tbuckley/cabot-search huggingface dataset:
Liverpool neurological infectious diseases course
Authors: Dhanasekhar Kesavelu
Journal: BMJ (2009)

The Liverpool neurological infectious diseases course is for anyone who has ever struggled with a patient who has meningitis, encephalitis, or another neurological infection and not known how best to manage him or her. The course is the only one of its kind in the United Kingdom, and there were 110 delegates from across the UK when I attended, plus people from Europe, Africa, and Asia.

I took the course when I was a year 4 specialist registrar, but I wish I had known about it earlier.

Patients with neurological infections are common, but their management is often very difficult. The presenting syndromes are elusive, which makes the diagnosis difficult, and determining the best treatment can be hard. Liverpool is the home of the School of Tropical Medicine, and it is also the base for several important institutions such as the Walton Centre for Neurology and Neurosurgery; Alder Hey …
MSc in biology of vision
Authors: Benjamin Sünkel-Laing, Walter Andreatta
Journal: BMJ (2011)

This is a one year, full time course aimed at doctors or biomedical graduates who wish to pursue a career in either clinical ophthalmology or academic visual sciences. The course could also benefit graduates pursuing a career in neurology or neuroscience. Prospective students should be fully aware that it is a basic science course, with little clinical teaching and no contact with patients. However, the course complements training in medical ophthalmology by providing a basis for a full understanding of aetiological mechanisms and the principles of therapeutic intervention.

Prospective ophthalmology trainees should aim to complete this …
Abstract P5-07-05: LOC283299 suppress the lymphnode metastatic cascade in breast cancer patients
Authors: R Guo, J Xue, Y Su, B Xiu, W Ji, Y Chi, J Wu
Journal: Cancer Research (2018)

Abstract Background Long non-coding RNAs (lncRNAs) have been proved to play an essential role in cancer metastasis. The accuracy of intraoperative assessment of lymph nodes metastasis need to be improved. In this study, we aimed to define the lncRNA biomarker ectopic expressed in breast cancer patients' metastatic lymph nodes, and to explore the potential molecular mechanisms. Experimental Design RNA-seq analyses in 3 paired breast cancer patients' primary tumor and metastatic lymph node was used as training set to determine differentially expressed lncRNAs that may be associated with lymph node metastasis. The other 40 patients were analyzed as validation set to test the accuracy of lncRNAs identification by quantitative real-time PCR. The correlation between LOC283299 expression level and prognosis in other 282 breast cancer patients was confirmed. In parallel, in vitro and in vivo analyses were carried out to determine the potential mechanisms of LncRNA-dependent lymph node metastases and prognosis. Results RNA-seq analyses in the training set revealed significant correlation between high expression level of LOC283299 and lower lymph node metastasis potential in breast cancer patients. We further validated that the expression level of LOC283299 was significantly higher in tumor primary tissue than that in paired metastatic lymph node (P=0.0245), and higher LOC283299 expression level was markedly associated with good metastasis-free survival in breast cancer patients (P=0.04). In breast cancer cell lines, CRISPR-on overexpression of LOC283299 inhibited proliferation, migration, invasion, and metastases both in vivo and in vitro. shRNA knockdown LOC283299 promotes the ability of tumor proliferation and metastasis. The molecular mechanisms by which LOC283299 as metastasis-suppressing lncRNAs regulates recurrence and metastasis may involve regulation of epithelial to mesenchymal transition (EMT), cellular invasion and microenvironment in breast cancer cells. Conclusion Our study revealed a strong correlation between LOC283299 expression and lymph node metastases in breast cancers. High level of LOC283299 was associated with better metastasis-free survival. The changed metastasis phenotype may be mediated by the interaction of LOC283299 and breast cancer cells. Therefore, LOC283299 may represent a potential predictive biomarker for early lymph node metastasis in breast cancer. Citation Format: Guo R, Xue J, Su Y, Xiu B, Ji W, Chi Y, Wu J. LOC283299 suppress the lymphnode metastatic cascade in breast cancer patients [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-07-05.
Foundation training places are not guaranteed, medical students are warned
Authors: Abi Rimmer
Journal: BMJ (2016)

UK medical graduates will not be guaranteed a foundation training post in the future, the Medical Schools Council has warned students.

In a statement aimed at medical students and future applicants to medicine, the council said that, to be eligible for registration with the General Medical Council (GMC), graduates need to first complete the initial foundation training year.1 Doctors need full GMC registration with a licence to practise to work unsupervised in the NHS or in private practice in the United Kingdom.

However, the Medical Schools …
EFFICACY AND SAFETY OF PRE-PROCEDURAL PRASUGREL IN ASIANS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION FOR ACUTE CORONARY SYNDROME: A REPORT FROM A JAPANESE MULTICENTER REGISTRY
Authors: Satoshi Shoji, Mitsuaki Sawano, Yasuyuki Shiraishi, Nobuhiro Ikemura, Ikuko Ueda, Yohei Numasawa, Shigetaka Noma, Masahiro Suzuki, Kentaro Hayashida, Shinsuke Yuasa, Keiichi Fukuda, Shun Kohsaka
Journal: Journal of the American College of Cardiology (2018)
Effect of Offering Same-Day ART vs Usual Health Facility Referral During Home-Based HIV Testing on Linkage to Care and Viral Suppression Among Adults With HIV in Lesotho
Authors: Niklaus D. Labhardt, Isaac Ringera, Thabo I. Lejone, Thomas Klimkait, Josephine Muhairwe, Alain Amstutz, Tracy R. Glass
Journal: JAMA (2018)

Home-based HIV testing is a frequently used strategy to increase awareness of HIV status in sub-Saharan Africa. However, with referral to health facilities, less than half of those who test HIV positive link to care and initiate antiretroviral therapy (ART).To determine whether offering same-day home-based ART to patients with HIV improves linkage to care and viral suppression in a rural, high-prevalence setting in sub-Saharan Africa.Open-label, 2-group, randomized clinical trial (February 22, 2016-September 17, 2017), involving 6 health care facilities in northern Lesotho. During home-based HIV testing in 6655 households from 60 rural villages and 17 urban areas, 278 individuals aged 18 years or older who tested HIV positive and were ART naive from 268 households consented and enrolled. Individuals from the same household were randomized into the same group.Participants were randomly assigned to be offered same-day home-based ART initiation (n = 138) and subsequent follow-up intervals of 1.5, 3, 6, 9, and 12 months after treatment initiation at the health facility or to receive usual care (n = 140) with referral to the nearest health facility for preparatory counseling followed by ART initiation and monthly follow-up visits thereafter.Primary end points were rates of linkage to care within 3 months (presenting at the health facility within 90 days after the home visit) and viral suppression at 12 months, defined as a viral load of less than 100 copies/mL from 11 through 14 months after enrollment.Among 278 randomized individuals (median age, 39 years [interquartile range, 28.0-52.0]; 180 women [65.7%]), 274 (98.6%) were included in the analysis (137 in the same-day group and 137 in the usual care group). In the same-day group, 134 (97.8%) indicated readiness to start ART that day and 2 (1.5%) within the next few days and were given a 1-month supply of ART. At 3 months, 68.6% (94) in same-day group vs 43.1% (59) in usual care group had linked to care (absolute difference, 25.6%; 95% CI, 13.8% to 36.3%; P < .001). At 12 months, 50.4% (69) in the same-day group vs 34.3% (47) in usual care group achieved viral suppression (absolute difference, 16.0%; 4.4%-27.2%; P = .007). Two deaths (1.5%) were reported in the same-day group, none in usual care group.Among adults in rural Lesotho, a setting of high HIV prevalence, offering same-day home-based ART initiation to individuals who tested positive during home-based HIV testing, compared with usual care and standard clinic referral, significantly increased linkage to care at 3 months and HIV viral suppression at 12 months. These findings support the practice of offering same-day ART initiation during home-based HIV testing.clinicaltrials.gov Identifier: NCT02692027.
I want to pursue a special interest in pain control and palliative care of chronic illness. What would be the best course of action?
Authors: Simon Auty
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>
ASSESSING THE ACCURACY OF AN AUTOMATED ATRIAL FIBRILLATION DETECTION ALGORITHM USING NOVEL SMARTWATCH TECHNOLOGY AMONG PATIENTS PRESENTING FOR ELECTIVE CARDIOVERSION
Authors: Joseph Bumgarner, Cameron Lambert, Daniel Cantillon, Bryan Baranowski, Kathy Wolski, Ayman Hussein, Oussama Wazni, Bruce Lindsay, Khaldoun Tarakji
Journal: Journal of the American College of Cardiology (2018)
Tumor contact surface area as a predictor of functional outcomes after partial nephrectomy.
Authors: Chalairat Suk-Ouichai, Jitao Wu, Wen Dong, Tanaka Hajime, Elvis Caraballo, Erick M. Remer, Jianbo Li, Sudhir Isharwal, Steven C. Campbell
Journal: Journal of Clinical Oncology (2018)

675 Background: New baseline GFR is a major factor for cancer survivorship after renal cancer surgery. Parenchymal mass preservation is the predominant factor associated with functional outcomes after partial nephrectomy (PN). Contact surface area (CSA) between the tumor and parenchyma may impact parenchymal preservation and predict functional outcomes after PN. We evaluated CSA as a predictor of parenchymal mass and function preserved by PN. Methods: 419 patients managed with PN had necessary studies to evaluate preoperative and postoperative parenchymal mass and renal function within the operated kidney. Patients with multifocal renal masses were excluded. Parenchymal mass in the operated kidney and CSA were measured using contrast-enhanced CT &lt; 2 months prior and 3-12 months after PN. CSA was calculated using mathematical formula: 2πrd, where r = radius and d = intraparenchymal depth of tumor. Pearson correlation evaluated relationships between CSA and parenchymal mass or GFR preservation. Multivariable linear regression assessed predictors for GFR preservation. Conceptually, the formula for CSA should function best for exophytic tumors, while predictive value for endophytic tumors may not be as strong. Results: Median tumor size and R.E.N.A.L. were 3.5 cm and 8, respectively. Median global/ipsilateral GFR preserved were 89%/79%, respectively. Median ipsilateral parenchymal mass preserved was 85% and significantly higher for exophytic masses (87% vs 83%, p = 0.001). Median CSA was 22.8cm 2 and significantly less for exophytic masses (19.8cm 2 vs 24.6cm 2 , p = 0.02). CSA associated modestly with both ipsilateral GFR and mass preserved ( r= 0.25 and 0.36, respectively, both p &lt; 0.001). On multivariable analysis, CSA associated with ipsilateral GFR preserved for exophytic masses (p = 0.011), but not for endophytic ones (p = 0.27). Limitations include retrospective design. Conclusions: CSA associates with parenchymal mass and function saved after PN, although its utility appears to be greatest for exophytic rather than endophytic tumors. Further study will be required to validate the utility of CSA in different clinical settings.
Perioperative inflammatory marker as a predictive factor for prolonged postoperative ileus after gastrectomy for gastric cancer.
Authors: Hyojin Park, Yoon Su Kim
Journal: Journal of Clinical Oncology (2018)

31 Background: Inflammatory markers such as the C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) have recently been proposed as prognostic markers for post-operative complications and poor prognosis in solid tumors especially in colon cancer. However, there are few related reports in gastric cancer patients. Therefore, the aim of this study is to assess how perioperative inflammatory markers influence the prolonged postoperative ileus (PPOI) following gastric cancer surgery. Methods: Between 2013 and 2016, 435 patients were diagnosed with gastric cancer and underwent surgery in Gangnam Severance hospital. Patients were divided into prolonged postoperative ileus (PPOI) and control groups. Uncomplicated postoperative ileus (POI) is generally identified as an inevitable process after surgery, which typically resolves within 3 days. Ileus that persists for more than 3 days following surgery is termed PPOI. Results: The total PPOI rate was 33.8%. In univariate analysis, PPOI group was significantly associated with male sex, old age, open operative technique, preoperative gastric outlet obstruction and combined colon resection. PPOI group also was significantly associated with elevated perioperative inflammatory marker (pre- and post-operative CRP, NLR, and PLR). In multivariate analysis, open operative technique and elevated perioperative inflammatory markers (CRP, NLR and PLR) were identified as significant predictors of PPOI. In addition, postoperative length of hospital stay delayed in PPOI group compared with the control group (11.58 ± 9.48 vs.7.98 ± 5.44, respectively; P &lt; 0.001). Conclusions: In this study, PPOI group was significantly associated with elevated perioperative inflammatory marker. Patients with PPOI also are more likely to have an increased postoperative hospital stay. Therefore, the perioperative inflammatory markers may be used as clinically relevant predictive markers for PPOI following gastric cancer surgery
US public health agency is sued over failure to release emails from Coca-Cola
Authors: Martha Rosenberg
Journal: BMJ (2018)

US Right to Know, a campaign group for transparency in the food industry, has sued the Centers for Disease Control and Prevention (CDC) over its failure to release correspondence between agency officials and current and former employees of Coca-Cola requested under freedom of information rules.1

Within days of filing the suit on 21 February the group said that it had received a small batch of new documents from the CDC. Asked whether the quick response was an attempt to stop the lawsuit, Gary Ruskin, co-director of US Right to Know, said “possibly,” but the group still sought the additional emails specified in the suit “to uncover the extent and nature of the CDC’s relationship with Coca-Cola.”

Coca-Cola provides funding to …
A preclinical study of tumor-infiltrating lymphocytes in NSCLC.
Authors: Lorenzo Federico, Cara L. Haymaker, Marie-Andree Forget, Andrea Ravelli, Ankit Bhatta, Tatiana Karpinets, Ran Zhang, Annikka Weissferdt, Bingliang Fang, Jianjun Zhang, Tina Cascone, Ara A. Vaporciyan, Andrew Futreal, Ignacio Ivan Wistuba, Boris Sepesi, John Heymach, Don Lynn Gibbons, Chantale Bernatchez
Journal: Journal of Clinical Oncology (2018)

161 Background: Multiple clinical studies have shown that adoptive cell transfer (ACT) of autologous tumor-infiltrating lymphocytes (TIL) is remarkably effective in melanoma patients. Non-small cell lung cancer (NSCLC) shares similarities with melanoma in terms of mutational burden and sensitivity to immune checkpoint inhibitors. We therefore sought to test whether TIL ACT may represent a viable option for the treatment of NSCLC patients. We utilized tissue collected from patients enrolled on the prospective ImmunogenomiC prOfiling of Non-small cell lung cancer (ICON) study. Methods: TIL and tissue-infiltrating lymphocytes were expanded ex vivo from 97 freshly resected early-stage localized NSCLC tumors and 39 matched uninvolved lung tissues. Growth and functional characteristics of TIL were assessed via flow cytometry, TIL-tumor reactivity assays, and analysis of TCRβ sequencing data. Results: NSCLC showed an increased proportion of CD3 + lymphocytes within the tumor-infiltrating leukocyte component as compared to matched normal lung tissue. The TIL compartment included a suppressed CD8 + T cell subset expressing significantly higher levels of PD-1 and lacking cytolytic potential compared to T cells expanded from normal tissue. TIL contained a higher proportion of proliferating (Ki67 + ) CD8 + CD103 + tissue-resident memory (T RM ) cells expressing activation markers such as CTLA4, LAG3, PD1 and ICOS, and increased CD4 + Tregs. Despite a highly immunosuppressive environment, TIL expansion was achieved with a success rate of 68% (n = 97) but appeared hindered in patients undergoing neoadjuvant chemotherapy treatment prior to surgery (56.2%, n = 16 vs 72.5% success rate in therapy-naïve patients). In addition, expansion efficiency (number expanded and time of culture) of TIL and matched lung residing lymphocytes were significantly associated (r = 0.379, p = 0.017, n = 39). Importantly, expanded CD8 + TIL products were oligoclonal and showed reactivity toward autologous tumors. Conclusions: Although NSCLC TIL are functionally inhibited in vivo they can be successfully expanded ex vivo and demonstrate recognition of autologous tumor cells. These data suggest that TIL can potentially be used for adoptive T cell-based immunotherapy in NSCLC.
I have been a principal for the past 28 years in the same practice and will be 57 next year. I have heard about taking an early pension with 28 day retirement and then returning to work possibly in a reduced capacity. The idea of receiving the lump sum is attractive. What are the benefits and hazards of this proposal?
Authors: John Adsett
Journal: BMJ (2005)

Have a career or related problem that needs answering? Can9t find the right person to point you in the right direction? Log on to the Advice Zone (www.bmjcareers.com/advicezone) 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.
Seven day services could leave emergency departments understaffed, doctors warn
Authors: Abi Rimmer
Journal: BMJ (2015)

Consultants have warned that introducing seven day services could lead to the understaffing of emergency departments and acute services. 

Delegates at the BMA’s annual UK consultants’ conference in London on Wednesday 4 March voted unanimously in favour of a motion which opposed proposals by NHS Employers for doctors to provide elective services at nights and weekends. 

The motion said that the proposals would “exacerbate the difficulty in recruitment to acute specialties, result in worse services for patients, and incentivise emigration [of doctors].” It said that the plans would also “necessitate increased use of agency staff and …
Evaluation of Retinal Nerve Fiber Layer Progression in Glaucoma
Authors: Christopher Kai-Shun Leung, Carol Yim-Lui Cheung, Robert Neal Weinreb, Shu Liu, Cong Ye, Gilda Lai, Nancy Liu, Chi Pui Pang, Kwok Kay Tse, Dennis Shun Chiu Lam
Journal: Ophthalmology (2010)
Royal college reports attrition and dissatisfaction among paediatrics trainees
Authors: Helen Jaques
Journal: BMJ (2013)

One in 10 trainees in paediatric medicine drops out by specialty training year 3 (ST3), and over 40% have seriously considered leaving the specialty, the Royal College of Paediatrics and Child Health has found.

The findings come from a pair of surveys conducted by the college.12

A cohort study of 354 paediatric trainees (81% response rate) who began training in the specialty in 2007 found that 11% were training in another specialty or working in another career.1 This indicates an …
Frontoparietal Subdural Hematoma in a Child With Mental Regression
Authors: Javier de las Heras, Luis Aldámiz-Echevarría, Alberto Cabrera
Journal: JAMA Neurology (2018)

This case report describes a 10-year-old boy who presented with progressive encephalopathy, deterioration in school performance, behavioral and personality changes, marked bradypsychia, and weight loss due to cobalamin D disease.
Abstract ES4-1: Her2 testing - 2017 guidelines for HER2 testing
Authors: RB Jenkins
Journal: Cancer Research (2018)

Abstract Currently the use of anti-HER2 directed therapy (HDT) is predicated on the identification of HER2-postive breast cancers. Immunohistochemistry (IHC) and in situ hybridization (ISH) are the most common (and FDA-approved methods) for detecting HER2-positive breast cancers. While IHC and ISH are generally robust testing modalities, both can be subject to various pre-analytic, analytic and post-analytic issues/problems. In response to these issues/problems, ASCO and CAP formed a joint HER2 Guideline Committee. The initial guidelines of this committee were released in 2007 and a first revision of the guidelines was released in 2013. Since 2013, additional issues with HER2 testing have arisen and the ASCO/CAP Committee will be releasing a second revision to the guidelines in late 2017 or early 2018. This educational presentation will discuss HER2 testing – with a focus on fluorescent in situ hybridization (FISH). It will outline the 2013 ASCO/CAP guidelines and describe some of the issues that have arisen with these guidelines. The presentation will conclude with a discussion of the pending 2017/2018 ASCO/CAP guidelines for HER2 testing. Citation Format: Jenkins RB. Her2 testing - 2017 guidelines for HER2 testing [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr ES4-1.
Why can't Scottish people get jobs?
Authors: Gillian Fraser
Journal: BMJ (2005)

EDITOR—I have just read your article about the recruitment and retention crisis in Scotland,1 and I couldn't believe what I was reading. I am a 100% thoroughbred Scot, was educated at a comprehensive in Fife, and went to medical school in Aberdeen. My first house job was in Aberdeen; however, for my second I had to go to Northern Ireland. The reason was that …
PROGNOSTIC IMPLICATIONS OF A HIGH-SENSITIVITY CARDIAC TROPONIN T ASSAY IN A REAL-LIFE POPULATION WITH NON-ST ACUTE CORONARY SYNDROME
Authors: Guglielmo Gallone, Marco Magnoni, Ferruccio Ceriotti, Vittoria Vergani, Daniela Giorgio, Giulia Angeloni, Attilio Maseri, Domenico Cianflone
Journal: Journal of the American College of Cardiology (2018)