tbuckley/cabot-search huggingface dataset:
Expansion of Treatment for Hepatitis C Virus Infection
Authors: Benjamin Emmanuel, Henry Masur, Shyam Kottilil, Sarah Kattakuzhy
Journal: Annals of Internal Medicine (2018)

Letters20 March 2018Expansion of Treatment for Hepatitis C Virus InfectionBenjamin Emmanuel, MPH, Henry Masur, MD, Shyam Kottilil, MD, PhD, and Sarah Kattakuzhy, MDBenjamin Emmanuel, MPHUniversity of Maryland School of Medicine, Baltimore, Maryland (B.E., S.K., S.K.)Search for more papers by this author, Henry Masur, MDNational Institutes of Health, Bethesda, Maryland (H.M.)Search for more papers by this author, Shyam Kottilil, MD, PhDUniversity of Maryland School of Medicine, Baltimore, Maryland (B.E., S.K., S.K.)Search for more papers by this author, and Sarah Kattakuzhy, MDUniversity of Maryland School of Medicine, Baltimore, Maryland (B.E., S.K., S.K.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0698 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:The objective of ASCEND (A Phase IV Pilot Study to Assess Community-Based Treatment Efficacy in Chronic Hepatitis C Monoinfection and Coinfection With HIV in the District of Columbia) was to evaluate the efficacy and safety of HCV treatment independently provided by NPs, PCPs, or specialist physicians using direct-acting antiviral therapy. Dr. Romano comments on the study design and efficacy. The nonrandomized design and patient allocation were created to mirror real-world practice, with specific stratification variables described. A direct comparison of SVR by provider type would not fully account for all sources of bias in this nonrandomized design and ... Author, Article, and Disclosure InformationAffiliations: University of Maryland School of Medicine, Baltimore, Maryland (B.E., S.K., S.K.)National Institutes of Health, Bethesda, Maryland (H.M.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-0118. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoExpansion of Treatment for Hepatitis C Virus Infection by Task Shifting to Community-Based Nonspecialist Providers Sarah Kattakuzhy , Chloe Gross , Benjamin Emmanuel , Gebeyehu Teferi , Veronica Jenkins , Rachel Silk , Elizabeth Akoth , Aurielle Thomas , Charisse Ahmed , Michelle Espinosa , Angie Price , Elana Rosenthal , Lydia Tang , Eleanor Wilson , Soren Bentzen , Henry Masur , Shyam Kottilil , and Expansion of Treatment for Hepatitis C Virus Infection Max J. Romano Expansion of Treatment for Hepatitis C Virus Infection Dev Katarey Metrics 20 March 2018Volume 168, Issue 6Page: 457-459KeywordsAntiviral therapyDisclosureHepatitis C virusInfectious hepatitisNursesPilot studiesPrimary care physiciansRacial and ethnic issuesSafetySystemic vascular resistance ePublished: 20 March 2018 Issue Published: 20 March 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Glycogen Phosphorylase: A Novel Biomarker in Doxorubicin-Induced Cardiac Injury
Authors: Yueming Zhu, David Gius
Journal: Clinical Cancer Research (2018)

Abstract Extracellular vesicles containing glycogen phosphorylase, brain/heart (PYGB) have been demonstrated as a sensitive biomarker for normal cardiac injuries for patients after chemotherapy. Oxidative stress was suggested to be the mechanism behind the chemotherapy-induced tissue damage and augmented with mitochondrial antioxidant could be an effective means of early intervention. Clin Cancer Res; 24(7); 1516–7. ©2018 AACR. See related article by Yarana et al., p. 1644
Abstract P223: Cardiometabolic Disease Costs Associated With an Unhealthy Diet in the United States
Authors: Thiago Jardim, Dariush Mozaffarian, Shafika Abrahams-Gessel, Stephen Sy, Yujin Lee, Liu Junxiu, Yue Huang, Parke Wilde, Renata Micha, Thomas Gaziano
Journal: Circulation (2018)

Introduction: Despite the clear association between poor diet and cardiometabolic diseases (CMD) and the overall economic burden of such conditions, the costs of an unhealthy diet pattern have not been assessed for the US population. Aim: Estimate the costs of CMD related to suboptimal intakes of 10 specific dietary factors in the US adult population. Methods: A validated microsimulation model (CVD PREDICT) was populated by weighted sampling (with replacement) of individuals aged 35–85y from the 2009-2010 and 2011-2012 National Health and Nutrition Examination Surveys (NHANES), in order to create an US representative model population. Consumption of 10 foods/nutrients associated with CMD were assessed: fruits, vegetables, nuts/seeds, whole grains, unprocessed red meats, processed meats, sugar-sweetened beverages, polyunsaturated fats, seafood omega-3 fats, and sodium. Cardiovascular disease progression and events were simulated and annual healthcare costs estimations were calculated. The model compared reported consumption of the 10 food/nutrients in the NHANES surveys to a hypothetical situation in which the consumption level of these nutrients were optimal. Each food/nutrient was assessed individually and combined. Estimates were stratified by gender, age, race and insurance. Results: The 2012 annual cost of an unhealthy diet was $USD 280 (Acute $USD 236, Chronic $USD 40 and Drug $USD 4) per adult. Individually the food/nutrient consumed below optimal levels that imposed the highest CMD economic burden was nuts/seeds ($USD 75) while non-optimal red meat consumption was associated with the lowest cost per person ($USD 3). Unhealthy diet costs of CMD by gender, age group, race and insurance are provided in table 1. The annual unhealthy diet cost of CMD in the US was $USD 44.9bn in 2012. Acute care costs represent 84.3% of this total ($USD 37.9bn). Conclusions: Suboptimal diet accounts for substantial CMD costs in the US, highlighting the need for timely implementation of diet policies to address these burdens.
CLOSED-LOOPED STIMULATION PACING FOR THE PREVENTION OF RECURRENT VASOVAGAL SYNCOPE: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Pattara Rattanawong, Tanawan Riangwiwat, Pakawat Chongsathidkiet, Wasawat Vutthikraivit, Nath Limpruttidham, Narut Prasitlumkum, Napatt Kanjanahattakij, Chanavuth Kanitsoraphan
Journal: Journal of the American College of Cardiology (2018)
Abstract 18331: Endothelial Microrna-155 Promotes Myocardial Microvascular Permeability and Inflammatory Cell Adhesion in Experimental Septic Cardiomyopathy
Authors: Francisco Vasques-Nóvoa, Catarina Quina-Rodrigues, Rui Cerqueira, Fabiana Baganha, Tiago L Laundos, Diana S Nascimento, Sara Ribeiro, Perpétua Pinto-do-Ó, Adelino F Leite-Moreira, Roberto Roncon-Albuquerque Jr.
Journal: Circulation (2015)

Introduction: Septic cardiomyopathy remains a leading cause of death in critically ill patients. Myocardial edema and inflammatory cell recruitment to cardiac interstitial space are proposed mechanisms underlying sepsis-induced contractile dysfunction. Hypothesis: Evaluate the role of endothelial microRNA-155 (miR-155) in experimental septic cardiomyopathy. Methods: Experimental sepsis was induced using LPS injection in WT (n=20) and miR-155-/- (KO; n=20) male mice. Cardiac function was evaluated through echocardiography. Expression of NOS2, NOS3, VASP phosphorylation and myocardial nitrite/nitrate content was evaluated. Cardiac microvascular (MV) permeability was assessed with evans blue-albumin conjugate leaking to extravascular space and myocardial water content. Mouse cardiac MV endothelial cells (MCMVEC; CD31+Sca-1+CD45-) were isolated with FACS. Quantification of miR-155, cytokine mRNA profile and adhesion molecules (ICAM1, VCAM1 and E-selectin) was performed. Human cardiac MV endothelial cells (HCMVEC) were transfected with anti-miR-155 or scramble LNA probe and incubated with LPS (100ng/mL) or vehicle for 24h. Evaluation of cytokine mRNA profile, NOS isoforms, VASP phosphorylation and adhesion molecules was performed. Monocyte adhesion assay was performed using Dil-stained THP1 monocytic cells. Results: LPS exposure increased miR-155 expression in the myocardium, MCMVEC and HCMVEC. KO mice presented with attenuated LPS-induced cardiac dysfunction, MV permeability, NOS2 expression and VASP phosphorylation, compared with WT. KO MCMVEC presented with attenuated LPS-induced cytokine expression and adhesion molecules, compared with WT cells. Mir-155 inhibition in HCMVEC prevented LPS-induced overexpression of cytokines and adhesion molecules, nitric oxide production and monocyte adhesion, through SOCS1-mediated inhibition of STAT3 and NF-kB signaling pathways. Conclusions: Endothelial miR-155 is upregulated in experimental septic cardiomyopathy. MiR-155 knockout attenuates LPS-induced myocardial dysfunction, edema and MV permeability. In MCMVEC and HCMVEC, miR-155 inhibition blunted LPS-induced nitric oxide production, cytokine and cell adhesion molecules overexpression.
Changing trends in prostate brachytherapy practice for clinically localized prostate cancer: Results of a survey in UK and Ireland.
Authors: Gemma Corey, Ahamed Badusha Mohamed Yoosuf, Monica M. Byrne, Geraldine Workman, Darren M. Mitchell, Suneil Jain
Journal: Journal of Clinical Oncology (2018)

16 Background: High Dose Rate (HDR) and Low Dose Rate ( LDR) prostate brachytherapy (PBT) with or without external beam radiotherapy provide excellent biochemical outcomes with practice adapting to ongoing research and technological advances. We wished to document current PBT practice in the UK and Ireland (UK &amp; I) and compare with previous published audit results. Methods: A link to an online survey was communicated to centres attending the UK &amp; I PBT conference in 2017 (n = 25). Sixty-three questions were grouped into six themed sections which included current experience, staffing, implant numbers (last 3 years), LDR pre / post implant dosimetry and HDR technique. Descriptive analysis was performed. Results: 18 of 25 centres responded (11 LDR only, 6 HDR &amp; LDR, 1 HDR only) with 13 and 3 centres having &gt; 10yrs experience with LDR and HDR respectively. 13 centres have two or more oncologists and 15 centres have two or more medical physics experts (MPE). 61% of lead clinicians performed &gt; 25 implants with 22% performing &gt; 50 in the year 2016. In the preceding 3 years, 44% of centres reported the number of LDR monotherapy cases as stable while 44% noted a reduction in numbers. Similarly 40% of centres reported LDR boost cases as stable, 40% as reduced and 20% with increased cases. The number of centres using HDR treatment as boost, monotherapy and salvage therapy has increased, with increased cases in the year 2016 as compared to 2014. Comparison with the UK 2012 audit showed that post implant LDR dosimetry is more consistently performed and the majority of cases were achieving the 3 defined quality standards of D90, V100 and CT:USS volume ratio. Average post implant D90 was &gt; 145Gy in 63% of centres in 2014 and 2015 compared to 70% in 2016. 50% of centres reported average D90’s of &gt; 155Gy in all three years surveyed. Conclusions: This survey offers a review of PBT practice across UK and I with an apparent fall in LDR monotherapy and boost cases but increase in HDR numbers noted. Surveyed centres report dosimetrically good quality implants. Current research supports PBT as a definitive primary treatment which should be discussed with eligible men at diagnosis.
Grading of cytokine release syndrome associated with the CAR T cell therapy tisagenlecleucel
Authors: David Porter, Noelle Frey, Patricia A. Wood, Yanqiu Weng, Stephan A. Grupp
Journal: Journal of Hematology & Oncology (2018)

Anti-CD19 CAR T cell therapy has demonstrated high response rates in patients with relapsed or refractory (r/r) B cell malignancies but is associated with significant toxicity. Cytokine release syndrome (CRS) is the most significant complication associated with CAR T cell therapy, and it is critical to have a reproducible and easy method to grade CRS after CAR T cell infusions. The Common Terminology Criteria for Adverse Events scale is inadequate for grading CRS associated with cellular therapy. Clinical experience with the anti-CD19 CAR T cell therapy tisagenlecleucel at the University of Pennsylvania (Penn) was used to develop the Penn grading scale for CRS. The Penn grading scale depends on easily accessible clinical features; does not rely on location of care or quantitation of supportive care; assigns grades to guide CRS management; distinguishes between mild, moderate, severe, and life-threatening CRS; and applies to both early-onset and delayed-onset CRS associated with T cell therapies. Clinical data from 55 pediatric patients with r/r B cell acute lymphoblastic leukemia and 42 patients with r/r chronic lymphocytic lymphoma treated with tisagenlecleucel were used to demonstrate the current application of the Penn grading scale. We show that the Penn grading scale provides reproducible CRS grading that can be useful to guide therapy and that can be applied across clinical trials and treatment platforms.
Hospitals should increase consultant presence and reduce elective work at August trainee changeover
Authors: Helen Jaques
Journal: BMJ (2012)

Hospitals and deaneries should make sure that enough consultants are available and should reduce the amount of elective work when junior doctors collectively move jobs each August, the chief medical officers of England, Wales, Scotland, and Northern Ireland have recommended.

Hospitals and deaneries should also be more flexible in rota design during this period and provide departmental inductions for trainees as well as corporate health and safety inductions, as per recommendations put forward by the Academy of Medical Royal Colleges.

Since the introduction of Modernising Medical Careers in 2007 most grades of junior doctor change jobs in the first week in August. This approach has been associated with a 6% rise in mortality among patients admitted on the first Wednesday in August …
Minimal residual disease (MRD) monitoring and mutational landscape in AML with RUNX1-RUNX1T1: a study on 134 patients
Authors: Alexander Höllein, Sabine Jeromin, Manja Meggendorfer, Annette Fasan, Niroshan Nadarajah, Wolfgang Kern, Claudia Haferlach, Torsten Haferlach
Journal: Leukemia (2018)
Ready-to-use food supplement, with or without arginine and citrulline, with daily chloroquine in Tanzanian children with sickle-cell disease: a double-blind, random order crossover trial
Authors: Sharon E Cox, Elizabeth A Ellins, Alphonce I Marealle, Charles R Newton, Deogratias Soka, Philip Sasi, Gian Luca Di Tanna, William Johnson, Julie Makani, Andrew M Prentice, Julian P Halcox, Fenella J Kirkham
Journal: The Lancet Haematology (2018)

Sickle-cell disease increases the risk of malnutrition. Low arginine and nitric oxide bioavailability are implicated in morbidity related to sickle-cell disease. Simple interventions are required, especially in low-income settings. We aimed to test the hypotheses that: (1) supplementary arginine, citrulline, and daily chloroquine increase bioavailable arginine and flow-mediated dilatation (FMD; maximal diameter change; FMD
Impact of enhanced viral haemorrhagic fever surveillance on outbreak detection and response in Uganda
Authors: Trevor R Shoemaker, Stephen Balinandi, Alex Tumusiime, Luke Nyakarahuka, Julius Lutwama, Edward Mbidde, Aaron Kofman, John D Klena, Ute Ströher, Pierre E Rollin, Stuart T Nichol
Journal: The Lancet Infectious Diseases (2018)
INCREASING INCIDENCE OF CARDIOGENIC SHOCK IN PATIENTS WITH ACUTE MYOCARDITIS: IS MECHANICAL CIRCULATORY SUPPORT DEVICE AN ANSWER TO THE PROBLEM
Authors: Mohit Pahuja, Emmanuel Akintoye, Oluwole Adegbala, Manmohan Singh, Mohamed Shokr, Luis Afonso
Journal: Journal of the American College of Cardiology (2018)
The euthanasia debate has meant that I have become increasingly interested in ethics. Could you tell me what distance learning courses on medical ethics are available please?
Authors: Justine McCulloch
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>
Breast Cancer Risk Model Requirements for Counseling, Prevention, and Screening
Authors: Mitchell H Gail, Ruth M Pfeiffer
Journal: JNCI Journal of the National Cancer Institute (2018)

Incorporation of polygenic risk scores and mammographic density into models to predict breast cancer incidence can increase discriminatory accuracy (area under the receiver operating characteristic curve [AUC]) from 0.6 for models based only on epidemiologic factors to 0.7. It is timely to assess what impact these improvements will have on individual counseling and on public health prevention and screening strategies, and to determine what further improvements are needed.We studied various clinical and public health applications using a log-normal distribution of risk.Provided they are well calibrated, even risk models with AUCs of 0.6 to 0.7 provide useful perspective for individual counseling and for weighing the harms and benefits of preventive interventions in the clinic. At the population level, they are helpful for designing preventive intervention trials, for assessing reductions in absolute risk from reducing exposure to modifiable risk factors, and for resource allocation (although a higher AUC would be desirable for risk-based allocation). Other public health applications require higher AUCs that can only be achieved with risk predictors 1.6 to 8.8 times as strong as all those yet discovered combined. Such applications are preventing an appreciable proportion of population disease when employing a high-risk prevention strategy and deciding who should be screened for subclinical disease.Current and foreseeable risk models are useful for counseling and some prevention activities, but given the daunting challenge of achieving, for example, an AUC of 0.8, considerable effort should be put into finding effective preventive interventions and screening strategies with fewer adverse effects.
Evolution of relative survival for acute promyelocytic leukemia patients alive at landmark time-points: a population-based study
Authors: Jorne Lionel Biccler, Lene Sofie Granfeldt Østgård, Marianne Tang Severinsen, Claus Werenberg Marcher, Peter Møller, Claudia Schöllkopf, Lone Smidstrup Friis, Martin Bøgsted, Lasse Hjort Jakobsen, Tarec Christoffer El-Galaly, Jan Maxwell Nørgaard
Journal: Leukemia (2018)
Specialty skills in emergency surgery and trauma (SSET)
Authors: Christine Biela
Journal: BMJ (2013)

This two day course aims to help junior surgical trainees in general surgery to develop theoretical and practical skills in emergency and trauma surgery. It allows junior doctors to get hands-on practice in key emergency surgical procedures, to which juniors often have limited exposure in the early stages of their training.

This course is designed primarily for core surgical trainees, but it is also suitable for foundation year 2 doctors with an interest in general surgery or those about to enter core surgical training. I took this course at the beginning of foundation year 2 and did some quick revision of common surgical emergencies beforehand to help me get up to speed with the core surgical trainees. 

This course appealed to me as I am keen on pursuing a career in surgery. I wanted the opportunity to learn and practise common emergency surgical procedures before starting core surgical training, which I hoped would build my confidence in …
Abstract P007: Atrial Fibrillation, Black or White Race, and Research Study Participation in a National Cohort Study: The REasons for Geographic And Racial Differences in Stroke (REGARDS) Study
Authors: Evan L Thacker, Elsayed Z Soliman, LeaVonne Pulley, Monika M Safford, Virginia J Howard, George Howard
Journal: Circulation (2013)

INTRODUCTION.  Atrial fibrillation (AF) has been consistently observed in epidemiologic studies to be less prevalent in blacks than in whites, despite higher prevalence of AF risk factors in blacks. A research methods question related to this paradox is whether AF and race jointly affect participation in research studies that require in-person examinations, leading to biased estimates of the racial distribution of AF. The unique two-stage data collection design of REGARDS allowed us to study this issue.   HYPOTHESES.  We hypothesized that people who self-report AF by telephone are less likely to participate in in-person research studies than people who do not self-report AF, and that this difference is more pronounced in blacks than in whites. We also hypothesized that the inverse association of black race with AF is more pronounced in people who participate in in-person studies than in people who do not participate.   METHODS.  In REGARDS, 42,018 people completed a preliminary telephone interview in which they reported race (black or white) and answered the question “has a doctor or other health professional ever told you that you had atrial fibrillation?” Subsequently, 29,403 (70%) participated in an in-person examination, where AF was determined by electrocardiogram (ECG). We used multiple imputation to estimate prevalence of ECG-detected AF in people who did not participate in the in-person examination.   RESULTS.  Participation in the in-person examination was 77.0% in whites without self-reported AF, 76.5% in whites with self-reported AF, 62.0% in blacks without self-reported AF, and 61.6% in blacks with self-reported AF. Racial distributions of self-reported AF and ECG-detected AF were similar in people who did or did not participate in the in-person examination (Table).   CONCLUSIONS.  Self-reported AF status was not related to participation in an in-person examination following a telephone interview. We found no evidence that estimates of racial distributions of AF in REGARDS were biased by differential study participation.
CUTOFF VALUE OF THE SHEATH-TO-ARTERY RATIO FOR RADIAL ARTERY OCCLUSION IN PATIENTS UNDERGOING TRANSRADIAL PERCUTANEOUS CORONARY INTERVENTIONS USING SHEATHLESS GUIDING CATHETERS FOR ACUTE CORONARY SYNDROME
Authors: Tsuyoshi Isawa, Kazunori Horie, Naoto Inoue
Journal: Journal of the American College of Cardiology (2018)