tbuckley/cabot-search huggingface dataset:
Esthetic evaluation and patient‐centered outcomes in root‐coverage procedures
Authors: Ilham Mounssif, Martina Stefanini, Claudio Mazzotti, Matteo Marzadori, Matteo Sangiorgi, Giovanni Zucchelli
Journal: Periodontology 2000 (2018)

Abstract Treatment of buccal gingival recession is performed for esthetic concerns, root sensitivity, root caries and cervical abrasion resulting from incorrect toothbrushing. Over the years, clinicians and researchers have improved surgical techniques to achieve surrogate end points, such as complete root coverage, gingival recession reduction or keratinized tissue increase, ignoring the input from the patient regarding the true indications for treatment. In the past few years there has been an emphasis to include patient‐centered outcomes in the evaluation of root‐coverage procedures. The aim of this narrative review is to describe the professional objective assessment of the esthetic results after root‐coverage procedures and the patient perception of outcome in terms of esthetics, postoperative morbidity and dentinal hypersensitivity resolution after the treatment of gingival recessions. The need to align professional (surrogate) end points with patient‐centered outcomes (true end points) in the future is emphasized.
Central nervous system inflammation
Authors: Pyari Bose
Journal: BMJ (2011)

This three day course, held at Keele University, covers the various inflammatory disorders affecting the central nervous system. The course content includes discussion of the pathophysiology, clinical manifestations, radiological appearances, and management of these disorders.

The course is designed for doctors who may have to deal with the various central nervous system inflammatory disorders, such as multiple sclerosis, neuromyelitis optica, central nervous system infections, vasculitis, neuro-Behcet’s disease, and neurosarcoid. The course will be useful for trainees in neurology, radiology, and general medicine. It will also be useful for hospital consultants in these specialties who wish to keep up to date with the latest advances in these disorders.

I took the course in 2009 as a second year neurology registrar.

I used to come across these disorders in my routine practice, and occasionally patients would ask me for the latest developments. With the introduction of many novel immunomodulatory drugs, it was imperative as …
Chemotherapy use in the elderly for stage IV pancreatic cancer: An NCDB analysis.
Authors: Aabra Ahmed, Jenna Sitenga, Gregory Aird, Ryan W Walters, Peter T. Silberstein
Journal: Journal of Clinical Oncology (2018)

223 Background: Cancer incidence is higher in the elderly, yet these patients tend to be underrepresented in clinical trials and receive less treatment than their younger counterparts. This study seeks to elucidate the impact of chemotherapy in elderly patients with stage IV pancreatic cancer. Methods: We identified 68,044 patients with stage IV pancreatic cancer over the age of 65 diagnosed between the years 2004-2013. Between-chemotherapy survival differences were estimated by the Kaplan-Meier method and associated log-rank tests; Tukey-Kramer adjusted p &lt; .05 indicated statistical significance. Results: Statistically significant differences in demographics of patients with and without chemotherapy included that patients given chemotherapy were more likely to live in an area with a median income of $63,000+ (34.9% vs 30.2%, respectively), receive treatment at an academic center (36.6% vs. 30.7% respectively), and have no comorbidities (66.9% vs. 59.4%, respectively) compared to those not given chemotherapy. Statistically significant survival differences were indicated between all chemotherapy groups (all adjusted p &lt; 0.05), such that patients receiving chemotherapy survived longer than those without chemotherapy (median survival 5.5, 1.3 months, respectively). A larger proportion of patients receiving chemotherapy were alive at 6, 12, and 24 months relative to patients receiving no chemotherapy. Use of chemotherapy has increased over time for elderly stage IV pancreatic cancer patients, such that 37.9% of patients diagnosed in 2004 received chemotherapy, while 45.9% of patients diagnosed in 2013 received chemotherapy. Conclusions: To our knowledge, we are the largest trial to investigate treatment of stage IV pancreatic cancer in the elderly. Although the prognosis is overall poor, chemotherapy provided a mild survival benefit. Use of chemotherapy in these patients increased from 2004 to 2013, yet less than half of patients received chemotherapy. [Table: see text]
Can I take MRCPCH exams directly after my MD training in India? Are there any centres providing training for the part 3 clinical round of the exam and do I need to clear any hurdles if I don't want to work in the UK?
Authors: Rajeev Gupta
Journal: BMJ (2006)

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>
Upregulation of FOXM1 in a subset of relapsed myeloma results in poor outcome
Authors: Chunyan Gu, Carol Holman, Ramakrishna Sompallae, Xuefang Jing, Michael Tomasson, Dirk Hose, Anja Seckinger, Fenghuang Zhan, Guido Tricot, Hartmut Goldschmidt, Ye Yang, Siegfried Janz
Journal: Blood Cancer Journal (2018)
Muddling Medical Careers—the foundation year appointment process
Authors: John Firth
Journal: BMJ (2005)

The introduction of the foundation programme has meant that the way in which medical students find jobs has changed considerably. <i>John Firth</i> believes that the change will be detrimental to students and consultants, and describes how medical students applied for jobs in the past, contrasts it with the way things happen now, and makes suggestions for the future
Surgical Training Is a 2-Way Street—The Faculty-Resident Entrustability Dynamic
Authors: Thomas H. Cogbill
Journal: JAMA Surgery (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 Surgery 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 Surgery journal
PERFORMANCE OF CHA2DS2-VASC SCORE IN STROKE PREDICTION IN PATIENTS UNDERGOING SURGICAL AORTIC VALVE REPLACEMENT WITH BIOPROSTHESIS
Authors: Tuomas Kiviniemi, Joonas Lehto, Maunu Nissinen, Markus Malmberg, Fredrik Yannopoulos, Tuomo Nieminen, Airaksinen Juhani, Juha Hartikainen, Fausto Biancari
Journal: Journal of the American College of Cardiology (2018)
Erdafitinib (ERDA; JNJ-42756493), a pan-fibroblast growth factor receptor (FGFR) inhibitor, in patients (pts) with metastatic or unresectable urothelial carcinoma (mUC) and <i>FGFR</i> alterations (FGFRa): Phase 2 continuous versus intermittent dosing.
Authors: Yohann Loriot, Andrea Necchi, Se Hoon Park, Jesús García-Donas, Robert A Huddart, Earle Frederick Burgess, Mark T. Fleming, Arash Rezazadeh, Begona Mellado, Sergei Varlamov, Monika Joshi, Ignacio Duran, Anne OHagan, Anjali Narayan Avadhani, Bob Zhong, Kim Stuyckens, Anne-Gaëlle Dosne, Arlene O. Siefker-Radtke
Journal: Journal of Clinical Oncology (2018)

411 Background: Although immune checkpoint inhibitors (ICI) have improved outcomes in some pts with platinum-resistant mUC, many pts (eg, pts with TCGA luminal 1 tumors, many of whom are FGFRa) may not benefit. ERDA, a pan-FGFR (1-4) inhibitor, demonstrated promising phase 1 activity: 11 partial responses among 24 FGFRa mUC pts. We report efficacy and safety of ERDA in the ongoing global open-label phase 2 study BLC2001 (NCT02365597). Methods: Pts had measurable mUC with specific FGFR2/ FGFR3 mutations or translocations per central lab Janssen assay, ECOG 0-2, and were chemorefractory (progressed during/following ≥ 1 line of prior systemic chemo or ≤ 12 mos of [neo]adjuvant chemo). Cisplatin-ineligible, chemo-naïve pts, and prior ICI treatment were allowed. Pts were randomized 1:1 to 28-d cycles of oral 6 mg/d continuous dosing (6 C) or 10 mg/d intermittent 7 d on/7 d off dosing (10 I) ERDA; the dose was further uptitrated if no significant treatment-related adverse events (TRAEs) were observed. The primary end point was ORR. Results: 78 pts received 6 C and 33 pts received 10 I (10 I cohort stopped early) ERDA. 31 pts in 6 C arm were further uptitrated. Across arms, 50% had ≥ 2 prior lines of therapy; 93% were chemorefractory. Confirmed ORRs (RECIST 1.1) were 35% and 24%, and disease control rates (CR+PR+SD) were 74% and 73% in the 6 C and 10 I arms, respectively. Adverse events (AEs) were manageable, and there were no treatment-related deaths (Table). Treatment is ongoing in 10 pts. Conclusions: ERDA (6 C or 10 I) has promising efficacy and tolerability in pts with FGFRa mUC. Based on these results and ERDA pharmacometric modeling, dosing was optimized at 8 mg/d (continuous), and this cohort is ongoing. Phase 3 study is planned. Clinical trial information: NCT02365597. [Table: see text]
The outstanding young person of the world 2004
Authors: Julie Sladden
Journal: BMJ (2005)

Koshy Eapen has recently been named “Outstanding Young Person of the World 2004” by Junior Chamber International—previous winners include JF Kennedy, Elvis Presley, and Jackie Chan. He9s an aspiring geriatrician with degrees in epidemiology, management, and creative writing, and is active in both research and charity work. Currently working in the United Kingdom, his broad research focus is on delivering high quality, modern geriatric care at low cost in developing countries. He has also launched a charitable trust, which is now estimated to be India9s largest private medical education charity.
A Thousand Words
Authors: Kevin Cao, Tyler Marion, Jorge Roman
Journal: JAMA Dermatology (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 Dermatology 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 Dermatology journal
SYSTOLIC IMPEDANCE AND DIASTOLIC WALL STRESS ARE NOVEL PREDICTORS OF HEART FAILURE HOSPITALIZATIONS IN PATIENTS UNDERGOING TRANSCATHETER AORTIC VALVE REPLACEMENT
Authors: Aishwarya Bhardwaj, Abhishek Sawant, Rosemary Hansen, Priya Sadawarte, Nikhil Agrawal, Tharmathai Ramanan, Everett Sinibaldi, Ankush Lahoti, Arnav Kumar, Kimi Sato, Stanley Fernandez, Umesh Sharma, Vijay Iyer
Journal: Journal of the American College of Cardiology (2018)
CORONARY STEAL SYNDROME DUE TO LEFT INTERNAL MAMMARY INTERCOSTAL BRANCH: IMPROVED WITH COILING
Authors: Emad A. Barsoum, Vratika Agarwal, Nikhil Nalluri, Samer Saouma, Peter Olson, Frank Tamburrino, James Lafferty, Mohammad Zgheib
Journal: Journal of the American College of Cardiology (2018)
The enhanced antitumor-specific immune response with mannose- and CpG-ODN-coated liposomes delivering TRP2 peptide
Authors: Chunhui Lai, Siliang Duan, Fang Ye, Xiaoqiong Hou, Xi Li, Jin Zhao, Xia Yu, Zixi Hu, Zhuoran Tang, Fengzhen Mo, Xiaomei Yang, Xiaoling Lu
Journal: Theranostics (2018)

Dendritic cell (DC)-based cancer vaccines is a newly emerging and potent form of immune therapy. As for any new technology, there are still considerable challenges that need to be addressed. Here, we investigate the antitumor potential of a novel liposomal vaccine, M/CpG-ODN-TRP2-Lipo.We developed a vaccination strategy by assembling the DC-targeting mannose and immune adjuvant CpG-ODN on the surface of liposomes, which were loaded with melanoma-specific TRP2180-188 peptide as liposomal vaccine. M/CpG-ODN-TRP2-Lipo treatment was used to intendedly induce activation of DCs and antitumor- specific immune response in vivo.Our results demonstrated in vitro that the prepared liposomal particles were efficiently taken up by DCs. This uptake led to an enhanced activation of DCs, as measured by the upregulation of MHC II, CD80, and CD86. Furthermore, M/CpG-ODN-TRP2-Lipo effectively inhibited the growth of implanted B16 melanoma and prolonged the survival of mice. This therapy significantly reduced the number of myeloid-derived suppressor cells (MDSCs) and regulatory T cells, while simultaneously increasing the number of activated T cells, tumor antigen-specific CD8+ cytotoxic T cells, and interferon-γ-producing cells. At the same time, it was found to suppress tumor angiogenesis and tumor cell proliferation, as well as up-regulate their apoptosis. Interestingly, MyD88-knockout mice had significantly shorter median survival times compared to wild-type mice following the administration of M/CpG-ODN-TRP2-Lipo.The results suggested that the antitumor activities of the vaccine partially rely on the Myd88 signaling pathway. Interestingly, compared to whole tumor cell lysate-based vaccine, M/CpG-ODN-TRP2-Lipo, tumor specific antigen peptide-based vaccine, improved survival of tumor-bearing mice as well as enhanced their antitumor responses. All in all, we describe a novel vaccine formulation, M/CpG-ODN-TRP2-Lipo, with the aim of improving antitumor responses by alleviating the immunosuppressive environment in tumors.
P095 Plasma levels of HSP90 are increased in patients with systemic sclerosis with more severe organ involvement
Authors: H Storkanova, S Oreska, M Spiritovic, K Pavelka, J Vencovský, J Distler, L Senolt, R Becvar, M Tomcik
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Introduction</h3> Our previous study demonstrated that Hsp90 is overexpressed in the skin of patients with systemic sclerosis (SSc), in cultured SSc fibroblasts and preclinical models of SSc. We showed that Hsp90 is a regulator of TGF-β signalling and its inhibition prevents the stimulatory effects of TGF-β on collagen synthesis and dermal fibrosis in three preclinical models of SSc.<sup>1</sup> <h3>Objectives</h3> The aim of this study was to evaluate Hsp90 in the circulation of SSc patients and characterise its potential association with skin changes and SSc-related features. <h3>Methods</h3> A total of 91 patients (78 females; mean age 52.7; disease duration 6.0 years; diffuse cutaneous (dc)SSc/limited cutaneous (lc)SSc=38/53) who met the ACR/EULAR 2013 criteria for SSc and 85 age-/sex- matched healthy controls (HC) were included. Plasma Hsp90 was measured by ELISA. Data are presented as median (IQR). <h3>Results</h3> Plasma Hsp90 levels were increased in SSc patients compared to HC [12.5 (9.6–17.9) vs. 9.9 (7.9–12.6) ng/mL, p=0.001], but no difference between lcSSc and dcSSc were detected [13.1 (9.4–18.1) vs. 11.5 (9.5–17.5) ng/mL, p=0.316]. Hsp90 levels in all patients positively correlated with CRP (r=0.313, p=0.006). Furthermore, Hsp90 was increased in patients with interstitial lung disease (ILD) compared to those without ILD [12.8 (10.2–17.9) vs. 10.3 (8.6–16.6) ng/mL, p=0.045] and was negatively associated with functional parameters of ILD: FVC (=−0.299, p=0.011), FEV1 (r=−0.256, p=0.031), DLCO (r=−0.303, p=0.009) and SpO<sub>2</sub> (r=−0.317, p=0.038). In addition, only in patients with dcSSc, Hsp90 levels positively correlated with the mRSS (r=0.437, p=0.006). Hsp90 concentrations were not significantly affected by other main clinical parameters of SSc. <h3>Conclusions</h3> We demonstrated higher plasma levels of Hsp90 in SSc patients compared to healthy controls. Concentrations of extracellular Hsp90 increase with higher inflammatory activity, with deteriorated lung functions in ILD and also with the extent and severity of the skin involvement in patients with diffuse cutaneous SSc. These data further highlight the role of Hsp90 as a significant regulator of fibroblast activation and tissue fibrosis in SSc. <h3>Reference</h3> . Tomcik M, et al. Ann Rheum Dis2014;73(6):1215–22. <h3>Acknowledgements</h3> Supported by AZV – 16–33542A and SVV – 2 60 373. <h3>Disclosure of interest</h3> None declared
Evaluating the cost-effectiveness of hydrogel spacer in radiotherapy (RT) of prostate cancer (PC).
Authors: Rahul Ramesh Khairnar, Joseph Levy, Mark Mishra
Journal: Journal of Clinical Oncology (2018)

43 Background: A hydrogel rectal spacer (HRS) is an FDA-approved medical device used to increase the separation between the rectum and the prostate. A recent phase III trial demonstrated a small reduction in the incidence of RT toxicities associated with use of HRS. We conducted a cost-effectiveness analysis of HRS use in PC patients undergoing intensity modulated radiation therapy (IMRT). Methods: A multi-state Markov model was constructed to examine the cost-effectiveness of HRS in men with localized PC receiving IMRT in the US (arms: IMRT alone vs. IMRT + HRS). Subgroups included delivery site of IMRT (hospital vs. ambulatory) and baseline sexual function (SF) (general population vs. those with good SF). Based on previous studies, recurrence and survival were assumed equal for both arms. Data on SF, gastrointestinal and genitourinary toxicities incidence, as well as potential risks associated with HRS implantation were obtained from a recently published clinical trial. Health utilities and costs were derived from the literature and 2018 Physician Fee Schedule. Quality-adjusted life years (QALYs) and costs were modeled for a 5-year period from receipt of RT. Probabilistic sensitivity analysis (PSA) and value-based threshold analysis were conducted. Costs and utilities were discounted at 3% annually. Results: The per-person 5-year incremental cost for HRS administered in a hospital was $4,008 and the incremental effectiveness was 0.0273 QALYs. The incremental cost-effectiveness ratio (ICER) was $146,746 (95% credible interval from PSA $125,638 – $178,049) for PC patients undergoing HRS insertion in a hospital vs. $73,359 ($66,732 – $86,767) for patients undergoing HRS insertion in an ambulatory facility. For men with good SF, the ICER was $55,153 ($46,002 – $76,090) and $26,542 ($17,399 – $46,044) in hospital vs. ambulatory facility. Conclusions: This study is the first to evaluate the cost-effectiveness of HRS based on long-term toxicity data. Based on the current Medicare Physician Fee Schedule, HRS is cost-effective in men with good SF at a willingness to pay threshold of $100,000 and it is marginally cost-effective for the entire population depending on the facility where the HRS is inserted.
Peristomal Nodule in a Patient With Ovarian Cancer
Authors: Sarika M. Ramachandran, Lucy Y. Liu, Sara H. Perkins
Journal: JAMA (2018)

A 56-year-old woman with a history of ovarian cancer and surgical colostomy for small bowel obstruction had a firm, nontender, multilobulated nodule with an ulcerated center adjacent to her stoma, without change despite multiple rounds of antibiotics. What would you do next?
Abstract 15193: The Impact of Age and Gender on Door to Balloon Time in Patients with ST Elevation Myocardial Infarction
Authors: Sakura Nagumo
Journal: Circulation (2014)

Introduction: Shortening door-to-balloon (D2B) time is important to improve outcomes in patients suffering ST elevated acute myocardial infarction (STEMI). Age and gender are associated with poor outcomes in previous reports, however the impact of differences in age and gender on D2B time is still unclear. Objective: To determine the association of age and gender with D2B time in patients suffering STEMI. Methods: The Yokohama cardiovascular workshop registry is a prospective multicenter cohort in an urban area of Japan. 1261 consecutive STEMI patients during May 2010 to May 2013 were enrolled for the present analysis. Patients were divided into four groups according to age (&gt;75years old) and gender; elderly female (n=146), young female (n=125), elderly male (n=206) and young male (n=783). Results: D2B time was longer in female gender (93.2 vs. 85.5 min, p&lt;0.01) and in the elderly (92.3 vs. 85.1, p&lt;0.001). Among the four groups described above, D2B time was the longest in elderly female patients and followed by young female patients (p=0.002). Elderly female patients also had the lowest proportion of Killip class I, the longest time interval from hospital arrival to achieve TIMI flow grade 2/3, the worst final TIMI flow grade and the highest in-hospital mortality. The percentage of patients in achieving D2B time &lt;90min was the lowest in elderly male (p&lt;0.001, odds ratio 0.54) followed by elderly female (p=0.009, odds ratio 0.61). Conclusions: Both female gender and higher age were associated with longer D2B time in patients with STEMI. Further effort should be made to shorten the D2B time, especially in the elderly and women, for the improvement of clinical outcomes.