tbuckley/cabot-search huggingface dataset:
Evaluating neutrophil/lymphocyte ratio as a predictor of 30-day high-grade complications following renal surgery.
Authors: Ryan Nasseri, Ahmet Bindayi, Kendrick Yim, Stephen Ryan, Madhumitha Reddy, Eric Ballon-Landa, Addison Yee, Fang Wan, James Proudfoot, Ithaar Derweesh
Journal: Journal of Clinical Oncology (2018)

659 Background: Radical nephrectomy (RN) and partial nephrectomy (PN) for patients with renal cortical masses may carry significant risk for postoperative complications. We analyzed patient demographics and serum laboratories and morphometric measures to determine predictors of 30-day complications following RN and PN. Methods: Single institution retrospective analysis of RNs and PNs between 7/2008-4/2017. Demographic and clinical characteristics, serum laboratories, and RENAL nephrometry score were recorded. 30-day complications were graded according to the modified Clavien classification system. Primary purpose was to identify predictive factors associated with 30-day complications overall. Secondary purposes included identification of predictive factors high-grade complications (HGC; Clavien ≥3) overall and in the PN group. Factors were screened with logistic regression analysis. Results: 814 patients were analyzed (460 PN, 354 RN). 190 (23%) patients experienced 30-day complications, 107/460 (23%) PN and 83/354 (24%) RN (p = 0.951). Albumin level ≤3.5 mg/dL was predictive of overall complications (OR = 4.803, p = .008), while minimally invasive surgery (MIS) was negatively associated (OR 0.444, p &lt; .001). Overall, 76 (9.3%) HGCs occurred, 52/460 (11%) in PN and 24/354 (6.8%) in RN (p = .028). Preoperative Neutrophil-Lymphocyte Ratio (NLR) of ≥2.78 (OR 3.216, p = .016) was a predictor of HGCs overall. MIS was negatively associated with HGCs (OR 0.444, p &gt; .001). In the PN group only MIS was negatively associated with overall complications (OR 0.323, p &lt; .001) and HGCs (OR 0.259, p &lt; .001). Conclusions: While decreased serum albumin was predictive of overall complications in patients undergoing PN and RN, elevated preoperative NLR is a novel predictor for HGC. Use of serum markers may be incorporated in preoperative risk stratification counseling and nomograms.
Multivessel Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction With Cardiogenic Shock
Authors: Joo Myung Lee, Tae-Min Rhee, Joo-Yong Hahn, Hyun Kuk Kim, Jonghanne Park, Doyeon Hwang, Ki Hong Choi, Jihoon Kim, Taek Kyu Park, Jeong Hoon Yang, Young Bin Song, Jin-Ho Choi, Seung-Hyuk Choi, Bon-Kwon Koo, Young Jo Kim, Shung Chull Chae, Myeong Chan Cho, Chong Jin Kim, Hyeon-Cheol Gwon, Ju Han Kim, Hyo-Soo Kim, Myung Ho Jeong
Journal: Journal of the American College of Cardiology (2018)
DESIGN AND BASELINE CHARACTERISTICS OF THE EVALUATION OF ERTUGLIFOZIN EFFICACY AND SAFETY CARDIOVASCULAR OUTCOMES TRIAL (VERTIS-CV)
Authors: Christopher P. Cannon, Darren McGuire, Richard Pratley, Samuel Dagogo-Jack, James Mancuso, Susan Huyck, Bernard Charbonnel, Weichung Shih, Silvina Gallo, Urszula Masiukiewicz, Gregory Golm, Cosentino Francesco, Brett Lauring, Steven Terra
Journal: Journal of the American College of Cardiology (2018)
Organ Dysfunction After Surgery in Patients Treated With Individualized or Standard Blood Pressure Management
Authors: Mahmoud Daoud
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 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
Pulmonary capillary recruitment in exercise and pulmonary hypertension
Authors: Horst Olschewski, Gabor Kovacs, Philippe Herve
Journal: European Respiratory Journal (2018)

<b>It is currently premature to judge the recruitment capacity of the pulmonary vasculature in healthy individuals based on the published literature, or to draw any final conclusions</b>http://ow.ly/BdbP30irkAF
All physicians should train in acute and general internal medicine, says Royal College of Physicians
Authors: Helen Jaques
Journal: BMJ (2013)

Training in general internal medicine should be mandatory for junior doctors in all physician specialties to help the NHS cope with the challenges it faces in secondary care, the Royal College of Physicians has recommended.

The medical workforce will need to adapt in other ways to ensure it can meet demographic pressures and to deliver continuity of care, seven day services, and integration of hospital and community healthcare, the college has stated in its review of how patients should be cared for in hospitals in the future.1

The report by the Future Hospital Commission sets out the college’s vision for how hospital services should be structured to meet the challenges facing the NHS now and in the future, such as rising numbers of acute admissions and of patients who are …
Atopic dermatitis phenotypes in African American and Black South African children
Authors: Kylie N. Jungles, Michael Levin, Maresa Botha, Betty Andy-Nweye, Sukruthi Jois, Claudia L. Gray, Carol Hlela, Avumile Mankahla, Ben Gaunt, Carl le Roux, Nonhlanhla Lunjani, Mary C. Tobin, Mahboobeh Mahdavinia
Journal: Journal of Allergy and Clinical Immunology (2018)
A Cluster-Randomized Trial of Blood-Pressure Reduction in Black Barbershops
Authors: Ronald G. Victor, Kathleen Lynch, Ning Li, Ciantel Blyler, Eric Muhammad, Joel Handler, Jeffrey Brettler, Mohamad Rashid, Brent Hsu, Davontae Foxx-Drew, Norma Moy, Anthony E. Reid, Robert M. Elashoff
Journal: New England Journal of Medicine (2018)

Uncontrolled hypertension is a major problem among non-Hispanic black men, who are underrepresented in pharmacist intervention trials in traditional health care settings.We enrolled a cohort of 319 black male patrons with systolic blood pressure of 140 mm Hg or more from 52 black-owned barbershops (nontraditional health care setting) in a cluster-randomized trial in which barbershops were assigned to a pharmacist-led intervention (in which barbers encouraged meetings in barbershops with specialty-trained pharmacists who prescribed drug therapy under a collaborative practice agreement with the participants’ doctors) or to an active control approach (in which barbers encouraged lifestyle modification and doctor appointments). The primary outcome was reduction in systolic blood pressure at 6 months.At baseline, the mean systolic blood pressure was 152.8 mm Hg in the intervention group and 154.6 mm Hg in the control group. At 6 months, the mean systolic blood pressure fell by 27.0 mm Hg (to 125.8 mm Hg) in the intervention group and by 9.3 mm Hg (to 145.4 mm Hg) in the control group; the mean reduction was 21.6 mm Hg greater with the intervention (95% confidence interval, 14.7 to 28.4; P<0.001). A blood-pressure level of less than 130/80 mm Hg was achieved among 63.6% of the participants in the intervention group versus 11.7% of the participants in the control group (P<0.001). In the intervention group, the rate of cohort retention was 95%, and there were few adverse events (three cases of acute kidney injury).Among black male barbershop patrons with uncontrolled hypertension, health promotion by barbers resulted in larger blood-pressure reduction when coupled with medication management in barbershops by specialty-trained pharmacists. (Funded by the National Heart, Lung, and Blood Institute and others; ClinicalTrials.gov number, NCT02321618 .).
<i>DICER1</i> and Associated Conditions: Identification of At-risk Individuals and Recommended Surveillance Strategies
Authors: Kris Ann P. Schultz, Gretchen M. Williams, Junne Kamihara, Douglas R. Stewart, Anne K. Harris, Andrew J. Bauer, Joyce Turner, Rachana Shah, Katherine Schneider, Kami Wolfe Schneider, Ann Garrity Carr, Laura A. Harney, Shari Baldinger, A. Lindsay Frazier, Daniel Orbach, Dominik T. Schneider, David Malkin, Louis P. Dehner, Yoav H. Messinger, D. Ashley Hill
Journal: Clinical Cancer Research (2018)

Pathogenic germline DICER1 variants cause a hereditary cancer predisposition syndrome with a variety of manifestations. In addition to conferring increased cancer risks for pleuropulmonary blastoma (PPB) and ovarian sex cord-stromal tumors, particularly Sertoli-Leydig cell tumor, individuals with pathogenic germline DICER1 variants may also develop lung cysts, cystic nephroma, renal sarcoma and Wilms tumor, nodular hyperplasia of the thyroid, nasal chondromesenchymal hamartoma, ciliary body medulloepithelioma, genitourinary embryonal rhabdomyosarcoma, and brain tumors including pineoblastoma and pituitary blastoma. In May 2016, the International PPB Registry convened the inaugural International DICER1 Symposium to develop consensus testing and surveillance and treatment recommendations. Attendees from North America, Europe, and Russia provided expert representation from the disciplines of pediatric oncology, endocrinology, genetics, genetic counseling, radiology, pediatric surgery, pathology, and clinical research. Recommendations are provided for genetic testing; prenatal management; and surveillance for DICER1-associated pulmonary, renal, gynecologic, thyroid, ophthalmologic, otolaryngologic, and central nervous system tumors and gastrointestinal polyps. Risk for most DICER1-associated neoplasms is highest in early childhood and decreases in adulthood. Individual and caregiver education and judicious imaging-based surveillance are the primary recommended approaches. These testing and surveillance recommendations reflect a consensus of expert opinion and current literature. As DICER1 research expands, guidelines for screening and treatment will continue to be updated. Clin Cancer Res; 24(10); 2251-61. ©2018 AACR.
Real world outcomes of nivolumab and cabozantinib in metastatic renal cell carcinoma: Results from the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC).
Authors: Igor Stukalin, J Connor Wells, Jeffrey Graham, Takeshi Yuasa, Benoit Beuselinck, Christian K. Kollmannsberger, D. Scott Ernst, Neeraj Agarwal, Tri Le, Frede Donskov, Aaron Richard Hansen, Georg A. Bjarnason, Sandy Srinivas, Lori Wood, Ajjai Shivaram Alva, Ravindran Kanesvaran, Simon Yuen Fai Fu, Ian D. Davis, Toni K. Choueiri, Daniel Yick Chin Heng
Journal: Journal of Clinical Oncology (2018)

615 Background: The immuno-oncology (IO) checkpoint inhibitor nivolumab and the tyrosine kinase inhibitor (TKI) cabozantinib have both been shown in phase III clinical trials to be effective in metastatic renal cell carcinoma (mRCC) after progression on first-line therapy. We sought to explore the real-world efficacy of these therapies in second-line mRCC. Methods: Using the IMDC database, a retrospective analysis was performed on mRCC patients treated with second-line nivolumab or cabozantinib. Baseline characteristics and IMDC risk factors were collected. Overall survival (OS), time to treatment failure (TTF), and response rates were determined for each therapy. Multivariable Cox regression analysis was performed to determine survival differences. Results: 225 patients were treated with nivolumab and 53 with cabozantinib. There was no significant difference in OS identified, with a mOS for nivolumab of 22.1 months (95% CI 17.18 – NR) and 23.7 months (95% CI 15.52 vs. NR) for cabozantinib, p = 0.6053. The TTF was also similar, with 6.90 months (95% CI 4.60 – 9.20) for nivolumab versus 7.39 months (95% CI 5.52 – 12.85) for cabozantinib, p = 0.1983. The adjusted hazard ratio (HR) for nivolumab vs. cabozantinib was 1.297 (95% CI – 0.728 – 2.312), p = 0.3775. Conclusions: Nivolumab and cabozantinib appear to have similar efficacy in terms of OS and TTF in this real-world patient population, thus both novel agents are reasonable therapeutic options for patients progressing after initial first-line therapy. [Table: see text]
I am an Italian doctor. Could you explain what positions such as trust doctor, staff grade, and so on actually mean?
Authors: Simon Eccles
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>
O017 Il-7 in primary sjÖgren syndrome (PSS) is secreted by salivary gland epithelial cells after ifn stimulation and is associated with B-cell activation
Authors: A Virone, J Pascaud, E Riviere, J-E Gottenberg, V Le Guern, X Mariette, G Nocturne
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Introduction</h3> pSS is characterised by a strong IFN signature, ectopic germinal centres formation and a chronic blood lymphopenia. IL-7 plays a central part in T cells homeostasis and in lymphoid structures organisation. <h3>Objectives</h3> To assess the role of IL-7 in pSS pathogenesis. <h3>Methods</h3> IL-7 serum level was assessed in 372 pSS patients and 73 paired controls. Primary cultures of salivary gland epithelial cells (SGEC) from patients and controls were stimulated by Poly I:C 30 ng/ml, IFN-α 600 UI/ml, IFN-γ 5 ng/ml and IFN-λ (IL-28) 25 ng/ml for 72 hours. IL-7 secretion was tested in culture supernatant by ELISA. IL-7 expression after 24 hours stimulation was assessed by quantitative RT-PCR. IL-7 and its receptor's expressions were evaluated in RNA-Seq analysis from cells form salivary glands biopsies (SGB) and PBMC. <h3>Results</h3> pSS patients had higher serum IL-7 levels than controls: 7.56 ng/ml±8.52 (mean±SD) versus 4.86 ng/ml±5.59; p&lt;0.0001. A positive correlation with B cells activation markers, IFN-induced chemokines and disease activity markers was observed. In multivariate analysis, serum IL-7 level was associated with CXCL13, anti-SSA, RF, κ light-chain and low C4. SGEC stimulation with Poly I:C, IFN-α, -γ and -λ induced IL-7 protein secretion in the supernatant (p=0.002, p=0.004, p=0.007, p=0.004 respectively). A trend for a greater IL-7 production in pSS patients compared to controls was observed. IL-7 expression was confirmed by quantitative RT-PCR. Among cell subsets purified <i>ex vivo</i> from SGB and PBMC, RNA-Seq analysis showed a greater expression of IL-7 by epithelial cells of patients compared to controls (p=0.03). No difference was observed regarding T and B cells either from biopsies or PBMC. IL-7 receptor expression was equivalent between patients and controls. Analysis of T cells exhaustion profile and IL-7 intracellular signalling are on-going. <h3>Conclusions</h3> Our data demonstrate that IL-7 is secreted within the target tissue of pSS by SGEC after stimulation by IFNs. This IFN/IL-7 pathway can be involved in the organisation of ectopic germinal centres found in pSS. But more importantly, since Il-7 is one of the major controller of homeostasis of T cells, this IFN/IL-7 pathway could be involved in the persistent lymphopenia which is a hallmark of the disease, either by favouring exhaustion of T cells or by an impaired function of the IL-7 intracellular signalling. Both mechanisms are currently explored and will be presented. <h3>Disclosure of interest</h3> None declared
A Neutralizing Antibody Recognizing Primarily N-Linked Glycan Targets the Silent Face of the HIV Envelope
Authors: Tongqing Zhou, Anqi Zheng, Ulrich Baxa, Gwo-Yu Chuang, Ivelin S. Georgiev, Rui Kong, Sijy O’Dell, Syed Shahzad-ul-Hussan, Chen-Hsiang Shen, Yaroslav Tsybovsky, Robert T. Bailer, Syna K. Gift, Mark K. Louder, Krisha McKee, Reda Rawi, Catherine H. Stevenson, Guillaume B.E. Stewart-Jones, Justin D. Taft, Eric Waltari, Yongping Yang, Baoshan Zhang, Sachin S. Shivatare, Vidya S. Shivatare, Chang-Chun D. Lee, Chung-Yi Wu, James C. Mullikin, Carole A. Bewley, Dennis R. Burton, Victoria R. Polonis, Lawrence Shapiro, Chi-Huey Wong, John R. Mascola, Peter D. Kwong, Xueling Wu, Betty Benjamin, Robert Blakesley, Gerry Bouffard, Shelise Brooks, Holly Coleman, Mila Dekhtyar, Michael Gregory, Xiaobin Guan, Jyoti Gupta, Joel Han, April Hargrove, Shiling Ho, Richelle Legaspi, Quino Maduro, Cathy Masiello, Baishali Maskeri, Jenny McDowell, Casandra Montemayor, James Mullikin, Morgan Park, Nancy Riebow, Karen Schandler, Brian Schmidt, Christina Sison, Mal Stantripop, James Thomas, Pam Thomas, Meg Vemulapalli, Alice Young
Journal: Immunity (2018)
GPs are warned over pension tax bill
Authors: Anne Gulland
Journal: BMJ (2015)

GPs are being sent letters to alert them to changes to the tax liability of their pensions. 

The NHS Business Services Authority has been sending out the letters, headed “NHS Pension Scheme—Annual Allowance Pensions Saving statement (2014/2015),” to GPs who are preparing their accounts for the last tax year and whose NHS benefits exceed the annual allowance. 

The annual allowance—the amount that an NHS pension is allowed to grow each year before being liable for tax—has been shrinking. At the beginning of the 2011 tax year it was cut from …
Community-Led Total Sanitation: A Mixed-Methods Systematic Review of Evidence and Its Quality
Authors: Vidya Venkataramanan, Jonny Crocker, Andrew Karon, Jamie Bartram
Journal: Environmental Health Perspectives (2018)

Background: Community-led total sanitation (CLTS) is a widely applied rural behavior change approach for ending open defecation. However, evidence of its impact is unclear. Objectives: We conducted a systematic review of journal-published and gray literature to a) assess evidence quality, b) summarize CLTS impacts, and c) identify factors affecting implementation and effectiveness. Methods: Eligible studies were systematically screened and selected for analysis from searches of seven databases and 16 websites. We developed a framework to appraise literature quality. We qualitatively analyzed factors enabling or constraining CLTS, and summarized results from quantitative evaluations. Discussion: We included 200 studies (14 quantitative evaluations, 29 qualitative studies, and 157 case studies). Journal-published literature was generally of higher quality than gray literature. Fourteen quantitative evaluations reported decreases in open defecation, but did not corroborate the widespread claims of open defecation–free (ODF) villages found in case studies. Over one-fourth of the literature overstated conclusions, attributing outcomes and impacts to interventions without an appropriate study design. We identified 43 implementation- and community-related factors reportedly affecting CLTS. This analysis revealed the importance of adaptability, structured posttriggering activities, appropriate community selection, and further research on combining and sequencing CLTS with other interventions. Conclusions: The evidence base on CLTS effectiveness available to practitioners, policy makers, and program managers to inform their actions is weak. Our results highlight the need for more rigorous research on CLTS impacts as well as applied research initiatives that bring researchers and practitioners together to address implementation challenges to improve rural sanitation efforts. https://doi.org/10.1289/EHP1965
THE RELATIONSHIP BETWEEN SEPTAL MORPHOLOGIES AND CARDIAC FIBROSIS IN HYPERTROPHIC CARDIOMYOPATHY
Authors: Keitaro Akita, Ryoma Fukuoka, Hikaru Tsuruta, Shinsuke Yuasa, Mitsushige Murata, Shigeo Okuda, Masahiro Jinzaki, Keiichi Fukuda, Yuichiro Maekawa
Journal: Journal of the American College of Cardiology (2018)
More hospital trusts are seeking to diverge from national pay agreements
Authors: Caroline White
Journal: BMJ (2012)

A further 12 hospital trusts in England are considering joining regional pay deals for NHS staff, bringing the total number of trusts thinking of abandoning nationally negotiated arrangements to 32, Labour’s shadow health secretary, Andy Burnham, has warned.

Speaking in a parliamentary debate in the House of Commons on Wednesday, Burnham said, “We have identified a further 12 trusts across England that are actively considering opting out of Agenda for Change.”

The debate was prompted by a growing concern that employers were increasingly seeking local settlements to pare back the wages bill of healthcare staff in a bid to save cash.

In August, an alliance of 20 hospital trusts—the South West Pay Terms and Conditions Consortium—published two discussion …
NHS diabetes prevention programme helps weight loss, analysis shows
Authors: Jacqui Wise
Journal: BMJ (2018)

Overweight patients who routinely attended an NHS type 2 diabetes prevention scheme lost an average of 3.7 kg over nine months, much more than initially predicted, an initial analysis has found.

The Healthier You diabetes prevention programme—run by NHS England, Public Health England, and Diabetes UK—was launched in 2016.1 Patients who are referred to the scheme receive tailored, personalised help to reduce their risk of developing type 2 diabetes, including education on healthy eating and lifestyle, help with losing weight, and bespoke physical activity programmes. Over nine …
Royal college sets out staffing requirements for consultant delivered care
Authors: Caroline White
Journal: BMJ (2012)

The availability of a consultant on the acute medical unit for 12 hours a day, seven days a week, should be a priority for all staff involved in the planning and delivery of acute medical services, the Royal College of Physicians has said.

Consultant duties on the acute medical unit should start no later than 8 am, and the consultant shift should usually last for between eight and 12 hours, the college has recommended. Individual consultants’ duties on the acute care unit should be for two or more consecutive days; any variation …
Advances in the diagnosis of pigmented skin lesions
Authors: P. Tschandl, T. Wiesner
Journal: British Journal of Dermatology (2018)

Early detection of skin cancer allows timely treatment and improves clinical outcome. The armamentarium for diagnosing skin cancer has been growing notably over the last decades. New tools have led to earlier recognition and a more specific and sensitive diagnosis. In this editorial, we discuss several recent studies published in the BJD on the diagnosis of pigmented skin lesions. The majority of studies published on the detection of skin cancer have investigated methods that are already widely accepted and increasingly used in dermatology, such as dermatoscopy, reflectance confocal microscopy (RCM) and teledermatology. Other investigators have walked off the beaten paths and reported unconventional findings, for example Willis et al. investigated a dog's olfactory ability to discriminate melanoma from control skin lesions.1 In this study, a Labrador, named Ronnie, performed 20 double‐blind tests, each requiring the selection of one melanoma from nine controls, consisting of three each of basal cell carcinomas, naevi and healthy skin. Ronnie correctly identified the melanoma on nine occasions (45%), vs. two expected by chance alone. This creative work demonstrates that invasive melanoma emits volatile organic compounds that differ from those of control lesions. The volatile compounds might be utilized as new biomarkers for a noninvasive diagnosis of melanoma using standardized biochemical assays.