tbuckley/cabot-search huggingface dataset:
Association of Surgical Volume With Perioperative Outcomes for Esophagomyotomy for Esophageal Achalasia
Authors: Francisco Schlottmann, Paula D. Strassle, Marco G. Patti
Journal: JAMA Surgery (2017)

This population-based analysis examines the association between surgical volume and postoperative results in patients with esophageal achalasia who underwent esophagomyotomy.
Endoscopic Treatment versus Shunting for Infant Hydrocephalus in Uganda
Authors: Abhaya V. Kulkarni, Steven J. Schiff, Edith Mbabazi-Kabachelor, John Mugamba, Peter Ssenyonga, Ruth Donnelly, Jody Levenbach, Vishal Monga, Mallory Peterson, Michael MacDonald, Venkateswararao Cherukuri, Benjamin C. Warf
Journal: New England Journal of Medicine (2017)

Postinfectious hydrocephalus in infants is a major health problem in sub-Saharan Africa. The conventional treatment is ventriculoperitoneal shunting, but surgeons are usually not immediately available to revise shunts when they fail. Endoscopic third ventriculostomy with choroid plexus cauterization (ETV-CPC) is an alternative treatment that is less subject to late failure but is also less likely than shunting to result in a reduction in ventricular size that might facilitate better brain growth and cognitive outcomes.We conducted a randomized trial to evaluate cognitive outcomes after ETV-CPC versus ventriculoperitoneal shunting in Ugandan infants with postinfectious hydrocephalus. The primary outcome was the Bayley Scales of Infant Development, Third Edition (BSID-3), cognitive scaled score 12 months after surgery (scores range from 1 to 19, with higher scores indicating better performance). The secondary outcomes were BSID-3 motor and language scores, treatment failure (defined as treatment-related death or the need for repeat surgery), and brain volume measured on computed tomography.A total of 100 infants were enrolled; 51 were randomly assigned to undergo ETV-CPC, and 49 were assigned to undergo ventriculoperitoneal shunting. The median BSID-3 cognitive scores at 12 months did not differ significantly between the treatment groups (a score of 4 for ETV-CPC and 2 for ventriculoperitoneal shunting; Hodges-Lehmann estimated difference, 0; 95% confidence interval [CI], -2 to 0; P=0.35). There was no significant difference between the ETV-CPC group and the ventriculoperitoneal-shunt group in BSID-3 motor or language scores, rates of treatment failure (35% and 24%, respectively; hazard ratio, 0.7; 95% CI, 0.3 to 1.5; P=0.24), or brain volume (z score, -2.4 and -2.1, respectively; estimated difference, 0.3; 95% CI, -0.3 to 1.0; P=0.12).This single-center study involving Ugandan infants with postinfectious hydrocephalus showed no significant difference between endoscopic ETV-CPC and ventriculoperitoneal shunting with regard to cognitive outcomes at 12 months. (Funded by the National Institutes of Health; ClinicalTrials.gov number, NCT01936272 .).
Sudden cardiac death after acute heart failure hospital admission: insights from ASCEND‐HF
Authors: Sean D. Pokorney, Sana M. Al‐Khatib, Jie‐Lena Sun, Phillip Schulte, Christopher M. O'Connor, John R. Teerlink, Paul W. Armstrong, Justin A. Ezekowitz, Randall C. Starling, Adriaan A. Voors, Eric J. Velazquez, Adrian F. Hernandez, Robert J. Mentz
Journal: European Journal of Heart Failure (2017)
Exhaled breath to screen for malignant pleural mesothelioma: a validation study
Authors: Kevin Lamote, Matthijs Vynck, Olivier Thas, Joris Van Cleemput, Kristiaan Nackaerts, Jan P. van Meerbeeck
Journal: European Respiratory Journal (2017)

Malignant pleural mesothelioma (MPM) is predominantly caused by asbestos exposure and has a poor prognosis. Breath contains volatile organic compounds (VOCs) and can be explored as an early detection tool. Previously, we used multicapillary column/ion mobility spectrometry (MCC/IMS) to discriminate between patients with MPM and asymptomatic high-risk persons with a high rate of accuracy. Here, we aim to validate these findings in different control groups. Breath and background samples were obtained from 52 patients with MPM, 52 healthy controls without asbestos exposure (HC), 59 asymptomatic former asbestos workers (AEx), 41 patients with benign asbestos-related diseases (ARD), 70 patients with benign non-asbestos-related lung diseases (BLD) and 56 patients with lung cancer (LC). After background correction, logistic lasso regression and receiver operating characteristic (ROC) analysis, the MPM group was discriminated from the HC, AEx, ARD, BLD and LC groups with 65%, 88%, 82%, 80% and 72% accuracy, respectively. Combining AEx and ARD patients resulted in 94% sensitivity and 96% negative predictive value (NPV). The most important VOCs selected were P1, P3, P7, P9, P21 and P26. We discriminated MPM patients from at-risk subjects with great accuracy. The high sensitivity and NPV allow breath analysis to be used as a screening tool for ruling out MPM.
Abstract 18859: Staphylococcus aureus Infective Endocarditis is Associated with Worsened Clinical Characteristics than Non-Staphylococcus aureus Organisms
Authors: Sang Myung Han, Sowmya Vasan, Mark Grbic, Halit Yerebakan, Robert Sorabella, Marc Najjar, Estibaliz Castillero, Yeu Sanz Wu, Hiroo Takayama, Michael Argenziano, Rachel Gordon, Bindu Kalesan, Isaac George
Journal: Circulation (2014)

Background: Staphylococcus aureus remains a leading cause of IE, but it is unknown whether S. aureus is associated with more severe infections or worsened outcomes compared to other bacterial organisms. The primary purpose of this study was to compare the clinical characteristics and mortality in S. aureus (SA) versus non-S. aureus (NSA) IE patients undergoing valvular surgery. Methods: All patients undergoing valvular surgery for bacterial IE between 1995 and 2013 at our institution were included in this study. Clinical data were retrospectively collected from chart review. Patients were categorized according to causative organism: 1) SA: n=85, and 2) NSA: n=238, composed of coagulase-negative staphylococci (23%), streptococci (12% viridans; 19% non-viridans), enterococci (17%), and other (51%). Results: SA patients had a higher severity of illness compared to NSA patients due to higher rates of preoperative vascular complications (58.8% vs. 39.4%, p = 0.002), preoperative septic shock (23.5% vs. 13.9%, p = 0.039), preoperative embolic events (33.3% vs. 20.7%, p = 0.02), preoperative stroke (27.1% vs. 13.5%, p = 0.004), and annular abscess (44.7% vs. 27.3%, p = 0.003). There were no statistically significant differences in 30-day (9.4% vs. 8.0%, p = 0.68, OR = 1.20) or 1-year (20% vs. 14.3%, p = 0.22, OR = 1.50) post-operative mortality between SA and NSA IE patients, respectively. However, length of hospital stay, and 30-day post-operative development of new renal failure were higher in SA patients. There was a trend to more post-operative embolic events in SA patients. Conclusions: SA IE is associated with higher morbidity on presentation, such as pre-operative embolic events, stroke and annular abscess, compared to IE caused by other bacterial organisms, but does not lead to increased mortality after surgery. Further research is needed to investigate the differences in post-operative complications among patients.
Abstract 12082: Radiofrequency Ablation of the Atherosclerotic Plaque: A Safety and Feasibility Study in an Atherosclerotic Rabbit Model
Authors: Guilielmus Ellenbroek, Gerardus van Hout, Saskia de Jager, Leo Timmers, Aryan Vink, Roel Goldschmeding, Petra van der Kraak, Gerard Pasterkamp, Imo Hoefer, Pieter Doevendans, Yolande Appelman
Journal: Circulation (2016)

Introduction: Angiogenesis from the vasa vasorum plays a key role in atheroprogression and plaque vulnerability. Immature neovessels are prone to leakage, hence facilitating additional lipid and inflammatory cell accumulation and increasing intraplaque hemorrhage risk. Hypothesis: Heat-generating radiofrequency ablation (RFA) safely reduces vasa vasorum, decreases inflammatory cell influx and stabilizes the plaque. Methods: Thirteen New-Zealand White rabbits on a 0.5% cholesterol-enriched diet were subjected to balloon denudation of the infrarenal aorta. After 13 weeks, either the proximal or distal half of the infrarenal aorta was exposed to transluminal RFA, the untreated half served as an intra-individual control. Optical coherence tomography (OCT) was performed directly after RFA. Results: Within 24 hours after RFA, no plaque ruptures or adverse events were observed by OCT or histology. Treated regions showed widespread decellularization of intimal, medial and (to a lesser extent) adventitial layers, which were recellularized after 7 and 28 days. Vasa vasorum density was not different between both regions at short-term (24 hours; RFA 19.8±5.1 vs. control 29.2±8.3/mm 2 ; p=0.15) or long-term follow-up (7 days; 39.1±11.5 vs. 41.7±8.6/mm 2 ; p=0.81 and 28 days; 46.4±13.4 vs. 38.5±6.6/mm 2 ; p=0.06). After 7 days, treated regions were comparable to control areas with respect to plaque size (5.6±1.7 vs. 5.5±1.5mm 2 ; p=0.62), intimal collagen (34.6±11.9 vs. 32.7±13.0%; p=0.22) and macrophage content (14.3±2.8 vs. 18.5±5.8%; p=0.32). RFA-treated regions did show a major decrease in intimal smooth muscle cell (αSMA) content (1.8±0.4 vs. 18.0±5.9%; p=0.038), which remained decreased after 28 days (6.8±3.8 vs. 12.6±1.6%; p=0.020). Again, after 28 days no differences were observed in plaque area (4.6±0.9 vs. 4.4±1.1 mm 2 ; p=0.46), intimal collagen (39.2±9.1 vs. 40.3±12.4%; p=0.85) or macrophage content (13.2±2.5 vs. 12.6±2.0%; p=0.73). Conclusion: Radiofrequency ablation of the rabbit atherosclerotic plaque is safe and leads to a major reduction in αSMA content, but does not affect other aspects of plaque stability over time. It may thus serve as a therapeutic option for major (re)stenosis in peripheral arterial disease.
Tramadol Extended Release and Opioid Withdrawal Management—Legal Implications
Authors: Joseph Benjamin Williams
Journal: JAMA Psychiatry (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 Psychiatry 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 Psychiatry journal
Acyclovir Treatment of the Chronic Fatigue Syndrome
Authors: Stephen E. Straus, Janet K. Dale, Martin Tobi, Thomas Lawley, Olivia Preble, R. Michael Blaese, Claire Hallahan, Werner Henle
Journal: New England Journal of Medicine (1988)

Twenty-seven adults with a diagnosis of the chronic fatigue syndrome were enrolled in a double-blind, placebo-controlled study of acyclovir therapy. The patients had had debilitating fatigue for an average of 6.8 years, accompanied by persisting antibodies to Epstein–Barr virus early antigens (titers ≥1:40) or undetectable levels of antibodies to Epstein–Barr virus nuclear antigens (titers <1:2) or both. Each course of treatment consisted of intravenous placebo or acyclovir (500 mg per square meter of body-surface area) administered every eight hours for seven days. The same drug was then given orally for 30 days (acyclovir, 800 mg four times daily). There were six-week observation periods before, between, and after the treatments. Three patients had acyclovir-induced nephrotoxicity and were withdrawn from the study. Of the 24 patients who completed the trial, similar numbers improved with acyclovir therapy and with placebo (11 and 10, respectively). Neither acyclovir treatment nor clinical improvement correlated with alterations in laboratory findings, including titers of antibody to Epstein–Barr virus or levels of circulating immune complexes or of leukocyte 2′,5′-oligoadenylate synthetase. Subjective improvement correlated with various measures of mood. We conclude that acyclovir, as used in this study, does not ameliorate the chronic fatigue syndrome. We believe that the clinical improvement observed in most patients reflected either spontaneous remission of the syndrome or a placebo effect. (N Engl J Med 1988; 319: 1692–8.)
Response by Halliday et al to Letter Regarding Article, “Association Between Midwall Late Gadolinium Enhancement and Sudden Cardiac Death in Patients with Dilated Cardiomyopathy and Mild and Moderate Left Ventricular Systolic Dysfunction”
Authors: Brian P. Halliday, Dudley J. Pennell, Sanjay K. Prasad
Journal: Circulation (2017)
Variation in the thrombin activatable fibrinolytic inhibitor (TAFI) modulation by heparin: Therapeutic implications.
Authors: M. Florian-Kujawski, J. Maddineni, D. Hoppensteadt, M.H.M. Janssen, M. Wilmer, R. Bick, O. Iqbal, M. Tobu, J. Fareed
Journal: Blood (2003)
Abstract 15722: Elevated Preoperative Hemoglobin A1c Level and Adverse Long-term Outcomes After Coronary Artery Bypass Surgery in Patients With Renal Dysfunction and Diabetes
Authors: Keiji Oi, Tomohiro Mizuno, Masafumi Yashima, Tsuyoshi Hachimaru, Eiki Nagaoka, Hidehito Kuroki, Dai Tasaki, Tatsuki Fujiwara, Masashi Takeshita, Ryoji Kinoshita, Hirokuni Arai
Journal: Circulation (2016)

Background:  Renal dysfunction (RD) and diabetes are respectively associated with adverse outcomes of patients undergoing coronary artery bypass grafting (CABG). However, among the patients with severe RD who undergo CABG, the impact of diabetes and preoperative hemoglobin A1c (HbA1c) level is not well defined. This study was performed to investigate whether diabetes and higher HbA1c level are associated with long-term adverse outcomes in patients with severe RD undergoing CABG.   Methods:  A retrospective review of 963 patients undergoing isolated CABG from 2000 to 2014 at our institution was performed. The estimated glomerular filtration rate (eGFR) was evaluated by the Japanese coefficient for the Modification of Diet in Renal Disease formula. The patients with eGFR less than 30 mL/min/1.73 m 2  were defined as severe RD and included in the study. The study patients were divided into groups based on the coexistence of diabetes and the preoperative HbA1c levels: HbA1c less than 7.0% and HbA1c of 7.0% or greater. Major Adverse Cardiovascular and Cerebrovascular Event (MACCE) and all-cause mortality were measured as long-term outcomes. Kaplan-Meier curves and log-rank test were used to estimate long-term outcomes.   Results:  A total of 111 patients (11.5%) had severe RD. Of these patients, 79 (71.2%) had diabetes. Of the patients with severe RD and diabetes, HbA1c level was less than 7.0% in 38 patients (48.1%) and equal to or greater than 7.0% in 41 patients (51.9%). 10-year MACCE free rate of patients with severe RD was 33.6% in non-diabetic patients and 31.3 % in diabetic patients (P=.727). Contrastingly, among the patients who had both severe RD and diabetes, 10-year MACCE free rate was 61.5% in those with HbA1c level less than 7.0% and 0% in those with HbA1c level of 7.0% or greater (P=. 013). 10-year survival of patients with severe RD was 36.2% in the non-diabetic group and 43.8 % in diabetic group (P=.632). 10-year survival of the patients who had both severe RD and diabetes was 71.3% in those with HbA1c level less than 7.0% and 0% in those with HbA1c level of 7.0% or greater (P=. 045).   Conclusions:  Preoperative HbA1c level of 7.0 % or higher was associated with elevated MACCE occurrence and reduced long-term survival after CABG in the patients who had both severe RD and diabetes.
Exosomal proteins as potential markers of tumor diagnosis
Authors: Aichun Li, Tianbao Zhang, Min Zheng, Yanning Liu, Zhi Chen
Journal: Journal of Hematology & Oncology (2017)

Liquid biopsy especially that of exosomes carries tumor-specific molecules and provides useful information during tumor development and progression in “real time.” Exosomes are membrane-encapsulated vesicles, constantly released by multiple cells, including cancer cells, in large quantities, and are widely present in body fluids. Tumor exosomes can remodel a tumor-supportive microenvironment via cross-talk with target cells. Recent research has mainly focused on exosomal miRNAs and to a small degree on proteins. However, detecting the genome output (active proteins such as phosphoproteins) can provide more direct information about disease progression, such as in the early discovery and monitoring of cancers. This review highlights the unique features of exosomal proteins over traditional serological markers and summarizes their recent use in cancer diagnosis and prognosis. Furthermore, we describe the general protocols of research on exosome proteomics with an emphasis on their clinical use.
PTU-071 A nurse led day case paracentesis service in a district general hospital saves bed days
Authors: D Wilkinson, J Jones, A Bassi, J McLindon, J Dobson, M Fox, V Theis, R Chandy, S Priestley, D McClements
Journal: Gut (2017)

Introduction  Some patients who have stable cirrhosis require regular therapeutic paracentesis. In our hospital these patients would be admitted directly to the Gastroenterology ward for treatment. Given the pressure on inpatient beds we established a nurse led treatment unit on the Gastroenterology ward to avoid admissions and improve efficiency.  Method  A ward administrative area was converted into a day unit containing two trolley beds. A paracentesis pathway including competency based training was developed and a band 6 specialist nurse position was established. Between May 2016 and December 2016 data was prospectively collected for all day case paracentesis procedures including demographics, length of stay, volume of ascites drained and complications. A retrospective review of electronic patient records was performed to calculate the length of stay (LoS) for those patients who had been previously admitted for elective paracentesis prior to the initiation of the nurse led service. National data for cost per bed day was used to estimate cost savings.  Results  Fifty six day case paracentesis procedures were performed in the nurse led treatment unit between May 2016 and December 2016. Male:Female ratio was 54:2, mean age was 52 (range ). The mean volume drained was 9100mls (range 1,600–20 200,200mls). 54 (96%) of patient were discharged the same day following paracentesis. Two patients were admitted to the Gastroenterology ward, 1 patient was diagnosed with spontaneous bacterial peritonitis, 1 patient was found to have renal dysfunction. Mean LoS for patients admitted for elective therapeutic paracentesis was 4 days. We calculate that the nurse led treatment unit has saved 216 bed days. Assuming a cost of £400/bed day 1  this equates to a cost saving of £86 400 over a 9 month period.  Conclusion  A protocol driven, nurse led day case paracentesis service is safe, avoids hospital admissions, reduces demand on inpatient beds and saves money. This model of care is easy to establish, requires minimal investment and can have a significant impact in reducing bed days. We plan to expand the treatments offered in the nurse led treatment unit to support new ambulatory treatment pathways.  Reference  . Department of Health (2015). Data Requests: NHS Hospital Stay. Available at: https://data.gov.uk/data-request/nhs-hospital-stay. [Accessed 24th Feb 2017].  Disclosure of Interest  None Declared
Phase 1 study of the bone-targeting cytotoxic conjugate, etidronate-cytosine arabinoside (MBC-11), in cancer patients with bone metastases.
Authors: Shawn Zinnen, Eric Keith Rowinsky, Alexander Alexandrov, Larisa Plekhova, Marina Roudas, Alexander Karpeisky
Journal: Journal of Clinical Oncology (2017)

2589 Background: MBC-11 is a first-in-class therapeutic conjugate of the bone targeting bisphosphonate etidronate covalently linked to the antimetabolite cytosine arabinoside (Ara-C). In preclinical studies, MBC-11 localizes at the site of cancer-induced bone disease (CIBD) where it demonstrates both antiresorptive and antitumor activities following local release of Ara-C. Robust efficacy was observed in several rodent models of CIBD, as well as in spontaneous osteosarcoma in dogs. Herein, the results of the first-in-human study of MBC-11 are reported. Methods: Patients with advanced solid cancers and CIBD were treated with escalating doses (0.5-10 mg/kg/day) of MBC-11 administered as an intravenous infusion daily for 5 days every 4 weeks for up to 4 cycles. Fifteen patients (prostate cancer [PC; 7], breast cancer [BC; 7], cervical cancer [1]) received 38 total cycles. The study sought to characterize the safety, pharmacokinetics, and the effects of MBC-11 on bone turnover, and tumor response by 18 F-FDG-PET/CT imaging and tumor biomarkers. Results: Myelosuppression was generally grade 1-2, involved all lineages, and was the principal toxicity of MBC-11. Two of three patients treated at the 10 mg/kg dose level had dose-limiting toxicity (DLT), each with both grade 4 neutropenia and thrombocytopenia, the maximum tolerated dose (MTD) was 5 mg/kg. Four of 5 patients with pretreatment elevations of the bone resorption marker Trap5b had persistent decrements. 18 F-FDG-PET/CT imaging demonstrated partial metabolic responses in 3 patients; one BC patient treated at the 0.5 mg/kg and two CRPC patients treated at 1.0 mg/kg dose levels. An additional 3 patients had stable metabolic responses according to PERSIST. SUV values were reduced by at least 25% in 111 (53.8%) of 206 measurable bone lesions; significant activity was noted at all doses. Conclusions: At doses that were well tolerated and even much lower than the MTD, MBC-11 treatment resulted in substantial reductions in metabolic activity in CIBD patients, providing a foundation for further disease-directed studies to further assess efficacy. Clinical trial information: NCT02673060.
Erratum: Mutations in TUBG1, DYNC1H1, KIF5C and KIF2A cause malformations of cortical development and microcephaly
Authors: Karine Poirier, Nicolas Lebrun, Loic Broix, Guoling Tian, Yoann Saillour, Cécile Boscheron, Elena Parrini, Stephanie Valence, Benjamin Saint Pierre, Madison Oger, Didier Lacombe, David Geneviève, Elena Fontana, Franscesca Darra, Claude Cances, Magalie Barth, Dominique Bonneau, Bernardo Dalla Bernadina, Sylvie N'Guyen, Cyril Gitiaux, Philippe Parent, Vincent des Portes, Jean Michel Pedespan, Victoire Legrez, Laetitia Castelnau-Ptakine, Patrick Nitschke, Thierry Hieu, Cecile Masson, Diana Zelenika, Annie Andrieux, Fiona Francis, Renzo Guerrini, Nicholas J Cowan, Nadia Bahi-Buisson, Jamel Chelly
Journal: Nature Genetics (2013)
Preparation and characterization of monoclonal antibodies recognizing two distinct differentiation antigens (Pro-Im1, Pro-Im2) on early hematopoietic cells.
Authors: Renling Peng, Ayad Al-Katib, Daniel M. Knowles, Li Lu, Hal Broxmeyer, Betty Tolidjian, Jen-Wei Chiao, Benjamin Koziner, Chang Yi Wang
Journal: Blood (1984)
Biomimetic thiamine- and niacin-decorated liposomes for enhanced oral delivery of insulin
Authors: Haisheng He, Yi Lu, Jianping Qi, Weili Zhao, Xiaochun Dong, Wei Wu
Journal: Acta Pharmaceutica Sinica B (2017)

Biomimetic nanocarriers are emerging as efficient vehicles to facilitate dietary absorption of biomacromolecules. In this study, two vitamins, thiamine and niacin, are employed to decorate liposomes loaded with insulin, thus facilitating oral absorption