tbuckley/cabot-search huggingface dataset:
Patient Preferences for Follow-up After Recent Excision of a Localized Melanoma
Authors: Wei-Yin Lim, Rachael L. Morton, Robin M. Turner, Marisa C. Jenkins, Pascale Guitera, Les Irwig, Angela C. Webster, Mbathio Dieng, Robyn P. M. Saw, Donald Low, Cynthia Low, Katy J. L. Bell
Journal: JAMA Dermatology (2018)

<h3>Importance</h3> The standard model of follow-up posttreatment of localized melanoma relies on clinician detection of recurrent or new melanoma, through routinely scheduled clinics (clinician-led surveillance). An alternative model is to increase reliance on patient detection of melanoma, with fewer scheduled visits and increased support for patients' skin self-examination (SSE) (eg, using smartphone apps to instruct, prompt and record SSE, and facilitate teledermatology; patient-led surveillance). <h3>Objective</h3> To determine the proportion of adults treated for localized melanoma who prefer the standard scheduled visit frequency (as per Australian guideline recommendations) or fewer scheduled visits (adapted from the Melanoma Follow-up [MELFO] study of reduced follow-up). <h3>Design, Setting, and Participants</h3> This survey study used a telephone interview for surveillance following excision of localized melanoma at an Australian specialist center. We invited a random sample of 400 patients who had completed treatment for localized melanoma in 2014 to participate. They were asked about their preferences for scheduled follow-up, and experience of follow-up in the past 12 months. Those with a recurrent or new primary melanoma diagnosed by the time of interview (0.8-1.7 years since first diagnosis) were asked about how it was first detected and treated. SSE practices were also assessed. <h3>Main Outcomes and Measures</h3> Proportion preferring standard vs fewer scheduled clinic visits, median delay between detection and treatment of recurrent or new primary melanoma, and SSE practices. <h3>Results</h3> Of the 262 people who agreed to be interviewed, the mean (SD) age was 64.3 (14.3) years, and 93 (36%) were women. Among the 230 people who did not have a recurrent or new primary melanoma, 149 vs 81 preferred the standard vs fewer scheduled clinic visits option (70% vs 30% after adjusting for sampling frame). Factors independently associated with preferring fewer visits were a higher disease stage, melanoma on a limb, living with others, not having private health insurance, and seeing a specialist for another chronic condition. The median delay between first detection and treatment of recurrent or new primary melanoma was 7 and 3 weeks, respectively. Only 8% missed a scheduled visit, while 40% did not perform SSE or did so at greater than 3-month intervals. <h3>Conclusions and Relevance</h3> Some patients with melanoma may prefer fewer scheduled visits, if they are supported to do SSE and there is rapid clinical review of anything causing concern (patient-led surveillance).
Ever-Pregnant Female Blood Donors and Mortality Risk in Male Recipients
Authors: Stuart J. Pocock, Andrés Conthe
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
The clinical presentation, diagnosis, treatment and long term outcome of germ cell tumor in 85 patients with Down syndrome.
Authors: Emma Weatherford, Jue Wang
Journal: Journal of Clinical Oncology (2018)

554 Background: The main objective of this study was to determine the clinical features, treatment, clinical outcome and prognosis of Down's syndrome (DS) patients with germ cell tumor (GCT). Methods: Literature search based on PubMed search was performed using the following keywords: “Germ cell tumor (GCT)” and “Down's syndrome”. A total of 85 cases of GCT in DS patients published in literature between January 1985 and October 2017 were identified. Results: Our final cohort of GCT in DS include 44 cases of testicular germ cell tumor (TGCT); 22 intracranial GCT, 2 primary mediastinal GCT, 3 gastrointestinal GCT, 9 retroperitoneal GCT, and 5 cases of ovarian GCT. The median age of forty-four testicular GCT was 30 years (range 2 years – 50 years). In most cases, cancer was diagnosed following the discovering of swelling by care provider or found incidentally (either painless or painful) in the region of the testes, although abdominal pain was a symptom in a few cases. 29 (66%) patients were diagnosed with seminoma and 15 (34%) with non-seminoma. In the seminoma group, 18 (62%) patients were diagnosed with stage I , 9 (31%) with stage II and 2 (7%) with stage III. In the non-seminoma group, 4 (27%) patients were diagnosed with stage I, 5 (33%) with stage II and 6 (40%) with stage III. Nearly all patients (94%) underwent orchiectomy. 52% patients received chemotherapy, with BEP being the most common administered regimen. 7 patients had retroperitoneal lymph node dissection ( RPLND). In the seminoma group, there were 5 deaths, 3 related to disease progression, 2 related to comorbidities, 1 died during chemotherapy. In the non-seminoma group, there were 2 deaths, 1 related to disease progression, 1 died during chemotherapy. The overall survival at 5 years for stage I was 100%, 76% for stage II and 68% for stage III. Conclusions: In this largest cohort of GCT in DS, we found TGCTs are often diagnosed at stage II or III. In addition, delayed diagnosis, comorbidities likely contributed to the inferior outcome in stage II/III TGCTs in patients with DS. Emphasis on education, better communication, early screening and detection, are needed to improve the outcome in this population.
Clinical and Genetic Risk Factors for Adverse Metabolic Outcomes in North American Testicular Cancer Survivors
Authors: Mohammad Abu Zaid, Wambui G. Gathirua-Mwangi, Chunkit Fung, Patrick O. Monahan, Omar El-Charif, Annalynn M. Williams, Darren R. Feldman, Robert J. Hamilton, David J. Vaughn, Clair J. Beard, Ryan Cook, Sandra K. Althouse, Shirin Ardeshir-Rouhani-Fard, Paul C. Dinh, Howard D. Sesso, Lawrence H. Einhorn, Sophie D. Fossa, Lois B. Travis
Journal: Journal of the National Comprehensive Cancer Network (2018)

Background: Testicular cancer survivors (TCS) are at significantly increased risk for cardiovascular disease (CVD), with metabolic syndrome (MetS) an established risk factor. No study has addressed clinical and genetic MetS risk factors in North American TCS. Patients and Methods: TCS were aged <55 years at diagnosis and received first-line chemotherapy. Patients underwent physical examination, and had lipid panels, testosterone, and soluble cell adhesion molecule-1 (sICAM-1) evaluated. A single nucleotide polymorphism in rs523349 (5-α-reductase gene, SRD5A2), recently implicated in MetS risk, was genotyped. Using standard criteria, MetS was defined as ≥3 of the following: hypertension, abdominal obesity, hypertriglyceridemia, decreased high-density lipoprotein (HDL) cholesterol level, and diabetes. Matched controls were derived from the National Health and Nutrition Examination Survey. Results: We evaluated 486 TCS (median age, 38.1 years). TCS had a higher prevalence of hypertension versus controls (43.2% vs 30.7%; P<.001) but were less likely to have decreased HDL levels (23.7% vs 34.8%; P<.001) or abdominal obesity (28.2% vs 40.1%; P<.001). Overall MetS frequency was similar in TCS and controls (21.0% vs 22.4%; P=.59), did not differ by treatment (P=.20), and was not related to rs523349 (P=.61). For other CVD risk factors, TCS were significantly more likely to have elevated low-density lipoprotein (LDL) cholesterol levels (17.7% vs 9.3%; P<.001), total cholesterol levels (26.3% vs 11.1%; P<.001), and body mass index ≥25 kg/m2 (75.1% vs 69.1%; P=.04). On multivariate analysis, age at evaluation (P<.001), testosterone level ≤3.0 ng/mL (odds ratio [OR], 2.06; P=.005), and elevated sICAM-1 level (ORhighest vs lowest quartile, 3.58; P=.001) were significantly associated with MetS. Conclusions and Recommendations: Metabolic abnormalities in TCS are characterized by hypertension and increased LDL and total cholesterol levels but lower rates of decreased HDL levels and abdominal obesity, signifying possible shifts in fat distribution and fat metabolism. These changes are accompanied by hypogonadism and inflammation. TCS have a high prevalence of CVD risk factors that may not be entirely captured by standard MetS criteria. Cancer treatment–associated MetS requires further characterization.
I want to spend six months to one year working in Canada after F2. Are short term jobs available? Will I have to do the exams?
Authors: Deana Midmer
Journal: BMJ (2005)

Have a career or related problem that needs answering? Can9t find the right person to point you in the right direction? Log on to the Advice Zone for reliable medical careers advice. You can post a question or see if one of our 300 advisers has already answered a similar question. Here is a selection of questions and answers posted on the site. <b>www.bmjcareers.com/advicezone</b>
Structure-based design, synthesis, and biological evaluation of novel pyrimidinone derivatives as PDE9 inhibitors
Authors: Xu-Nian Wu, Ya-Dan Huang, Jin-Xuan Li, Yan-Fa Yu, Zhou Qian, Chen Zhang, Yinuo Wu, Hai-Bin Luo
Journal: Acta Pharmaceutica Sinica B (2018)

The pathological processes of Alzheimer's disease and type 2 diabetes mellitus have been demonstrated to be linked together. Both PDE9 inhibitors and PPARγ agonists such as rosiglitazone exhibited remarkable preclinical and clinical treatment effects for these two diseases. In this study, a series of PDE9 inhibitors combining the pharmacophore of rosiglitazone were discovered. All the compounds possessed remarkable affinities towards PDE9 and four of them have the IC50 values <5 nmol/L. In addition, these four compounds showed low cell toxicity in human SH-SY5Y neuroblastoma cells. Compound 11a, the most effective one, gave the IC50 of 1.1 nmol/L towards PDE9, which is significantly better than the reference compounds PF-04447943 and BAY 73-6691. The analysis of putative binding patterns and binding free energy of the designed compounds with PDE9 may explain the structureactivity relationships and provide evidence for further structural modifications.
I have been a part time GP for five years and no longer wish to continue. I would like to cross over into psychology, but I am clueless how to do this as I would have to continue working while training and I have three young children. Any advice would be appreciated.
Authors: Ruth Chambers
Journal: BMJ (2005)

Have a career or related problem that needs answering? Can9t find the right person to point you in the right direction? Log on to the Advice Zone for reliable medical careers advice. You can post a question or see if one of our 300 advisers has already answered a similar question. Here is a selection of questions and answers posted on the site. <b>www.bmjcareers.com/advicezone</b>
Chamonix expedition medicine
Authors: Wendy Russell
Journal: BMJ (2009)

The Chamonix expedition medicine course is ideal for any medical professional with an interest in expedition or remote medicine, from those who are brand new to the subject to those who have previously been on expeditions. Healthcare professionals from all countries are equally welcomed. Candidates this year consisted of doctors, nurses, and medical students.

I was a third year medical student at the time and was spending a six week placement in France.

I was exploring career paths and doing some elective planning, and I wanted to know more about the role and opportunities for an expedition medic. As I had no previous experience of expeditions except for the odd snowboarding trip, this course really helped me to get a feel of what is required for this kind of work in terms of medical skills and the personality required. I was totally hooked. Doing this course has given …
Response by Kusters et al to Letter Regarding Article, “Effect of Rosuvastatin on Carotid Intima-Media Thickness in Children With Heterozygous Familial Hypercholesterolemia: The CHARON Study (Hypercholesterolemia in Children and Adolescents Taking Rosuvastatin Open Label)”
Authors: D. Meeike Kusters, Marjet J.A.M. Braamskamp, Gisle Langslet, Brian W. McCrindle, David Cassiman, Gordon A. Francis, Claude Gagne, Daniel Gaudet, Katherine M. Morrison, Albert Wiegman, Traci Turner, Elinor Miller, Joel Raichlen, Paul D. Martin, Evan A. Stein, John J.P. Kastelein, Barbara A. Hutten
Journal: Circulation (2018)
Only a 10th of doctors would recommend a career in medicine
Authors: Tom Moberly
Journal: BMJ (2015)

One in 10 doctors would recommend a career in medicine, while around two thirds would discourage a relative from becoming a doctor, show the results of an online poll of over 400 doctors.

In response to a survey by Doctors.net.uk, answered by 480 doctors, 10% said that they would encourage or strongly encourage a relative who was wondering whether to pursue a career as …
Handling Tough Job Interviews
Authors: Peter Cross
Journal: BMJ (2005)

Julie-Ann Amos

How To Books, 2005, 165 pages, £9.99

ISBN: 1 85703 845 2

Rating: ⋆/5



I almost returned this book to the shelf seconds after opening it. I chanced across the following sentence in the preface—“This book is not about manipulating interviews or quick hints to pass difficult ones.” Why else would you want to buy this sort of book? But Julie-Ann Amos, a human resources consultant, has other ideas. She has a few useful titbits here and there but they are well concealed beneath pages of padding. Do you, …
Tropoelastin Implants That Accelerate Wound Repair
Authors: Suzanne M. Mithieux, Behnaz Aghaei‐Ghareh‐Bolagh, Leping Yan, Kekini V. Kuppan, Yiwei Wang, Francia Garces‐Suarez, Zhe Li, Peter K. Maitz, Elizabeth A. Carter, Christina Limantoro, Wojciech Chrzanowski, David Cookson, Alan Riboldi‐Tunnicliffe, Clair Baldock, Kosuke Ohgo, Kristin K. Kumashiro, Glenn Edwards, Anthony S. Weiss
Journal: Advanced Healthcare Materials (2018)

Abstract A novel, pure, synthetic material is presented that promotes the repair of full‐thickness skin wounds. The active component is tropoelastin and leverages its ability to promote new blood vessel formation and its cell recruiting properties to accelerate wound repair. Key to the technology is the use of a novel heat‐based, stabilized form of human tropoelastin which allows for tunable resorption. This implantable material contributes a tailored insert that can be shaped to the wound bed, where it hydrates to form a conformable protein hydrogel. Significant benefits in the extent of wound healing, dermal repair, and regeneration of mature epithelium in healthy pigs are demonstrated. The implant is compatible with initial co‐treatment with full‐ and split‐thickness skin grafts. The implant's superiority to sterile bandaging, commercial hydrogel and dermal regeneration template products is shown. On this basis, a new concept for a prefabricated tissue repair material for point‐of‐care treatment of open wounds is provided.
Boost GP recruitment by training medical students in practices, say researchers
Authors: Abi Rimmer
Journal: BMJ (2017)

Medical students who receive their primary care training in general practice rather than a classroom are more likely to choose to enter the profession, researchers have found.

The researchers said that their findings showed that more medical undergraduate funding should be directed towards general practice placements “to address the crisis in recruitment in primary medical care.”1

In a paper published in the British Journal of General Practice , researchers from Newcastle Medical School said that they had found “an association between the quantity of clinical general practice teaching at medical school and later …
Provider attitudes and management regarding returning to drive after concussion
Authors: John A Lucas, Justin B Moore, Stephen Davis, Johnell O Brooks, Christopher Miles
Journal: British Journal of Sports Medicine (2018)

The annual incidence of sports and recreational-related concussion in the USA is 1.6–3.8 million.1 Just as concussions are common in adolescents, so are motor vehicle crashes. Asif et al 2 recently showed that motor vehicle crashes are the most common cause of sudden death in collegiate athletes across levels of competition, gender, race and sport.2 

Driving is a complex task that requires coordination of cognitive, visual and motor skills as well as higher cognitive skills such as concentration, attention, visual perception, insight and memory. Concussion may induce a variety of cognitive perturbations that might compromise driving ability— including physical symptoms such as headache or dizziness, cognitive dysfunction, emotional lability, as well as impaired sleep. Though there are no published data on driving after concussion, there are published data regarding driving after mild traumatic brain injury (mTBI). …
Mutational profiling of isolated myeloid sarcomas and utility of serum 2HG as biomarker of IDH1/2 mutations
Authors: Christophe Willekens, Aline Renneville, Sophie Broutin, Véronique Saada, Jean-Baptiste Micol, Julia Delahousse, Vianney Poinsignon, Claire Bories, Céline Berthon, Raphael Itzykson, Nicolas Boissel, Cyril Quivoron, Marie Terroir-Cassou-Mounat, Jacques Bosq, Claude Preudhomme, Angelo Paci, Virginie Penard-Lacronique, Stéphane De Botton
Journal: Leukemia (2018)
A D B Webster
Authors: Helen Chapel, Brett Webster
Journal: BMJ (2018)

A D B Webster (“David”) was born in Stanmore, Middlesex, on 1 March 1940. He was a junior registrar at the Royal Devon and Exeter Hospital from 1967 to 1969. He passed his membership exam for the Royal College of Physicians in 1969 and consolidated his general medical training in the Wessex regional renal unit. Having discovered an interest in and a flair for immunology, David joined the clinical research centre at Northwick Park Hospital as a senior registrar in immunology, the first to be created in 1971. While there he was introduced to primary immune deficiency (PID) and autoimmune disorders, under the guidance of Geoffrey Asherson. His many clinical publications on PIDs during this …
GPs defend independent contractor status
Authors: Matthew Limb
Journal: BMJ (2016)

GPs have mounted a successful defence of their independent contractor status at the BMA’s special conference of local medical committees (LMCs) in London this week.

The conference rejected a call for the BMA’s General Practitioners Committee to explore “moving away” from the model in considering future types of contract. Some delegates argued that the move was needed because many younger doctors were opting to be salaried rather than take on the responsibilities of running their own businesses and partnerships.

Paul Roblin, of Berkshire, Buckinghamshire, and Oxfordshire LMC, said that there was a “crisis in partnership,” linked to financial, workload, and regulatory pressures and the departure of many older GPs. He said, “There’s no question …
Inaugural European Louisville Microsurgery Course—Frankfurt
Authors: Ewan Wilson
Journal: BMJ (2008)

Microsurgery is becoming more commonplace with the advent of better equipment and techniques.

Christine M Kleinert was responsible for the first revascularisation of an incompletely amputated thumb in 1963, and since then the Kleinert Institute, Louisville, has been at the forefront of hand and microsurgery.

Robert Acland has furthered research in this area and has developed a teaching course, which is delivered year round to fellows and visiting clinicians. Research links between Frankfurt and Louisville enabled this course to take place in Europe for the first time.

Anyone who practises microsurgery within their specialty. This is normally commonplace in plastic, maxillofacial, paediatric, cardiac, vascular, neuro, and some orthopaedic and trauma surgery.

Within my specialty (plastic surgery) microsurgery is an everyday practice, anastomosing nerves and blood vessels to restore sensation and revascularise after trauma or free tissue transfer.

It is important to have experience as well as a sound basis and technique before performing microsurgery in an operative setting.

A great deal. …
SPECTRAL DETECTOR CT ASSISTED TAVR PLANNING: INITIAL RESULTS FROM A PROSPECTIVE STUDY
Authors: Rahul Balan Thomas, Amer Alaiti, Anas Fares, Nils Grosse HoKamp, Rivka Kessner, Sadeer Al-Kindi, Ben Ravaee, Les Ciancebello, Guilherme Attizzani, Hiram Bezerra, Robert Gilkeson, Sanjay Rajagopalan
Journal: Journal of the American College of Cardiology (2018)
Chest radiograph survival course for doctors
Authors: Neil Folwell
Journal: BMJ (2009)

The Chest X-ray Survival Course organised by www.radiology-courses.com is one of the few chest radiograph courses designed to provide formal teaching on different disease presentations and commonly missed diagnoses. Clear, well structured information that would be useful to doctors from all specialties is delivered. The course organisers, all of whom are consultant radiologists, are quick to highlight that the chest radiograph is still the most common radiology request in every general hospital. Basic skills that are essential for accurate and informed assessment are often absent, however, because of a preoccupation with other more sophisticated imaging techniques.

Doctors at all levels could benefit from the course, although it is mainly aimed at …
Legal aspects of surgical practice
Authors: Niroshan Sivathasan
Journal: BMJ (2010)

I attended the first Legal aspects of surgical practice course held at the Royal College of Surgeons of England. This one day course, covering red flag situations, was convened by Paul Marks, consultant neurosurgeon and deputy coroner for West Yorkshire. 

This course is suitable for doctors at all levels. Most of the 50 attendees when I took the course were registrars, many of whom were approaching their exit exams, but there were also a large number of consultants (including professors). Junior trainees (foundation doctors and core trainees) may not benefit as much as middle tier and senior staff.

I took this course during my specialist training period just before doing a part time higher research degree.

The law is a living and dynamic system that affects most areas of our lives, and certainly governs several principles in our …