tbuckley/cabot-search huggingface dataset:
How Rare Is Too Rare Not to Care?
Authors: Katherine L. Florecki, Elliott R. Haut
Journal: JAMA Surgery (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 Surgery 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 Surgery journal
I have dual nationality (one is British), but I lived outside the United Kingdom for three years. How should I apply for a senior house officer post in the United Kingdom and are my prospects any better than those for non-British doctors?
Authors: Elitham B Turya
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 (www.bmjcareers.com/advicezone) 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.
SAFETY AND EFFICACY OF STATIN MANAGEMENT DURING GLECAPREVIR/PIBRENTASVIR TREATMENT FOR CHRONIC HEPATITIS C
Authors: Paul Kwo, Peter Jones, Lisa Barcomb, Joseph Gathe, Yao Yu, Douglas Dylla, Ariel Porcalla, Federico Mensa, Peter Toth
Journal: Journal of the American College of Cardiology (2018)
THE IMPACT OF PRE-MEDICAL TREATMENT FOR RISK REDUCTION OF BALLOON PULMONARY ANGIOPLASTY FOR CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION
Authors: Nobutaka Ikeda, Shuji Kubota, Toru Okazaki, Raisuke Iijima, Hidehiko Hara, Yukio Hiroi, Masato Nakamura
Journal: Journal of the American College of Cardiology (2018)
<i>Helicobacter pylori</i> Treatment for Gastric Cancer Prevention
Authors: Peter Malfertheiner
Journal: New England Journal of Medicine (2018)

Gastric cancer has become a potentially preventable disease through eradication of Helicobacter pylori. However, issues that are associated with "screen and treat" strategies — their effectiveness, proper selection of populations to target, and cost–benefit considerations — continue to interfere with the application of such strategies in regular practice. A major uncertainty relates to the most effective timing for the implementation of a screen-and-treat program. One factor influencing this uncertainty is whether H. pylori eradication is effective at stopping the carcinogenic process in patients with severe chronic atrophic gastritis, an advanced precursor lesion to gastric cancer.1 In this issue of the . . .
Learning To Consult
Authors: Stephanie Young
Journal: BMJ (2007)

Learning to consult 

Ed Rodger Charlton

Radcliffe, £24.95, 2006

320 pages

ISBN: 10 1 85775 852 8

Rating: ⋆⋆⋆/5



Before I even opened this book, I hoped its content would be more inspiring than its title. I'm glad to say it was, but with some reservations. Although it generally fulfils its purpose as a guide to consultation and communication, its key audience is perhaps too broad—that is, undergraduate and postgraduate trainees, general practitioners (GPs), and hospital doctors. This is reflected in its varying detail on certain topics, which means it might not be considered good value for money …
Martha goes to court
Authors: Nicola Sharp
Journal: BMJ (2004)

⇓



“I could go to prison,” said Martha. “I need another pint.” She gestured at the bar, and Ed Barrel nodded.

“Are you sure you should, Martha?” said David. “I don't think you should go to court tomorrow hung over or drunk.”

“But they might lock me up,” said Martha.

“Yes, dear, I've been trying to tell you that for weeks,” said David Millstone, “but that's no reason to get inebriated tonight. You need a clear mind for court.”

“But how long can they send me to prison for? I must speak to my solicitor immediately.” Ed Barrel put a pint of beer down on the table in front of Martha.

“But dear, if you remember, you sacked your solicitor last month.”

Martha downed her pint in one. “I can't go to prison.”

“But dear, I'm afraid that's for the court to decide.”

“You don't care.”

“Of course I do, dear.”

“I might not be here tomorrow. This might be the last night we spend together.”

“I know, dear.” David put his arm around Martha.

“How will you cope without me?” said Martha.

“It will be very quiet, dear.”

“What about Douglas? I must see Douglas. I have to..,” Martha coughed. “I …
Genomic Testing in Lung Cancer: Past, Present, and Future
Authors: Céline Mascaux, Ming-Sound Tsao, Fred R. Hirsch
Journal: Journal of the National Comprehensive Cancer Network (2018)

Precision medicine commonly refers to the selection of the most effective cancer treatments based on the presence of specific biomarkers (eg, genomic abnormalities) in a patient's tumor. Therefore, genomic testing is used to identify patients whose tumors harbor the vulnerability that is sensitive to corresponding targeted therapies. This approach allows for the selection of patients who have the greatest chance of deriving benefit from the treatments, reduces toxicity, and significantly improves outcome; precision medicine is recommended for advanced non–small cell lung cancer. This article reviews the evolution of genomic testing in lung cancer, from its development, including first success and failures, to its current use in the care of patients with lung cancer, and addresses future considerations, such as the expected increase of targetable abnormalities, the need to follow the genomic profile over time, and tumor heterogeneity.
Trends in Hospitalizations for Acute Kidney Injury — United States, 2000–2014
Authors: Meda E. Pavkov, Jessica L. Harding, Nilka R. Burrows
Journal: MMWR Morbidity and Mortality Weekly Report (2018)

Acute kidney injury is a sudden decrease in kidney function with or without kidney damage, occurring over a few hours or days. Diabetes, hypertension, and advanced age are primary risk factors for acute kidney injury. It is increasingly recognized as an in-hospital complication of sepsis, heart conditions, and surgery (1,2). Its most severe stage requires treatment with dialysis. Acute kidney injury is also associated with higher likelihood of long-term care, incidence of chronic kidney disease and hospital mortality, and health care costs (1,2). Although a number of U.S. studies have indicated an increasing incidence of dialysis-treated acute kidney injury since the late 1990s (3), no data are available on national trends in diabetes-related acute kidney injury. To estimate diabetes- and nondiabetes-related acute kidney injury trends, CDC analyzed 2000-2014 data from the National Inpatient Sample (NIS) (4) and the National Health Interview Survey (NHIS) (5). Age-standardized rates of acute kidney injury hospitalizations increased by 139% (from 23.1 to 55.3 per 1,000 persons) among adults with diagnosed diabetes, and by 230% (from 3.5 to 11.7 per 1,000 persons) among those without diabetes. Improving both patient and provider awareness that diabetes, hypertension, and advancing age are frequently associated with acute kidney injury might reduce its occurrence and improve management of the underlying diseases in an aging population.
T-cell receptor sequencing of bladder tumor infiltrating lymphocytes to reveal a clonal immune response.
Authors: Alexander Sankin, Damini Chand, Mark P. Schoenberg, Xingxing Zang
Journal: Journal of Clinical Oncology (2018)

437 Background: High T cell receptor (TCR) repertoire clonality is associated with clinical response to immune checkpoint blockade in bladder cancer (Funt et al ASCO 2016). We hypothesized that T cell repertoire is more clonal in tumors than in benign inflammation. Methods: After obtaining IRB approval, we prospectively identified 12 patients with bladder lesions at Montefiore Medical Center/Albert Einstein College of Medicine undergoing transurethral resection of bladder tumor (TURBT). Specimens collected at the time of TURBT were stored at -80C. After DNA extraction, high throughput sequencing of the CDR3 region of the TCR beta chain using the ImmunoSEQ assay (Adaptive Biotechnologies) was performed. Various parameters such as T infiltrating lymphocyte (TIL) percentage, total productive rearrangements, unique productive rearrangements, and maximum frequency of TCR clone were assessed. Results: 9/12 specimens were malignant (UC+) and 3/12 specimens were benign (UC-). There was an even distribution of specimens across all pathologic stages: 3/12 were T0, 3/12 were Ta, 3/12 were T1, and 3/12 were T2 or greater. The median number of T cells sequenced in UC+ and UC- specimens was 5,569 and 25,872 respectively. The median number of unique TCR rearrangements sequenced in UC+ and UC- specimens was 3,069 and 9,680, respectively. The median TIL percentage in UC+ and UC- specimens was 2% and 12%, respectively. The UC+ specimens demonstrated clonality as indicated by maximum productive frequency of up to 17% as opposed to a maximum productive frequency of 2% in UC- specimens. Conclusions: Primary urothelial tumors contain clonally expanded T cell populations that are not present in benign urothelium. Our data supports the hypothesis that bladder tumors induce a clonal T cell host response against tumor derived antigens. In contrast, benign inflammatory response does not appear to demonstrate any T cell clonal dominance. Future studies to identify tumor specific antigens that contribute to clonal expansion and predict therapeutic efficacy of immunotherapy will be of clinical significance.
Leeds surgical neuroradiology course
Authors: Hugh Sims-Williams, James Sutcliffe
Journal: BMJ (2012)

The past 10 years have seen a rapid increase in the application of diagnostic imaging techniques and image guided treatments, and as a direct result the Royal College of Radiologists is seeking an increase of 60 trainees a year for the next five years.12 Neuroradiology in particular is a growing specialty, and there has been a considerable increase in the number of endovascular procedures performed, especially in acute stroke management and the treatment of intracranial aneurysms. This increase is in part owing to the results of the international subarachnoid aneurysm trial (ISAT),3 which initiated a move to multidisciplinary team treatment of aneurysms; endovascular management is becoming increasingly common in the United Kingdom and the United States. 

The Leeds surgical neuroradiology course reflects this move to multidisciplinary team management of neurosurgical pathology, and the faculty reflects this change, with teaching being provided by radiologists, physicists, interventionalists, and neurosurgeons. 

Despite its niche name, this course is not just for radiologists or surgeons and has relevance for …
Third generation EGFR TKIs: current data and future directions
Authors: Chee-Seng Tan, Nesaretnam Barr Kumarakulasinghe, Yi-Qing Huang, Yvonne Li En Ang, Joan Rou-En Choo, Boon-Cher Goh, Ross A. Soo
Journal: Molecular Cancer (2018)

Acquired T790 M mutation is the commonest cause of resistance for advanced non-small cell lung cancer (NSCLC) epidermal growth factor receptor (EGFR) mutant patients who had progressed after first line EGFR TKI (tyrosine kinase inhibitor). Several third generation EGFR TKIs which are EGFR mutant selective and wild-type (WT) sparing were developed to treat these patients with T790 M acquired resistant mutation. Osimertinib is one of the third generation EGFR TKIs and is currently the most advanced in clinical development. Unfortunately, despite good initial response, patients who was treated with third generation EGFR TKI would develop acquired resistance and several mechanisms had been identified and the commonest being C797S mutation at exon 20. Several novel treatment options were being developed for patients who had progressed on third generation EGFR TKI but they are still in the early phase of development. Osimertinib under FLAURA study had been shown to have better progression-free survival over first generation EGFR TKI in the first line setting and likely will become the new standard of care.
GNIP1 E3 ubiquitin ligase is a novel player in regulating glycogen metabolism in skeletal muscle
Authors: Marta Montori-Grau, Robert Pedreira-Casahuga, Zoé Boyer-Díaz, Iréna Lassot, Celia García-Martínez, Anna Orozco, Judith Cebrià, Oscar Osorio-Conles, Matilde R. Chacón, Joan Vendrell, Manuel Vázquez-Carrera, Solange Desagher, Josep Carles Jiménez-Chillarón, Anna Ma Gómez-Foix
Journal: Metabolism (2018)
Bariatric Surgery Controls Blood Pressure
Authors: Anita Slomski
Journal: JAMA (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 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
False-Positive Plasma Genotyping Due to Clonal Hematopoiesis
Authors: Yuebi Hu, Bryan C. Ulrich, Julianna Supplee, Yanan Kuang, Patrick H. Lizotte, Nora B. Feeney, Nicolas M. Guibert, Mark M. Awad, Kwok-Kin Wong, Pasi A. Jänne, Cloud P. Paweletz, Geoffrey R. Oxnard
Journal: Clinical Cancer Research (2018)

Abstract Purpose: Plasma cell-free DNA (cfDNA) genotyping is increasingly used in cancer care, but assay accuracy has been debated. Because most cfDNA is derived from peripheral blood cells (PBC), we hypothesized that nonmalignant mutations harbored by hematopoietic cells (clonal hematopoiesis, CH) could be a cause of false-positive plasma genotyping. Experimental Design: We identified patients with advanced non–small cell lung cancer (NSCLC) with KRAS, JAK2, or TP53 mutations identified in cfDNA. With consent, PBC DNA was tested using droplet digital PCR (ddPCR) or next-generation sequencing (NGS) to test for CH-derived mutations. Results: We first studied plasma ddPCR results from 58 patients with EGFR-mutant NSCLC. Two had KRAS G12X detected in cfDNA, and both were present in PBC, including one where the KRAS mutation was detected serially for 20 months. We then studied 143 plasma NGS results from 122 patients with NSCLC and identified 5 JAK2 V617F mutations derived from PBC. In addition, 108 TP53 mutations were detected in cfDNA; for 33 of the TP53 mutations, PBC and tumor NGS were available for comparison, and 5 were present in PBC but absent in tumor, consistent with CH. Conclusions: We find that most JAK2 mutations, some TP53 mutations, and rare KRAS mutations detected in cfDNA are derived from CH not tumor. Clinicians ordering plasma genotyping must be prepared for the possibility that mutations detected in plasma, particularly in genes mutated in CH, may not represent true tumor genotype. Efforts to use plasma genotyping for cancer detection may need paired PBC genotyping so that CH-derived mutations are not misdiagnosed as occult malignancy. Clin Cancer Res; 24(18); 4437–43. ©2018 AACR. See related commentary by Bauml and Levy, p. 4352
Abstract 12574: Difference in Optical Coherence Tomography Findings of Very Late In-Stent Restenosis Lesions Between After Bare-Metal Stent and Sirolimus-Eluting Stent Implantation
Authors: Takeshi Tada, Kazushige Kadota, Seiji Habara, Hiroyuki Tanaka, Yasushi Fuku, Tsuyoshi Goto, Kazuaki Mitsudo
Journal: Circulation (2014)

Introduction:  It was reported that there are differences in tissue morphology of in-stent restenosis (ISR) lesions according to stent type and timing of restenosis. However, little is known about optical coherence tomography (OCT) findings of very late ISR lesions after bare-metal stent (BMS) and sirolimus-eluting stent (SES) implantations.   Methods:  Between July 2008 and November 2013, OCT was performed in 53 ISR lesions (BMS group; 25 BMS-ISR lesions and SES group; 28 SES-ISR lesions) which had occurred beyond 5 years after stent implantation. We examined tissue structure (homogeneous, heterogeneous, or layered), incomplete stent apposition (ISA) and multiple inter-strut hollows (MIH) as indices of endothelial delayed healing, and lipid-rich intima and thin-cap fibroatheroma (TCFA) as indices of neoatherosclerosis. OCT finding of ISA was defined as separation of at least 1 stent strut from the vessel wall which is not related to a side branch, and MIH was defined as multiple hollows (the maximum depth >0.5 mm) existing between and outside the well-apposed stent struts. Lipid-rich intima was defined as a diffuse border, low signal lesion due to marked signal attenuation and lipid arc more than 90 degrees. TCFA was defined as a lipid-rich plaque with thinnest fibrous cap thickness less than 65 μm.   Results:  The patients were 46 men and 7 women, and the mean age was 69.2±7.7 years. The mean time between stent implantation and OCT procedure was significantly longer in the BMS group than in the SES group (10.6±2.7 years vs. 6.1±1.0 years, p   Conclusions:  Although there was a difference in the stent age between the two groups, OCT findings of endothelial delayed healing were frequently observed in ISR lesions beyond 5 years after SES implantation, while those of neoatherosclerosis were frequently observed in ISR lesions beyond 5 years after BMS implantation.
Dicer-2-Dependent Generation of Viral DNA from Defective Genomes of RNA Viruses Modulates Antiviral Immunity in Insects
Authors: Enzo Z. Poirier, Bertsy Goic, Lorena Tomé-Poderti, Lionel Frangeul, Jérémy Boussier, Valérie Gausson, Hervé Blanc, Thomas Vallet, Hyelee Loyd, Laura I. Levi, Sophie Lanciano, Chloé Baron, Sarah H. Merkling, Louis Lambrechts, Marie Mirouze, Susan Carpenter, Marco Vignuzzi, Maria-Carla Saleh
Journal: Cell Host & Microbe (2018)
GMC should audit effects of its investigations on doctors, report recommends
Authors: Tom Moberly
Journal: BMJ (2015)

The General Medical Council should audit how its investigations affect doctors’ lives and careers, a report of a roundtable event has concluded.

A report of the event, which took place in September, was shared with the event’s participants in December 2014 and has been seen by BMJ Careers. The report recommended that the GMC begin a “review of practices and procedures” and take appropriate action as a result of the review’s findings. It said that the GMC should “audit the impact of investigation on individual doctors and include how sanctions affect a doctor’s career.”

The event, called “Regulation, respect, and healthcare practitioners,” was organised by Clare Gerada, medical director of the Practitioner Health Programme, a London based, confidential health service for doctors and dentists. Event participants included doctors, lawyers, academics, and representatives of medical defence organisations and regulatory bodies.

The …
INCIDENCE AND PREDICTORS OF CONTEMPORARY DES FAILURE: INDIVIDUAL-PATIENT DATA POOLED ANALYSIS FROM 11 RANDOMIZED CONTROLLED TRIALS
Authors: Maayan Konigstein, Hussein Rahim, Thomas McAndrew, Evan Shlofmitz, Ori Ben-Yehuda, Gregg Stone, Ziad Ali
Journal: Journal of the American College of Cardiology (2018)
ERK Inhibition: A New Front in the War against MAPK Pathway–Driven Cancers?
Authors: Inna Smalley, Keiran S.M. Smalley
Journal: Cancer Discovery (2018)

<b/> ERK inhibitors have enormous therapeutic potential against tumors that are BRAF mutant, BRAF-MEK inhibitor resistant, or RAS mutant. In this issue of Cancer Discovery, Sullivan and colleagues report on the first-in-human dose-escalation study of the ERK inhibitor ulixertinib, which they show to be well tolerated with clinical activity against a wide range of tumor types. Cancer Discov; 8(2); 140-2. ©2018 AACR.See related article by Sullivan et al., p. 184.
Welsh GPs offered more early evening appointments last year
Authors: Caroline White
Journal: BMJ (2012)

Most general practices in Wales offered early evening appointments in 2011, show figures on GP appointment times published by the Welsh government.1

Some 93% (440) of practices provided appointments between 5 pm and 6.30 pm at least twice a week in 2011. And almost two thirds of practices (63%) provided appointments during these hours every weekday, the data show. …
ENHANCED LYSYL OXIDASE EXPRESSION IN PERIPHERAL ARTERY RESTENOSIS IS ASSOCIATED WITH ALTERED COLLAGENS: IMPLICATIONS IN RESTENOTIC PLAQUE PROGRESSION AND THERAPEUTIC INTERVENTION
Authors: Prakash Krishnan, Pedro Moreno, Meerarani Purushothaman, M. Urooj Zafar, Arthur Tarricone, Miguel Vasquez, Sandeep Singla, Sachin Kumar Amruthlal Jain, Annapoorna Subhash Kini, Samin K. Sharma, K-Raman Purushothaman
Journal: Journal of the American College of Cardiology (2018)
Government must act to eradicate bullying in NHS, BMA says
Authors: Abi Rimmer
Journal: BMJ (2014)

The government must act to “eradicate the current bullying culture within the NHS,” the BMA has said. Delegates at the BMA’s annual representative meeting in Harrogate unanimously voted in favour of a motion that also called for the government to “remove the stigma surrounding whistleblowing.”

The motion said that, in the wake of the findings of Robert Francis QC’s report on failings at Mid Staffordshire NHS Foundation Trust, the government must help staff and students to …