy (N/P) and dabrafenib+trametinib combination therapy (D+T) are currently the most commonly used regimens for the treatment of MM in anti-PD1 and BRAF inhibitor classes, respectively. We describe time to discontinuation of 1L therapy with N/P or D+T in patients (pts) with MM in a real-world setting. Methods: Adults with MM initiated on N/P or D+T in 1L were identified in Truven MarketScan databases (Q1/2014 - Q2/2016; n = 443). Outcomes included (a) distribution of time to 1L discontinuation among pts who discontinued 1L therapy during the study follow-up (reported by year of 1L start) and (b) rates of pts still on 1L therapy at different time points after 1L therapy start ("on treatment" rates) estimated from Kaplan-Meier analyses. Results: Of 443 pts, 243 (55%) were initiated on N/P and 200 (45%) on D+T. Pts initiated on D+T appeared to be younger, with more brain metastases, and higher use of emergency care in the 6 mo prior to 1L therapy start as compared to those initiated on N/P (Table). Time to 1L discontinuation and "on treatment" rates were similar between the treatment groups, with a tendency towards longer time to 1L discontinuation for D+T (Table). Conclusions: This real-world data study showed numerically longer time to 1L discontinuation for pts treated with D+T as compared to N/P, despite higher comorbidity burden. [Table: see text]
Active enhancer and chromatin accessibility landscapes chart the regulatory network of primary multiple myeloma
Authors: Yi Jin, Kenian Chen, Ayla De Paepe, Eva Hellqvist, Aleksandra D. Krstic, Lauren Metang, Charlotte Gustafsson, Richard E. Davis, Yair M. Levy, Rakesh Surapaneni, Ann Wallblom, Hareth Nahi, Robert Mansson, Yin C. Lin
Journal: Blood (2018)
I am a year 2 specialist registrar. How can I do an MSc in either obstetric ultrasound or maternal medicine for a year as an elective?
Authors: Philip Owen
Journal: BMJ (2005)

Have a career or related problem that needs answering? Can9t find the right person to point you in the right direction? Log on to the Advice Zone for reliable medical careers advice. You can post a question or see if one of our 300 advisers has already answered a similar question. Here is a selection of questions and answers posted on the site. <b>www.bmjcareers.com/advicezone</b>
2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries
Authors: Clare L Ardern, Guri Ranum Ekås, Hege Grindem, Håvard Moksnes, Allen F Anderson, Franck Chotel, Moises Cohen, Magnus Forssblad, Theodore J Ganley, Julian A Feller, Jón Karlsson, Minider S Kocher, Robert F LaPrade, Michael McNamee, Bert Mandelbaum, Lyle Micheli, Nicholas Mohtadi, Bruce Reider, Justin Roe, Romain Seil, Rainer Siebold, Holly J Silvers-Granelli, Torbjørn Soligard, Erik Witvrouw, Lars Engebretsen
Journal: British Journal of Sports Medicine (2018)

In October 2017, the International Olympic Committee hosted an international expert group of physiotherapists and orthopaedic surgeons who specialise in treating and researching paediatric ACL injuries. Representatives from the American Orthopaedic Society for Sports Medicine, European Paediatric Orthopaedic Society, European Society for Sports Traumatology, Knee Surgery & Arthroscopy, International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine, Pediatric Orthopaedic Society of North America and Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte attended. Physiotherapists and orthopaedic surgeons with clinical and research experience in the field, and an ethics expert with substantial experience in the area of sports injuries also participated. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision-making with children and the potential long-term ramifications of the injury. This consensus statement addresses six fundamental clinical questions regarding the prevention, diagnosis and management of paediatric ACL injuries. The aim of this consensus statement is to provide a comprehensive, evidence-informed summary to support the clinician, and help children with ACL injury and their parents/guardians make the best possible decisions.
A case of disseminated follicular spicules in HIV-associated follicular syndrome in the absence of the seven known human polyomaviruses, suggesting that this disorder is distinct from trichodysplasia spinulosa
Authors: A.J. Maddy, E.E. Lee, A.D. Maderal, R.C. Wang, A. Tosti, J.H. Cho-Vega
Journal: British Journal of Dermatology (2018)
Reducing Racial/Ethnic Disparities in Cardiovascular Genetic Testing
Authors: Lisa M. Dellefave-Castillo, Megan J. Puckelwartz, Elizabeth M. McNally
Journal: JAMA Cardiology (2018)

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 Cardiology 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 Cardiology journal
Masters in Health Research (MRes)
Authors: Srimathy Vijayan, K Tyler
Journal: BMJ (2009)

This is a masters degree offered to postgraduate health professionals, including doctors and intercalating medical students. In broad terms, the MRes can be considered to parallel an MPhil, but whereas the MPhil is usually the first year of a PhD, the MRes is a standalone one year postgraduate masters degree. It allows candidates the opportunity to experience and learn about research within the fields of human health.

Modern day medical practice is based on strong evidence, underpinned by high quality research. This allows doctors, with the involvement of their patients, to make optimum decisions about patient care. Doing research enhances a doctor’s career profile, and in an increasingly competitive world those who have done something beyond the usual requirements stand out. It is therefore important that all individuals involved with or working in the healthcare set-up understand the process of research: from the initial concept through to the analysis of its output, and, where possible, try to take part in it. It can, however, be difficult to find …
Effect of body mass index and albumin level on outcomes of patients receiving anti PD-1/PD-L1 therapy.
Authors: Sami Ibrahimi, Sarbajit Mukherjee, Darwin Roman, Caleb King, Michael Machiorlatti, Raid Aljumaily
Journal: Journal of Clinical Oncology (2018)

213 Background: Obesity has been previously investigated for its role in cancer and promoting tumor growth, at least partially by inducing a chronic inflammatory state. However, it’s unclear how this would play out in the era of immunotherapy, where inflammation has been linked to treatment response. Albumin, a marker of nutritional status, is also a negative inflammatory marker. Patients with low albumin levels have been known to have a poor prognosis. In this study, we aim to assess the association of body mass index (BMI) and albumin level with outcomes of patients treated with immunotherapy. Methods: We retrospectively evaluated the outcomes of 198 patients, aged 18 years or older, treated with anti PD-1/PD-L1 at the University of Oklahoma Health Sciences Center from 2014 to 2017. Simple descriptive statistics were created for all covariates. Kaplan Meier and Cox Proportional Hazard regression were performed to assess how categorical and continuous variables were related to overall survival (OS) and progression free survival (PFS). A final multi-variable model was created using all variables associated with OS and PFS. Results: The median age was 62 years and the median follow-up time was 272 days. Melanoma was the most common diagnosis (25.7%) followed by lung cancer (23.5%) and ovarian cancer (11.5%). Higher BMI was associated with better outcomes. BMI (≥30 vs &lt; 30) unadjusted was significantly associated with better OS (236 vs 133 days, p = 0.04) and PFS (316 vs 210 days, p = 0.01). As a continuous variable, a higher BMI was significantly associated with a better OS but not PFS with HR 0.96 (95% CI 0.93-0.99, p = 0.04) and HR 0.98 (95% CI 0.95-1.01, p = 0.09) respectively. BMI was not associated with OS or PFS in a multivariate analysis. Albumin level at initiation of treatment was not associated with OS (p = 0.12) or PFS (p = 0.19). Conclusions: In this single institution cohort, BMI had a significant effect on outcomes of patients receiving anti PD-1/PD-L1 agents. This warrants further investigation of BMI as a prognostic factor.
Membership of the College of Emergency Medicine
Authors: Atika Sabharwal
Journal: BMJ (2007)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following Membership of the College of Emergency Medicine Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.