tbuckley/cabot-search huggingface dataset:
Randomised controlled trial of a psycho-educational intervention to reduce fear of cancer recurrence in people at high risk of developing another primary melanoma.
Authors: Anne E. Cust, Mbathio Dieng, Phyllis Butow, Daniel SJ Costa, Rachael L Morton, Scott Menzies, Shab Mireskandari, Stephanie Tesson, Graham J Mann, Nadine Kasparian
Journal: Journal of Clinical Oncology (2016)

10068 Background: Melanoma patients at high risk of developing new primary disease commonly report fears of cancer recurrence, yet psychological support is not routinely implemented as part of their ongoing care. Using a randomised controlled trial design, the Melanoma Care Study aimed to examine the efficacy of a psycho-educational intervention to improve psychological and behavioural adjustment in this patient group, compared to usual care. Methods: The intervention comprised a newly developed psycho-educational booklet and three telephone-based sessions with a trained psychologist over a 1-month period. Psychology sessions were timed around dermatological follow-up appointments. Participants were randomly assigned to the intervention (n = 80) or usual care (n = 84). Follow-up assessments were completed at 1 and 6 months. Linear mixed models were used to examine differences between treatment and control arms for patient-reported outcomes, including fear of melanoma recurrence (primary outcome at 6-months), depression, anxiety, stress, melanoma-related knowledge, health behaviours, satisfaction with clinical care, unmet needs, and health-related quality of life. Results: At 6-months follow-up, participants in the intervention group reported lower fear of melanoma recurrence, with 1.94-point decrease in severity score compared to 0.75-point decrease in controls (p = 0.02; score range 0-36). This remained statistically significant after adjusting for baseline covariates (p = 0.03). Participants in the intervention group had a 1.16-point decrease in stress compared to a 0.48-point increase in the control group (p = 0.01; score range 0-42). Intervention arm participants demonstrated significantly improved melanoma-related knowledge compared to controls (p = 0.003), and reported more met needs (p < 0.0001). Significant differences in anxiety, depression, health-related quality of life, health behaviours, or satisfaction with clinical care were not found. Conclusions: This psycho-educational intervention was effective in reducing fear of melanoma recurrence and stress, and increasing melanoma-related knowledge and met needs. Clinical trial information: 12613000304730.
Endoscopic extraction of a chopstick impacted in the gastric antrum
Authors: Liansong Ye, Honglin Chen, Chuncheng Wu, Wei Liu, Yuhang Zhang, Chuanhui Li, Bing Hu
Journal: Endoscopy (2017)

A 36-year-old woman was referred for moderate epigastric pain following intentional ingestion of a 26-cm chopstick; this was attributed to a family disturbance 7 days earlier. As there were no systemic symptoms of peritonitis or significant bleeding, an emergency upper endoscopy was performed. The examination showed the lower end of the chopstick impacted in the gastric antrum ([Fig. 1 a]) while the upper end was proximal to the gastric fundus. An open snare was initially maneuvered to grasp the chopstick from the upper end, but this failed after repeated attempts. Then we used a closed snare to slightly lift up the chopstick, and successfully grasped the upper end of the chopstick ([Fig. 1 b]). After adjusting the direction of the chopstick, we easily extracted it with withdrawal of the scope ([Fig. 1 c]). An area showing hyperemia and swelling without perforation remained ([Fig. 1 d]; [Video 1]). The patient returned to her normal diet on the first postoperative day with no discomfort.
Association of Adverse Events With Antibiotic Use in Hospitalized Patients
Authors: Pranita D. Tamma, Edina Avdic, David X. Li, Kathryn Dzintars, Sara E. Cosgrove
Journal: JAMA Internal Medicine (2017)

<h3>Importance</h3> Estimates of the incidence of overall antibiotic-associated adverse drug events (ADEs) in hospitalized patients are generally unavailable. <h3>Objective</h3> To describe the incidence of antibiotic-associated ADEs for adult inpatients receiving systemic antibiotic therapy. <h3>Design, Setting, and Participants</h3> Retrospective cohort of adult inpatients admitted to general medicine wards at an academic medical center. <h3>Exposures</h3> At least 24 hours of any parenteral or oral antibiotic therapy. <h3>Main Outcomes and Measures</h3> Medical records of 1488 patients were examined for 30 days after antibiotic initiation for the development of the following antibiotic-associated ADEs: gastrointestinal, dermatologic, musculoskeletal, hematologic, hepatobiliary, renal, cardiac, and neurologic; and 90 days for the development of<i>Clostridium difficile</i>infection or incident multidrug-resistant organism infection, based on adjudication by 2 infectious diseases trained clinicians. <h3>Results</h3> In 1488 patients, the median age was 59 years (interquartile range, 49-69 years), and 758 (51%) participants were female. A total of 298 (20%) patients experienced at least 1 antibiotic-associated ADE. Furthermore, 56 (20%) non–clinically indicated antibiotic regimens were associated with an ADE, including 7 cases of<i>C difficile </i>infection. Every additional 10 days of antibiotic therapy conferred a 3% increased risk of an ADE. The most common ADEs were gastrointestinal, renal, and hematologic abnormalities, accounting for 78 (42%), 45 (24%), and 28 (15%) 30-day ADEs, respectively. Notable differences were identified between the incidence of ADEs associated with specific antibiotics. <h3>Conclusions and Relevance</h3> Although antibiotics may play a critical role when used appropriately, our findings underscore the importance of judicious antibiotic prescribing to reduce the harm that can result from antibiotic-associated ADEs.
Abstract P036: Regional Characterization of Myocardial Renewal in Humans
Authors: Olaf Bergmann, Sofia Zdunek, Mehran Salehpour, Samuel Bernard, Staffan Sjöström, Karl Håkansson, Kanar Alkass, Henrik Druid, Göran Possnert, Jonas Frisén
Journal: Circulation Research (2011)

We and other groups have reported cardiomyocyte renewal in adult human hearts. However, there is no consensus about magnitude and regional heterogeneity in myocardial turnover. Important requirements to quantify cellular turnover are the accurate identification of cardiomyocytes and ploidy level. We present a regional analysis of turnover in the adult myocardium, using the integration of atmospheric radiocarbon (14C) into genomic myocardial DNA. Cardiomyocyte nuclei were labeled with pericentriolar protein 1 (PCM-1) and isolated by flow cytometry. In order to improve estimates on cardiomyocyte turnover, nuclei were isolated according to their DNA content. A substantial fraction of cardiomyocyte nuclei in the right and left ventricle were polyploid: 28.9%±10.6% diploid, 58.9%±8.5% tetraploid and 12.1%±7.4% octaploid in the left ventricle and 47.9%±10.6% diploid, 46.6%±8.3% tetraploid and 5.6%±3.2% octaploid in the right ventricle. Cardiomyocyte turnover was analyzed according to their ploidy distribution in the left and right ventricle. Data from this ongoing study indicates a limited regenerative potential in both ventricles. A comprehensive mathematical analysis of regional turnover distribution will be presented. Non-cardiomyocytes were in average 18.0±2.3 years younger than the respective subjects, indicating a substantial turnover in the whole myocardium. The human heart has the capability to regenerate cardiomyocytes. However, the magnitude of this process does not allow for the renewal of the whole myocardium under homeostatic condition in a lifetime. Understanding the underlying mechanisms of cardiac renewal will open up new avenues to treat cardiac injuries.
Abstract 149: Parkin Translocation And Mitophagy Occur Independently of PINK1 in the Myocardium
Authors: Dieter A Kubli, Youngil Lee, Alexandra G Moyzis, Åsa B Gustafsson
Journal: Circulation Research (2014)

We recently reported that Parkin plays a crucial role in preserving myocardial tissue following a myocardial infarction (MI) by promoting removal of damaged mitochondria via autophagy (mitophagy). Parkin is thought to function downstream of the serine/threonine kinase PINK1 for mitophagy of mitochondria that have lost membrane potential (ΔΨm). Here, we describe the ability of Parkin to translocate to dysfunctional mitochondria in the absence of PINK1. We discovered that after 4 hours of MI, Parkin accumulated on mitochondria in the infarct border zone in both wild type (WT) and PINK1 knockout mice (PINK1 -/- ). Additionally, ex vivo perfusion of PINK1 -/- hearts with the mitochondrial uncoupler FCCP caused rapid translocation of Parkin to mitochondria, equivalent to the response in WT hearts. We further confirmed Parkin translocation and subsequent mitophagy by fluorescence microscopy in isolated PINK1 -/- adult cardiac myocytes treated with the mitochondrial complex I inhibitor rotenone. Rotenone-stimulated Parkin translocation resulted in increased co-localization of GFP-LC3-labeled autophagosomes with mitochondria in both WT and PINK1 -/- myocytes. Thus, PINK1 is dispensable for Parkin translocation and mitophagy in cardiac myocytes. In contrast, we found that Drp1-mediated mitochondrial fission was a prerequisite for Parkin translocation and mitophagy activation. Drp1 translocation to mitochondria preceded Parkin translocation in WT and PINK1 -/- hearts perfused with FCCP. Moreover, overexpression of the dominant negative Drp1-K38E mutant prevented Parkin translocation in rotenone-treated isolated adult rat cardiac myocytes. Interestingly, while Drp1 was able to rapidly translocate to mitochondria in FCCP-perfused Parkin -/- hearts, Drp1 translocation to border zone mitochondria was only observed in WT hearts after MI and not Parkin -/- . This suggests that Parkin stabilizes Drp1 that has translocated to mitochondria upon damage. We conclude that while Parkin translocation to cardiac mitochondria is independent of PINK1 activity, Drp1-mediated fission is required for Parkin translocation. Parkin and PINK1 are therefore components of distinct but overlapping pathways for mitochondrial maintenance in the heart.
Crowdsourcing the Million Brains Initiative—Reply
Authors: David S. Liebeskind, Konark Malhotra, Jason D. Hinman
Journal: JAMA Neurology (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 Neurology 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 Neurology journal
Intratumoral Administration of the Immunotherapeutic Combination Anti-ctla4, Anti-cd137 and Anti-ox40: Comparison to Systemic Administration, Peri-Draining Lymph Node Injection, and Cellular Vaccine in a Mouse Lymphoma Model
Authors: Jonathan P. O. Hebb, Adriane Mosley, Felipe Vences Catalan, Peter Ellmark, Per Norlen, Dean W Felsher
Journal: Blood (2016)
Haematopoetic Stem Cells in the Adult Human Intestine
Authors: L Lynch, L Golden-Mason, D O'Donoghue, C O'Farrelly
Journal: Endoscopy (2004)

Stem cells resident in the small intestinal crypts constantly give rise to epithelial cells of the villi. The small intestine is also recognized as a site of lymphoid development in mice. It is also possible that haematopoetic stem cells are present in the adult human intestine which give rise to lymphoid cells. Detection of recombinase activating gene (RAG) transcripts and IL-7 and IL-15 in the human intestine supports this hypothesis. In this study, multi-parameter flow cytometry was used to detect and characterise hematopoetic stem cells (CD34+ CD45+) in the epithelium and lamina propria of human small intestine. Biopsies and blood were taken from non-diseased patients (n=12) and patients with coeliac disease (n=8). The ratio of lymphocytes to epithelial cells yielded by the biopsies was significantly higher in coeliac patients (p=0.001). Hematopoetic stem cells (HSCs) were detected in the epithelium and lamina propria of all samples at levels significantly higher than peripheral blood (p<0.05). There were significantly more HSCs in the lamina propria than the epithelium of normal patients (p<0.05). Levels of HSCs in the epithelial layer of the coeliac patients were significantly lower than that in normal patients (p=0.02). This is the first demonstration of hematopoetic stem cells in the human small intestine, which, along with the RAG, IL-7 and IL-15 data, supports the hypothesis that lymphoid cells are developing locally.
Impact of IgVH mutational status in patients with chronic lymphocytic leukemia with isolated good and intermidiate risk genetic aberrations.
Authors: Jose David Sandoval-Sus, Samir Dalia, Chetasi Talati, Bijal D. Shah, Celeste M. Bello, Jeffrey E. Lancet, Paul A. Chervenick, Frederick Lundry Locke, Mohamed Kharfan-Dabaja, Eduardo M. Sotomayor, Lubomir Sokol, Julio C. Chavez, Javier Pinilla-Ibarz
Journal: Journal of Clinical Oncology (2016)

7534 Background: Genetic abnormalities in chronic lymphocytic leukemia (CLL) have prognostic impact. The presence of trisomy 12 (T12) and normal karyotype (NK), and 13q deletion (del13q) are associated with an intermediate and good risk profile in CLL, respectively (Dohner, 2000). The unmutated (unmut) status of the immunoglobulin variable heavy chain gene (IgVH) correlates with survival in sole del13q CLL (Gladstone, 2011). The prognostic relevance of IgVH mutational status in intermediate risk genetic variants (T12 and NK) has not been described. We investigated the impact of the IgVH mutational status in CLL patients (pts) with isolated Del13q, T12 or NK in a large cohort. Methods: From January 2000 to January 2013 we identified 1267 CLL patients using the Moffitt Cancer Center and Total Cancer Care databases. Descriptive data was reported in patients with both unmut (< 2% from the germline sequence) and mutated (mut) IgVH (> 2% from the germline sequence). Overall survival (OS) was estimated using the Kaplan-Meier method and the log-rank test. All analyses were done using SPSS version 19.0. Results: We identified 145 CLL patients (median age: 59 years) with isolated del13q (mut = 96, 66.2%; unmut = 49, 33.8%), 49 pts (median age: 64 years) with isolated T12 (mut = 17, 34.7%; unmut = 65.3%), and 79 pts (median age: 57 years) with NK (mut = 41, 51.9%; unmut = 38, 48.1%), respectively. Patients with isolated del13q and mut IgVH had a longer median OS compared to unmut patients (non-reached vs. 10.5 years, p = 0.03). However, the IgVH mutational status did not significantly impact the OS of sole T12 pts (p = 0.29) and NK (p = 0.14). Conclusions: Our results confirm the negative survival impact of unmut IgVH in CLL patients carrying an isolated del13q. However, this association was not seen in CLL pts with T12 and NK in our cohort. Future research should evaluate the imapct of next generation sequencing methods in relation to the IgVH mutational status in CLL pts. IgVH mut IgVH unmut p value 10 year OS Del13q 79% 44% 0.03 Trisomy 12 68% 69% 0.29 Normal karyotype 88% 78% 0.14
Lafora Disease Is an Inherited Metabolic Cardiomyopathy
Authors: María Villalba-Orero, Gentzane Sánchez-Elexpuru, Marina López-Olañeta, Oscar Campuzano, Elisabet Bello-Arroyo, Pablo García-Pavía, José M. Serratosa, Ramón Brugada, Marina P. Sánchez, Enrique Lara-Pezzi
Journal: Journal of the American College of Cardiology (2017)
Montgomery—time to focus on consent but not to panic
Authors: Hugo Wellesley
Journal: BMJ (2017)

The Montgomery v Lanarkshire case1 discussed by Chan and colleagues2 usefully focuses attention on consent, but it does not represent a substantive shift in the law.

The Bolam test was already largely defunct for consent cases,1 and the Supreme Court has simply reformulated the test set out in 1998 by Lord Woolf in the Court of …
The aggressive peripheral T‐cell lymphomas: 2017
Authors: James O. Armitage
Journal: American Journal of Hematology (2017)

T-cell lymphomas make up approximately 10%-15% of lymphoid malignancies. The frequency of these lymphomas varies geographically, with the highest incidence in parts of Asia.The diagnosis of aggressive peripheral T-cell lymphoma (PTCL) is usually made using the World Health Organization classification. The ability of hematopathologists to reproducibly diagnose aggressive PTCL is lower than that for aggressive B-cell lymphomas, with a range of 72%-97% for the aggressive PTCLs. Risk Stratification: Patients with aggressive PTCL are staged using the Ann Arbor Classification. Although somewhat controversial, positron emission tomography scans seem to be useful as they are in aggressive B-cell lymphomas. The specific subtype of aggressive PTCL is an important risk factor with the best survival seen in anaplastic large-cell lymphoma-particularly young patients with the anaplastic lymphoma kinase positive subtype.Anaplastic large-cell lymphoma is the only subgroup to have a good response to a CHOP-like regimen. Angioimmunoblastic T-cell lymphoma has a prolonged disease-free survival in only ∼20% of patients, but younger patients who have an autotransplant in remission seem to do better. PTCL-not otherwise specified is not one disease. Anthracycline-containing regimens have disappointing results, and a new approach is needed. Natural killer/T-cell lymphoma localized to the nose and nasal sinuses seems to be best treated with radiotherapy-containing regimens and the majority of patients are cured. Enteropathy-associated PTCL and hepatosplenic PTCL are rare disorders with a generally poor response to therapy although selected patients with enteropathy- associated PTCL seem to benefit from intensive therapy.
Will academic and community physicians engage and share knowledge in an online physician social network? Lessons from the Radiation Oncology Community
Authors: Nadine Housri, Lindsay Burt, John Thomas Lucas, Samir Housri
Journal: Journal of Clinical Oncology (2016)

e18200 Background: The exponential growth of medical knowledge has made it increasingly difficult for clinicians to make sense of new information and recognize how to incorporate new research results into clinical practice. We sought to determine whether a social question and answer website designed to connect academic and community physicians would consistently engage radiation oncologists (RO) to share evidence based information and clinical insights with each other. Methods: theMednet was initially piloted in radiation oncology and, after 2 years, opened to medical oncologists. Questions were posted via an ‘Ask Question’ button and answers were solicited from ROs involved in research relevant to the questions being asked. Engagement was measured in question clicks, monthly and quarterly logins, and searches. Answers were analyzed for quality by reference sources. Results: A total of 1696 US radiation oncologists registered to theMednet from 10/2013 to 1/2015. Users included community ROs (61%), academic ROs (22.6%), and residents (16.4%). Every quarter, 70% of ROs returned to the site and 42% returned monthly. Five hundred sixty-six questions were posted by 150 ROs, of which 497 were approved and 93% were answered. A total of 756 answers were viewed 81,125 times by 1,680 ROs. Answers were posted by 175 ROs from 111 institutions. Academics answered 97% of these questions and asked 8%. In a sample of 547 answers, 58% cited data, including a total of 508 publications. Personal insights were cited in 70% of the answers, and 42% cited both personal insights and published data. Conclusions: Academic and community radiation oncologists will engage regularly through an online social network when the conversations provide value to clinical practice, discuss published data, and share personal insights. Academics focus their efforts on answering questions, while community physicians are more likely to ask questions, showing a flow of knowledge from academic to community physicians. Future directions are focused on expanding to all oncology disciplines and introducing more customized educational content.
Real-world burden of comorbidities in US patients with psoriasis
Authors: Kamal Shah, Lillian Mellars, Arun Changolkar, Steven R. Feldman
Journal: Journal of the American Academy of Dermatology (2017)

Understanding background comorbidity rates in psoriasis can provide perspective for adverse events associated with new therapies.We sought to assess the extent of comorbidities in psoriasis patients by use of the Truven Health Analytics MarketScan database.MarketScan, comprising commercial claims representative of a large US-insured population, had 1.22 million patients with ≥1 claim with a psoriasis diagnosis between January 1, 2008, and December 31, 2014. Patients ≥18 years of age who had ≥2 health claims in any diagnosis field for psoriasis (International Classification of Diseases, 9th Revision, Clinical Modification 696.1) with a psoriasis diagnosis (index) date between July 1, 2008, and June 30, 2014, were included to allow follow-up observation time.Prevalence and incidence of 24 comorbidities were assessed in 469,097 psoriasis patients; the most common comorbidities were hyperlipidemia (45.64% and 30.83%, respectively), hypertension (42.19% and 24.19%), depression (17.91% and 12.68%), type 2 diabetes mellitus (17.45% and 8.44%), and obesity (14.38% and 11.57%).A limitation of the study was that only a certain insured population was represented.Comorbidity rates align with those described in the literature and support the concept that psoriasis patients have high rates of cardiometabolic comorbidities. This analysis highlights the potential utility of very large insurance databases for determining comorbidity prevalence in psoriasis, which may aid health care providers in managing psoriasis.