tbuckley/cabot-search huggingface dataset:
Reactivation of the Nkx2.5 cardiac enhancer after myocardial infarction does not presage myogenesis
Authors: Marcus-André Deutsch, Stefanie A Doppler, Xinghai Li, Harald Lahm, Gianluca Santamaria, Giovanni Cuda, Stefan Eichhorn, Thomas Ratschiller, Elda Dzilic, Martina Dreßen, Annekathrin Eckart, Konstantin Stark, Steffen Massberg, Anna Bartels, Christoph Rischpler, Ralf Gilsbach, Lutz Hein, Bernd K Fleischmann, Sean M Wu, Rüdiger Lange, Markus Krane
Journal: Cardiovascular Research (2018)

The contribution of resident stem or progenitor cells to cardiomyocyte renewal after injury in adult mammalian hearts remains a matter of considerable debate. We evaluated a cell population in the adult mouse heart induced by myocardial infarction (MI) and characterized by an activated Nkx2.5 enhancer element that is specific for multipotent cardiac progenitor cells (CPCs) during embryonic development. We hypothesized that these MI-induced cells (MICs) harbour cardiomyogenic properties similar to their embryonic counterparts.MICs reside in the heart and mainly localize to the infarction area and border zone. Interestingly, gene expression profiling of purified MICs 1 week after infarction revealed increased expression of stem cell markers and embryonic cardiac transcription factors (TFs) in these cells as compared to the non-mycoyte cell fraction of adult hearts. A subsequent global transcriptome comparison with embryonic CPCs and fibroblasts and in vitro culture of MICs unveiled that (myo-)fibroblastic features predominated and that cardiac TFs were only expressed at background levels.Adult injury-induced reactivation of a cardiac-specific Nkx2.5 enhancer element known to specifically mark myocardial progenitor cells during embryonic development does not reflect hypothesized embryonic cardiomyogenic properties. Our data suggest a decreasing plasticity of cardiac progenitor (-like) cell populations with increasing age. A re-expression of embryonic, stem or progenitor cell features in the adult heart must be interpreted very carefully with respect to the definition of cardiac resident progenitor cells. Albeit, the abundance of scar formation after cardiac injury suggests a potential to target predestinated activated profibrotic cells to push them towards cardiomyogenic differentiation to improve regeneration.
Prospective randomized trial of genomic classifier impact on treatment decisions in patients at high risk of recurrence following radical prostatectomy (G-MINOR).
Authors: Todd Matthew Morgan, David Christopher Miller, Rodney Dunn, Linsell Susan, Linda Okoth, Anna Johnson, Felix Y Feng, Ghani Khurshid, Elai Davicioni, Marguerite Du Plessis, James E. Montie, Michael L. Cher
Journal: Journal of Clinical Oncology (2018)

TPS154 Background: Approximately 30% of patients will have ≥pT3 disease and/or positive surgical margins at radical prostatectomy (RP), indicating a high risk of local recurrence. While current guidelines recommend consideration of adjuvant radiotherapy (aRT) in this setting, &lt; 10% undergo aRT. The Decipher assay is a novel, tissue-based genomic classifier (GC) developed and validated in the post-RP setting as a predictor of metastasis. Current retrospective evidence suggests that patients with a high GC score may benefit from aRT, while observation may be safe for those with a lower GC score. However, there are no randomized prospective data evaluating the clinical utility of biomarkers in men with adverse features after RP. Here we see to determine the impact of GC test results on adjuvant treatment decisions for high-risk post-RP patients vs. clinical factors alone. Methods: Genomics in Michigan ImpactiNg Observation or Radiation (G-MINOR) is a 4-year (12-month enrollment, 3-year follow-up) prospective, cluster-crossover, unblinded, study of 350 subjects from twelve Urology practices in the Michigan Urological Surgery Improvement Collaborative (MUSIC). MUSIC is a physician-led quality improvement consortium nearly all academic and community urology practices within the state of Michigan. Each clinical center participating in this trial will be randomly assigned to either a Genomic Classifier (GC)-based strategy or control arm for a period of 3 months. Patients in both arms will receive a predicted risk of recurrence based on a validated clinical nomogram, the CAPRA-S score, enabling a head-to-head comparison of the Decipher assay with a freely-available validated prognostic tool. Random assignments will be generated centrally by a study statistician and provided to centers immediately before commencing enrollment in each 3-month period. Each center will have two GC and two UC enrollment periods, maintaining study-wide balance and blinding of assignments in subsequent periods. Patients will be followed for receipt of adjuvant therapy as well as oncologic (recurrence, metastasis, and death) and patient-reported quality of life. Clinical trial information: NCT02783950.
IMPROVEMENT IN SKIN DISEASE SEVERITY IS ASSOCIATED WITH REDUCED PROGRESSION OF AORTIC WALL THICKNESS IN PATIENTS WITH PSORIASIS
Authors: Jacob Groenendyk, Parag Shukla, Agastya Belur, Amit Dey, Youssef Elnabawi, Justin Rodante, Aditya Goyal, Ahmed Sadek, Navya Nanda, Mark Ahlman, Aditya Joshi, Joel Gelfand, Martin Playford, Nehal Mehta
Journal: Journal of the American College of Cardiology (2018)
General practice has become less attractive as a career choice, researchers find
Authors: Matthew Limb
Journal: BMJ (2017)

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 General practice has become less attractive as a career choice, researchers find Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
I will feel no guilt on strike day
Authors: Janis Burns
Journal: BMJ (2016)

It is my firm belief that no junior doctor wants to strike. But it is a fact that junior doctors in England are poised to take industrial action next Tuesday.1 Should the action go ahead, 12 January 2016 will become a historic date for the medical profession. Having reached this stalemate for a second time, junior doctors and the government have both already lost. Damage has been inflicted on both parties, and the wounds will be enduring.

The words “doctor” and “strike” are each emotive. That a caring professional, relied on to do the right thing and uphold moral standards, would deliberately engage in an activity that seeks to inconvenience society and vulnerable people who need their service is seen by many as inherently wrong. Herein lies the problem with our dispute and our collective need to have public approval for it. At best, this dichotomy—striking doctors—is emotive to …
Atypical Appearance on Thyroid Scintigraphy
Authors: Ayca Arcay, Ozhan Ozgur, Funda Aydin
Journal: Clinical Nuclear Medicine (2018)

We report the case of a 49-year-old woman with achalasia in whom thyroid stimulating hormone supression was incidentally detected on routine blood tests and who therefore underwent thyroid scintigraphy. Thyroid scan demonstrated low intensity diffuse technetium Tc sodium pertechnetate accumulation inferior to thyroid gland. After correlating the images with her previous barium esophagogram, tracer accumulation caudal to thyroid gland was explained on the presumption of Tc sodium pertechnetate retention within the dilated esophagus.
在工作中遭受的紫外线照射是否是皮肤鳞状细胞癌最重要的风险因素?基于人群的病例对照研究FB-181的结果
Authors: J. Schmitt, E. Haufe, F. Trautmann, H.-J. Schulze, P. Elsner, H. Drexler, A. Bauer, S. Letzel, S.M. John, M. Fartasch, T. Brüning, A. Seidler, S. Dugas-Breit, M. Gina, W. Weistenhöfer, K. Bachmann, I. Bruhn, B.M. Lang, S. Bonness, J.P. Allam, W. Grobe, T. Stange, S. Westerhausen, P. Knuschke, M. Wittlich, T.L. Diepgen
Journal: British Journal of Dermatology (2018)

鳞状细胞癌(SCC)是一种特定形式的皮肤癌,也是欧洲最常见的癌症之一。因此,SCC对患者本身以及在社会代价方面都造成了极大的负担。SCC的一个主要原因是暴露在自然阳光下,因此可以通过避免过度曝晒来预防SCC。外出时,人们可以利用衣物(例如长袖、帽子)和防晒霜来保护皮肤。到目前为止,SCC和其他皮肤癌的预防计划主要是尝试减少在休闲时间中的过度曝晒。然而,有许多人是在室外工作的,例如农民、建筑工人和屋顶工。职业(与工作相关)和休闲时间的阳光曝晒在导致SCC中所起的作用仍不明确。由德国的医生和科学家组成的团队调查了职业和休闲时间的阳光曝晒与SCC风险之间的关联。他们将超过600名SCC患者与相同数量的健康人员进行了比较,考虑到他们在过去的阳光暴晒因素。训练有素的医生们对所有研究参与者都进行了医学检查。参与者平时在职业和休闲时间中曝晒阳光的时间通过访谈进行评估。这些访谈在研究开始之间就进行了测试,以确保准确的结果。该项研究发现,在工作中过度曝晒的人员患SCC的风险是正常人的两倍。人们在工作中曝晒越多,SCC发生的概率就越高。这项结果非常重要,它指出,要预防SCC等皮肤癌,不仅在休闲时间中需要防晒,在工作中也同样需要。
I would like to know how an MBChB degree can be used for careers other than clinical medicine. Where can I get advice on alternative career pathways for medical graduates? I only have one year of postgraduate experience.
Authors: Adam Poole
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. www.bmjcareers.com/advicezone
BMA and HMRC to discuss tax relief for junior doctors’ costs
Authors: Helen Jaques
Journal: BMJ (2013)

The BMA has begun investigating with HM Revenue & Customs how tax relief could be used to cut the amount that junior doctors pay towards their training.

The association estimated that doctors spend around £17 000 during postgraduate training on items such as professional fees and exams.1 The present HMRC rules on deducting expenses stipulate that such costs must be incurred exclusively and necessarily in the performance of contracted duties of employment. …
Beware of Limb Lead Reversal
Authors: Laszlo Littmann
Journal: JAMA Internal Medicine (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 Internal Medicine 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 Internal Medicine journal
Overall survival of patients with metastatic prostate cancer starting androgen deprivation therapy with degarelix, a gonadotropin-releasing hormone antagonist.
Authors: Stephen J. Freedland, Per Settergren Sørensen, Bo-Eric Persson
Journal: Journal of Clinical Oncology (2018)

198 Background: Morbidity and mortality amongst patients diagnosed with metastatic prostate cancer remains high and androgen deprivation therapy is the mainstay of hormonal treatments for these patients. The gonadotropin-releasing hormone (GnRH) antagonist, degarelix, has a fast and profound onset of action and compares favorably with GnRH agonists in terms of progression-free survival (PFS) and overall survival during the first year of treatment. It is of interest to assess longer term survival data in patients with very advanced disease. Methods: Data from several studies of patients treated with degarelix are available for descriptive analysis from a study repository. We analyzed data from patients with metastatic disease and prostate-specific antigen (PSA) &gt; 50 ng/mL treated with degarelix from 17 controlled and uncontrolled trials for overall survival and PFS. Possible selection bias over time was also estimated. Results: Overall, 519 patients with metastatic disease and PSA &gt; 50 ng/mL were included; median age was 71 (±6) years. Survival at 36 months was 83% for patients with baseline PSA &gt; 50 to &lt; 200 ng/mL and 72% for patients with baseline PSA &gt; 200 ng/mL. The corresponding numbers for PSA-PFS were 29% and 15%, respectively (Table). A delayed separation of Kaplan-Meier estimates was observed between the PSA &gt; 50 to &lt; 200 ng/mL and &gt; 200 ng/mL groups; 6 months for PSA-PFS and 12 months for survival. A Cox regression indicated no significant effect of age (p = 0.20) or BMI (p = 0.33). The data suggest some selection bias over time in the most advanced patients. Conclusions: The data indicate that 77% of patients with metastatic disease and PSA &gt; 50 ng/mL who start degarelix treatment are alive after an observation period of 36 months. This is an analysis of uncontrolled data and a comparative randomized approach is required to allow potential comparison with other treatments. [Table: see text]
Association of Cigarette, Cigar, and Pipe Use With Mortality Risk in the US Population
Authors: Carol H. Christensen, Brian Rostron, Candace Cosgrove, Sean F. Altekruse, Anne M. Hartman, James T. Gibson, Benjamin Apelberg, Maki Inoue-Choi, Neal D. Freedman
Journal: JAMA Internal Medicine (2018)

Tobacco products have changed in recent years. Contemporary mortality risk estimates of combustible tobacco product use are needed.To investigate the mortality risks associated with current and former use of cigars, pipes, and cigarettes.The National Longitudinal Mortality Study is a longitudinal population-based, nationally representative health survey with mortality follow-up that includes demographic and other information from the Current Population Survey, tobacco product use information from the Tobacco Use Supplement, and mortality data from the National Death Index. In this study, participants provided tobacco use information at baseline in surveys starting from 1985 and were followed for mortality through the end of 2011. The study includes 357 420 participants who reported exclusively using cigar, pipes, or cigarettes or reported never using any type of tobacco product.Current or former exclusive use of any cigar (little cigar, cigarillos, large cigar), traditional pipe, or cigarette and never tobacco use. Information on current daily and nondaily use was also collected. Estimates adjusted for age, sex, race/ethnicity, education, and survey year.All-cause and cause-specific mortality as identified as the primary cause of death from death certificate information.Of the 357 420 persons included in the analysis, the majority of current and former cigar and pipe smokers were male (79.3%-98.0%), and smokers were more evenly divided by sex (46% of current daily smokers were male). There were 51 150 recorded deaths during follow-up. Exclusive current cigarette smokers (hazard ratio [HR], 1.98; 95% CI, 1.93-2.02) and exclusive current cigar smokers (HR, 1.20; 95% CI, 1.03-1.38) had higher all-cause mortality risks than never tobacco users. Exclusive current cigarette smokers (HR, 4.06; 95% CI, 3.84-4.29), exclusive current cigar smokers (HR, 1.61; 95% CI, 1.11-2.32), and exclusive current pipe smokers (HR, 1.58; 95% CI, 1.05-2.38) had an elevated risk of dying from a tobacco-related cancer (including bladder, esophagus, larynx, lung, oral cavity, and pancreas). Among current nondaily cigarette users, statistically significant associations were observed with deaths from lung cancer (HR, 6.24; 95% CI, 5.17-7.54), oral cancer (HR, 4.62; 95% CI, 1.84-11.58), circulatory death (HR, 1.43; 95% CI, 1.30-1.57), cardiovascular death (HR, 1.24; 95% CI, 1.11-1.39), cerebrovascular death (stroke) (HR, 1.39; 95% CI, 1.12-1.74), and chronic obstructive pulmonary disease (HR, 7.66; 95% CI, 6.09-9.64) as well as for daily smokers.This study provides further evidence that exclusive use of cigar, pipes, and cigarettes each confers significant mortality risks.
TRENDS OF HOSPITALIZATIONS AND OUTCOMES WITH SINGLE VESSEL CHRONIC TOTAL OCCLUSION TREATED WITH PERCUTANEOUS CORONARY INTERVENTION
Authors: Rajkumar Doshi, Nirav Patel, Rajat Kalra, Harpreet Arora, Navkaranbir Bajaj, Garima Arora, Pankaj Arora
Journal: Journal of the American College of Cardiology (2018)
Thromboembolic (TE) complications in germ cell tumor (GCT) patients: Should use of peripherally inserted central catheters (PICC-Line) be pursued?
Authors: Louis Francois, Marine Gross-Goupil, Gregoire Robert, Alain Ravaud
Journal: Journal of Clinical Oncology (2018)

571 Background: Patients with GCT receiving cisplatin-based chemotherapy are at high risk of TE events (TEE). Several risk factors have been reported previously, such as cisplatin, Lactate Deshydrogenase, body surf area (BSA)... Methods: we conducted a retrospective study of all patients (pts) with GCT, treated with platinum salts and followed at the university hospital and anticancer center of Bordeaux (June 2007 - January 2015). The following characteristics were recorded: age, performans status, BSA, histological type, site of primitive tumor, stage, prognosis (IGCCCG classification), size of retroperitoneal lymphnode, LDH, type of venous pathway (peripheral vein, implantable venous access port or PICC-Line), prophylaxis of anticoagulant or not, TEE and median time to onset. Results: 206 pts were selected. Thirty-six (17.4%) had one or more venous or arterial TEE during or within 3 months of the end of chemotherapy: 26 deep vein thromboses, 13 pulmonary embolisms and 4 arterial accidents (2 acute limb ischemia and 2 acute coronary syndromes). The median time between treatment initiation and occurrence of TEE was 38.5 days [7-248]. Among the 12 pts with PICC-line, 6 (50%) had a TEE, including 4 cases of pulmonary embolism. In addition to the presence of a PICC-line (OR 4.62 [1.28, 15.56]), factors associated with an increased TE risk in univariate analysis were the use of implantable venous access port (OR: 3.97 [1.81; 9.12]), size of retroperitoneal adenopathy ≥ 2 cm ([2-5 cm]: OR: 24.39 [4.50 - 454.39]; &gt; 5cm : OR : 26.25 [5,00 - 484.5]), stage II (OR : 10.19 [1,9 - 188.96]), stage III (OR :27.2 [5.34 - 479.9]), prognosis group (good : OR : 11.16 [2.16 - 205.04]) ; intermediate : OR : 31.50 [4.81 – 624.20] ; unfavorable : OR : 33.35 [5.7 – 637.34]), VIP (etoposide-ifosfamide-cisplatin) protocol (OR :6.35 [1.51 – 28.15]) and high LDH level (OR :3.88 [1.63 – 10.34]). Conclusions: These results suggest a significant association between PICC-line and the occurrence of TEE in univariate analysis. PICC-line is not risk-free and should be used sparingly in pts with GCT whose treatment objective remains primarily a cure at the cost of less toxicity.
Comprehensive genomic profiling (CGP) in <i>KRAS</i> wild-type (WT) pancreatic ductal adenocarcinoma (PDAC).
Authors: Ben George, Joel R. Greenbowe, Andrew Eugene Hendifar, Talia Golan, Milind M. Javle, Anirban Maitra, Nathan Bahary, Alexa Betzig Schrock, Philip J. Stephens, Vincent A. Miller, Jeffrey S. Ross, Evgeny Yakirevich, Paul S. Ritch, James P. Thomas, Siraj Mahamed Ali, Aatur D. Singhi
Journal: Journal of Clinical Oncology (2018)

271 Background: Mutations in oncogenic KRAS have been widely accepted as the signature genomic alteration (GA) in sporadic PDAC, but therapeutic efforts aimed at targeting constitutively activated KRAS have been disappointing. We examined somatic GAs in KRAS WT PDAC utilizing a CGP platform to identify actionable targets. Methods: DNA was extracted from formalin fixed paraffin embedded (FFPE) PDAC clinical specimens and CGP was performed on hybrid-capture, adaptor ligation based libraries to a mean coverage depth of &gt; 600 unique reads. Alterations in the RAS/ RAF/ MEK pathway genes ( KRAS, NRAS, HRAS, ARF, BRAF, EGFR, MAP2K2, MAP2K1, MAPK1) and DNA Damage Repair (DDR) pathway genes ( BRCA1/2, ATM, ATR, BRIP1, RAD50, RAD51, RAD52, PALB2, CHEK1, CHEK2) were examined. Tumor mutational burden (TMB) was determined on 1.1 Mbp of sequenced DNA and microsatellite instability (MSI) was determined on 114 loci. TMB was categorized based on mutations(m)/Mbp of DNA - high (H; &gt; 20), Intermediate (I; 8-20) and low (L; &lt; 8). Results: CGP was performed on 3426 PDAC specimens; 1815 (53%) were male, 390 (11.3%) were KRAS WT. GAs in the RAS/ RAF/ MEK pathway were identified in 90.6% of all cases, while 68 (17.4%) KRAS WT cases had one or more GAs in RAS/ RAF/ MEK pathway genes. DDR pathway GAs were identified in 1405 (41%) cases for a total of 2050 GAs, and 180 (46%) KRAS WT cases for a total of 285 GAs. DDR pathway alterations were common in KRAS WT PDAC compared to KRAS mutated PDAC (p = 0.028). Among the 842 (24.6%) cases with available TMB data, 5 (0.6%), 104 (12.3%) and 733 (87.1%) pts had H, I and L, TMB respectively. Among 88 (22.6%) KRAS WT cases with available TMB data, 2 (2.3%), 12 (13.6%) and 74 (84.1%) pts had H, I and L, TMB, respectively. MSI status was available in 2314 (67.5%) cases, 13 (0.6%) were MSI-high (MSI-H); among the KRAS WT cases, 222 (57%) had MSI status available, 3 (1.3%) were MSI-H. Conclusions: MSI-H status and high TMB are rare in PDAC, regardless of KRAS mutation status. GAs in the DDR pathway are relatively common in PDAC and may serve as predictive biomarkers for platinum chemotherapeutic agents and/or PARP inhibitors. Prospective validation of such predictive gene signatures will improve therapeutic efficacy and minimize toxicities.
iwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of CLL
Authors: Michael Hallek, Bruce D. Cheson, Daniel Catovsky, Federico Caligaris-Cappio, Guillermo Dighiero, Hartmut Döhner, Peter Hillmen, Michael Keating, Emili Montserrat, Nicholas Chiorazzi, Stephan Stilgenbauer, Kanti R. Rai, John C. Byrd, Barbara Eichhorst, Susan O’Brien, Tadeusz Robak, John F. Seymour, Thomas J. Kipps
Journal: Blood (2018)
RISK OF OBSTRUCTIVE CORONARY ARTERY DISEASE AND MAJOR ADVERSE CARDIAC EVENTS IN PATIENTS WITH NON-CORONARY ATHEROSCLEROSIS: INSIGHTS FROM THE VETERANS AFFAIRS CLINICAL ASSESSMENT, REPORTING AND TRACKING (CART) PROGRAM
Authors: Antonio Gutierrez, Deepak Bhatt, Subhash Banerjee, Thomas Glorioso, Meg Plomondon, Rajesh Swaminathan, Thomas M. Maddox, Ehrin J. Armstrong, Claire Duvernoy, Stephen Waldo, Sunil V. Rao
Journal: Journal of the American College of Cardiology (2018)
Poor Correlation, Reproducibility, and Agreement Between Volumetric Versus Linear Epicardial Adipose Tissue Measurement
Authors: Nitesh Nerlekar, Yi-Wei Baey, Adam J. Brown, Rahul G. Muthalaly, Damini Dey, Balaji Tamarappoo, James D. Cameron, Thomas H. Marwick, Dennis T. Wong
Journal: JACC. Cardiovascular imaging (2018)
I am just applying to the foundation programme, anticipating graduation this year. I have a three year gap in my medical training (midway through) on health grounds. Do I need to put the entry date to medical school on my CV? If so, how best can I explain, or not explain, the temporary withdrawal from studies?
Authors: Sarah Burnett
Journal: BMJ (2007)

Have a career related problem that needs answering? Can9t find the 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>