tbuckley/cabot-search huggingface dataset:
Hospital volume and mortality after transjugular intrahepatic portosystemic shunt creation in the United States
Authors: Ammar Sarwar, Lujia Zhou, Victor Novack, Elliot B. Tapper, Michael Curry, Raza Malik, Muneeb Ahmed
Journal: Hepatology (2017)

The link between higher procedure volume and better outcomes for surgical procedures is well established. We aimed to determine whether procedure volume affected inpatient mortality in patients undergoing transjugular intrahepatic portosystemic shunt (TIPS). An epidemiological analysis of an all-payer database recording hospitalizations during 2013 in the United States (Nationwide Readmissions Database) was performed. All patients ≥ 18 years old undergoing TIPS during a hospital admission (n = 5529) without concurrent or prior liver transplantation were selected. All-cause inpatient mortality was assessed. Risk-adjusted mortality was assessed for hospitals categorized into quintiles based on annual TIPS volume (very low, 1-4/year; low, 5-9/year; medium, 10-19/year; high, 20-29/year; and very high, ≥ 30/year). TIPS were placed in all 5529 patients (mean age, 57 years [standard deviation, ± 10.9 years]; women, n = 2071; men, n = 3458). Mortality decreased with rising annual TIPS volume (13% for very low to 6% for very high volume hospitals; P < 0.01). Elective admissions were more common in hospitals with higher annual TIPS volume (20.3% for very low to 30.8% for very high; P < 0.01). On multivariate analysis, compared with hospitals performing ≥30 TIPS per year, only hospitals performing 1-4/year (adjusted odds ratio [aOR], 1.9; 95% confidence interval [CI], 1.21-3.01; P = 0.01), 5-9/year (aOR, 2.0; 95% CI, 1.25-3.17; P < 0.01), and 10-19/year (aOR, 1.9; 95% CI, 1.17-3.00; P = 0.01) had higher inpatient mortality (20-29/year: aOR, 1.4; 95% CI, 0.84-2.84; P = 0.19). The absolute difference between risk-adjusted mortality rate for very low volume and very high volume hospitals was 6.1% (13.9% versus 7.8%). TIPS volume of ≤ 20 TIPS/year, variceal bleeding, and nosocomial infections were independent risk factors for inpatient mortality in patients with both elective and emergent admissions. Conclusion: The risk of inpatient mortality is lower in hospitals performing ≥20 TIPS per year. Future research exploring preventable factors for higher mortality and benefits of patient transfer to higher volume centers is warranted. (Hepatology 2018;67:690-699).
Referral System for Colorectal Cancers. Does it Make a Difference?
Authors: N Kulkarni, P Shah, A Joseph, M Foster, A Woodward, P Haray
Journal: Endoscopy (2006)

Aims: To analyse the management and outcome of colorectal cancer patients at 2 adjacent DGH's (Hospitals A & B) in Wales. Patients suspected to have colorectal cancer are seen at a one stop rapid access clinic with flexible sigmoidoscopies using a designated referral form in Hospital A while they are seen in a general surgical clinic or in a nurse led open access endoscopy clinic in Hospital B.
MYC is a positive regulator of choline metabolism and impedes mitophagy-dependent necroptosis in diffuse large B-cell lymphoma
Authors: J Xiong, L Wang, X-C Fei, X-F Jiang, Z Zheng, Y Zhao, C-F Wang, B Li, S-J Chen, A Janin, R P Gale, W-L Zhao
Journal: Blood Cancer Journal (2017)

The activation of oncogenes can reprogram tumor cell metabolism. Here, in diffuse large B-cell lymphoma (DLBCL), serum metabolomic analysis revealed that oncogenic MYC could induce aberrant choline metabolism by transcriptionally activating the key enzyme phosphate cytidylyltransferase 1 choline-α (PCYT1A). In B-lymphoma cells, as a consequence of PCYT1A upregulation, MYC impeded lymphoma cells undergo a mitophagy-dependent necroptosis. In DLBCL patients, overexpression of PCYT1A was in parallel with an increase in tumor MYC, as well as a decrease in serum choline metabolite phosphatidylcholine levels and an International Prognostic Index, indicating intermediate–high or high risk. Both in vitro and in vivo, lipid-lowering alkaloid berberine (BBR) exhibited an anti-lymphoma activity through inhibiting MYC-driven downstream PCYT1A expression and inducing mitophagy-dependent necroptosis. Collectively, PCYT1A was upregulated by MYC, which resulted in the induction of aberrant choline metabolism and the inhibition of B-lymphoma cell necroptosis. Referred as a biomarker for DLBCL progression, PCYT1A can be targeted by BBR, providing a potential lipid-modifying strategy in treating MYC-High lymphoma.
Important Considerations for Diversity in the Selection of Dermatology Applicants
Authors: Kenneth G. Gross
Journal: JAMA Dermatology (2017)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Dermatology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Dermatology journal
Prospective multicentre clinical study on inter- and intrapatient genetic variability for antimicrobial resistance of Helicobacter pylori
Authors: C. Bilgilier, A. Stadlmann, A. Makristathis, J. Thannesberger, M.-T. Kastner, P. Knoflach, P. Steiner, M. Schöniger-Hekele, C. Högenauer, A. Blesl, C. Datz, U. Huber-Schönauer, R. Schöfl, F. Wewalka, A. Püspök, N. Mitrovits, J. Leiner, H. Tilg, M. Effenberger, M. Moser, F. Siebert, I. Hinterberger, H. Wurzer, T. Stupnicki, N. Watzinger, G. Gombotz, R. Hubmann, S. Klimpel, S. Biowski-Frotz, C. Schrutka-Kölbl, I. Graziadei, O. Ludwiczek, M. Kundi, A.M. Hirschl, C. Steininger
Journal: Clinical Microbiology and Infection (2017)
Practice that suspended GP who later died by suicide used “a sledgehammer to crack a nut,” says coroner
Authors: Clare Dyer
Journal: BMJ (2017)

The NHS lost sight of the fact that a GP who was suspended from work and later died by suicide was “a human being,” a coroner has concluded.

Wendy Potts was suspended from her practice after a patient complained about an online blog post she wrote about the effects of her bipolar disorder on her and her family. The patient questioned whether she should work as a GP when she had the disorder.

Potts was suspended from the practice in October 2015, which was not identified during the inquest, and the next …
Splanchnic vein thrombosis in ambulatory pancreatic cancer patients receiving chemotherapy.
Authors: Vanessa Pachón Olmos, Silvia Garcia Adrian, Mercedes Cavanagh Podesta, Luisa Sánchez Lorenzo, Eva Martinez De Castro, Purificación Martínez del Prado, Mercedes Salgado Fernández, Jose David Cumplido Buron, Joaquina Martínez-Galán, Ana Isabel Ferrer Perez, Maria Muniz Castrillo, Cynthia S. González Rivas, Borja Lopez de San Vicente Hernandez, Paula Jiménez-Fonseca, Andres Jesus Muñoz Martin
Journal: Journal of Clinical Oncology (2015)

e20658 Background: Splanchnic vein thrombosis (SVT) is a common complication in exocrine pancreatic cancer (EPC) receiving chemotherapy in ambulatory setting. However it´s true incidence and prognosis remains uncertain. So far, only few studies have addressed the outcome of patients with EPC and SVT. Methods: We performed a retrospective chart review to determine the incidence of SVT in patients attended in ten hospitals of the Cancer & Thrombosis Working Group of the Spanish Society of Medical Oncology (SEOM). 626 consecutive patients who were diagnosed and received chemotherapy for EPC from January 2008 through December 20011 were identified and included in the analysis. Results: SVT was identified in 47 (7.5%) patients after a median follow-up of 9.5 months. Clinical characteristics Table 1. Median time to diagnosis of SVT was 1.9 months (range 0-53 months). 64% of the events occurred during the first six months after diagnosis. We identified other 6 patients who experienced two simultaneous different events (2 deep vein thrombosis [DVT] and 4 pulmonary embolism [PE]) but they were excluded form the analysis. 96% percent of the SVT events were incidentally discovered. Overall survival in SVT patients was comparable to patients without venous thromboembolism diagnosis (hazard ratio 0.80, 95% CI, 0.57-1.10; p=0.17). However, a significant worse overall survival was observed in patients diagnosed with PE or DVT compared to SVT (hazard ratio 1.92, 95% CI, 1.29-2.86). Conclusions: SVT is a relative common finding in EPC and the majority of the events are diagnosis incidentally. Our findings suggest incidental SVT in EPC is not associated to worse prognosis. Clinical characteristics. Clinical Characteristics Overall population SVT population Number Percentage (%) Number Percentage (%) Age- year old Median 65.0 Range 31-88 Median 60.5 Range (44-79) Sex Male 359 57 24 51 Female 267 43 23 49 ECOG 0 160 26 14 30 1 310 50 25 53 ≥ 2 140 22 8 17 Unknown 16 2 Pancreatic cancer location Head 375 60 15 32 Body 80 13 16 34 Tail 77 12 11 23 Overlapping 65 11 5 11 Unknown/not defined 14 2 Disease extent Localized 70 11 2 4 Locally advanced 186 30 12 26 Metastatic 369 59 33 70 Unknown 1 0.2 Previous VTE 20 3.5 0 0 Previous arterial thromboembolism 52 8 1 2
Protein analysis of primary and recurrent human malignant gliomas
Authors: Michael Mitchell, Laura L. Eggink, Adrienne C. Scheck
Journal: Cancer Research (2006)

3583  Malignant gliomas are typically treated with surgery, radiation and chemotherapy. In spite of available treatments, recurrence is common and the median survival following diagnosis continues to be less than a year. It is thought that recurrent tumors may arise, in part, from a subpopulation of cells present in the primary tumor that possess genetic and/or epigenetic attributes that confer resistance to radiation and chemotherapy. In addition, the treatments themselves cause DNA damage which can lead to genetic changes in the cells that survive. Many studies have been carried out investigating changes in DNA and RNA that lead to therapy resistance; however, few studies have been done to study the global protein changes that occur between the primary tumor and recurrence following therapy. An understanding of the changes that occur in the cell populations of primary tumors leading to the formation of recurrent tumor may point to additional targets for the design of novel therapies. We have used 2-dimensional polyacrylamide gel electrophoresis (PAGE) to analyze proteins isolated from cells from primary and recurrent tumor pairs with and without in vitro selection for drug resistance. Proteins are separated based on their isoelectric point using an IPG strip (pH 4-7) followed by gradient PAGE to separate the proteins based on molecular weight. The proteins are identified by MALDI-TOF analysis of a tryptic digest. To date we have analyzed total protein samples from 2 primary/recurrent tumor pairs prior to and following selection for resistance to 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) - a total of 8 cell lines. Twenty nine protein spots were found to be consistently differentially expressed. These proteins range in pI from 4.65 - 6.22 and they range in size from 28-65 kD. Of these spots, 16 appear to be proteins that are upregulated in cells from recurrent tumor versus primary tumor and 9 appear to be down-regulated. In addition, 4 proteins are differentially regulated in cells from both primary and recurrent tumor following selection for BCNU resistance. Identification of these proteins is in progress, as are the analyses of additional cell and tissue samples from primary and recurrent tumors. Global proteomic analysis of primary and recurrent malignant gliomas will corroborate previously published evidence implicating specific genes in tumor recurrence and therapy resistance, and will lead to the identification of new therapeutic targets for the treatment of recurrent tumor.
Comprehension and Choice Under the Revised Common Rule: Improving Informed Consent by Offering Reasons Why Some Enroll in Research and Others Do Not
Authors: Stephanie A. Kraft, Kathryn M. Porter, Seema K. Shah, Benjamin S. Wilfond
Journal: The American Journal of Bioethics (2017)

The revised Common Rule emphasizes the importance of comprehension as a goal of the informed consent process, requiring consent forms to “facilitate … the prospective subject's or legally authorize...
Bevacizumab in the first-line treatment of metastatic right-sided colon cancer: Does it influence patients’ outcome?
Authors: Ingrid Garajová, Veronica Mollica, Maria Massucci, Francesca Abbati, Andrea Palloni, Giorgio Frega, Ilaria Maggio, Giovanni Brandi, Guido Biasco
Journal: Annals of Oncology (2017)
Incidental Papillary Bladder Carcinoma on 18F-Fluoromethylcholine PET/CT Undertaken to Evaluate Prostate Malignancy
Authors: Amit Parekh, Ian Hagan, Lisa Capaldi, Iain Lyburn
Journal: Clinical Nuclear Medicine (2017)

FDG PET is known to have a low sensitivity for the detection of prostate and bladder tumors because of high levels of urinary excretion, which potentially obscures sites of disease. Fluoromethylcholine PET has a higher sensitivity for the detection of metastatic prostate cancer compared with F-FDG PET, partly because of lower levels of urinary excretion. We present a case of a patient who underwent F-fluoromethylcholine PET for possible recurrent prostate cancer. The study identified an incidental, avid metachronous bladder tumor. We discuss the potential use of fluoromethylcholine PET in the detection of bladder tumors.
Recessive epidermolytic palmoplantar keratoderma caused by a keratin 1 mutation
Authors: P. Dewan, A. Terron-Kwiatkowski, S. Rajpopat, P. J. Dopping-Hepenstal, J. A. McGrath, D. Baty, E. A. O'Toole
Journal: British Journal of Dermatology (2011)
Metformin effects on clinical outcome in advanced HCC patients receiving sorafenib: Validation study.
Authors: Andrea Casadei Gardini, Luca Faloppi, Serena De Matteis, Giuseppe Francesco Foschi, Nicola Silvestris, Francesco Tovoli, Oronzo Brunetti, Vespasiani-Gentilucci Umberto, Giorgio Ercolani, Martina Valgiusti, Giuseppe Aprile, Lorenzo Fornaro, Luca Saragoni, Giovanni Luca Frassineti, Daniele Santini, Stefano Cascinu, Mario Scartozzi
Journal: Journal of Clinical Oncology (2017)

e15684 Background: In 2015 we published a paper where we have assessed the outcome of patient with HCC treated with metformin(M)and sorafenib(S). The data show that the concomitant use of S and m was associated with a lower PFS and OS respect for patients receiving S alone. The aim of this study was to validate the prognostic significance of m in patients with HCC treated with S. Methods: 280 patients with HCC consecutively treated with S twice daily between March 2008 and August 2016 were included in the study. Patients who had been taking insulin (I) for at least 5 years at the time of the HCC diagnosis were considered “ patients with diabetes treated with I,” whereas those who had been on m at for at least 5 years when HCC was diagnosed were considered “ patients with diabetes treated with M.” Results: In patients treated chronically with m the treatment with S was associated with a median PFS of 1.9 months (95% CI 1.8-2.3) compared to 3.7 months (95% CI 3.1-4.6) for patients without DM2 and compared to 8.4 months (95% CI 5.3-11.4) for patients treatment chronically with I (P &lt; 0.0001). In patients treated chronically with m the treatment with sorafenib was associated with a median OS of 6.6 months (95% CI 4.6-8.7) compared to 10.8 months (95% CI 9.0-13.1) for patients without DM2 and compared to 16.6 months (95% CI 14.5-25.5) for patients treatment chronically with I (P = 0.0001). Metformin effects on clinical outcome were also investigated in relation to ORR. Patients treated chronically with metformin showed a higher percentage of progression at the first CT re-evaluation than those patients treatment with I and patients without DM2 (75.8% vs. 14.7% vs 38,8%, respectively). Considering the overall population, the risk of progression, was higher in DM2 patients taking m compared with patients without DM2 (HR = 1.91, 95% CI 1.28-2.8,). Regarding the risk of survival, similar results were observed (HR = 1.70, 95% CI 1.14-2.55). Conclusions: These results confirm an increased tumor aggressiveness and resistance to S in patients treated with m cronicaly.Molecular alterations in transporter genes or transcription factors involved in m molecular action and pharmacokinetics could contribute to a different response to these drugs combination.
Genomic investigation of a suspected outbreak of Legionella pneumophila ST82 reveals undetected heterogeneity by the present gold-standard methods, Denmark, July to November 2014
Authors: Susanne Schjørring, Marc Stegger, Charlotte Kjelsø, Berit Lilje, Jette M Bangsborg, Randi F Petersen, Sophia David, Søren A Uldum
Journal: Eurosurveillance (2017)

Between July and November 2014, 15 community-acquired cases of Legionnaires´ disease (LD), including four with Legionella pneumophila serogroup 1 sequence type (ST) 82, were diagnosed in Northern Zealand, Denmark. An outbreak was suspected. No ST82 isolates were found in environmental samples and no external source was established. Four putative-outbreak ST82 isolates were retrospectively subjected to whole genome sequencing (WGS) followed by phylogenetic analyses with epidemiologically unrelated ST82 sequences. The four putative-outbreak ST82 sequences fell into two clades, the two clades were separated by ca 1,700 single nt polymorphisms (SNP)s when recombination regions were included but only by 12 to 21 SNPs when these were removed. A single putative-outbreak ST82 isolate sequence segregated in the first clade. The other three clustered in the second clade, where all included sequences had &lt; 5 SNP differences between them. Intriguingly, this clade also comprised epidemiologically unrelated isolate sequences from the UK and Denmark dating back as early as 2011. The study confirms that recombination plays a major role in L. pneumophila evolution. On the other hand, strains belonging to the same ST can have only few SNP differences despite being sampled over both large timespans and geographic distances. These are two important factors to consider in outbreak investigations.
Surgical site infection with extended-spectrum β-lactamase-producing Enterobacteriaceae after cardiac surgery: incidence and risk factors
Authors: S. Jolivet, F.-X. Lescure, L. Armand-Lefevre, R. Raffoul, M.-P. Dilly, W. Ghodbane, P. Nataf, J.-C. Lucet
Journal: Clinical Microbiology and Infection (2017)
A randomized phase II cross-over study of abiraterone + prednisone (ABI) vs enzalutamide (ENZ) for patients (pts) with metastatic, castration-resistant prostate cancer (mCRPC).
Authors: Kim N. Chi, Matti Annala, Katherine Sunderland, Daniel Khalaf, Daygen Finch, Conrad D. Oja, Joanna Vergidis, Muhammad Zulfiqar, Kevin Beja, Gillian Vandekerkhove, Martin Gleave, Alexander William Wyatt
Journal: Journal of Clinical Oncology (2017)

5002 Background: ABI and ENZ are indicated as 1 st line therapy for mCRPC but have not been directly compared. Optimal sequencing of these agents has not been prospectively evaluated and predictive biomarkers are lacking. Methods: Multicenter, phase 2 study randomizing treatment-naïve mCRPC pts to ABI vs ENZ, with cross over at PSA progression. Primary endpoints: response and time to PSA progression (TTPP, PCWG3 criteria) after 2 nd line therapy. Reported here are secondary endpoints: PSA ≥50% decline (PSA50) from baseline, TTPP with 1 st line therapy, and correlation with deep targeted sequencing of 73 mCRPC genes in circulating tumor DNA (ctDNA). Results: Accrual completed October 2016 with 202 pts randomized (ABI:ENZ = 101:101). Median follow-up 12.8 months. Baseline characteristics were similar between arms: median for age was 75 years (range 49-94), PSA 36.1 (1.7-2817), HGB 130 (89-165), ALK PHOS 105 (31-6600), LDH 207 (77-3098). ECOG PS was 0-1 in 83%, presence of metastases in bone/liver/lung in 83%/6%/10%. With 1 st line therapy for ABI vs ENZ, PSA50 at 12 weeks was 53% vs 73% (P = 0.004), no PSA decline occurred in 21% vs 15% (P = 0.243), and median TTPP was 7.4 vs 8.0 months (HR = 0.88, 95% CI 0.61, 1.27). Baseline ctDNA fraction was &gt;2% in 60% of patients, and associated with worse TTPP (HR 1.80, P=0.005). Baseline pathogenic ctDNA alterations in AR, TP53, RB1, and DNA repair (BRCA2, ATM) genes were associated with a shorter TTPP (univariate analysis: TABLE). On multivariate analysis including clinical factors, TP53 and BRCA2/ATM alterations remained significant (HR = 2.54 (95%CI 1.55-4.19) and HR = 2.68 (1.58-4.54)). Pts with a PSA increase as best response were enriched for alterations in DNA repair (P &lt;0.001), TP53 (P = 0.005), RB1 (P = 0.04), and (in 1 pt) a genomically truncated AR. Conclusions: There was a difference in PSA response for 1 st line ABI vs ENZ, but no difference for TTPP. Baseline pathogenic ctDNA alterations, particularly in TP53 and BRCA2, identify pts with poor outcomes. Clinical trial information: NCT02125357. [Table: see text]
Limitations Concerning the Association of Physician Sex and Patient Outcomes
Authors: Matthew J. Hayat, Thomas R. Knapp
Journal: JAMA Internal Medicine (2017)

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
Loss of memory B cells during chronic HIV infection is driven by Foxo3a- and TRAIL-mediated apoptosis
Authors: Julien van Grevenynghe, Rafael A. Cubas, Alessandra Noto, Sandrina DaFonseca, Zhong He, Yoav Peretz, Abdelali Filali-Mouhim, Franck P. Dupuy, Francesco A. Procopio, Nicolas Chomont, Robert S. Balderas, Elias A. Said, Mohamed-Rachid Boulassel, Cecile L. Tremblay, Jean-Pierre Routy, Rafick-Pierre Sékaly, Elias K. Haddad
Journal: Journal of Clinical Investigation (2012)