tbuckley/cabot-search huggingface dataset:
Abstract P4-13-15: A retrospective head-to-head comparison between TiLoop Bra/TiMesh and seragyn in 320 cases of reconstructive breast surgery
Authors: C Eichler, C Schulz, K Brunnert, W Mathias
Journal: Cancer Research (2018)

Abstract Background: As an alternative option to ADMs (acellular dermal matrices) synthetic meshes are a cheaper and equally effective option in implanted breast reconstruction. However, clinical data concerning these synthetic meshes is limited. Also, direct comparisons between titanium-coated polypropylene mesh (TiLoop Bra/TiMesh) and partially absorbable polypropylene mesh (Seragyn) have not yet been reported. Therefore, this work will report clinical complication rate data on 320 cases of synthetic meshes TiLoop Bra/TiMesh and Seragyn. Methods: This analysis represents a retrospective single surgeon multi-center study of 320 cases over 14 years (2003 until 2016) using either TiLoop Bra/TiMesh (n=192) or Seragyn (n=128) in breast reconstruction. Patient recruitment was consecutive. 124 cases of the TiLoop Bra /TiMesh cohort and 74 cases in the Seragyn cohort were oncological interventions. Results were correlated with ADM based reconstructions (Epiflex and SurgiMend) performed by the same surgeon. Results: Major complication rates (i.e. revision surgery) occurred in 3.9 % (Seragyn) and 8.3 % (TiLoop Bra/TiMesh) of all cases. (not statistically significant). Minor complications (i.e. seroma requiring aspiration, infection requiring antibiotics, red breast syndrome/rash (RBS) and wound dehiscence occurred in 18 % (Seragyn) and 8.9 % (TiLoop Bra/TiMesh). Overall minor complication rates did also not differ statistically significant. However, subgroup analysis showed RBS to occur more often in the Seragyn group (3.9 % Seragyn vs. 0.5 % TiLoop Bra/TiMesh, p&amp;lt;0.05). A significant difference between SurgiMend and Epiflex compared to the synthetic meshes could also not been shown. Conclusion: This retrospective analysis shows that titanium-coated polypropylene meshes like TiLoop Bra/TiMesh and partially absorbable meshes like Seragyn do not differ significantly in complication rates. Compared to the exponentially more expensive ADM alternatives complication rates did also not differ significantly. Synthetic meshes seem to be a cheaper and equally effective option. Citation Format: Eichler C, Schulz C, Brunnert K, Mathias W. A retrospective head-to-head comparison between TiLoop Bra/TiMesh and seragyn in 320 cases of reconstructive breast surgery [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-13-15.
CCTG IND.231: A phase 1 trial evaluating CX-5461 in patients with advanced solid tumors
Authors: J. Hilton, D.W. Cescon, P. Bedard, H. Ritter, D. Tu, J. Soong, K. Gelmon, S. Aparicio, L. Seymour
Journal: Annals of Oncology (2018)
Identification of occult prostate malignancy in a large patient cohort using a stereotactic transperineal prostate biopsy technique.
Authors: Brian Joseph Moran, Michelle H. Braccioforte
Journal: Journal of Clinical Oncology (2018)

9 Background: Continued rising PSA, despite prior transrectal prostate biopsy (TRPB), can cause significant anxiety for patients and physicians. This study investigates the detection rate of non-palpable, isoechoic occult malignancy using a stereotactic transperineal prostate biopsy (STPB) technique in patients with previous negative TRPB. Methods: 2,565 men with continued rising prostate specific antigen (PSA) with a minimum of 1 prior benign TRPB, underwent STPB at a single out-patient institution between 04/04 - 02/17 (See table). Specimens were obtained according to x, y, and z coordinates from 8 equal octants with pathology reported accordingly. A greater number of specimens were obtained from the apical half than the basilar half of the prostate; this was attributed to smaller glands in which the apical specimens sufficiently sampled the anterior curvature of the gland. Results: STPB yielded adenocarcinoma in 965/2,565 (37.6%) patients. The number of biopsy cores obtained per patient approximated the prostate gland volume in cm 3 . Statistical analysis demonstrated there was a significant difference in detection rates with the apex having a higher incidence of malignancy than the base of the prostate gland (p=.000). Furthermore, the anterior apex harbored significantly more adenocarcinoma when compared to the posterior apex (p=.026). Conclusions: STPB is efficacious for diagnosis of non-palpable, isoechoic occult prostate malignancy. Repeated sequential analysis of malignancy identification has consistently resulted in approximately 40% positive yield. Furthermore, a possible explanation for the significant finding in this study that occult malignancies occupy a higher percentage of apical biopsies using STPB may be related to difficulty and limitations of apical sampling using a standard transrectal biopsy approach. [Table: see text]
Proposed timetable and costs for GMC’s plan to approve medical trainers raise concerns
Authors: Caroline White
Journal: BMJ (2012)

The General Medical Council’s plan to boost the profile and standards of doctors’ trainers have met with approval overall. But respondents to its consultation have raised concerns over the proposed timetable for implementation and the potential cost implications.

The GMC’s proposals include setting minimum standards for trainers, formal recognition of four training roles across undergraduate and postgraduate education, and an annual survey of trainers.

The responses to the GMC’s plan to approve trainers for medical training from next year, which were set out in Recognising and Approving Trainers in January (the GMC aims to approve medical trainers from 11 January 2013),1 indicated majority support for most of the proposals.2

Most (79%) of the 270 respondents …
Biocatalytic access to diverse prenylflavonoids by combining a regiospecific C-prenyltransferase and a stereospecific chalcone isomerase
Authors: Jianhua Li, Ridao Chen, Ruishan Wang, Xiao Liu, Kebo Xie, Dawei Chen, Jungui Dai
Journal: Acta Pharmaceutica Sinica B (2018)

Prenylflavonoids are valuable natural products that have diverse biological properties, and are usually generated biologically by multiple metabolic enzymes in nature. In this study, structurally diverse prenylflavonoids were conveniently synthesized by enzymatic catalysis by combining GuILDT, a regiospecific chalcone prenyltransferase, and GuCHI, a stereospecific chalcone isomerase that has promiscuous activity for both chalcones and prenylchalcones as substrates. Our findings provided a new approach for the synthesis of natural/unnatural bioactive prenylflavonoids, including prenylchalcones and optical prenylflavanones with chalcone origins.
RISK OF STROKE AFTER CAVO-TRICUSPID ISTHMUS ABLATION IN PATIENTS WITH LONE TYPICAL ATRIAL FLUTTER
Authors: Sanghamitra Mohanty, Chintan Trivedi, Carola Gianni, Domenico Giovanni Della Rocca, John Burkhardt, Javier Sanchez, Patrick Hranitzky, Gerald Gallinghouse, Amin Al-Ahmad, Rodney Horton, Luigi Di Biase, Andrea Natale
Journal: Journal of the American College of Cardiology (2018)
CHADS-VASC TO PREDICT READMISSION TO PREDICT READMISSION WITH NEW-ONSET ATRIAL FIBRILLATION, ATRIAL FLUTTER, OR ACUTE CVA
Authors: Joshua James Rutland, Karam Ayoub, Gbolahan Ogunbayo, Meera Marji, Steve Leung, Samy Elayi
Journal: Journal of the American College of Cardiology (2018)
A sensitive biomarker panel to distinguish pancreaticobiliary malignancies from benign disease.
Authors: Atuhani S. Burnett, Dare Ajibade, Stephen Peters, Sushil Ahlawat, Omar Mahmoud, Ravi Chokshi
Journal: Journal of Clinical Oncology (2018)

238 Background: Biliary strictures present a diagnostic challenge to differentiate benign disease from hepatopancreaticobiliary (HPB) malignancies. Cytology from Endoscopic retrograde cholangiopancreatography (ERCP) or Endoscopic ultrasound with fine needle aspiration (EUS-FNA) have both been plagued by poor sensitivity and high false negative rates. In a review of over 80 adjunct molecular biology tests that have been attempted on ERCP and EUS-FNA samples, four immunohistochemistry biomarkers with sensitivities ranging 74-80% were identified; von Hippel Lindau loss of expression (VHL), over-expression of insulin-like growth factor 2 mRNA-binding Protein 3 (IMP3), and EF-hand Calcium 2+ binding S100 subfamily members A4 (S100A4) and P (S100P). We sought to determine if these results could be validated in a tumor explant model and furthermore if combining these tests into a biomarker panel could boost overall diagnostic sensitivity to 100%. Methods: Tumor tissue and normal surrounding pancreas from 27 pancreaticoduodenectomy specimens were selected by an experienced pathologist, subjected to immunohistochemistry staining with VHL, IMP3, S100A4, S100P, and the intensity and percent of cells staining was graded. Using ROC curve analysis, threshold criteria were chosen for each biomarker to differentiate between tumor and normal pancreas. Biomarkers were then evaluated as a panel for their ability to discriminate malignant from benign specimens. Results: Individual sensitivity of VHL, IMP3, S100A4, and S100P were found to be 75.0%, 79.2%, 45.8%, and 0%. When VHL, IMP3, and S100A4 were grouped into a panel, they were able to distinguish cancer from normal tissue with a sensitivity of 100% and a specificity of 96%. S100P was dispensable in our assay and only VHL, IMP3, and S100A4 staining were required to achieve 100% sensitivity. Conclusions: A panel of three biomarkers, VHL, IMP3, and S100A4, were able to distinguish pancreatic cancer from surrounding normal tissue with 100% sensitivity in our tumor explant model. Prospective studies on patient biopsy specimens are required to further validate the clinical use of this biomarker panel.
ELECTROCARDIOGRAPHIC CHANGES AFTER RADIOTHERAPY FOR BREAST CANCER IS A PREDICTOR OF LATE CARDIOVASCULAR OUTCOME: A FOLLOW-UP OF 10 YEARS
Authors: Lafayete W.F. Ramos, Marcos V.F. Ramos, Bárbara Cristina, Cristiano Souza, Eliane Elly
Journal: Journal of the American College of Cardiology (2018)
Pathophysiological understanding of HFpEF: microRNAs as part of the puzzle
Authors: Monika Rech, Arantxa Barandiarán Aizpurua, Vanessa van Empel, Marc van Bilsen, Blanche Schroen
Journal: Cardiovascular Research (2018)

Half of all heart failure patients have preserved ejection fraction (HFpEF). Comorbidities associated with and contributing to HFpEF include obesity, diabetes and hypertension. Still, the underlying pathophysiological mechanisms of HFpEF are unknown. A preliminary consensus proposes that the multi-morbidity triggers a state of systemic, chronic low-grade inflammation, and microvascular dysfunction, causing reduced nitric oxide bioavailability to adjacent cardiomyocytes. As a result, the cardiomyocyte remodels its contractile elements and fails to relax properly, causing diastolic dysfunction, and eventually HFpEF. HFpEF is a complex syndrome for which currently no efficient therapies exist. This is notably due to the current one-size-fits-all therapy approach that ignores individual patient differences. MicroRNAs have been studied in relation to pathophysiological mechanisms and comorbidities underlying and contributing to HFpEF. As regulators of gene expression, microRNAs may contribute to the pathophysiology of HFpEF. In addition, secreted circulating microRNAs are potential biomarkers and as such, they could help stratify the HFpEF population and open new ways for individualized therapies. In this review, we provide an overview of the ever-expanding world of non-coding RNAs and their contribution to the molecular mechanisms underlying HFpEF. We propose prospects for microRNAs in stratifying the HFpEF population. MicroRNAs add a new level of complexity to the regulatory network controlling cardiac function and hence the understanding of gene regulation becomes a fundamental piece in solving the HFpEF puzzle.
EFFECT OF THE ABSENCE OF STATIN PRESCRIPTION UPON DISCHARGE AFTER A CORONARY ARTERY DISEASE EVENT ON FUTURE CARDIOVASCULAR HOSPITAL RESOURCE UTILIZATIONS AND ADVERSE CARDIOVASCULAR EVENTS
Authors: Heidi Thomas May, Tami Bair, Jeffrey Anderson, Kirk Knowlton, Donald Lappe, Joseph B. Muhlestein
Journal: Journal of the American College of Cardiology (2018)
The Medical Job Interview: Secrets for Success
Authors: Karen Hebert
Journal: BMJ (2006)

Colin Mumford

Blackwell Publishing, 2nd edn 2005, £9.49, 80 pages

ISBN: 1 40512 185 8

Rating: ★★★★/5



Medicine is well known for being a very competitive career. Often, what might seem minor details, such as the layout of a curriculum vitae (CV), or the choice of tie to wear to interview, can make all the difference. This book dispels the myths while also letting applicants in on some less known, sometimes surprising, truths.

A user friendly format takes the reader through a logical timeline. The initial chapters address issues faced …
Treatment strategy for lateral spreading superficial esophageal squamous cell carcinoma.
Authors: Hirofumi Kawakubo, Koichi Suda, Shyuhei Mayangai, Rieko Nakamura, Norihito Wada, Yuko Kitagawa
Journal: Journal of Clinical Oncology (2018)

169 Background: ESD is the one of the options of treatment even for lateral spreading (size is over 5 cm) esophageal squamous cell carcinoma (L-S ESCC). Some patients have to undergo additional treatment because tumor is invaded to submucosal layer or lymphovascular invasion. On the other hand, wide resection by ESD could cause the delay of additional treatment because of the treatment for esophageal stricture after ESD. Thus, treatment strategy for L-S ESCC has to include additional treatment after ESD. Methods: From January 2010 to December 2014, 49 cases of l L-S ESCC were resected by surgery or ESD. Diagnosis, treatment methods and outcomes are evaluated. Results: In 49 cases of L-S ESCC, 32 cases were treated by ESD and 17 case were treated by surgery. Average size of tumor treated by ESD is 59.4 mm(50-85 mm). Accuracy of estimated depth of invasion by endoscopy for ESD cases is 65.7%. Four of 32 cases of ESD underwent additional therapy (3 for surgery and 1 for CRT) because of pT1b (SM2) or lymphvascular invasion, and one case has lymph-node metastasis. Rate of stricture after ESD is 20.0% for sub-circumference ESD and 77.8% for circumference ESD instead of steroid injection. Average time and duration for control of esophageal stricture by Balloon Bougie is 13.5 times and 18 weeks. Average size of tumor treated by surgery is 76.5 mm(50-130 mm). Accuracy of estimated depth of invasion by endoscopy for surgical cases is 47.1%. Seven cases in 17 (41.2%) have lymph node metastasis. One case died by recurrence after surgery and 48 cases were survived without any recurrences. Conclusions: Accuracy of estimated depth of invasion by endoscopy for L-S ESCC is cute low compared to normal superficial ESCC. Most of strictures after sub-circumference ESD could be prevented by steroid injection. However control of strictures after circumference ESD is difficult. Thus, diagnostic ESD should not be performed for circumferencial lesions of L-S ESCC for the patients who will select CRT for additional treatment, and CRT should be selected for first treatment of these cases. Long survival could be obtained by ESD or surgery for the patients of L-S ESCC by our treatment strategy.
Who's still smoking? Disparities in adult cigarette smoking prevalence in the United States
Authors: Jeffrey Drope, Alex C. Liber, Zachary Cahn, Michal Stoklosa, Rosemary Kennedy, Clifford E. Douglas, Rosemarie Henson, Jacqui Drope
Journal: CA A Cancer Journal for Clinicians (2018)

The continuing high prevalence of cigarette smoking among specific subpopulations, many of them vulnerable, is one of the most pressing challenges facing the tobacco control community. These populations include individuals in lower education and/or socioeconomic groups; from certain racial/ethnic groups; in the lesbian, gay, bisexual, and transgender community; with mental illness; and in the military, particularly among those in the lowest pay grades. Although traditional tobacco control measures are having positive health effects for most groups, the effects are not sufficient for others. More attention to and support for promising novel interventions, in addition to new attempts at reaching these populations through conventional interventions that have proven to be effective, are crucial going forward to find new ways to address these disparities. CA Cancer J Clin 2018;68:106-115. © 2018 American Cancer Society.
Doctors reject calls to boycott clinical commissioning groups
Authors: Helen Jaques
Journal: BMJ (2012)

Delegates at the BMA’s annual representatives meeting this week turned down calls for the association to ballot GPs on a boycott of involvement in England’s new clinical commissioning groups (CCGs).

Despite considerable disquiet in the profession about the ways in which the groups will operate, all-out opposition would eliminate any influence that GPs might have in clinical commissioning and hasten the private sector’s involvement in the NHS, the conference heard.

The groups are set to take over full responsibility for commissioning primary and secondary care services in the NHS in England from April 2015, with the help of commissioning support services, many of which are run by commercial organisations.

Louise Irvine, who represents London GPs on the BMA council, said that …
Recognizing the Global Impact of Zika Virus Infection during Pregnancy
Authors: Margaret A. Honein
Journal: New England Journal of Medicine (2018)

In 2016, recognition of the causal relationship between Zika virus (ZIKV) infection during pregnancy and serious birth defects, including brain abnormalities and microcephaly, forever changed the public health approach to this virus1; the potential threat to pregnancies extends to residents of and travelers to nearly 100 countries and territories in which there is an ongoing risk of infection with ZIKV (https://wwwnc.cdc.gov/travel/page/zika-information). This virus has long been endemic in many countries in Africa and Asia, but reports of ZIKV disease in these settings have been relatively rare.2 The prevalence of ZIKV infection in countries in which the virus is endemic is . . .
Early Immune Function and Duration of Organ Dysfunction in Critically III Children with Sepsis
Authors: Jennifer A. Muszynski, Ryan Nofziger, Melissa Moore-Clingenpeel, Kristin Greathouse, Larissa Anglim, Lisa Steele, Josey Hensley, Lisa Hanson-Huber, Jyotsna Nateri, Octavio Ramilo, Mark W. Hall
Journal: American Journal of Respiratory and Critical Care Medicine (2018)

Rationale: Late immune suppression is associated with nosocomial infection and mortality in adults and children with sepsis. Relationships between early immune suppression and outcomes in children with sepsis remain unclear.Objectives: Prospective observational study to test the hypothesis that early innate and adaptive immune suppression are associated with longer duration of organ dysfunction in children with severe sepsis or septic shock.Methods: Children younger than 18 years of age meeting consensus criteria for severe sepsis or septic shock were sampled within 48 hours of sepsis onset. Healthy control subjects were sampled once. Innate immune function was quantified by whole blood ex vivo LPS-induced TNF-α (tumor necrosis factor-α) production capacity. Adaptive immune function was quantified by ex vivo phytohemagglutinin-induced IFN-γ production capacity.Measurements and Main Results: One hundred two children with sepsis and 35 healthy children were enrolled. Compared with healthy children, children with sepsis demonstrated lower LPS-induced TNF-α production (P < 0.0001) and lower phytohemagglutinin-induced IFN-γ production (P < 0.0001). Among children with sepsis, early innate and adaptive immune suppression were associated with greater number of days with multiple organ dysfunction syndrome and greater number of days with any organ dysfunction. On multivariable analyses, early innate immune suppression remained independently associated with increased multiple organ dysfunction syndrome days (adjusted relative risk, 1.2; 95% confidence interval, 1.03–1.5) and organ dysfunction days (adjusted relative risk, 1.2; 95% confidence interval, 1.1–1.3).Conclusions: Critically ill children with severe sepsis or septic shock demonstrate early innate and adaptive immune suppression. Early innate and adaptive immune suppression are associated with longer durations of organ dysfunction and may be useful markers to help guide future investigations of immunomodulatory therapies in children with sepsis.
RETRACTED: Diagnosis of Microvascular Angina Using Cardiac Magnetic Resonance
Authors: Alexander Liu, Rohan S. Wijesurendra, Joanna M. Liu, John C. Forfar, Keith M. Channon, Michael Jerosch-Herold, Stefan K. Piechnik, Stefan Neubauer, Rajesh K. Kharbanda, Vanessa M. Ferreira
Journal: Journal of the American College of Cardiology (2018)

In patients with angina and nonobstructive coronary artery disease (NOCAD), confirming symptoms due to coronary microvascular dysfunction (CMD) remains challenging. Cardiac magnetic resonance (CMR) assesses myocardial perfusion with high spatial resolution and is widely used for diagnosing obstructive coronary artery disease (CAD).The goal of this study was to validate CMR for diagnosing microvascular angina in patients with NOCAD, compared with patients with obstructive CAD and correlated to the index of microcirculatory resistance (IMR) during invasive coronary angiography.Fifty patients with angina (65 ± 9 years of age) and 20 age-matched healthy control subjects underwent adenosine stress CMR (1.5- and 3-T) to assess left ventricular function, inducible ischemia (myocardial perfusion reserve index [MPRI]; myocardial blood flow [MBF]), and infarction (late gadolinium enhancement). During subsequent angiography within 7 days, 28 patients had obstructive CAD (fractional flow reserve [FFR] ≤0.8) and 22 patients had NOCAD (FFR >0.8) who underwent 3-vessel IMR measurements.In patients with NOCAD, myocardium with IMR <25 U had normal MPRI (1.9 ± 0.4 vs. controls 2.0 ± 0.3; p = 0.49); myocardium with IMR ≥25 U had significantly impaired MPRI, similar to ischemic myocardium downstream of obstructive CAD (1.2 ± 0.3 vs. 1.2 ± 0.4; p = 0.61). An MPRI of 1.4 accurately detected impaired perfusion related to CMD (IMR ≥25 U; FFR >0.8) (area under the curve: 0.90; specificity: 95%; sensitivity: 89%; p < 0.001). Impaired MPRI in patients with NOCAD was driven by impaired augmentation of MBF during stress, with normal resting MBF. Myocardium with FFR >0.8 and normal IMR (<25 U) still had blunted stress MBF, suggesting mild CMD, which was distinguishable from control subjects by using a stress MBF threshold of 2.3 ml/min/g with 100% positive predictive value.In angina patients with NOCAD, CMR can objectively and noninvasively assess microvascular angina. A CMR-based combined diagnostic pathway for both epicardial and microvascular CAD deserves further clinical validation.
Writing Tips on...
Authors: Graham Easton
Journal: BMJ (2004)

Tips on... are single column summaries on anything relevant to doctors' careers, working lives, or personal lives. (In other words, they can be on just about anything.)

They should be original, practical, useful, and interesting and can be written by anyone who has the relevant knowledge and experience—this could be anyone from a medical student to a consultant, depending on the topic.

The word count can vary …