tbuckley/cabot-search huggingface dataset:
Abstract 16917: Hemodynamic Effects of Synchronized Chest Compression in a Porcine Post Countershock PEA Model
Authors: Weilun Quan, Ulrich Herken, Norman Paradis
Journal: Circulation (2015)

Purpose: Post countershock Pulseless Electrical Activity (PCC-PEA) is encountered frequently during resuscitation from cardiac arrest. External chest compression (CC) remains the principal treatment for PCC-PEA, but unsynchronized CC may interfere with myocardial recovery. We investigated the efficacy of CC synchronized to PEA’s R waves as compared to standard CC in an animal model. Methods: Seven domestic pigs weighing 35-42 kg were anesthetized, endotracheally intubated and mechanically ventilated. Aortic and right atrial pressures were invasively monitored and coronary perfusion pressure (CPP) calculated. Carotid blood flow (CBF) was continuously monitored by a flow probe. VF was electrically induced and left untreated for 3 minutes before delivering the 1st shock. If the post countershock rhythm remained in VF a 2nd shock was delivered after an additional period of VF from 1 to 2 minutes. Countershocks were continued until PEA was obtained. If shock resulted in a perfusing rhythm, VF was re-induced. After PEA was induced, 15 seconds of chest compression or medium energy pacing were delivered to the animal per another concurrent protocol. The rate of standard CC was 100. Animals were then randomized to receive synchronized or standard CC for 15 seconds, with continuous alternation of therapy for the maximum 120 seconds before the 1 st administration of epinephrine. A standard CPR rescue protocol continued for maximum of 20 minutes. If ROSC was achieved, the animal received at least 4 minutes for recovery before the study sequence was repeated. Results: A total of 32 matched synchronization pairs were obtained from 7 animals. The PEA pulse pressure was 2.47 + 2.34 mmHg and the PEA rate was 74 + 16.5. CC with R wave synchronization maintained CBF (53.6 vs. 46.7, p=0.11) and CPP (15.6 vs. 16.6 mmHg, p=0.34), and increased CBF stroke volume (=CBF/PEA rate) (0.76 vs. 0.47 ml, p=0.0004) as compared to standard CC. Conclusions: During near complete electromechanical dissociation (true PEA), synchronization of external chest compression with R waves maintained CBF and CPP despite lower compression rates as compared to standard chest compression without synchronization. This may represent a first observation that synchronization may be beneficial even in true PEA.
Care Quality Commission finds growing inequalities in access to health and social care in England
Authors: Matthew Limb
Journal: BMJ (2018)

People in England face a growing “care injustice,” where many cannot access the care they need or have only poor quality services available, a leading regulator has warned in its annual quality assessment of health and social care.1

The Care Quality Commission (CQC) said that many older people, patients with mental health problems, and people in some parts of the country cannot access good, safe care. It said that access was especially problematic where health and care services were poorly coordinated, while all sectors face rising demand and struggles to recruit and retain staff.

Two years ago the commission warned that adult social care was so fragile that it was approaching a “tipping point” where some services would become unsustainable. “This tipping point has already been reached for some people who are not getting …
Modulating intestinal mucus barrier for nanoparticles penetration by surfactants
Authors: Xin Zhang, Wei Dong, Hongbo Cheng, Meixia Zhang, Yongqiang Kou, Jian Guan, Qiaoyu Liu, Mingyue Gao, Xiuhua Wang, Shirui Mao
Journal: Asian Journal of Pharmaceutical Sciences (2018)
Prognostic ability of CD44 expression in ER-positive breast cancer.
Authors: Yesim Gokmen-Polar, Sunil S. Badve
Journal: Journal of Clinical Oncology (2014)

11062 Background: CD44, a cell surface receptor, is implicated in both progression and suppression of metastatic cascade. CD44 has gained attention as a breast cancer stem cell marker and is considered a therapeutic target. However, loss of CD44 expression is also associated with high-grade tumors and metastasis. Earlier studies have been small, therefore, we analyzed the value of CD44 expression in larger gene expression datasets to clarify its prognostic and predictive ability in breast cancer. Methods: CD44 expression levels were analyzed based on ER-status, molecular subtypes and other clinico-pathological parameters using 11 publicly available Affymetrix datasets. Association of outcome was investigated for each patient cohort with distant metastasis free-survival (DMFS) as endpoint and 10 year censoring in the following subgroups: 1) all 1,881 tumors, 2) ER positive tumors (n=1,225), 3) ER-negative tumors (n=395), 4) systemically untreated patients (n=927), and 5) patients treated with tamoxifen alone (n=326). Results: Lower expression of CD44 was associated with ER positivity (P=0.01), and higher histological grade (grade 3)(P≤0.00001). Expression was highest in luminal A tumors with progressive decrease in basal, luminal B and HER2 subtypes respectively. In multivariate analysis, high CD44 expression correlated with higher DMFS in ERpos tumors [(P=0.004; HR= 0.7 (95%CI 0.55-0.9)], ERposLNneg tumors [(P=0.002; HR= 0.64 (95%CI 0.48-0.85)], grade 2 tumors [(P=0.02; HR=0.51 (95% CI 0.29-0.91)] and TAM treated tumors [(P=0.002; HR 0.1 (95% CI 0.03-034)], whereas low CD44 expression was associated with lower DMFS in TAM treated tumors [(P=0.02); HR= 2.21 (95% 1.12-4.38)]. Of all tumors, CD44 was most prognostic in ERpos and ERposLNneg groups (P≤0.001) followed by HU_Luminal B and PAM50_HER2 enriched groups (P=0.02). Of eight gene modules analyzed, CD44 expression was negatively correlated with checkpoint genes, M-phase and immune response, while positively correlated with basal phenotype. Conclusions: The analysis provides relevance of the prognostic and predictive utility of CD44 in ER+LN- breast cancer. This also suggests the importance of patient stratification in the management of these patients and therapeutic strategies.
Periprocedural Outcomes of Direct Oral Anticoagulants Versus Warfarin in Nonvalvular Atrial Fibrillation
Authors: Bassel Nazha, Bhavi Pandya, Jessica Cohen, Meng Zhang, Renato D. Lopes, David A. Garcia, Matthew W. Sherwood, Alex C. Spyropoulos
Journal: Circulation (2018)

Background: Direct oral anticoagulants (DOACs) are surpassing warfarin as the anticoagulant of choice for stroke prevention in nonvalvular atrial fibrillation. DOAC outcomes in elective periprocedural settings have not been well elucidated and remain a source of concern for clinicians. The aim of this meta-analysis was to evaluate the periprocedural safety and efficacy of DOACs versus warfarin in patients with nonvalvular atrial fibrillation. Methods: We reviewed the literature for data from phase III randomized controlled trials comparing DOACs with warfarin in the periprocedural period among patients with nonvalvular atrial fibrillation. Substudies from 4 trials (RE-LY [Randomized Evaluation of Long-Term Anticoagulation Therapy], ROCKET AF [Rivaroxaban Once Daily Oral Direct Factor Xa Inhibitor Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation], ARISTOTLE [Apixaban for the Prevention of Stroke in Subjects With Atrial Fibrillation], and ENGAGE-AF [Effective Anticoagulation With Factor xA Next Generation in Atrial Fibrillation]) were included in the meta-analysis. DOACs as a group and warfarin were compared in terms of the 30-day pooled risk for stroke/systemic embolism, major bleeding, and death, according to whether the study drug was interrupted or not periprocedurally. The overall relative risk (RR) was estimated with a random-effects model. The I 2 test was used to assess heterogeneity in RR among the studies. Results: In the uninterrupted anticoagulant strategy, there were no differences in the rates of stroke/systemic embolism (pooled risk, 0.6% [29 events/4519 procedures] versus 1.1% [31/2971]; RR, 0.70; 95% confidence interval [CI], 0.41–1.18) and death (1.4% versus 1.8%; RR, 0.77; 95% CI, 0.53–1.12) between DOACs and warfarin and significantly fewer major bleeding events (2.0% versus 3.3%; RR, 0.62; 95% CI, 0.47–0.82) with DOACs compared to warfarin. Under an interrupted strategy, there was no significant difference between DOACs versus warfarin for stroke/systemic embolism (0.4% [41/9260] versus 0.5% [31/7168]; RR, 0.95; 95% CI, 0.59–1.55), major bleeding (2.1% versus 2.0%; RR, 1.05; 95% CI, 0.85–1.30), and death (0.7% versus 0.6%; RR, 1.24; 95% CI, 0.76–2.04). The studies were homogeneous ( I 2 =0.0%) for all calculated pooled associations except for the RR of death in the interrupted strategy ( I 2 =26.3%). Conclusions: The short-term safety and efficacy of DOACs and warfarin are not different in patients with nonvalvular atrial fibrillation periprocedurally. Under an uninterrupted anticoagulation strategy, DOACs are associated with a 38% lower risk of major bleeding compared with warfarin.
Identification of the rational combination of two epigenetic inhibitors therapy in refractory AML using patient tumor derived ex vivo platform
Authors: P.K. Majumder, G. Babu, C. Rajagowda, S. Thiyagarajan, M. Biswas, P. Radhakrishnan, P. Chaudhuri, A. Chatterjee
Journal: Annals of Oncology (2018)
Abstract 10436: The Association of Time to First Epinephrine Administration With Neurological Outcomes in Out of hospital Cardiac Arrest in Japan: Sos-kanto 2012 Study Report
Authors: Yosuke Homma, Hiraku Funakoshi, Takashi Shiga, Dai Miyazaki, Naohiro Yonemoto, Yoshio Tahara, Ken Nagao, Arino Yaguchi, Naoto Morimura, Atsushi Sakurai
Journal: Circulation (2015)

Introduction: The clinical effectiveness of the timing of first epinephrine administration (EA) including prehospital setting has not been established, especially in regards to neurological outcomes in patients subsequently receiving intensive care after admission. Study Objectives: The aim of this study was to evaluate the effectiveness of time to first EA on neurological outcomes following OHCA. Methods: This was a multicenter retrospective cohort study in Japan from January 2012 to March 2013. We used data from the Survey of Survivors after Cardiac Arrest in the Kanto Area in 2012 (SOS-KANTO 2012) database. All adult patients who were registered in this database and were administered epinephrine were included; unwitnessed OHCA and initial asystolic rhythms were excluded. Collected variables included age, gender, activities of daily living, witnessed status, bystander CPR, first documented rhythm, cause, and intensive care after admission. Multivariate logistic regression was performed to investigate the association between time to first EA and 1) ROSC, 2) 1-month survival, and 3) 1-month favorable neurological outcome. Results: Of 16,452 OHCAs, 5,281 met the inclusion criteria (male, 63.1%; mean age, 71.5 years). Mean time between call to first EA is 33.7min. 1,501patients (28.4%) had ROSC. Multivariate logistic regression showed that the earlier the EA, the better chance of ROSC if initial documented rhythm was both VF/VT (adjusted odds ratio [OR] for one minute delay, 0.98; 95% confidence interval [CI], 0.97-0.99) and Asystole/PEA (adjusted OR, 0.97; 95%CI, 0.97-0.98). In contrast, the earlier the EA, the better chance of 1-month survival if initial documented rhythm was only Asystole/PEA (adjusted OR, 0.95; 95%CI, 0.93-0.98). There were no significant differences between early EA and good neurological outcomes (VF/VT, 1.01 [95% CI, 0.97-1.04] and Asystole/PEA, 1.01 [95% CI, 0.96-1.05]). Conclusions: If initial documented rhythm was VF/VT, early EA was associated with increased chance of only ROSC. In contrast, early EA was associated with increased chance of ROSC and 1 month survival if initial documented rhythm was Asystole/PEA. Time to first EA was not associated with good neurological outcomes in any initial documented rhythm.
GW29-e0885 A Systematic Review :The Prognosis In Elderly And Very Elderly Patients With Acute Myocardial Infarction
Authors: Yubo Liang, Qiongying Wang, Cheng Jiang, XiaoQing Kou, Qianqiu Che, DingYao Hu, DingYao Hu, YaLi Du, ShuWen Zhang, JiaoJiao Xu, Jing Zhang, Feng Bai
Journal: Journal of the American College of Cardiology (2018)
On the Gender Identity of Breast Patients
Authors: Ian T. Nolan, Alexes Hazen, Shane D. Morrison
Journal: JAMA Surgery (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 Surgery 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 Surgery journal
GW29-e1055 Clinical Characteristics and Statin Prescription of Acute Coronary Syndrome Patients with Low-Density Lipoprotein Cholesterol Less than 55 mg/dL: Findings from CCC-ACS Project
Authors: Yueyan Xing, Jing Liu, Yongchen Hao, Sidney C. Smith, Yong Huo, Junbo Ge, Kathryn A. Taubert, Louise Morgan, Changsheng Ma, Yaling Han, Dong Zhao, Gregg C. Fonarow
Journal: Journal of the American College of Cardiology (2018)
Risk of congenital toxoplasmosis in women with low or indeterminate anti-Toxoplasma IgG avidity index in the first trimester of pregnancy: an observational retrospective study
Authors: L.R. Tomasoni, G. Messina, F. Genco, L. Scudeller, M. Prestia, V. Spinoni, C. Bonfanti, F. Prefumo, F. Castelli, V. Meroni
Journal: Clinical Microbiology and Infection (2018)
BRAF Inhibition in <i>BRAF</i><sup>V600</sup>-Mutant Gliomas: Results From the VE-BASKET Study
Authors: Thomas Kaley, Mehdi Touat, Vivek Subbiah, Antoine Hollebecque, Jordi Rodon, A. Craig Lockhart, Vicki Keedy, Franck Bielle, Ralf-Dieter Hofheinz, Florence Joly, Jean-Yves Blay, Ian Chau, Igor Puzanov, Noopur S. Raje, Jurgen Wolf, Lisa M. DeAngelis, Martina Makrutzki, Todd Riehl, Bethany Pitcher, Jose Baselga, David M. Hyman
Journal: Journal of Clinical Oncology (2018)

Purpose BRAF V600 mutations are frequently found in several glioma subtypes, including pleomorphic xanthoastrocytoma (PXA) and ganglioglioma and much less commonly in glioblastoma. We sought to determine the activity of vemurafenib, a selective inhibitor of BRAF V600 , in patients with gliomas that harbor this mutation. Patients and Methods The VE-BASKET study was an open-label, nonrandomized, multicohort study for BRAF V600 -mutant nonmelanoma cancers. Patients with BRAF V600 -mutant glioma received vemurafenib 960 mg twice per day continuously until disease progression, withdrawal, or intolerable adverse effects. Key end points included confirmed objective response rate by RECIST version 1.1, progression-free survival, overall survival, and safety. Results Twenty-four patients (median age, 32 years; 18 female and six male patients) with glioma, including malignant diffuse glioma (n = 11; six glioblastoma and five anaplastic astrocytoma), PXA (n = 7), anaplastic ganglioglioma (n = 3), pilocytic astrocytoma (n = 2), and high-grade glioma, not otherwise specified (n = 1), were treated. Confirmed objective response rate was 25% (95% CI, 10% to 47%) and median progression-free survival was 5.5 months (95% CI, 3.7 to 9.6 months). In malignant diffuse glioma, best response included one partial response and five patients with stable disease, two of whom had disease stabilization that lasted more than 1 year. In PXA, best response included one complete response, two partial responses, and three patients with stable disease. Additional partial responses were observed in patients with pilocytic astrocytoma and anaplastic ganglioglioma (one each). The safety profile of vemurafenib was generally consistent with that of previously published studies. Conclusion Vemurafenib demonstrated evidence of durable antitumor activity in some patients with BRAF V600 -mutant gliomas, although efficacy seemed to vary qualitatively by histologic subtype. Additional study is needed to determine the optimal use of vemurafenib in patients with primary brain tumors and to identify the mechanisms driving differential responses across histologic subsets.
GW29-e0644 Impact of dual antiplatelet therapy duration on clinical outcomes in medically managed patients with acute coronary syndromes: insights from 2-year results of the OPT-CAD study.
Authors: Yi Li, Miaohan Qiu, Jing Li, Heyang Wang, Jing Yang, Xiaozeng Wang, Yaling Han
Journal: Journal of the American College of Cardiology (2018)
Confident BRCA1/2 variant classification: using ACMG and public data for systematic molecular profiling
Authors: Udo Schmidt-Edelkraut, Elena Ioana Braicu, Sajo Kaduthanam, Salvador Santiago-Mozos, Markus Hartenfeller, Ram Narang, Martin Stein, Michael Weber, Stephan Brock, David Jackson, Stephan Hettich, Josef Hermanns, Theodoros G. Soldatos
Journal: Annals of Oncology (2018)
Ensuring Optimal Adjustment for Determinations of Institutional Quality—Reply
Authors: Peter W. Groeneveld, Andrew J. Epstein
Journal: JAMA Cardiology (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 Cardiology 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 Cardiology journal
Re: van Poppelen et al.: Genetic background of iris melanomas and iris melanocytic tumors of uncertain malignant potential (Ophthalmology. 2018;125:904-912)
Authors: Simone L. Scholz, Rajmohan Murali, Henrike Westekemper, Dirk Schadendorf, Klaus G. Griewank
Journal: Ophthalmology (2018)
Drug repurposing: progress, challenges and recommendations
Authors: Sudeep Pushpakom, Francesco Iorio, Patrick A. Eyers, K. Jane Escott, Shirley Hopper, Andrew Wells, Andrew Doig, Tim Guilliams, Joanna Latimer, Christine McNamee, Alan Norris, Philippe Sanseau, David Cavalla, Munir Pirmohamed
Journal: Nature Reviews Drug Discovery (2018)
Impact of prenatal exercise on neonatal and childhood outcomes: a systematic review and meta-analysis
Authors: Margie H Davenport, Victoria L Meah, Stephanie-May Ruchat, Gregory A Davies, Rachel J Skow, Nick Barrowman, Kristi B Adamo, Veronica J Poitras, Casey E Gray, Alejandra Jaramillo Garcia, Frances Sobierajski, Laurel Riske, Marina James, Amariah J Kathol, Megan Nuspl, Andree-Anne Marchand, Taniya S Nagpal, Linda G Slater, Ashley Weeks, Ruben Barakat, Michelle F Mottola
Journal: British Journal of Sports Medicine (2018)

Objective We aimed to identify the relationship between maternal prenatal exercise and birth complications, and neonatal and childhood morphometric, metabolic and developmental outcomes. Design Systematic review with random-effects meta-analysis and meta-regression. Data sources Online databases were searched up to 6 January 2017. Study eligibility criteria Studies of all designs were eligible (except case studies and reviews) if published in English, Spanish or French, and contained information on the relevant population (pregnant women without contraindication to exercise), intervention (subjective/objective measures of frequency, intensity, duration, volume or type of exercise, alone (‘exercise-only’) or in combination with other intervention components (eg, dietary; ‘exercise+cointervention’)), comparator (no exercise or different frequency, intensity, duration, volume, type or trimester of exercise) and outcomes (preterm birth, gestational age at delivery, birth weight, low birth weight (&lt;2500 g), high birth weight (&gt;4000 g), small for gestational age, large for gestational age, intrauterine growth restriction, neonatal hypoglycaemia, metabolic acidosis (cord blood pH, base excess), hyperbilirubinaemia, Apgar scores, neonatal intensive care unit admittance, shoulder dystocia, brachial plexus injury, neonatal body composition (per cent body fat, body weight, body mass index (BMI), ponderal index), childhood obesity (per cent body fat, body weight, BMI) and developmental milestones (including cognitive, psychosocial, motor skills)). Results A total of 135 studies (n=166 094) were included. There was ‘high’ quality evidence from exercise-only randomised controlled trials (RCTs) showing a 39% reduction in the odds of having a baby &gt;4000 g (macrosomia: 15 RCTs, n=3670; OR 0.61, 95% CI 0.41 to 0.92) in women who exercised compared with women who did not exercise, without affecting the odds of growth-restricted, preterm or low birth weight babies. Prenatal exercise was not associated with the other neonatal or infant outcomes that were examined. Conclusions Prenatal exercise is safe and beneficial for the fetus. Maternal exercise was associated with reduced odds of macrosomia (abnormally large babies) and was not associated with neonatal complications or adverse childhood outcomes.
Use of a Bougie for Intubation in an Emergency Department—Reply
Authors: Brian E. Driver, Matthew E. Prekker, Jon B. Cole
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