tbuckley/cabot-search huggingface dataset:
Prenatal Exposure to Mercury: Associations with Global DNA Methylation and Hydroxymethylation in Cord Blood and in Childhood
Authors: Andres Cardenas, Sheryl L. Rifas-Shiman, Lode Godderis, Radu-Corneliu Duca, Ana Navas-Acien, Augusto A. Litonjua, Dawn L. DeMeo, Kasey J. Brennan, Chitra J. Amarasiriwardena, Marie-France Hivert, Matthew W. Gillman, Emily Oken, Andrea A. Baccarelli
Journal: Environmental Health Perspectives (2017)

Background: Mercury is a global pollutant, and prenatal exposure is associated with adverse health effects. To date, no studies have evaluated the association between prenatal mercury exposure and DNA hydroxymethylation, an epigenetic modification important for tissue differentiation and embryonic development. Objectives: We sought to evaluate the association between prenatal mercury exposure and offspring global DNA methylation and hydroxymethylation at birth and test for persistence of the association in childhood. Methods: Within Project Viva, a U.S. prebirth cohort, we examined associations of maternal second trimester red blood cell mercury (RBC-Hg) concentrations with global 5-hydroxymethylcytosine (%-5hmC) and 5-methylcytosine (%-5mC) DNA content in blood collected at birth (n=306), early childhood (n=68; 2.9 to 4.9 y), and midchildhood (n=260; 6.7 to 10.5 y). Results: Median prenatal RBC-Hg concentration was 3.23μg/g [interquartile range (IQR)=3.29]. At birth, median cord blood %-5mC, %-5hmC, and their ratio were 4.95%, 0.22%, and 24.37, respectively. The mean adjusted difference [95% confidence interval (CI)] of blood %-5hmC for a doubling in prenatal RBC-Hg concentration was −0.013% (−0.029, 0.002), −0.031% (−0.056, −0.006), and 0.005% (−0.007, 0.018) at birth, early, and midchildhood, respectively. The corresponding relative adjusted change in the genomic ratio of %-5mC to %-5hmC for a doubling in prenatal RBC-Hg concentration was 4.70% (0.04, 9.58), 22.42% (7.73, 39.11), and 0.73% (−4.18, 5.88) at birth, early, and midchildhood, respectively. No associations were present between prenatal maternal RBC-Hg and %-5mC at any time point. Conclusions: Prenatal mercury exposure was associated with lower %-5hmC genomic content and a corresponding increase in the ratio of %-5mC to %-5hmC in cord blood. This association was persistent in early but not midchildhood blood. Our results demonstrate the potential malleability of epigenetic modifications associated with mercury exposure in utero. https://doi.org/10.1289/EHP1467
Residents' hours of work
Authors: I. Philibert
Journal: BMJ (2002)

To many, “resident physician” conjures up an image of long hours of work, fuelled by caffeine and adrenaline. This overlooks the reality that residency is an educational experience that completes a physician's preparation for independent practice. About 100 000 resident doctors in the United States—as providers of care and as learners—will be affected by reforms regarding their hours of duty, which were recently announced by the US Accreditation Council for Graduate Medical Education.1 Under the new rules, set to take effect in July 2003, residents will work no more than 80 hours per week, have shifts that are no longer than 24 hours, and have 10 hours of rest between shifts.

The literature on sleep deprivation supports these reforms. Many articles show that sleep deprivation in laboratory and field studies has shown a negative effect on the performance of residents.2–4 Reduced performance due to sleep deprivation may be associated with increased errors and contribute to adverse events when fatigued members of staff participate in the care of patients.5

Accreditation is a voluntary approach of professional self regulation. The consequences of failed self regulation are often regulatory interventions, which are costly. …
Adherence to yoga practice improves symptom control and quality of life in breast cancer patients undergoing conventional treatment.
Authors: Rao M. Raghavendra, Kodaganur Srinivasachar Gopinath, B S Srinath, Shekhar Patil, P Shashidhara, Ravi B Diwakar, Ramesh Bilimagga S, Nalini K Rao, Basavalinga S. Ajaikumar, Jayanna Prashanth, K N Chidambaramurthy
Journal: Journal of Clinical Oncology (2012)

e11511 Background: Adherence plays an important role in success of mind body interventions such as yoga. In this study we evaluated the effects of adherence to yoga intervention on psychological and quality of life outcomes. Methods: Adherence to yoga program was assessed in a randomized controlled trial comparing yoga (n=45) vs. supportive therapy in breast cancer patients with stage II and III disease undergoing primary surgery followed by adjuvant radiotherapy and chemotherapy. Subjects were assessed for self reported symptoms and affective states using symptom checklist, Spielberger’s State Trait Anxiety, Becks Depression Inventory and Functional Living Index in cancer for Quality of life following surgery and during radiotherapy and chemotherapy. Adherence was categorized based on number of sessions of yoga practiced at home per week [regular (&gt;5 sessions), not so regular (3-5 sessions), occasionally (upto 2 sessions)].Multiple hierarchical regression analysis was used to examine the variance in the above outcomes explained by independent prognostic variables (age group, clinical stage of cancer, type of surgery, respective baseline psychological outcomes and regularity of practice) in yoga group alone. Model B includes these four variables plus regularity of practice. Results: Regularity of practice emerged as a secondary predictor for symptom severity following surgery (β= 0.38, p=0.007) and primary predictor for depression (β= 0.37, p=0.05) and severity of symptoms (β= 0.42, p=0.04) during radiotherapy and depression(β= 0.35, p=0.05), severity of symptoms (β= 0.45, p=0.03), anxiety trait(β= 0.40, p=0.03) and quality of life (β= -0.61, p=0.001) during chemotherapy. Conclusions: Adherence to mind body interventions such as yoga improves psychological and quality of life outcomes in breast cancer patients undergoing conventional cancer treatment.
Endoscopic papillary large-balloon dilation: when and how?
Authors: Horst Neuhaus
Journal: Endoscopy (2017)

See also: Complete endoscopic sphincterotomy with vs. without large-balloon dilation for the removal of large bile duct stones: randomized multicenter studyEndoscopy 2017; 49(10): 968-976DOI: 10.1055/s-0043-114411
Extended versus limited pelvic lymphadenectomy during radical prostatectomy for intermediate- and high-risk prostate cancer: Early outcomes from a randomized controlled phase III study.
Authors: Jean Felipe Prodocimo Lestingi, Giuliano Guglielmetti, Jose Pontes Jr, Anuar Ibrahim Mitre, Alvaro Sarkis, Diogo Assed Bastos, Rachel Riechelmann, Romulo Loss Mattedi, Mauricio Cordeiro, Rafael Coelho, Miguel Srougi, William Carlos Nahas
Journal: Journal of Clinical Oncology (2017)

5018 Background: The role of extended pelvic lymph node dissection (ePLND) in treating prostate cancer (PCa) patients remains controversial, mainly by the lack of RCTs. Methods: Patients with D'Amico intermediate or high risk PCa, absence of bone metastasis and no previous treatment were prospectively computer randomised to undergo extended or limited PLND (1:1) during radical prostatectomy. Limited PLND (lPLND) included the obturator chain bilaterally; ePLND involved bilaterally chains: obturator, external-, internal-, common-iliac and pre-sacral. Surgical specimens and each chain were analyzed separately, according to College of American Pathologists. All patients signed a free and informed consent and local ethics committee approved the study. The primary endpoint was biochemical recurrence-free survival, analysed in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT01812902. Results: Since May 2012 until August 2016, 291 patients were randomly assigned, 145 to ePLND and 146 to lPLND. Preoperative data were comparable between groups. Median follow-up was 35.2 months. EPLND increased significantly operative time (54 minutes), estimated blood loss (100 mL), length of hospital stays (1 day) [p≤0.001], transfusion rate [p = 0.05] and postoperative complications according to Clavien scale [p = 0.03]. There was no difference in Pathologic Gleason grade, T stage or positive surgical margin. On ePLND and lPLND groups, 59.3% and 61.7% were staged ≥ pT3a, respectively. EPLND and lPLND yielded median (mean) 17 (19.8) and 3 (4.1) nodes, respectively (p &lt; 0.001). EPLND showed 6.3 times more lymph node metastases (p &lt; 0.001) and only it was able to show positive nodes in intermediate risk. There were no difference in biochemical recurrence (PSA ≥ 0.2 ng/mL) using Kaplan-Meyer method (p = 0.4), Radiotherapy, Androgen Deprivation Therapy, bone metastases or death. Conclusions: Extended lymphadenectomy in intermediate- and high-risk prostate cancer patients is associated with better tumor staging, increased morbidity and no oncological benefits in this initial short follow-up time. Clinical trial information: NCT01812902.
Early therapy response assessment by apparent diffusion coefficient (ADC) quantification following glass-based yttrium-90 radioembolization for unresectable hepatocellular carcinoma (HCC).
Authors: Nima Kokabi, Juan C. Camacho, Bassel F. El-Rayes, John S. Kauh, Hyun Sik Kim
Journal: Journal of Clinical Oncology (2013)

e15140 Background: Early objective imaging biomarker assessment of infiltrative HCC following Y90 radioembolization is not well understood. Early diffusion weighted imaging (DWI) of treated lesions was evaluated and correlated with anatomical treatment response using modified response evaluation criteria in solid tumors (mRECIST). Methods: In an IRB approved prospective proof of concept study, 10 consecutive patients (89% men, median age 55) with unresectable infiltrative HCC and portal vein thrombosis underwent Y90. MR imaging was obtained pre-Y90, 1 and 3 months post-Y90. DWI fat-suppressed single-shot echo-planar sequence with tri-directional diffusion gradient was performed (b=50,400,800 s/mm 2 ). Using pixel-based ADC maps, mean values of treated lesions and surrounding tumor-free liver were measured by manually drawing a noncircular region of interest around corresponding areas on the same image slice. Treatment response was evaluated using mRECIST with complete response as non-enhancement of treated lesion. T-test was performed using SPSS Statistics v20.0 (IBM, Armonk, NY) and significance set at &lt; 0.05. Results: On 30 day post therapy MR and based on mRECIST, 70% of patients had objective response (CR=30%, PR=40%, SD=20%, PD=10%). Mean pre and post-Y90 ADC value of cancer-free liver was 1.10 × 10 −3 and 1.08 × 10 −3 mm 2 /sec (p=0.65). Mean ADC value of all treated tumors pre and post-Y90 was 0.82 × 10 −3 and 1.19 × 10 −3 mm 2 /sec respectively (p &lt;0.001). Correlating with mRECIST treatment response, mean post-Y90 ADC of lesions with objective and those with no objective response were 1.03 × 10 −3 mm 2 /sec and 1.26 × 10 −3 mm 2 /sec respectively (p=0.003). While there was a significant difference between ADC values of lesion with objective response vs. others, no significant difference was observed at baseline ADC of tumors with eventual objective response vs. others. Corresponding ADC values on 30 and 90 day followup scans were unchanged. Conclusions: Mean ADC value measured 30-days post-therapy shows promises as an objective imaging biomarker to assess treatment response following Y90 therapy for infiltrative HCC.
Aliskiren alone or in combination with enalapril vs. enalapril among patients with chronic heart failure with and without diabetes: a subgroup analysis from the ATMOSPHERE trial
Authors: Søren L. Kristensen, Ulrik M. Mogensen, Georgia Tarnesby, Claudio R. Gimpelewicz, Mohammed A. Ali, Qing Shao, YannTong Chiang, Pardeep S. Jhund, William T. Abraham, Kenneth Dickstein, John J.V. McMurray, Lars Køber
Journal: European Journal of Heart Failure (2017)
Quantitative Clinical Staging for Patients With Malignant Pleural Mesothelioma
Authors: Ritu R Gill, Beow Y Yeap, Raphael Bueno, William G Richards
Journal: JNCI Journal of the National Cancer Institute (2017)

BackgroundAnalysis of the International Association for the Study of Lung Cancer (IASLC) Malignant Pleural Mesothelioma (MPM) database revealed that clinical (cTNM) staging minimally stratified survival and was discrepant with pathological (pTNM) staging. To improve prognostic classification of MPM, alternative staging models based on quantitative parameters were explored.
Low-Fat Diet Reduces Mortality After Breast Cancer
Authors: Anita Slomski
Journal: JAMA (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 HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Monitoring the effect of cytostatic treatment by immune activity
Authors: T.F. Hansen, L. Nederby, T. Bechmann, E. Jakobsen, A. Zedan, I. Mejlholm, J. Henriksen, K. Steffensen, C. Thomsen, L. Raunkilde, L.H. Jensen, A. Jakobsen
Journal: Annals of Oncology (2017)
Effect of Systematic Intensive Care Unit Triage on Long-term Mortality Among Critically Ill Elderly Patients in France
Authors: Bertrand Guidet, Guillaume Leblanc, Tabassome Simon, Maguy Woimant, Jean-Pierre Quenot, Olivier Ganansia, Maxime Maignan, Youri Yordanov, Samuel Delerme, Benoit Doumenc, Muriel Fartoukh, Pierre Charestan, Pauline Trognon, Bertrand Galichon, Nicolas Javaud, Anabela Patzak, Maïté Garrouste-Orgeas, Caroline Thomas, Sylvie Azerad, Dominique Pateron, Ariane Boumendil
Journal: JAMA (2017)

<h3>Importance</h3> The high mortality rate in critically ill elderly patients has led to questioning of the beneficial effect of intensive care unit (ICU) admission and to a variable ICU use among this population. <h3>Objective</h3> To determine whether a recommendation for systematic ICU admission in critically ill elderly patients reduces 6-month mortality compared with usual practice. <h3>Design, Setting, and Participants</h3> Multicenter, cluster-randomized clinical trial of 3037 critically ill patients aged 75 years or older, free of cancer, with preserved functional status (Index of Independence in Activities of Daily Living ≥4) and nutritional status (absence of cachexia) who arrived at the emergency department of one of 24 hospitals in France between January 2012 and April 2015 and were followed up until November 2015. <h3>Interventions</h3> Centers were randomly assigned either to use a program to promote systematic ICU admission of patients (n=1519 participants) or to follow standard practice (n=1518 participants). <h3>Main Outcomes and Measures</h3> The primary outcome was death at 6 months. Secondary outcomes included ICU admission rate, in-hospital death, functional status, and quality of life (12-Item Short Form Health Survey, ranging from 0 to 100, with higher score representing better self-reported health) at 6 months. <h3>Results</h3> One patient withdrew consent, leaving 3036 patients included in the trial (median age, 85 [interquartile range, 81-89] years; 1361 [45%] men). Patients in the systematic strategy group had an increased risk of death at 6 months (45% vs 39%; relative risk [RR], 1.16; 95% CI, 1.07-1.26) despite an increased ICU admission rate (61% vs 34%; RR, 1.80; 95% CI, 1.66-1.95). After adjustments for baseline characteristics, patients in the systematic strategy group were more likely to be admitted to an ICU (RR, 1.68; 95% CI, 1.54-1.82) and had a higher risk of in-hospital death (RR, 1.18; 95% CI, 1.03-1.33) but had no significant increase in risk of death at 6 months (RR, 1.05; 95% CI, 0.96-1.14). Functional status and physical quality of life at 6 months were not significantly different between groups. <h3>Conclusions and Relevance</h3> Among critically ill elderly patients in France, a program to promote systematic ICU admission increased ICU use but did not reduce 6-month mortality. Additional research is needed to understand the decision to admit elderly patients to the ICU. <h3>Trial Registration</h3> clinicaltrials.gov Identifier:NCT01508819
Integrating Health into Local Climate Response: Lessons from the U.S. CDC Climate-Ready States and Cities Initiative
Authors: Mary C. Sheehan, Mary A. Fox, Charlotte Kaye, Beth Resnick
Journal: Environmental Health Perspectives (2017)

Public health has potential to serve as a frame to convey the urgency of behavior change needed to adapt to a changing climate and reduce greenhouse gas emissions. Local governments form the backbone of climate-related public health preparedness. Yet local health agencies are often inadequately prepared and poorly integrated into climate change assessments and plans. We reviewed the climate health profiles of 16 states and two cities participating in the U.S. Centers for Disease Control and Prevention (CDC)'s Climate-Ready States and Cities Initiative (CRSCI) that aims to build local capacity to assess and respond to the health impacts of climate change. Following recommendations from a recent expert panel strategic review, we present illustrations of emerging promising practice and future directions. We found that CRSCI has strengthened climate preparedness and response in local public health agencies by identifying critical climate-health impacts and vulnerable populations, and has helped integrate health more fully into broader climate planning. Promising practice was found in all three recommendation areas identified by the expert panel (leveraging partnerships, refining assessment methodologies and enhancing communications), particularly with regard to health impacts of extreme heat. Vast needs remain, however, suggesting the need to disseminate CRSCI experience to non-grantees. In conclusion, the CRSCI program approach and selected activities illustrate a way forward toward robust, targeted local preparedness and response that may serve as a useful example for public health departments in the United States and internationally, particularly at a time of uncertain commitment to climate change agreements at the national level. https://doi.org/10.1289/EHP1838.
侵襲性黒色腫の治療のための多機能「コア‐シェル」ナノ粒子遺伝子デリバリー【Powered by NICT】
Authors: Li Ling, Song Linjiang, Yang Xi, Li Xia, Wu Yuzhe, He Tao, Wang Ning, Yang Suleixin, Zeng Yan, Yang Li, Wu Qinjie, Wei Yuquan, Gong Changyang
Journal: Biomaterials (2016)
Abstract #3573: Drug reposition for brain metastasis of breast cancer
Authors: Hong Zhao, Guangxu Jin, Helen Wong, Kemi Cui, Fuhai Li, Sufang Zhang, Solomen Wong, Xiaobo Zhou, Jenny Chang, Stephen Wong
Journal: Cancer Research (2009)

The incidence of central nervous system (CNS) metastases in breast cancer has been estimated as much as 16% in clinical series. Recently a trend towards increasing CNS relapse has been noted, up to 25-34%. The treatment of CNS metastases in breast cancer remains challenging. We proposed a systems approach by integrate computational biology methods and high-throughput biological analysis to decipher multiple targets in the pathways of brain metastases of breast tumors, and to rationally reposition FDA approved drugs for the brain metastasis of breast tumors. We performed Affymetrix HGU133A genome chip on 11 primary breast cancers from patients who developed eventual brain metastasis and 17 samples from breast cancer patients who relapsed at other sites but without brain metastasis. Based on the analysis of the microarray data sets and 8 breast cancer related pathways, and network motif topology clustering of these pathways, e.g. the \#8216;MAPK\#8217;, \#8216;ErbB\#8217;, \#8216;Wnt\#8217;, \#8216;Notch\#8217;, \#8216;VEGF\#8217;, \#8216;mTOR\#8217;, \#8216;Cell Cycle\#8217;, and \#8216;P53\#8217; pathways in KEGG database, we constructed a key signal pathway with 101 gene nodes for brain metastasis of breast cancer. The identified genes can classify the brain metastatic from non-brain metastatic patients with 82.14% (for single gene) and 96.43% (for 2 genes) accuracy by the statistical classification. 32 FDA approved drugs, including SAHA, Sorafenib, Arsenic trioxide, Sunitinib and Dasatinib, et al, hit the target genes in the network as the candidates for our further validation. If validated, our systems biology approach for drug reposition offers the potential to fundamentally change the drug treatment of breast cancer brain metastasis. Hong Zhao  and  Guangxu Jin contributed equally to this work   Citation Information:  In: Proc Am Assoc Cancer Res; 2009 Apr 18-22; Denver, CO. Philadelphia (PA): AACR; 2009. Abstract nr 3573.
Abstract 17826: Long-term Survivors With Transposition of the Great Arteries After Arterial Switch Operation Show No Signs of Adverse Myocardial Remodeling
Authors: Heynric B Grotenhuis, Luc Mertens, Barbara Cifra, Eugenie Riessenkampff, Cedric Manlhiot, Lars Grosse-Wortmann
Journal: Circulation (2015)

Background: The arterial switch operation (ASO) for transposition of the great arteries (TGA) involves coronary translocation. The altered coronary geometry may lead to subclinical myocardial ischemia, which may result in myocardial scarring and diffuse myocardial fibrosis. We hypothesized that myocardial fibrosis is present late after ASO, despite excellent functional outcomes of the ASO in most patients. Methods: 30 pediatric TGA patients after ASO were prospectively studied by cardiac magnetic resonance imaging (CMR). Late gadolinium enhancement (LGE) was used to detect discrete myocardial scarring. Native T1 relaxation times and extracellular volumes (ECVs) at the mid-ventricular short-axis level of the left ventricle (LV) were used to quantify diffuse myocardial fibrosis. The midventricular short-axis slice was divided into 6 segments. Patients were compared to 21 healthy controls. Results: Mean ages at ASO and at CMR were 6.3±5.2 days and 15.4±2.9 years, respectively. Mean age of controls at CMR was 14.1±2.6 years. TGA patients showed preserved LV ejection fraction (57±5% vs. 59±4% in controls, p=0.08) and similar indexed LV mass (54±10g/m2 vs. 49±9%, p=0.12). LV end-diastolic and end-systolic volumes were mildly increased (104±20ml/m2 vs. 89±11ml/m2, p=0.01 and 46±13ml/m2 vs. 36±6ml/m2, p&lt;0.01, respectively). None of the TGA patients demonstrated evidence of localized myocardial scarring by LGE. Native T1 times and ECV values for all 6 LV segments were not significantly different to controls. There was no association between global T1 times or global ECV and LV volumes and ejection fraction. Furthermore, native T1 and ECV were not associated with bypass and cross-clamp times at the time of the ASO, or with coronary artery patterns. Conclusions: Adolescent TGA patients late after ASO have preserved systolic LV function. There is no evidence of myocardial scarring or fibrosis. Our results suggest excellent long-term myocardial and cardiac health after the ASO, paralleling the encouraging clinical outcomes with this procedure.
Eosinophils release extracellular DNA traps in response to Aspergillus fumigatus
Authors: Valdirene S. Muniz, Juliana C. Silva, Yasmim A.V. Braga, Rossana C.N. Melo, Shigeharu Ueki, Masahide Takeda, Akira Hebisawa, Koichiro Asano, Rodrigo T. Figueiredo, Josiane S. Neves
Journal: Journal of Allergy and Clinical Immunology (2017)