tbuckley/cabot-search huggingface dataset:
Abstract 18957: Modulation of Ganglionated Plexi as an Addition to Pv Isolation in Persistent Atrial Fibrillation Ablation
Authors: Sabine Ernst, Richard Underwood, Sonya Babu-Narayan, Simona Ben-Haim
Journal: Circulation (2015)

Introduction: Catheter ablation of ganglionated plexi (GP) as an add on to pulmonary vein (PV) isolation has been reported to significantly improve outcome of atrial fibrillation (AF) ablation. In order to facilitate localization of these GPs, a novel imaging study is proposed that investigates the uptake of iodine-123 metaiodobenzylguanidine (mIBG, an analogon for norepinephrine) on the atrial level. This information is combined with 3D surface reconstruction from contrast computed tomography (cCT) or cardiac magnetic resonance (CMR). Methods: A total of 7 patients (5 male, mean age 64.3 yrs) with AF underwent mIBG nuclear studies using a dedicated solid state cardiac camera (D-SPECT, Spectrum Dynamics). Four patient had 4 persistent AF (3 prev. abl.) with less than 1 year of sustained AF, whereas 3 patient were in longstanding persistent AF (all prev. abl). The acquired data was merged with the 3D imaging and subsequently imported into the 3D electroanatomical mapping system (CARTO, Biosense Webster). During invasive AF ablations these sites were mapped to perform high frequency stimulation (HFS) to confirm GP locations. Results: In all pts, both the mIBG and CT scans were performed without any complications. Locations of high mIBG uptake corresponded to anatomical GP sites (LA &amp; RA) in the majority of patients, but individual variations were observed. PV isolation was added in all but 1 pt (who had previous ablation) plus CFAE ablation if necessary. Follow-up of in median of 10.4 months demonstrated SR in all persistent AF patients (1 redo for atrial reentry). In patients with longstanding persistent AF: 2 pts are in SR (both AF at 1 week and 1 pt in AT at 6 weeks), while 1 pt remained in AF. Conclusion: The combination of mIBG and 3D imaging provides a novel type of “road map” for localizing GPs during AF ablation. As an add-on to PV (re-) isolation, this strategy was found to be beneficial for patients with persistent and longstanding persistent AF. Interestingly, pts with longstanding persistent AF (and multiple previous ablations) all recurred early in F/U but showed reversal to AT and finally SR at later stages. Further studies in larger patient cohorts need to confirm these initial observations.
Measures of the Burden of Medical Expenses
Authors: Jason D. Buxbaum, Alicia J. Cohen, A. Mark Fendrick
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
Targetable Alterations in Adult Patients With Soft-Tissue Sarcomas
Authors: Carlo Lucchesi, Emmanuel Khalifa, Yec’han Laizet, Isabelle Soubeyran, Simone Mathoulin-Pelissier, Christine Chomienne, Antoine Italiano
Journal: JAMA Oncology (2018)

Patients with advanced soft-tissue sarcomas (STS) have a median overall survival of less than 18 months. Identification of molecular abnormalities for which targeted therapies are available or can be developed is critical for improving patient outcomes.To characterize targetable genomic alterations (GAs) in patients with STS.This cross-sectional study of next-generation sequencing results from 584 patients with STS included in the AACR GENIE Database.Presence of targetable GAs in STS.Of 584 patients included in the analysis, 294 (50.3%) were men and 290 (49.7%) were women, with a median age of 56 years (range, 18-89 years). There were 331 (57%) patients with complex genomics sarcomas, 144 (25%) with translocation-related sarcomas, and 112 (18%) with other sarcomas (inactivating mutation, simple amplicon). A total of 2697 alterations were identified in 451 genes (1154 substitutions, 765 gene amplifications, 364 short indels and splicing variants, 346 gene homozygous deletions, and 68 gene rearrangements) with a median of 4 (1-53) per case. In order of frequency, the 20 genes most often altered were: TP53, MDM2, CDK4, RB1, ATRX, CDKN2A, PTEN, NF1, CDKN2B, KMT2D, GLI1, ATM, TERT, PI3KCA, NOTCH1, MAP2K4, ERBB4, ARID1A, TSC2, and TNFAIP3. At least 1 targetable GA was found in 239 cases (41%) with a statistically significant higher number in other and complex genomics sarcomas than in translocation-related sarcomas (respectively other: n=89, 82%, complex: n = 131, 40%, translocation: n = 19, 13%; χ2 test, P < .001).Up to 41% of STS harbored at least 1 clinically relevant GA with potential to influence and personalize therapy. Comprehensive genomic profiling can identify novel treatment paradigms to address the limited options and poor prognoses of patients with STS.
Abstract 13272: Efficacy and Safety of Non-invasive Renal Denervation Study Using Externally Delivered Focused Ultrasound in Severe Resistant Hypertension
Authors: Roland E Schmieder, John A Ormiston, Petr Neuzil, Zdenek Stárek, Patrick Kay, Omar Dawood, Thomas L Anderson, Michael Gertner, William B White
Journal: Circulation (2015)

Background: Invasive catheter based techniques for renal denervation have been extensively examined in treating patients with resistant hypertension, with mixed results and some periprocedural complications. New evidence suggested that not all renal nerves are in the range of invasive procedures limited to a distance 4 to 6 mm from the lumen. Aims: To evaluate the safety and efficacy of an entirely non-invasive approach to renal denervation using externally delivered focused ultrasound to the peri-renal artery tissue with real time Doppler-based image guidance. Methods and results: Twenty-seven patients with severe, treatment resistant hypertension, defined as persistent systolic blood pressure (BP) &gt; 160 mmHg despite 3 or more antihypertensive medications, were treated non-invasively with the Kona Medical Surround Sound System™. Focused ultrasound energy was delivered to the renal arteries bilaterally and surrounding tissue using Doppler-based imaging and continuous tracking with automatic correction for kidney motion throughout treatment. Patients received conscious sedation during the treatment period. At this time, all patients have completed 24 weeks and 23 patients 52 weeks of follow up. Post-denervation, the mean changes from baseline BP (175/92 mmHg) were -16.8/-8.6 mmHg at 3 weeks, -23.2/-10.8 mmHg at 6 weeks, -29.7/-13.1 mmHg at 12 weeks, -21.6/-8.7 mmHg at 24 weeks and -25.6/-10.1 mmHg at 52 weeks . No serious device-related events have been reported to date. Forty-one percent of subjects (11/27) reported mild back pain immediately following the denervation treatment. The majority of cases (7/11) completely resolved within three days post treatment without any significant intervention and no case was associated with any motor, sensory deficits. Conclusions: This is the first study in humans using a non-invasive renal denervation system in severe resistant hypertension. Results showed clinically meaningful reductions from baseline in office BP through 52 weeks post-denervation. The procedure was well-tolerated with no serious adverse events. This technology should enable patients to benefit from renal denervation therapy without the invasive risks associated with catheter based techniques.
A functional ATG16L1 (T300A) gene variant is associated with increased risk for hepatocellular carcinoma in cirrhosis
Authors: P. Reuken, P. Lutz, M. Casper, E. Al-Herwi, A. Stallmach, F. Lammert, H.D. Nischalke, T. Bruns
Journal: Journal of Hepatology (2018)
Robotic prostatectomy could save the NHS millions
Authors: Jasmesh Sandhu
Journal: BMJ (2018)

The discussion of cost effectiveness of robot assisted radical prostatectomy compared with laparoscopic radical prostatectomy is ongoing.1 The cost per quality adjusted life year (QALY) metric calculated in a 2011 health technology assessment to determine incremental cost effectiveness of robotic compared with laparoscopic radical prostatectomy is questionable.2 The report found that 150 robotic prostatectomies a year would justify …
Addition of pegylated interferon alfa-2a to an ongoing nucleos(t) ide treatment accelerates decrease of HBs-antigen levels in patients with chronic hepatitis B: Results from the PADD-ON study
Authors: M. Sprinzl, A. Grambihler, G. Teuber, C. Antoni, S. Zeuzem, T. Discher, M. Cornberg, T. Berg, H. Loehr, F. Tacke, F. Lammert, E. Schott, C. Berg, E. Zizer, R. Heyne, U. Spengler, R. Thimme, A. Pathil, H. Klinker, K. Weigand, M. Riedl, J. Wosniok, U. Alshuth, J. Kittner, M. Schuchmann, P.R. Galle
Journal: Journal of Hepatology (2018)
Clinical features and prognosis of advanced stage hepatocellular carcinoma; verification of diverse progression processes
Authors: M. Yokoyama, S. Ogasawara, Y. Ooka, M. Inoue, T. Chiba, E. Suzuki, T. Maeda, T. Wakamatsu, K. Kobayashi, S. Kiyono, M. Nakamura, T. Saito, S. Nakamoto, S. Yasui, A. Tawada, M. Arai, T. Kanda, H. Maruyama, S. Kuboki, M. Miyazaki, O. Yokosuka, M. Ohtsuka, N. Kato
Journal: Journal of Hepatology (2018)
BMJ Careers launches recruitment tool to help NHS trusts fill vacancies
Authors: Abi Rimmer
Journal: BMJ (2018)

BMJ Careers has launched a new initiative designed to help NHS trusts fill medical vacancies (recruiter.bmj.com).

The recruitment packages give trusts unlimited access to posting jobs online, regular updates, and opportunities for branding and promotion, for a fixed annual subscription.

Last year a census of UK consultants and higher specialty …
Mutations in HCV NS3 but no Sec14L2 variants alter HCV RNA replication of natural occuring viruses in cell culture
Authors: R. Costa, D. Todt, F. Belinchon, A. Walker, C. Schenk, J. Timm, V. Lohmann, V.H. Thomas, S. Ciesek
Journal: Journal of Hepatology (2018)
Eleven loci with new reproducible genetic associations with allergic disease risk
Authors: Manuel A.R. Ferreira, Judith M. Vonk, Hansjörg Baurecht, Ingo Marenholz, Chao Tian, Joshua D. Hoffman, Quinta Helmer, Annika Tillander, Vilhelmina Ullemar, Yi Lu, Franz Rüschendorf, David A. Hinds, Norbert Hübner, Stephan Weidinger, Patrik K.E. Magnusson, Eric Jorgenson, Young-Ae Lee, Dorret I. Boomsma, Robert Karlsson, Catarina Almqvist, Gerard H. Koppelman, Lavinia Paternoster
Journal: Journal of Allergy and Clinical Immunology (2018)
Disease burden, complication rates, and health-care costs of heparin-induced thrombocytopenia in the USA: a population-based study
Authors: Binod Dhakal, Lisa Baumann Kreuziger, Lisa Rein, Ariel Kleman, Raphael Fraser, Richard H Aster, Parameswaran Hari, Anand Padmanabhan
Journal: The Lancet Haematology (2018)
Potassium and the use of renin–angiotensin–aldosterone system inhibitors in heart failure with reduced ejection fraction: data from BIOSTAT‐CHF
Authors: Joost C. Beusekamp, Jasper Tromp, Haye H. van der Wal, Stefan D. Anker, John G. Cleland, Kenneth Dickstein, Gerasimos Filippatos, Pim van der Harst, Hans L. Hillege, Chim C. Lang, Marco Metra, Leong L. Ng, Piotr Ponikowski, Nilesh J. Samani, Dirk J. van Veldhuisen, Aeilko H. Zwinderman, Patrick Rossignol, Faiez Zannad, Adriaan A. Voors, Peter van der Meer
Journal: European Journal of Heart Failure (2018)
A transcriptomics study of hereditary angioedema attacks
Authors: Giuseppe Castellano, Chiara Divella, Fabio Sallustio, Vincenzo Montinaro, Claudia Curci, Andrea Zanichelli, Erika Bonanni, Chiara Suffritti, Sonia Caccia, Fleur Bossi, Anna Gallone, Francesco Paolo Schena, Loreto Gesualdo, Marco Cicardi
Journal: Journal of Allergy and Clinical Immunology (2018)
Effect of epigallocatechin-3-gallate from green tea on 5-flurouracil-induced intestinal mucositis.
Authors: Jung Min Lee, Kichul Yoon, Geeho Min, Woojung Kim, Seong ji Choi, Seung Han Kim, Jae Min Lee, Hyuk Soon Choi, Eun Sun Kim, Bora Keum, Yoon Tae Jeen, Hoon Jai Chun, Hong Sik Lee, Chang Duck Kim
Journal: Journal of Clinical Oncology (2018)

522 Background: Chemotherapy-induced mucositis is a common complication during anticancer treatment. Epigallocatechin-3-gallate (EGCG), derived from green tea, has been shown to have antioxidant effects and immunomodulatory activities. However, studies on EGCG for chemotherapy-induced mucositis have been scarce. In this study, we aimed to prove the protective effect of EGCG in murine chemotherapy-induced mucositis model Methods: Twenty-four 8-wk-old male C57BL/6 mice were randomized to 4 groups : control, EGCG, 5-Flurouracil (5-FU), EGCG plus 5-FU. Mucositis was induced by intraperitoneal injection of 5-FU (400mg/kg). EGCG (50mg/kg) was administered orally for 5 days from the day before administration of 5-FU. After 6 days of 5-FU injection, the mice were sacrificed and intestinal tissue was obtained. WBC count was performed with whole blood from Inferior vena cava of mice. The end points were villus height, villus/crypt ratio, histologic characteristics, and mRNA expression of tumor necrosis factor ( TNF)-α, and interleukin ( IL)-6. Results: In 5-FU group, neutropenia was confirmed by laboratory test (5-FU, 0.650 K/μL; Control, 5.317 K/μL), indicating sufficient 5-FU effect. Histologic findings showed that crypt dilatation, villus stunting, and villus atrophy were reduced in EGCG plus 5-FU group than in 5-FU group. Quantitatively, mean villus height (EGCG plus 5-FU, 352 μm; 5-FU, 319 μm) and villus/crypt ratio (EGCG plus 5-FU, 3.28; 5-FU, 2.31) in EGCG plus 5-FU group, compared with 5-FU treated group, were significantly higher. mRNA expression of TNF-α was significantly lower in EGCG plus 5-FU group compared with 5-FU group (P &lt; 0.05) (Figure 2). Conclusions: EGCG derived from green tea reduced 5-FU induced intestinal mucositis, suggesting a possibility for novel treatment of chemotherapy-induced mucositis.
Evaluating Treatment Effect Based on Duration of Response for a Comparative Oncology Study
Authors: Bo Huang, Lu Tian, Enayet Talukder, Mace Rothenberg, Dae Hyun Kim, Lee-Jen Wei
Journal: JAMA Oncology (2018)

This study evaluates the duration of response for crizotinib vs chemotherapy for patients with ALK-positive lung cancer using data from the PROFILE-1014 randomized clinical trial.
Comparative effectiveness of tocilizumab versus TNF inhibitors as monotherapy or in combination with conventional synthetic disease-modifying antirheumatic drugs in patients with rheumatoid arthritis after the use of at least one biologic disease-modifying antirheumatic drug: analyses from the pan-European TOCERRA register collaboration
Authors: Kim Lauper, Dan C Nordström, Karel Pavelka, Maria Victoria Hernández, Tore K Kvien, Eirik Klami Kristianslund, Maria Jose Santos, Žiga Rotar, Florenzo Iannone, Catalin Codreanu, Galina Lukina, Sara L Gale, Khaled Sarsour, Yves Luder, Delphine Sophie Courvoisier, Cem Gabay
Journal: Annals of the Rheumatic Diseases (2018)

Objective To compare the effectiveness of tocilizumab (TCZ) and tumour necrosis factor (TNF) inhibitors (TNFi) as monotherapy or in combination with conventional synthetic disease-modifying antirheumatic drugs (DMARDs) in patients with rheumatoid arthritis (RA) after the use of at least one biologic DMARD (bDMARD). Methods We included patients with RA having used at least one bDMARD from 10 European registries. We compared drug retention using Kaplan-Meier and Cox models and Clinical Disease Activity Index (CDAI) change over time with mixed-effects models for longitudinal data. The proportions of CDAI remission and low disease activity (LDA) at 1 year were compared using LUNDEX correction. Results 771 patients on TCZ as monotherapy (TCZ mono), 1773 in combination therapy (TCZ combo), 1404 on TNFi as monotherapy (TNFi mono) and 4660 in combination therapy (TNFi combo) were retrieved. Crude median retention was higher for TCZ mono (2.31 years, 95% CI 2.07 to 2.61) and TCZ combo (1.98 years, 95% CI 1.83 to 2.11) than TNFi combo (1.37 years, 95% CI 1.30 to 1.45) and TNFi mono (1.31 years, 95% CI 1.18 to 1.47). In a country and year of treatment initiation-stratified, covariate-adjusted analysis, hazards of discontinuation were significantly lower among patients on TCZ mono or combo compared with patients on TNFi mono or combo, and TNFi combo compared with TNFi mono, but similar between TCZ mono and combo. Average adjusted CDAI change was similar between groups. CDAI remission and LDA rates were comparable between groups. Conclusion With significantly longer drug retention and similar efficacy to TNFi combo, TCZ mono or combo are reasonable therapeutic options in patients with inadequate response to at least one bDMARD.
MRI-Targeted versus Ultrasonography-Guided Biopsy for Suspected Prostate Cancer
Authors: Michael J. Barry, Andrew B. Rosenkrantz
Journal: New England Journal of Medicine (2018)

Three large trials of prostate-specific antigen (PSA) screening have shown that any benefit of lower prostate-cancer mortality comes with a higher risk of prostate-cancer diagnosis.1 PSA screening appeared to significantly reduce prostate-cancer mortality only in the European Randomised Study of Screening for Prostate Cancer, which showed that screening performed every 2 to 4 years was associated with 1.28 fewer deaths due to prostate cancer but with 27 additional diagnoses per 1000 men over a period of 13 years.2 These extra diagnoses may lead to the overtreatment of men in whom the cancer was never destined to cause death. In the . . .
Modestly liberal fluid regimen during major surgery is safer than a restrictive one, study finds
Authors: Jacqui Wise
Journal: BMJ (2018)

Patients undergoing major abdominal surgery should not be given a tightly restricted intravenous fluid regimen as it puts them at risk of acute kidney injury, researchers have said in the New England Journal of Medicine .1 The results of this randomised controlled trial contradict the findings of previously published trials and recommendations.

Traditional intravenous fluid regimens administered during abdominal surgery deliver up to 7 L of fluid on the day of surgery and can lead to tissue oedema and weight gain of 2 to 6 kg. Recent advice has supported fluid restriction after some small trials showed that a more restrictive fluid regimen led to …
Survival benefit of liver transplantation in Catalonia: A 2007–13 analysis
Authors: J. Colmenero, J. Lombardo, N. Trota, G. Crespo, I. Bilbao, A. Rafecas, X. Xiol, L. Castells, C. Baliellas, P. Ruiz, S. Biggins, C. Fondevila, J. Tort, M. Navasa
Journal: Journal of Hepatology (2018)
Prebiotic treatment prevents alcohol-induced liver lesions in mice with indigenous microbiota and mice with human microbiota
Authors: L. Wrzosek, G. Ferrere, D. Ciocan, W. Turpin, C. Hugot, P. Virginie, M. Spatz, M. Dupeux, F. Gaudin, S. Prevot, G. Perlemuter, A.-M. Cassard Doulcier
Journal: Journal of Hepatology (2018)
Effect of Atropine With Propofol vs Atropine With Atracurium and Sufentanil on Oxygen Desaturation in Neonates Requiring Nonemergency Intubation
Authors: Xavier Durrmeyer, Sophie Breinig, Olivier Claris, Pierre Tourneux, Cénéric Alexandre, Elie Saliba, Alain Beuchée, Camille Jung, Corinne Levy, Laetitia Marchand-Martin, Marie-Odile Marcoux, Agnes Dechartres, Claude Danan
Journal: JAMA (2018)

Propofol or a combination of a synthetic opioid and muscle relaxant are both recommended for premedication before neonatal intubation but have yet to be compared.To compare prolonged desaturation during neonatal nasotracheal intubation after premedication with atropine-propofol vs atropine-atracurium-sufentanil treatment.Multicenter, double-blind, randomized clinical trial (2012-2016) in 6 NICUs in France that included 173 neonates requiring nonemergency intubation. The study was interrupted due to expired study kits and lack of funding.Eighty-nine participants were randomly assigned to the atropine-propofol group and 82 to the atropine-atracurium-sufentanil group before nasotracheal intubation.The primary outcome was prolonged desaturation (Spo2 <80% lasting > 60 seconds), using intention-to-treat analysis using mixed models. Secondary outcomes assessed the characteristics of the procedure and its tolerance.Of 173 neonates randomized (mean gestational age, 30.6 weeks; mean birth weight, 1502 g; 71 girls), 171 (99%) completed the trial. Of 89 infants, 53 (59.6%) in the atropine-propofol group vs 54 of 82 (65.9%) in the atropine-atracurium-sufentanil group achieved the primary outcome (adjusted RD, -6.4; 95% CI, -21.0 to 8.1; P = .38). The atropine-propofol group had a longer mean procedure duration than did the atropine-atracurium-sufentanil group (adjusted RD, 1.7 minutes; 95% CI, 0.1-3.3 minutes; P = .04); a less frequent excellent quality of sedation rate, 51.7% (45 of 87) vs 92.6% (75 of 81; P < .001); a shorter median time to respiratory recovery, 14 minutes (IQR, 8-34 minutes) vs 33 minutes (IQR, 15-56 minutes; P = .002), and shorter median time to limb movement recovery, 18 minutes (IQR, 10-43 minutes) vs 36 minutes (IQR, 19-65 minutes; P = .003). In the 60 minutes after inclusion, Spo2 was preserved significantly better in the atropine-propofol group (time × treatment interaction P = .02). Of the atropine-propofol group 20.6% had head ultrasound scans that showed worsening intracranial hemorrhaging (any or increased intraventricular hemorrhage) in the 7 days after randomization vs 17.6% in the atropine-atracurium-sufentanil group (adjusted RD, 1.2; 95% CI, -13.1 to 15.5, P = .87). Severe adverse events occurred in 11% of the atropine-propofol group and in 20% of the atropine-atracurium-sufentanil group.Among neonates undergoing nonemergency nasotracheal intubation, the frequency of prolonged desaturation did not differ significantly between atropine used with propofol or atropine used with atracurium and sufentanil. However, the study may have been underpowered to detect a clinically important difference, and further research may be warranted.ClinicalTrials.gov Identifier: NCT01490580, EudraCT number: 2009-014885-25.