tbuckley/cabot-search huggingface dataset:
COPD prevalence and hospital admissions in Galicia (Spain). An analysis using the potential of new health information systems
Authors: R. Barbosa-Lorenzo, A. Ruano-Ravina, A. Fernández-Villar, E. López-Pardo, C. Carballeira-Roca, J.M. Barros-Dios
Journal: Pulmonology (2018)

Chronic obstructive pulmonary disease (COPD) is a major public health problem. The aim of this study was to ascertain the prevalence of COPD and whether such prevalence was positively or negatively associated with COPD admissions, using all the data of a regional health care system. We designed a descriptive cross-sectional study which included all subjects aged over 45 years, diagnosed with COPD in primary care in 2013. We also calculated the number of such patients who had a record of hospital admissions due to this disease. COPD prevalence and incidence of admissions were calculated. Poisson regression models were then used to analyse the association between cases with diagnosis of COPD and admissions due to COPD, by sex, adjusting for socio-demographic variables and distance to hospital. Sensitivity subanalyses were performed by reference to the respective municipal rurality indices. Median municipal prevalence of COPD was 5.29% in men and 2.19% in women. Among patients with COPD, 28.22% of men and 16.00% of women had at least one hospital admission. The relative risk of admission per unit of the standardised prevalence ratio was 0.37 (95% CI 0.34–0.41) for men and 0.39 (95% CI 0.34–0.45) for women. There is a significant negative association between COPD prevalence and hospital admissions due to this disease. The proportion of admissions is lower in municipalities lying furthest from hospitals. There is considerable municipal variability in terms of COPD prevalence and proportion of admissions. In-depth attention should be given to disease-management training programmes.
Public Reporting of Percutaneous Coronary Intervention Outcomes
Authors: Rishi K. Wadhera, Karen E. Joynt Maddox, Robert W. Yeh, Deepak L. Bhatt
Journal: JAMA Cardiology (2018)

More than 20 years have passed since public reporting of percutaneous coronary intervention (PCI) outcomes first began in New York State, but reporting remains a polarizing issue.Advocates of public reporting point to the strong incentive that public disclosure of outcomes data provides for institutions and clinicians to improve clinical care and to the importance of enabling patients to make informed choices about their care. Critics highlight the methodological challenges that impede fair and accurate assessments of care quality as well as reporting's unintended consequences. Public reporting of PCI outcomes has only been implemented in 5 states, but reporting efforts for multiple conditions and procedures are now proliferating nationally, propelled by the notion that transparency improves the quality of health care and fosters trust in health care institutions. Careful evaluation of the evidence to date for PCI in particular, however, suggests that enthusiasm for such efforts should be tempered.Public reporting has not achieved its primary objectives. Policy makers should consider variations of reporting that might strengthen care quality, empower patients, and mitigate undesirable repercussions.
Novel tools for dissecting the functions of Kupffer cells in homeostasis and disease reveal a role for the transcription factors Zeb2 and LXRa in maintaining Kupffer cell identity
Authors: C. Scott, W. T’jonck, D. Sichien, B. Johnny, L. Martens, H. Todorov, R. Cannoodt, P. De Baetselier, G. Berx, A. Beschin, Y. Saeys, M. Guilliams
Journal: Journal of Hepatology (2018)
Saving a Death When We Cannot Save a Life in the Intensive Care Unit
Authors: Michael E. Wilson
Journal: JAMA Internal Medicine (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 Internal Medicine 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 Internal Medicine journal
Prospective multinational serosurveillance study of Bordetella pertussis infection among 10- to 18-year-old Asian children and adolescents
Authors: S. Son, V. Thamlikitkul, K. Chokephaibulkit, J. Perera, K. Jayatilleke, P.-R. Hsueh, C.-Y. Lu, V. Balaji, H. Moriuchi, Y. Nakashima, M. Lu, Y. Yang, K. Yao, S.H. Kim, J.H. Song, S. Kim, M.-J. Kim, U. Heininger, C.-H. Chiu, Y.-J. Kim
Journal: Clinical Microbiology and Infection (2018)
Oxaliplatin (OX), chronomodulated capecitabine, and UGT1A1 genotype-directed dosing of irinotecan (IR) triplet chemotherapy (OXIRI) in patients (pts) with advanced pancreatic cancer (APC).
Authors: Amanda Oon Lim Seet, Sylvia Chen, Yingnan Yu, Su Pin Choo, David Wai-Meng Tai, Justina Yick Ching Lam, Yvonne Chang, Balram Chowbay, Matthew CH Ng
Journal: Journal of Clinical Oncology (2018)

411 Background: The FOLFIRINOX regimen is highly active in APC, but its use is limited by toxicity. Irinotecan (IR) toxicity is correlated with UGT1A1 genotype status and chronomodulated delivery of fluoropyrimidines may reduce toxicity and increase efficacy. We have presented the dose escalation (DES) of OXIRI. In dose expansion (DXP), several pts required dose reduction after cycle 1 and we evaluated a lower starting dose. We now present data of the recommended Phase II dose (RP2D) and DES combined. Methods: Pts with APC and ECOG performance status ≤2, adequate organ function were enrolled. Previous OX or IR exposure was disallowed. During DES, APC pts homozygous for UGT1A1*6/*6 or UGT1A1*28/*28 were excluded. During DXP, only pts progressing on ≥ 1 line prior chemo was allowed and IR was dosed according to UGT1A1 genotype. At RP2D, pts received iv OX 37.5mg/m 2 and IR 50mg/m 2 on D1, 8 and po capecitabine 2650mg once at midnight on D1-14 every 21D until progression. Results: A total of 25 pts were enrolled, 17 in DES and 8 in DXP, 21 had metastatic and 4 had locally advanced APC. Male:Female 11:14, median (range) age and ECOG PS was 65yrs (50-77) and 0 (0-1) respectively. Pts with 0, 1 or 2 lines of prior chemo were 4 (16%) , 14 (56%) and 7(28%) respectively. Grade 3/4 AEs (≥5%) related to OXIRI were neutropenia (32%), anaemia (12%), diarrhoea (16%). No events of febrile neutropenia were reported. At data cut-off on 31 Aug 2017, 4 pts are on study. Median progression-free and overall survival was 22 and 35 wks respectively. Response rate (RR) was 5/25 (20%, overall); 5/20 (25%, evaluable pts) including 1 complete response and 1 unconfirmed partial response. Disease control rate for ≥ 12wks was 16/25 (64%) with 3 pts &gt; 52wks. CA19-9 decrease of ≥ 20% was seen in 9/25 pts. Conclusions: OXIRI is an active regimen with RR of 20% despite 84% of pts having prior chemo, with disease control for ≥ 12wks in 64% of pts. Predominant toxicity was neutropenia. This study was supported by the National Medical Research Council Singapore. Clinical trial information: NCT02368860.
Digital pancreatoscopy in the evaluation of main duct intraductal papillary mucinous neoplasm: a multicenter study
Authors: Arvind J. Trindade, Petros C. Benias, Praneet Kurupathi, Benjamin Tharian, Sumant Inamdar, Neil Sharma, Divyesh V. Sejpal, Ali A. Siddiqui, Douglas G. Adler
Journal: Endoscopy (2018)

Abstract Background The aim of this study was to investigate the outcomes of digital pancreatoscopy in main duct intraductal papillary mucinous neoplasm (MD-IPMN). Methods This was a multicenter retrospective study. Outcomes analyzed were safety, incremental pathology yield compared with previous cross-sectional/endoscopic ultrasound (EUS) imaging, and whether the surgical procedure was dictated by the pancreatoscopy. Results A total of 31 patients were enrolled from six tertiary care centers. Overall, 42 % of cases had findings on pancreatoscopy that were not seen on cross-sectional imaging or EUS. Digital pancreatoscopy dictated the type of surgery performed in 13 patients (42 %) who underwent surgery. However, in patients with a diffusely dilated pancreatic duct (&gt; 10 mm), the pancreatoscopy dictated the type of surgery in 77 % of cases vs. 17 % of cases in the focally dilated pancreatic duct group (10/13 vs. 3/18; P = 0.001). Conclusion Digital pancreatoscopy should be considered in the diagnostic algorithm of MD-IPMN in patients with a diffusely dilated pancreatic duct and without any focal lesions seen on cross-sectional imaging or EUS.
NHS failed to communicate feeding advice to refugee mother, court rules
Authors: Clare Dyer
Journal: BMJ (2018)

The NHS will have to pay millions of pounds in compensation after a baby was left severely brain damaged because his mother, a refugee, could not understand English.

Barking, Havering and Redbridge University Hospitals NHS Trust was liable for Nilujan Rajatheepan’s injuries because staff failed to communicate to his mother how to feed him properly, Judge Martin McKenna ruled at the High Court.

Nilujan was born by emergency caesarean section on the night of 16 July 2009 at King George Hospital in Goodmayes, Essex. His Apgar scores and blood cord readings were normal, and a consultant paediatrician who examined him had no concerns.

Nilujan’s parents were Tamil refugees from Sri Lanka, and his 21 year old mother, Sinthiya, spoke only a very few words of English.

She went through the formal discharge …
Abstract 20132: Drug-eluting Stents versus Bare Metal Stents for Non-ST-segment Elevation Myocardial Infarction (NSTE-ACS): A Meta-analysis of 44,123 Patients
Authors: Chirag Bavishi, Abdur R Khan, Vrinda Trivedi, Carlos Gongora, Sameer Ather
Journal: Circulation (2015)

Introduction: The efficacy of drug-eluting stents (DES) compared to bare-metal stents (BMS) in patients with Non-ST-segment Elevation Myocardial Infarction (NSTE-ACS) is unclear. Methods: Pubmed, Scopus and Clinical trials.gov databases were searched to identify all studies that compared DES with BMS in patients with NSTE-ACS. We evaluated the following efficacy and safety outcomes: all-cause mortality, cardiovascular mortality, myocardial infarction, stent thrombosis, target vessel revascularization and major advance cardiovascular events (MACE) at the longest reported follow-up times. Random-effects model was used to pool study results. Results: A total of 11 cohort studies with 44,123 patients were included. The mean follow-up duration was 2.3 years. Of note, all studies compared first generation DES with BMS. Patients receiving DES had significantly lower all-cause mortality (Relative risk [RR]: 0.74, 95% confidence interval [CI]: 0.64 - 0.86, p&lt;0.001), cardiovascular mortality (RR: 0.73, 95% CI: 0.54 - 0.99, p=0.02), MACE (RR: 0.71, 95% CI: 0.54 - 0.94, p=0.02) and target vessel revascularization (RR: 0.64, 95% CI: 0.49 - 0.82, p=0.001). There was no significant difference in the incidence of myocardial infarction (RR: 0.88, 95% CI: 0.67 - 1.15, p=0.34) and stent thrombosis (RR: 0.98, 95% CI: 0.71 - 1.35, p=0.89). Conclusions: Compared to BMS, DES is associated with improved outcomes with non-significant differences in myocardial infarction and stent thrombosis. Further randomized controlled trials including studies with newer DES, are required to evaluate the efficacy and safety of DES in patients with NSTE-ACS.
Illnesses caused by US ticks and mosquitoes tripled in recent years
Authors: Owen Dyer
Journal: BMJ (2018)

Three times as many Americans fell ill from a vectorborne disease in 2016 as in 2004, the Centres for Disease Control and Prevention (CDC) has warned in a new report.1

A sharp recent spike was driven by Zika, but there is also a worrying long term growth in tickborne illnesses, especially Lyme disease.

Since 2004, nine diseases have been seen for the first time in the US, including the mosquitoborne viruses Zika and Chikungunya and several completely new tickborne pathogens.

Tickborne diseases accounted for 77% of all vectorborne diseases reported between 2004 and 2016, during which time they doubled in frequency. Of these cases of tickborne illness, 82% were Lyme disease, caused by bacteria of the Borrelia type and …
Risk of Infective Endocarditis After Invasive Dental Treatments
Authors: Tzu-Ting Chen, Yi-Chun Yeh, Kuo-Liong Chien, Mei-Shu Lai, Yu-Kang Tu
Journal: Circulation (2018)

Invasive dental treatments (IDTs) can yield temporary bacteremia and have therefore been considered a potential risk factor of infective endocarditis (IE). It is hypothesized that, through the trauma caused by IDTs, bacteria gain entry to the bloodstream and may attach to abnormal heart valves or damaged heart tissue, giving rise to IE. However, the association between IDTs and IE remains controversial. The aim of this study is to estimate the association between IDTs and IE.The data in this study were obtained from the Health Insurance Database in Taiwan. We selected 2 case-only study designs, case-crossover and self-controlled case series, to analyze the data. The advantage of these methods is that confounding factors that do not vary with time are adjusted for implicitly. In the case-crossover design, a conditional logistic regression model with exposure to IDTs was used to estimate the risks of IE following an IDT with 4, 8, 12, and 16 weeks delay, respectively. In the self-controlled case series design, a conditional Poisson regression model was used to estimate the risk of IE for the risk periods of 1 to 4, 5 to 8, 9 to 12, and 13 to 16 weeks following an IDT.In total, 9120 and 8181 patients with IE were included in case-crossover design and self-controlled case series design, respectively. In the case-crossover design, 277 cases and 249 controls received IDTs during the exposure period, and the odds ratio was 1.12 (95% confidence interval, 0.94-1.34) for 4 weeks. In the self-controlled case series design, we observed that 407 IEs occurred during the first 4 weeks after IDTs, and the age-adjusted incidence rate ratio was 1.14 (95% confidence interval, 1.02-1.26) for 1 to 4 weeks after IDTs.In both study designs, we did not observe a clinically larger risk for IE in the short periods after IDTs. We also found no association between IDTs and IE among patients with a high risk of IE. Therefore, antibiotic prophylaxis for the prevention of IE is not required for the Taiwanese population.
Signaling and Function of Interleukin-2 in T Lymphocytes
Authors: Sarah H. Ross, Doreen A. Cantrell
Journal: Annual Review of Immunology (2018)

The discovery of interleukin-2 (IL-2) changed the molecular understanding of how the immune system is controlled. IL-2 is a pleiotropic cytokine, and dissecting the signaling pathways that allow IL-2 to control the differentiation and homeostasis of both pro- and anti-inflammatory T cells is fundamental to determining the molecular details of immune regulation. The IL-2 receptor couples to JAK tyrosine kinases and activates the STAT5 transcription factors. However, IL-2 does much more than control transcriptional programs; it is a key regulator of T cell metabolic programs. The development of global phosphoproteomic approaches has expanded the understanding of IL-2 signaling further, revealing the diversity of phosphoproteins that may be influenced by IL-2 in T cells. However, it is increasingly clear that within each T cell subset, IL-2 will signal within a framework of other signal transduction networks that together will shape the transcriptional and metabolic programs that determine T cell fate.
3-month daily rifampicin and isoniazid compared to 6- or 9-month isoniazid for treating latent tuberculosis infection in children and adolescents less than 15 years of age: an updated systematic review
Authors: Yibeltal Assefa, Yalemzewod Assefa, Solomon Woldeyohannes, Yohhei Hamada, Haileyesus Getahun
Journal: European Respiratory Journal (2018)

<b>Treatment of latent tuberculosis infection in children with a 3-month daily rifampicin and isoniazid regimen is safe with better compliance, adherence and completion rate than a 6- or 9-month isoniazid monotherapy</b>http://ow.ly/x28Z30jDfCE
Translational Biomarkers and Ex Vivo Models of Joint Tissues as a Tool for Drug Development in Rheumatoid Arthritis
Authors: Cecilie F. Kjelgaard‐Petersen, Adam Platt, Martin Braddock, Martin A. Jenkins, Kishwar Musa, Emma Graham, Thorbjørn Gantzel, Gillian Slynn, Michael E. Weinblatt, Morten A. Karsdal, Christian S. Thudium, Anne‐C. Bay‐Jensen
Journal: Arthritis & Rheumatology (2018)

Objective Rheumatoid arthritis (RA) is a chronic and degenerative autoimmune joint disease that leads to disability, reduced quality of life, and increased mortality. Although several synthetic and biologic disease‐modifying antirheumatic drugs are available, there is still a medical need for novel drugs that control disease progression. As only 10% of experimental drug candidates for treatment of RA that enter phase I trials are eventually registered by the Food and Drug Administration, there is an immediate need for translational tools to facilitate early decision‐making in drug development. In this study, we aimed to determine if the inability of fostamatinib (a small molecule inhibitor of Syk) to demonstrate sufficient efficacy in phase III of a previous clinical study could have been predicted earlier in the development process. Methods Biomarkers of bone, cartilage, and interstitial matrix turnover (C‐telopeptide of type I collagen [CTX‐I], matrix metalloproteinase–derived types I, II, and III collagen neoepitopes [C1M, C2M, and C3M]) were measured in 450 serum samples from the Oral Syk Inhibition in Rheumatoid Arthritis 1 study (OSKIRA‐1, a phase III clinical study of the efficacy of fostamatinib in RA) at baseline and follow‐up. Additionally, the same biomarkers were subsequently measured in conditioned media from osteoclast, cartilage, and synovial membrane cultured with the active metabolite of fostamatinib, R406, to assess the level of suppression induced by the drug. Results In OSKIRA‐1 serum samples and osteoclast and cartilage cultures, fostamatinib suppressed the levels of CTX‐I and C2M. In OSKIRA‐1 serum samples and synovial membrane cultures, fostamatinib did not mediate any clinical or preclinical effect on either C1M or C3M, which have previously been associated with disease response and efficacy. Conclusion These data demonstrate that translational biomarkers are a potential tool for early assessment and decision‐making in drug development for RA treatment.
Tissue adhesive, rapid forming, and sprayable ECM hydrogel via recombinant tyrosinase crosslinking
Authors: Su-Hwan Kim, Sang-Hyuk Lee, Ju-Eun Lee, Sung Jun Park, Kyungmin Kim, In Seon Kim, Yoon-Sik Lee, Nathaniel S. Hwang, Byung-Gee Kim
Journal: Biomaterials (2018)
Detection of clonal hematopoiesis of indeterminate potential in clinical sequencing of solid tumor specimens
Authors: Eric A. Severson, Gregory M. Riedlinger, Caitlin F. Connelly, Jo-Anne Vergilio, Mendel Goldfinger, Shakti Ramkissoon, Garrett M. Frampton, Jeffrey S. Ross, Anthony Fratella-Calabrese, Laurie Gay, Siraj Ali, Vincent Miller, Julia Elvin, Mohammad Hadigol, Kim M. Hirshfield, Lorna Rodriguez-Rodriguez, Shridar Ganesan, Hossein Khiabanian
Journal: Blood (2018)
Insulin receptor isoform A is a new player in the progression of hepatocellular carcinoma
Authors: E. Benabou, Z. Salame, D. Wendum, M. Lequoy, S. Tahraoui, F. Merabtene, C. Yves, O. Scatton, O. Rosmorduc, L. Fouassier, L. Fartoux, F. Praz, C. Desbois-Mouthon
Journal: Journal of Hepatology (2018)
Radioembolization in Advanced Hepatocellular Carcinoma
Authors: Ahsun Riaz, Robert Lewandowski, Riad Salem
Journal: Journal of Clinical Oncology (2018)

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice. A 68-year-old man with a remote history of alcohol abuse presented with vague abdominal pain. A review of systems suggested the patient had an Eastern Cooperative Oncology Group performance status 1 (restriction of strenuous physical activity). There were no physical examination findings of note. Laboratory studies disclosed Child-Pugh A liver status (no ascites; no encephalopathy; total bilirubin, 1 mg/dL; albumin, 3.5 g/dL; and international normalized rato, 1.2). The alpha-fetoprotein was mildly elevated (19.5 ng/mL). Magnetic resonance imaging with contrast disclosed an infiltrative mass with extensive malignant right and left portal vein thrombosis ( Fig 1A ) with cavernous transformation of the portal vein. The infiltrative mass ( Fig 2A ) was biopsied, revealing hepatocellular carcinoma. No distant metastases were found on a bone scintigraphy or computerized tomography scan. Given these features, this patient was classified as Barcelona Clinic for Liver Cancer stage C. The patient was referred for management of advanced hepatocellular carcinoma.
Changing patterns in clinical–histological presentation and renal outcome over the last five decades in a cohort of 499 patients with lupus nephritis
Authors: Gabriella Moroni, Paolo Gilles Vercelloni, Silvana Quaglini, Mariele Gatto, Davide Gianfreda, Lucia Sacchi, Francesca Raffiotta, Margherita Zen, Gloria Costantini, Maria Letizia Urban, Federico Pieruzzi, Piergiorgio Messa, Augusto Vaglio, Renato Alberto Sinico, Andrea Doria
Journal: Annals of the Rheumatic Diseases (2018)

Objectives To evaluate changes in demographic, clinical and histological presentation, and prognosis of lupus nephritis (LN) over time. Patients and methods We studied a multicentre cohort of 499 patients diagnosed with LN from 1970 to 2016. The 46-year follow-up was subdivided into three periods (P): P1 1970–1985, P2 1986–2001 and P3 2002–2016, and patients accordingly grouped based on the year of LN diagnosis. Predictors of patient and renal survival were investigated by univariate and multivariate proportional hazards Cox regression analyses. Survival curves were compared using the log-rank test. Results A progressive increase in patient age at the time of LN diagnosis (p&lt;0.0001) and a longer time between systemic lupus erythematosus onset and LN occurrence (p&lt;0.0001) was observed from 1970 to 2016. During the same period, the frequency of renal insufficiency at the time of LN presentation progressively decreased (p&lt;0.0001) and that of isolated urinary abnormalities increased (p&lt;0.0001). No changes in histological class and activity index were observed, while chronicity index significantly decreased from 1970 to 2016 (p=0.023). Survival without end-stage renal disease (ESRD) was 87% in P1, 94% in P2% and 99% in P3 at 10 years, 80% in P1 and 90% in P2 at 20 years (p=0.0019). At multivariate analysis, male gender, arterial hypertension, absence of maintenance immunosuppressive therapy, increased serum creatinine, and high activity and chronicity index were independent predictors of ESRD. Conclusions Clinical presentation of LN has become less severe in the last years, leading to a better long-term renal survival.