tbuckley/cabot-search huggingface dataset:
A novel device for intracolonoscopy cleansing of inadequately prepared colonoscopy patients: a feasibility study
Authors: Kelly van Keulen, Helmut Neumann, Jörn Schattenberg, Aura van Esch, Wietske Kievit, Manon Spaander, Peter Siersema
Journal: Endoscopy (2018)

Abstract Background The importance of high quality preprocedural bowel preparation is widely acknowledged, but suboptimal bowel cleansing still occurs in up to 20 % of all colonoscopy patients. The aim of this study was to evaluate the performance of a novel intraprocedural cleaning device for cleaning poorly prepared colons. Methods This multicenter feasibility study included patients aged 18 – 75 years who were referred for colonoscopy. Intraprocedural cleaning was performed in patients after a limited preprocedural bowel preparation regimen (2 days of dietary restrictions and 2 × 10 mg bisacodyl). The primary outcome was the proportion of adequately prepared patients (Boston Bowel Preparation scale [BBPS] ≥ 2 in each segment) before and after segmental washing with the new device. Secondary outcomes included: cecal intubation rate, procedure time, system usability, patient satisfaction, and safety. Results 47 patients (42.6 % male), with a median age of 61 years (interquartile range [IQR] 46 – 67 years), were included at three clinical sites. Cecal intubation was achieved in 46/47 patients (97.9 %). The cleaning device significantly improved the proportion of patients with adequate bowel cleansing (from 19.1 % to 97.9 %; P &lt; 0.001) and median BBPS score (from 3.0 [IQR 0.0 – 5.0] to 9.0 [IQR 8.0 – 9.0]). Median cecal intubation time and total procedure time were 16.5 minutes (IQR 9.0−28.3) and 34.0 minutes (IQR 25.0 – 42.8), respectively. Physicians were satisfied with the ease of use of the device and it was well tolerated by patients. No severe adverse events occurred during the study period. Conclusions This feasibility study suggests that the intraprocedural cleaning device appears to be safe and effective in cleaning poorly prepared colons to an adequate level, allowing a thorough colorectal examination.
A study of 15 matricidal men
Authors: J Campion, J M Cravens, A Rotholc, H C Weinstein, F Covan, M Alpert
Journal: American Journal of Psychiatry (1985)

The authors studied 15 men who committed matricide. The majority were diagnosed as having chronic schizophrenia and had been living alone with their mothers. Other diagnoses included substance-induced psychosis and impulse disorders. Specific psychodynamic and environmental factors can be identified for each diagnostic category. The authors conclude that the matricidal impulse evolves through successive stages of psychological development; therefore, the motives for matricide are varied and correlate with the level of psychological development or regression.
Non-invasive tri-modal visualisation via PET/SPECT/μCT of recombinant human bone morphogenetic protein-2 retention and associated bone regeneration: A proof of concept
Authors: Gry Hulsart-Billström, Ram Kumar Selvaraju, Sergio Estrada, Mark Lubberink, Veronika Asplund, Kristoffer Bergman, Richard Marsell, Sune Larsson, Gunnar Antoni
Journal: Journal of Controlled Release (2018)

Bone morphogenetic proteins (BMP's) are vital for bone and cartilage formation, where bone morphogenetic protein-2 (BMP-2) is acknowledged as a growth factor in osteoblast differentiation. However, uncontrolled delivery may result in adverse clinical effects. In this study we investigated the possibility for longitudinal and non-invasive monitoring of implanted [125I]BMP-2 retention and its relation to ossification at the site of implantation. A unilateral critically sized femoral defect was produced in the left limb of rats while the right femur was retained intact as a paired reference control. The defect was filled with a hyaluronan hydrogel with 25% hydroxyapatite alone (carrier control; n = 2) or combined with a mixture of [125I]BMP-2 (150 μg/ml; n = 4). Bone formation was monitored using micro computed tomography (μCT) scans at 1, 3, 5, 7, 9 and 12 weeks. The retention of [125I]BMP-2 was assessed with single photon emission computed tomography (SPECT), and the bone healing process was followed with sodium fluoride (Na18F) using positron emission tomography (PET) at day 3 and at week 2, 4, and 6. A rapid burst release of [125I]BMP-2 was detected via SPECT. This was followed by a progressive increase in uptake levels of [18F]fluoride depicted by PET imaging that was confirmed as bone formation via μCT. We propose that this functional, non-invasive imaging method allows tri-modal visualisation of the release of BMP-2 and the following in vivo response. We suggest that the potential of this novel technique could be considered for preclinical evaluation of novel smart materials on bone regeneration.
Effect of Electronic Health Record–Based Medication Support and Nurse-Led Medication Therapy Management on Hypertension and Medication Self-management
Authors: Stephen D. Persell, Kunal N. Karmali, Danielle Lazar, Elisha M. Friesema, Ji Young Lee, Alfred Rademaker, Darren Kaiser, Milton Eder, Dustin D. French, Tiffany Brown, Michael S. Wolf
Journal: JAMA Internal Medicine (2018)

Complex medication regimens pose self-management challenges, particularly among populations with low levels of health literacy.
Performance of Cardiovascular Disease Risk Scores in People Diagnosed With Type 2 Diabetes: External Validation Using Data From the National Scottish Diabetes Register
Authors: Stephanie H. Read, Merel van Diepen, Helen M. Colhoun, Nynke Halbesma, Robert S. Lindsay, John A. McKnight, David A. McAllister, Ewan R. Pearson, John R. Petrie, Sam Philip, Naveed Sattar, Mark Woodward, Sarah H. Wild
Journal: Diabetes Care (2018)

OBJECTIVE To evaluate the performance of five cardiovascular disease (CVD) risk scores developed in diabetes populations and compare their performance to QRISK2. RESEARCH DESIGN AND METHODS A cohort of people diagnosed with type 2 diabetes between 2004 and 2016 was identified from the Scottish national diabetes register. CVD events were identified using linked hospital and death records. Five-year risk of CVD was estimated using each of QRISK2, ADVANCE (Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation), Cardiovascular Health Study (CHS), New Zealand Diabetes Cohort Study (NZ DCS), Fremantle Diabetes Study, and Swedish National Diabetes Register (NDR) risk scores. Discrimination and calibration were assessed using the Harrell C statistic and calibration plots, respectively. RESULTS The external validation cohort consisted of 181,399 people with type 2 diabetes and no history of CVD. There were 14,081 incident CVD events within 5 years of follow-up. The 5-year observed risk of CVD was 9.7% (95% CI 9.6, 9.9). C statistics varied between 0.66 and 0.67 for all risk scores. QRISK2 overestimated risk, classifying 87% to be at high risk for developing CVD within 5 years; ADVANCE underestimated risk, and the Swedish NDR risk score calibrated well to observed risk. CONCLUSIONS None of the risk scores performed well among people with newly diagnosed type 2 diabetes. Using these risk scores to predict 5-year CVD risk in this population may not be appropriate.
Abstract 18030: Prevalence Predictors and Clinical Implications of 90-Day Readmission for Patients With Critical Limb Ischemia
Authors: Reza Masoomi, Jenny Cho, Kirk Hance, Zubair Shah, Buddhadeb Dawn, Kamal Gupta
Journal: Circulation (2016)

Introduction:  Critical limb ischemia (CLI) represents an advanced stage of Peripheral arterial disease with significant attendant morbidity and mortality and it often requires hospitalization. This study was designed to study the prevalence, predictors and outcomes of 90-day readmission in CLI patients.   Methods:  We did a secondary analysis of the Nationwide Readmissions Database (NRD) for the year 2013. We included all patients with a primary diagnosis of extremity rest pain, ulceration and tissue necrosis secondary to peripheral arterial disease (PAD) who presented to the hospital in the first three quarters of 2013. From this group, all patients readmitted with similar diagnosis within 90 days were recorded.   Results:  From estimated 126,534 patients hospitalized with primary diagnosis of CLI, 15,546 were readmitted for CLI again within 90 days (readmission rate of 12.5%). Mean time to readmission was 38.3±23.5 days. Men had slightly higher rate of readmission than women (12.6% vs 11.8%, P  Patients underwent surgical revascularization at first presentation had lower rate of readmission in comparison to percutaneous intervention (8.3% vs 16.1%, P    Conclusion:  Our study demonstrates that 90-day readmission for CLI is common (12.5%), and it is seen more often in those undergoing percutaneous rather than surgical revascularization. Also, readmission was associated with a significantly higher rate of amputation. Further research is needed to elucidate the reasons behind these findings.
REM sleep enhancement by bupropion in depressed men
Authors: E A Nofzinger, C F Reynolds, M E Thase, E Frank, J R Jennings, A L Fasiczka, L R Sullivan, D J Kupfer
Journal: American Journal of Psychiatry (1995)

The authors compared the effects of bupropion, fluoxetine, and cognitive behavior therapy on EEG sleep in depressed subjects.All-night sleep EEG studies were performed before treatment and after partial or full remission on 18 men with depression diagnosed according to Research Diagnostic Criteria and randomly assigned to treatment with either bupropion (N = 7) or fluoxetine (N = 11). Response to these drugs was measured by changes in Hamilton Depression Rating Scale scores. Pre- and posttreatment EEG sleep study results before and after treatment with cognitive behavior therapy were also available for 18 men matched in age and severity of Hamilton depression scale score, and one-time EEG sleep measures were available for 36 men who were not depressed.REM latency was reduced and REM sleep percent and REM time increased after treatment in the depressed men given bupropion. These effects contrasted with the effects of fluoxetine and cognitive behavior therapy.This study represents the first report of an antidepressant medication that shortens REM latency and increases REM sleep. If confirmed, this finding may require a revision of our current understanding of the relation among depression, REM sleep, and anti-depressant mechanisms.
Identification of a xenobiotic as a potential environmental trigger in primary biliary cholangitis
Authors: Philip M. Probert, Alistair C. Leitch, Michael P. Dunn, Stephanie K. Meyer, Jeremy M. Palmer, Tarek M. Abdelghany, Anne F. Lakey, Martin P. Cooke, Helen Talbot, Corinne Wills, William McFarlane, Lynsay I. Blake, Anna K. Rosenmai, Agneta Oskarsson, Rodrigo Figueiredo, Colin Wilson, George E. Kass, David E. Jones, Peter G. Blain, Matthew C. Wright
Journal: Journal of Hepatology (2018)

Primary biliary cholangitis (PBC) is an autoimmune-associated chronic liver disease triggered by environmental factors, such as exposure to xenobiotics, which leads to a loss of tolerance to the lipoic acid-conjugated regions of the mitochondrial pyruvate dehydrogenase complex, typically to the E2 component. We aimed to identify xenobiotics that might be involved in the environmental triggering of PBC.Urban landfill and control soil samples from a region with high PBC incidence were screened for xenobiotic activities using analytical, cell-based xenobiotic receptor activation assays and toxicity screens.A variety of potential xenobiotic classes were ubiquitously present, as identified by their interaction with xenobiotic receptors - aryl hydrocarbon receptor, androgen receptor and peroxisome proliferator activated receptor alpha - in cell-based screens. In contrast, xenoestrogens were present at higher levels in soil extracts from around an urban landfill. Furthermore, two landfill sampling sites contained a chemical(s) that inhibited mitochondrial oxidative phosphorylation and induced the apoptosis of a hepatic progenitor cell. The mitochondrial effect was also demonstrated in human liver cholangiocytes from three separate donors. The chemical was identified as the ionic liquid [3-methyl-1-octyl-1H-imidazol-3-ium]+ (M8OI) and the toxic effects were recapitulated using authentic pure chemical. A carboxylate-containing human hepatocyte metabolite of M8OI, bearing structural similarity to lipoic acid, was also enzymatically incorporated into the E2 component of the pyruvate dehydrogenase complex via the exogenous lipoylation pathway in vitro.These results identify, for the first time, a xenobiotic in the environment that may be related to and/or be a component of an environmental trigger for PBC. Therefore, further study in experimental animal models is warranted, to determine the risk of exposure to these ionic liquids.Primary biliary cholangitis is a liver disease in which most patients have antibodies to mitochondrial proteins containing lipoic acid binding site(s). This paper identified a man-made chemical present in soils around a waste site. It was then shown that this chemical was metabolized into a product with structural similarity to lipoic acid, which was capable of replacing lipoic acid in mitochondrial proteins.
Safety and Efficacy of BIND-014, a Docetaxel Nanoparticle Targeting Prostate-Specific Membrane Antigen for Patients With Metastatic Castration-Resistant Prostate Cancer
Authors: Karen A. Autio, Robert Dreicer, Justine Anderson, Jorge A. Garcia, Ajjai Alva, Lowell L. Hart, Matthew I. Milowsky, Edwin M. Posadas, Charles J. Ryan, Ryon P. Graf, Ryan Dittamore, Nicole A. Schreiber, Jason M. Summa, Hagop Youssoufian, Michael J. Morris, Howard I. Scher
Journal: JAMA Oncology (2018)

Preferential delivery of docetaxel to tumors by prostate-specific membrane antigen (PSMA)-targeted nanoparticles is clinically effective, and the selective reduction of PSMA-positive circulating tumor cells (CTCs) after treatment has implications for patient selection and disease monitoring.To determine the safety and efficacy of BIND-014, a PSMA-directed docetaxel-containing nanoparticle, in patients with metastatic castration-resistant prostate cancer (mCRPC).A multicenter open-label, phase 2 clinical trial of 42 chemotherapy-naive patients with progressing mCRPC after treatment with abiraterone acetate and/or enzalutamide was conducted from June 24, 2013, to June 10, 2016.Treatment with BIND-014 at a dosage of 60 mg/m2 was given intravenously on day 1 of 21-day cycles in combination with prednisone until disease progression or unacceptable toxic effects occurred.The primary end point was radiographic progression-free survival according to Prostate Cancer Working Group 2 recommendations and Response Evaluation Criteria in Solid Tumors, version 1.1. Secondary end points included prostate-specific antigen (PSA) response (≥50% reduction from baseline) and changes in CTC number (from ≥5 to <5 cells per 7.5 mL of blood) (CellSearch). Changes in CTC number based on PSMA expression levels on CTCs were also evaluated (Epic Sciences).Among the 42 patients (81% white), the median age was 66 (range, 50-85) years, and median number of doses received was 6 (range, 1-21). A PSA response was observed in 12 of 40 patients (30%; 95% CI, 18%-45%), measurable disease response in 6 of 19 (32% [95% CI, 15%-54%]), and CTC conversions in 13 of 26 (50%; 95% CI, 32%-68%). Median radiographic progression-free survival was 9.9 (95% CI, 7.1-12.6) months. With use of the Epic Sciences non-EPCAM-based CTC detection platform, CTCs were detected in 16 of 18 patients (89%); 11 of 18 (61%) had CTCs with PSMA expression above the analytical threshold level (PSMA positive) at baseline (range, 0.4-72.4 CTCs/mL). After treatment, PSMA-positive CTCs were preferentially reduced. Treatment-related adverse events included grade 1 or 2 fatigue (29 of 42 patients [69%]), nausea (23 [55%]), neuropathy (14 [33%]), and neutropenic fever (1 [2%]).These findings suggest that treatment with BIND-014 is active and well tolerated in patients with chemotherapy-naive mCRPC. Antitumor activity may be related to PSMA expression levels on CTCs, which suggests that patients who are likely to benefit from this treatment can be identified before treatment is initiated.ClinicalTrials.gov Identifier: NCT01812746.
Abstract 12003: Brain Injury in Cognition and Mood Regulatory Regions in Adolescents With Single Ventricle Heart Disease
Authors: Nancy A Pike, Ritika Gupta, Bhaswati Roy, Mary A Woo, Nancy J Halnon, Alan B Lewis, Rajesh Kumar
Journal: Circulation (2016)

Introduction: Adolescents with palliated single ventricle congenital heart disease (SVCHD) show a distinct pattern of cognitive and mood impairment, indicating the probability of brain injury in regions that control these functions. However, brain tissue integrity in cognitive and mood regulatory sites in SVCHD remains unclear. Our aim was to evaluate regional brain tissue changes in SVCHD compared to controls using T2-relaxometry procedures, which measure free water in tissues (higher T2-relaxation values indicate tissue damage). Methods: Proton-density and T2-weighted images were collected from 9 SVCHD (age: 15.8±1.1 years, male: 6, BMI: 19.8±3.6 kg/m 2 ) and 8 healthy controls (age: 16.3±0.9 years, male: 4, BMI: 25.4±8.1 kg/m 2 ), using a 3.0-Tesla magnetic resonance imaging scanner. Whole-brain T2-relaxation maps were calculated, normalized to a common space, smoothed, and compared between groups using ANCOVA (covariates: age and gender). Results: Several brain regions in SVCHD showed increased T2-relaxation values, indicating tissue injury, including the prefrontal cortices (a, b; executive thinking), anterior and posterior cingulate cortices (f; conflict resolution; emotion and memory), bilateral insular cortices (c; autonomic and emotion control), and bilateral parahippocampal gyrus (g; facial and topographical recognition; see Figure). In addition to gray matter injury, white matter changes were also detected in regions that link important gray matter regions associated with cognition and mood, including bilateral frontal white matter, anterior corpus callosum, and middle cerebellar peduncles (d, e), compared to controls [all regions p&lt;0.05]. Conclusion: Adolescents with palliated SVCHD showed significantly increased T2-relaxation values, indicating tissue injury, in brain regions that control cognition and mood. These findings indicate that functional deficits in SVCHD may result from tissue injury in those regulatory areas.
Restrict use of antibiotics for COPD, NICE says
Authors: Susan Mayor
Journal: BMJ (2018)

Health professionals should weigh up the limited benefits of antibiotics against the risk of antimicrobial resistance when treating patients with acute exacerbations of chronic obstructive pulmonary disease (COPD), the National Institute for Health and Care Excellence (NICE) recommended in draft guidance published on 9 July.1

“The evidence shows that there are limited benefits of using antibiotics for managing acute exacerbations of COPD and that it’s important other options are taken into account before antibiotics are prescribed,” said Mark Baker, director of the centre for guidelines at NICE. …
An Atrophic and Spiny Eruption of the Palms
Authors: Kevin John Gaddis, Jing Huang, Paul Lawrence Haun
Journal: JAMA Dermatology (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 Dermatology 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 Dermatology journal
Employers must tackle high level of burnout among trainees, says GMC
Authors: Abi Rimmer
Journal: BMJ (2018)

Almost one in four trainees (24%) and just over one in five trainers (21%) from across the UK feel burnt out to a high or very high degree because of their work, the General Medical Council’s national training survey has shown.1

The 2018 national training survey was completed by 51 956 doctors in training (a 96% response rate) and 19 193 trainers (a 41% response rate) between 20 March to 9 May 2018. It included questions about burnout for the first time.1

The survey also found that over half of all UK trainees (57%) and half of all UK trainers (50%) who responded always …
Kinetics of CEA and CA15–3 correlate with response in patients undergoing chemotherapy for metastatic breast cancer
Authors: P. Stieber, D. Laessig, V. Heinemann, M. Untch, S. Kahlert, D. Nagel
Journal: Journal of Clinical Oncology (2007)

1087 Background: The aim of this retrospective analysis was to determine the correlation between tumor marker kinetic (TMK) like CEA and/ or CA 15–3 and imaging during of MBC pts. Methods: TMK (CEA, AxSYM, Abbott; CA 15–3, Elecsys, Roche) were evaluated in MBC pts at the beginning of palliative chemotherapy (pre-treatment value = A), after 20–30 days (1 st intermediate value = B), after 40–60 days (2 nd intermediate value = C) and at the time of staging with imaging techniques (D). Response to treatment was assessed by UICC criteria. Two criteria for progressive and two for non-progressive disease based on TMK were established. The 1 st criterion for progression required that the increase from A to C had to be &gt;25 %, and the increase per day from A to C had to be greater than the increase from A to B. The 2 nd criterion for progression required that D should be &gt;25% than A and an increase of C to D was required. The 1 st criterion for non-progressive disease required that the decrease from A to C had to be &gt; 25% and C &lt; B. The 2 nd criterion for non-progressive disease required D &lt;25% than B and D &lt; C. Results: 54 (70%) pts showed a correlation of TMK and imaging results. In 10 (13%) pts no correlation was obtained, and in 13 (17%) pts no biochemical statement was possible because of divergent TMK. Using our criteria a sensitivity of 70.2 % was reached. Conclusion: We could show a correlation between TMK and imaging results. After validation in a prospective trial using our criteria in clinical practice could improve therapeutic monitoring and reduce radiation exposure in pts with MBC. No significant financial relationships to disclose.
Hemodynamic Deterioration of Surgically Implanted Bioprosthetic Aortic Valves
Authors: Erwan Salaun, Haïfa Mahjoub, Abdellaziz Dahou, Patrick Mathieu, Éric Larose, Jean-Pierre Després, Josep Rodés-Cabau, Benoit J. Arsenault, Rishi Puri, Marie-Annick Clavel, Philippe Pibarot
Journal: Journal of the American College of Cardiology (2018)
MONITORING OF COLONOSCOPY QUALITY INDICATORS REVEALS ADHERENCE TO ESGE GUIDELINE IN AN ACADEMIC ENDOSCOPY FACILITY
Authors: K Triantafyllou, S Karamaroudis, S Hariklia Vorri, P Gkolfakis, V Papadopoulos, G Tziatzios, E Karagkouni, P Katsouli, A Stamou, GD Dimitriadis
Journal: Endoscopy (2018)

We monitor colonoscopy service quality biannually, by measuring sedation administration, colonoscopy completion, adenoma detection and early complications rates, in our endoscopy facility. We herein present our audit results for the years 2013 and 2015.