tbuckley/cabot-search huggingface dataset:
Hernia mesh complications may have affected up to 170 000 patients, investigation finds
Authors: Jacqui Wise
Journal: BMJ (2018)

Up to 170 000 patients who have had hernia mesh operations in the past six years could be experiencing complications, yet NHS trusts in England have no consistent policy for treatment or follow-up with patients, an investigation by the BBC’s Victoria Derbyshire programme has found.

Around 570 0000 hernia mesh operations have taken place in England over the past six years, figures from NHS Digital show. Leading surgeons think that the complication rate is between 12% and 30%, meaning that between 68 000 and 170 000 patients could have been adversely affected in this period.

Patients who had had hernia mesh operations told the programme about being in constant pain, unable to sleep, and finding it difficult to walk or even pick up a sock. Some patients said that they felt suicidal.

The Department of Health and Social Care …
Lessons learned from implementing the first Alliance NCORP Research Base Cancer Care Delivery Research (CCDR) trial A191402CD.
Authors: Joel E Pacyna, Jeff A. Sloan, Simon P. Kim, Hillary Sedlacek, Jon Charles Tilburt
Journal: Journal of Clinical Oncology (2018)

175 Background: Biomedical research focused on the experiences of cancer patients in care delivery has progressed remarkably in recent years, including the emergence of Cancer Care Delivery Research (CCDR) within the NCI Community Oncology Research Program (NCORP). CCDR is a relatively new mechanism with the NCORP to support protocols that test questions beyond standard clinical trials for treatment or symptom control interventions. CCDR leverages the NCORP infrastructure to develop and test care delivery interventions in community hospital settings and in settings serving underserved and minority populations. CCDR enables researchers to conduct care delivery studies in critical places and in niche populations. Methods: We will describe our experience coordinating the first Alliance NCORP Research Base Cancer CCDR trial. Our trial – a four arm, cluster-randomized trial of decision aids among sites capable of oversampling minority men with a diagnosis of early stage prostate cancer – was the first CCDR trial in the Alliance NCORP Research Base. We will describe the opportunities and challenges we encountered. Results: We implemented a CCDR protocol even as the oversight for CCDR was being worked out in parallel. Curating partnerships outside of established channels of clinical trials, engaging minority serving institutions, and engaging surgical practices like urology illustrate some of the challenges of implementing a care-delivery trial in a diverse multi-site network. Research staff must learn the art of mitigating the disruption of care delivery research procedures within clinics. Additionally, the researcher’s skills are drawn upon at multiple points— establishing relationships, advocating for flexibility in implementing rules, cheerleading, connecting dots, and directing traffic. Conclusions: Our “lessons learned” presentation will provide an experiential account that will inform aspiring care delivery researchers in their work and describe some of the emerging aspects of the institutional implementation of new initiatives in modern cooperative group research. Our presentation will also inform key stakeholders about how to best facilitate this type of research.
Abstract 12267: Clinical Significance of Very Late Ischemic and Bleeding Events After Percutaneous Coronary Intervention
Authors: Eric Secemsky, Robert W Yeh, Dean J Kereiakes, P. Gabriel Steg, Donald E Cutlip, Patricia K Apruzzese, Joseph M Massaro, Laura Mauri
Journal: Circulation (2015)

Background: Ischemic and bleeding events following percutaneous coronary intervention are associated with increased mortality, but the prognosis of events occurring beyond 1 year is unknown. Methods: The Dual Antiplatelet Therapy study randomized 11,648 subjects following percutaneous coronary intervention who completed 12 months of dual antiplatelet therapy to either continued thienopyridine plus aspirin treatment for another 18 months versus aspirin therapy alone. Subjects were followed for 21 months after randomization. Ischemic events were defined as Academic Research Consortium definite or probable stent thrombosis, myocardial infarction, ischemic stroke and other cardiovascular deaths. Bleeding events were defined by GUSTO classification (moderate or severe). Kaplan-Meier methods were used to estimate the cumulative incidence of death (regardless of cause) following ischemic and bleeding events over the full study follow-up. Results: At 21 months after randomization, 566 (4.9%) patients had ischemic events and 232 (2.0%) patients had bleeding events. Of the ischemic events, 58.8% were myocardial infarctions, 16.4% were stent thromboses and 12.8% were other cardiovascular deaths. Of all myocardial infarctions and stent thromboses, 8 (2.0%) were fatal on presentation. Among bleeding events, 66.0% were moderate and 34.0% were severe. Of all bleeding events, 3 (1.3%) were immediately fatal. In patients with ischemic events, 24.7% died, and the cumulative incidence of death preceded by an ischemic event was greater following myocardial infarction (0.39%) compared with stent thrombosis (0.13%) and ischemic stroke (0.11%). Among patients with a bleed, 17.7% died, and the cumulative incidence of death preceded by a bleed was 0.14% after a moderate bleed and 0.24% after a severe bleed (see Figure). Conclusions: Very late ischemic and bleeding events were infrequent, but patients who suffered these events are subject to high mortality risk.
Addressing the Tuberculosis Epidemic
Authors: Anthony S. Fauci
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
Mlh1 deficiency increases the risk of hematopoietic malignancy after simulated space radiation exposure
Authors: Rutulkumar Patel, Luchang Zhang, Amar Desai, Mark J. Hoenerhoff, Lucy H. Kennedy, Tomas Radivoyevitch, Yuguang Ban, Xi Steven Chen, Stanton L. Gerson, Scott M. Welford
Journal: Leukemia (2018)
Using electronic medical record system to improve compliance with national guidelines for comprehensive distress screening in cancer patients.
Authors: Chintan Pandya, Sandra Sabatka, Michelle Kettinger, Alexander Alongi, Lauren M. Hamel, Elizabeth A. Guancial, David W. Dougherty
Journal: Journal of Clinical Oncology (2018)

309 Background: Psychosocial distress screening (DS) and management is associated with improved quality of life and outcomes in cancer patients and is required for accreditation by the American College of Surgeons Commission on Cancer. Comprehensive distress screening (CDS) consists of routine distress screening, evaluation, referral to appropriate psychosocial services, and follow-up to ensure adequate care. Electronic medical record (EMR) systems can be leveraged to facilitate and document CDS as part of clinical care and to evaluate the CDS process as a quality standard. The aim of this study is to develop and implement an EMR-based tool to document and evaluate the CDS process as part of routine oncology care. Methods: An EMR-based tool with structured data fields is developed for social workers to document risk factors for distress, assessment, management plan including psychosocial service referrals, and time spent delivering care following DS using the NCCN distress thermometer (DT). Evaluation of CDS process is done in cancer patients who have documented psychosocial care in the EMR-system from 1/2017-5/2018. Results: During the study period, 1327 cancer patients underwent 2480 distress screening evaluations. The average distress score was 3.2 (median = 2) on the DT scale of 0-10, with 855 (64%), 326 (25%), and 146 (11%) patients reporting on average mild (0-3), moderate (4-6), and severe (7-10) distress respectively. 400/1327 (30%) patients accounted for 1177 documented social work contact/visits, of which financial (40%) and emotional (15%) were the most common concerns. 89% (1047) of the visits had follow-up plans and 77% of encounters resulted in referrals, of which financial support (26%) and pharmacy assistance (22%) were the most common referral services. The average time spent on each psychosocial care visit was reported to be 21 minutes. Conclusions: EMR-based forms with structured data fields can be used to document and promote improved adherence to national guidelines for CDS as part of routine oncology care by facilitating data collection. Such tools can be leveraged to capture relevant data on impact of CDS on social work resource utilization.
Risk assessment in scleroderma patients with newly diagnosed pulmonary arterial hypertension: application of the ESC/ERS risk prediction model
Authors: Valentina Mercurio, Nermin Diab, Grace Peloquin, Traci Housten-Harris, Rachel Damico, Todd M. Kolb, Stephen C. Mathai, Paul M. Hassoun
Journal: European Respiratory Journal (2018)

Pulmonary arterial hypertension (PAH) is characterised by sustained pulmonary vasoconstriction and remodelling of the pulmonary circulation leading to progressive right ventricular (RV) dysfunction. Although recent registry data suggest improving outcomes, PAH still carries a high morbidity and mortality burden [1]. The risk stratification model from current guidelines accurately predicts survival in scleroderma-associated PAH <http://ow.ly/WmpN30lI5XF>
Communication lapses and navigation needs for non-English-speaking patients: An MSK Patient and Family Advisory Council and Immigrant Health and Cancer Disparities initiative.
Authors: Kate Southworth Niehaus, Julia Ramirez, Javier Gonzalez, Frank Licciardi, Alexander Zimmer, Elizabeth Krug, Diane Lauren Reidy
Journal: Journal of Clinical Oncology (2018)

178 Background: In 2017, 5,939 outpatients (5%) and 1,065 inpatients (9%) treated at MSK were non-English-speaking. Given the new and varying treatment paradigms combined with the need to consider clinical trial enrollment, there are increasingly complex communication needs. We sought to address the needs of this vulnerable patient population. Methods: Patient Family Advisory Council in collaboration with the Immigrant Health &amp; Cancer Disparities Service conducted focus groups to determine needs of non-English speaking patients treated at MSKCC. Mass emails were sent out to the MSK attendings and nurses to recommend appropriate patients to participate. A coordinator called all those patients and invited them to the focus groups. A trained bilingual moderator led each 120-minute group discussion using an interview guide. Results: Three focus groups were conducted : 2 in Spanish and 1 in Russian. Questions related to communication, patient experience and support services were asked to the patient volunteers. In total, 10 patients and 4 caregivers participated. Across all 3 focus groups, three major themes emerged: (1) inadequate communication, participants brought up examples of communication breakdowns (2) access to resources and information, participants expressed that there was a substantial need for accessible, competent, and social support/navigation services and (3) MSK patient experience, participants discussed interactions with doctors, nurses, and staff. Conclusions: Non-English-speaking patients and family members not only deal have to deal with the fear of a cancer diagnosis but also lack the ability to comfortably communicate their concerns. Programs to empower patients and their families to ask for help and advocate for themselves are desperately needed. Additionally, navigation services are needed to provide assistance in making the appropriate linkages for the services required. This qualitative research at MSK is ongoing.
Medically integrated pharmacy: A team-based approach to improve oral oncolytic therapy for cancer patients.
Authors: Gurjyot K. Doshi, Kelani Condon, Jim R. Schwartz, Neal Dave, Chris Sellers, Margaret Harville, Holly Books, Lalan S. Wilfong
Journal: Journal of Clinical Oncology (2018)

140 Background: The use of oral oncolytic therapies in the treatment of cancer is rising dramatically. Cost barriers to obtaining drugs and side effects of therapies lead 1 to poor adherence to oral regimens resulting in detrimental outcomes. External specialty pharmacies have attempted to assist patients but this often leads to further fragmentation of care. We report on the performance of a medically integrated pharmacy within a large community oncology practice to achieve better patient outcomes. Methods: The Texas Oncology medically integrated pharmacy (MIP)consists of oncologists, oncology nurses, advanced practice providers, and specially trained pharmacy staff utilizing real-time access to the patient’s electronic medical and pharmacy records when oral therapy is prescribed. The team processes prior authorizations and patient assistance requests, ensures drug delivery, provides education, monitoring, and follow up of side effects for oral therapies. The care team is available to provide early intervention and side effect management. Treatment initiations, dose adjustments, and treatment discontinuations are communicated seamlessly in real time. Results: Texas Oncology MIPs process over 14,500 prescriptions annually with a 99% prior authorization approval rate. Service is timely with a representative sample of 4 practices showing 64% of prescriptions filled within 24 hours of prescribing and 72% filled within 72 hours. Prior authorization and patient assistance were the leading causes of delays. The patient assistance team processes over 3,200 requests annually with over $121 million copay assistance obtained. Adherence to therapy within Texas Oncology is over 92% for the 7 most commonly prescribed oral oncolytic drugs. Patient satisfaction surveys reveal 96% satisfaction with the medically integrated pharmacy. Conclusions: The MIP is a fully aligned team based approach for the delivery of oral oncolytics. A medically integrated pharmacy provides timely access, copay assistance, monitoring and management of side effects resulting in increased adherence to therapy and an overall improvement in quality and satisfaction.
NKR-P1B expression in gut-associated innate lymphoid cells is required for the control of gastrointestinal tract infections
Authors: Elias Abou-Samra, Zachary Hickey, Oscar A. Aguilar, Michal Scur, Ahmad Bakur Mahmoud, Sergey Pyatibrat, Megan M. Tu, Jeffrey Francispillai, Arthur Mortha, James R. Carlyle, Mir Munir A. Rahim, Andrew P. Makrigiannis
Journal: Cellular and Molecular Immunology (2018)
Defining the patient experience in medical oncology.
Authors: Ashley Odai-Afotey, Andrea Kliss, Janet Hafler, Tara B. Sanft
Journal: Journal of Clinical Oncology (2018)

167 Background: The relationship between the physician and patient is directly associated with positive patient satisfaction. High patient satisfaction is associated with improved health outcomes, treatment adherence, and quality of life. The goal was to explore patients’ perceptions on their hospital experience, focusing on quality of care. Methods: A mixed-methods study design with a sample of 58 patients at Yale New Haven Hospital. Data were from patient interviews and observation of rounds. Results: Two themes emerged: patient experience and patient communication with physicians. Within patient experience positive factors identified were feeling attended to (45.9%), nurses (43.2%), staff (27.0%), doctors (27.0%), facility (10.8%) and coordination of care (8.1%). Negative factors were low quality of life (82.8%), lack of physician emotional support, attentiveness and availability (24.1%), and poor coordination of care (20.7%). Within physician communication positive factors included effectively engaging the patient (27.5%) and attending to patient needs (7.5%). Negative factors were nature of distilling information (17.5%), lack of coordination of care (15.0%), inadequate involvement of the patient and/or family (12.5%), use of medical jargon (10.0%), and inability to elicit patients’ perspective (7.5%). The quantitative data supported qualitative results of overall satisfaction with 72.4% of patients (n = 58) rating their experience as an ‘A’. Areas of dissatisfaction (an ‘A’ rating &lt; 70% of time) included describing team member roles, explaining next steps in care or treatment to the patient and/or family, and meeting patients’ needs. Conclusions: Our findings, demonstrate that physician attentiveness or lack thereof defines the quality of patient experience, is an important theme in communication and that patients perceive their needs are not being fully addressed. Agreement in themes from mixed-method approach shows effectiveness of methods in exploring patients’ perceptions on quality of care. The study intends to inform clinical and operational practices physicians can incorporate into their patient relationships. These data are being used to design a faculty development program to address physician communication.
ABLE: blockwise site frequency spectra for inferring complex population histories and recombination
Authors: Champak R. Beeravolu, Michael J. Hickerson, Laurent A. F. Frantz, Konrad Lohse
Journal: Genome biology (2018)

We introduce ABLE (Approximate Blockwise Likelihood Estimation), a novel simulation-based composite likelihood method that uses the blockwise site frequency spectrum to jointly infer past demography and recombination. ABLE is explicitly designed for a wide variety of data from unphased diploid genomes to genome-wide multi-locus data (for example, RADSeq) and can also accommodate arbitrarily large samples. We use simulations to demonstrate the accuracy of this method to infer complex histories of divergence and gene flow and reanalyze whole genome data from two species of orangutan. ABLE is available for download at https://github.com/champost/ABLE .
Treatment Algorithms for Staphylococcal Bacteremia
Authors: Eli N. Perencevich, Preeti N. Malani
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
Brigatinib versus Crizotinib in <i>ALK</i>-Positive Non–Small-Cell Lung Cancer
Authors: D. Ross Camidge, Hye Ryun Kim, Myung-Ju Ahn, James Chih-Hsin Yang, Ji-Youn Han, Jong-Seok Lee, Maximilian J. Hochmair, Jacky Yu-Chung Li, Gee-Chen Chang, Ki Hyeong Lee, Cesare Gridelli, Angelo Delmonte, Rosario Garcia Campelo, Dong-Wan Kim, Alessandra Bearz, Frank Griesinger, Alessandro Morabito, Enriqueta Felip, Raffaele Califano, Sharmistha Ghosh, Alexander Spira, Scott N. Gettinger, Marcello Tiseo, Neeraj Gupta, Jeff Haney, David Kerstein, Sanjay Popat
Journal: New England Journal of Medicine (2018)

Brigatinib, a next-generation anaplastic lymphoma kinase (ALK) inhibitor, has robust efficacy in patients with ALK-positive non-small-cell lung cancer (NSCLC) that is refractory to crizotinib. The efficacy of brigatinib, as compared with crizotinib, in patients with advanced ALK-positive NSCLC who have not previously received an ALK inhibitor is unclear.In an open-label, phase 3 trial, we randomly assigned, in a 1:1 ratio, patients with advanced ALK-positive NSCLC who had not previously received ALK inhibitors to receive brigatinib at a dose of 180 mg once daily (with a 7-day lead-in period at 90 mg) or crizotinib at a dose of 250 mg twice daily. The primary end point was progression-free survival as assessed by blinded independent central review. Secondary end points included the objective response rate and intracranial response. The first interim analysis was planned when approximately 50% of 198 expected events of disease progression or death had occurred.A total of 275 patients underwent randomization; 137 were assigned to brigatinib and 138 to crizotinib. At the first interim analysis (99 events), the median follow-up was 11.0 months in the brigatinib group and 9.3 months in the crizotinib group. The rate of progression-free survival was higher with brigatinib than with crizotinib (estimated 12-month progression-free survival, 67% [95% confidence interval {CI}, 56 to 75] vs. 43% [95% CI, 32 to 53]; hazard ratio for disease progression or death, 0.49 [95% CI, 0.33 to 0.74]; P<0.001 by the log-rank test). The confirmed objective response rate was 71% (95% CI, 62 to 78) with brigatinib and 60% (95% CI, 51 to 68) with crizotinib; the confirmed rate of intracranial response among patients with measurable lesions was 78% (95% CI, 52 to 94) and 29% (95% CI, 11 to 52), respectively. No new safety concerns were noted.Among patients with ALK-positive NSCLC who had not previously received an ALK inhibitor, progression-free survival was significantly longer among patients who received brigatinib than among those who received crizotinib. (Funded by Ariad Pharmaceuticals; ALTA-1L ClinicalTrials.gov number, NCT02737501 .).