tbuckley/cabot-search huggingface dataset:
Heterogeneity in early oncologic outcomes among men with NCCN intermediate-risk prostate cancer treated with radical prostatectomy.
Authors: Kamyar Ghabili, Kevin Nguyen, Amanda Lu, Walter Hsiang, Brian M. Shuch, Michael Leapman
Journal: Journal of Clinical Oncology (2018)

144 Background: The National Comprehensive Cancer Network (NCCN) risk classification scheme for prostate cancer (PCa) encompasses several definitions and has been shown to contain significant heterogeneity. Because patients possessing a single intermediate-risk (IR) feature may be regarded as ineligible for active surveillance (AS), we aimed to compare pathologic and early oncologic outcomes between those with low-risk (LR) and IR features based on the number of criteria met. Methods: We queried the National Cancer Database (NCDB) to identify men with NCCN LR (cT1-T2a, prostate-specific antigen [PSA] &lt; 10 ng/mL, and Gleason score (GS)≤6) and IR PCa diagnosed from 2010-2014 who were treated with radical prostatectomy (RP). Patients with IR PCa were stratified based on a single factor: clinical stage (cT2b-T2c), PSA (10-20 ng/mL), GS 3+4, or GS 4+3 alone. The pathologic outcomes including any Gleason upgrade, and adverse pathology (primary Gleason 4 or ≥pT3 at RP), and receipt of adjuvant radiation therapy (RT) were compared between the LR and IR groups. Odds ratios for pathologic outcomes and receipt of adjuvant RT were computed using logistic regression analyses. Results: Of 181,847 men treated with RP, we identified 30.7% and 37.1% with LR and IR PCa, respectively. Of 67,623 with IR PCa, 4,075 (6%) were due to clinical stage alone, 5,004 (7.4%) by PSA, 43,409 (64.2%) by GS 3+4, and 15,135 (22.4%) by GS 4+3. Patients meeting IR by clinical stage alone had similar risks of adverse pathology as LR patients (OR 1.03, 95%CI 0.94-1.13, p = 0.49). In contrast, those meeting IR by PSA alone had higher risks of adverse pathology compared with LR individuals (OR 2.20, 95%CI 2.05-2.36, p &lt; 0.001). Moreover, receipt of adjuvant RT was similar among LR and IR patients by clinical stage alone (p = 0.62), and higher among patients meeting IR by PSA alone (OR 2.99, 95% CI 2.43-3.69, p &lt; 0.001). Conclusions: Based on national cancer registry data, early outcomes among men meeting the NCCN IR definition for PCa are heterogeneous. IR patients by clinical stage alone had similar rates of adverse pathology as did LR group. Broadened eligibility for AS should be considered to include those meeting favorable IR definitions.
The impact of switching systemic treatment after radiosurgery (SBRT) for oligo-progressive, metastatic renal cell carcinoma (mRCC).
Authors: Pedro C. Barata, Rupesh Kotecha, Prateek Mendiratta, Aditya Juloori, Lilyana Angelov, Samuel T. Chao, Paul Elson, Vadim S. Koshkin, Moshe Chaim Ornstein, Timothy D. Gilligan, Petros Grivas, Laura S. Wood, Brian I. Rini, Jorge A. Garcia
Journal: Journal of Clinical Oncology (2018)

599 Background: Local therapy such as SBRT is increasingly applied to RCC metastases when progression involves a limited number of metastatic sites (oligo-progression; O-PD). We aimed to assess the clinical outcome of patients (pts) with O-PD who changed systemic treatment upon SBRT (SWITCH) compared with those who remained on same therapy after SBRT (STAY); and also with the group of pts who progressed systemically (PD-SYS) and changed systemic treatment as well. Methods: Retrospective analysis of clear-cell mRCC pts treated with SBRT to brain or spinal metastases was undertaken. Clinical outcomes and treatment duration on current therapy of pts in the SWITCH, STAY and PD-SYS groups were compared. Treatment duration was defined as the time interval between SBRT and discontinuation of current systemic therapy for STAY group and discontinuation of first subsequent therapy in the SWITCH and PD-SYS groups. Results: A total of 100 pts with mRCC who had SBRT were identified, including 44 in STAY, 23 in SWITCH and 33 in PD-SYS. Median age was 58 yrs (range 36-79), 76% men, 66% ECOG PS 0-1, 60% IMDC intermediate risk. 61 pts received SBRT to brain and 40 pts to spine with 87% local control rate. Most common systemic treatments at time of SBRT included anti-VEGF (72%), mTOR (11%), PD-1 inhibitors (10%), other (7%). Median treatment duration for STAY was 5.2 months (95% CI, 3.5-6.9) compared with 5.0 months (95% CI, 4.3-5.7) for SWITCH (p = 0.549) and 2.6 months (95% CI, 1.5-3.7) for the PD-SYS group (p = 0.002, compared to all O-PD pts). Median OS was 24.2 months (95% CI, 8.7-39.7) and 27.1 (95% CI, 12.7-41.9) months for STAY and SWITCH groups, respectively (p = 0.461) and 8.5 months (95% CI, 2.1-14.9) in the PD-SYS group (p = 0.014, compared to all O-PD pts). Conclusions: SBRT for pts with mRCC in brain or spine was feasible with excellent local control. The decision to allow pts to remain on their current systemic therapy did not compromise treatment duration or survival. Pts with progressive disease outside SBRT-treated sites had a worse outcome.
Reduce paperwork to retain young GPs, researchers say
Authors: Abi Rimmer
Journal: BMJ (2016)

Reducing paperwork and slowing the pace of administrative change would help retain young GPs in the workforce, researchers have said.

The research, published in the British Journal of General Practice , found that many young GPs felt unsupported and vulnerable to burnout as a result of increases in their workload pressures and changes to the nature of their work.1

The research was commissioned by Health Education England and NHS England to investigate why “so many GPs leave the NHS below the age of 50 years.” …
RESOLUTE INTEGRITY ZOTAROLIMUS-ELUTING STENT IMPLANTATION FOR UNPROTECTED LEFT MAIN CORONARY ARTERY STENOSIS: THE PRECOMBAT-4 (PREMIER OF RANDOMIZED COMPARISON OF BYPASS SURGERY VERSUS ANGIOPLASTY USING ZOTAROLIMUS-ELUTING STENT IN PATIENTS WITH LEFT MAIN CORONARY ARTERY DISEASE) TRIAL
Authors: Do-Yoon Kang, Cheol Hyun Lee, Osung Kwon, Kyusup Lee, Pil Hyung Lee, Jung-Min Ahn, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park
Journal: Journal of the American College of Cardiology (2018)
Clinician managers are being left to struggle without management support and training, research finds
Authors: Matthew Limb
Journal: BMJ (2015)

Hybrid clinician managers are crucial to NHS improvement, but many are struggling in their jobs without support and training in management, a study has suggested.

Higher financial rewards and better training would encourage more people to take up these roles and to become more effective, the researchers who carried out the study say.1 The research looked at issues to do with the roles, professional identities, and effectiveness of hybrid managers, those who combine managerial responsibilities with clinical or medical duties. The study found that service improvement and organisational change in the NHS were “more effective” …
mTOR masters monocyte development in bone marrow by decreasing the inhibition of STAT5 on IRF8
Authors: Yang Zhao, Xiaofei Shen, Ning Na, Zhulang Chu, Huiting Su, Shanshan Chao, Lu Shi, Yanan Xu, Lianfeng Zhang, Bingyi Shi, Yong Zhao
Journal: Blood (2018)
TREATMENT VARIATION AND ITS IMPLICATION FOR SEVERE FONTAN-ASSOCIATED PROTEIN LOSING ENTEROPATHY
Authors: Jonathan N. Johnson, Sunkyung Yu, Ray Lowery, Ryan Butts, Chesney Castleberry, Sharon Chen, Erik Edens, Justin Godown, Jeffrey Gossett, Mariska Kemna, Kimberly Lin, Kathleen Simpson, Shawn West, Ivan Wilmot, Kurt Schumacher
Journal: Journal of the American College of Cardiology (2018)
Association of Time to Attrition in Surgical Residency With Individual Resident and Programmatic Factors
Authors: Heather L. Yeo, Jonathan S. Abelson, Matthew M. Symer, Jialin Mao, Fabrizio Michelassi, Richard Bell, Art Sedrakyan, Julie A. Sosa
Journal: JAMA Surgery (2018)

<h3>Importance</h3> Attrition in general surgery residency remains high, and attrition that occurs in the later years is the most worrisome. Although several studies have retrospectively investigated the timing of attrition, no study to date has prospectively evaluated a national cohort of residents to understand which residents are at risk for attrition and at what point during residency. <h3>Objective</h3> To prospectively evaluate individual resident and programmatic factors associated with the timing of attrition during general surgery residency. <h3>Design, Setting, and Participants</h3> This longitudinal, national cohort study administered a survey to all categorical general surgery interns from the class of 2007-2008 during their first 30 days of residency and linked the data with 9-year follow-up data assessing program completion. Data were collected from June 1, 2007, through June 30, 2016. <h3>Main Outcomes and Measures</h3> Kaplan-Meier curves evaluating time to attrition during the 9 years after the start of residency. <h3>Results</h3> Among our sample of 836 residents (306 women [36.6%] and 528 men [63.2%]; gender unknown in 2), cumulative survival analysis demonstrated overall attrition for the cohort of 20.8% (n = 164). Attrition was highest in the first postgraduate year (67.6% [n = 111]; absolute rate, 13.3%) but continued during the next 6 years, albeit at a lower rate. Beginning in the first year, survival analysis demonstrated higher attrition among Hispanic compared with non-Hispanic residents (21.1% vs 12.4%;<i>P</i> = .04) and at military programs compared with academic or community programs after year 1 (32.3% vs 11.0% or 13.5%;<i>P</i> = .01). Beginning in year 4 of residency, higher attrition was encountered among women compared with men (23.3% vs 17.4%;<i>P</i> = .05); at year 5, at large compared with small programs (26.0% vs 18.4%;<i>P</i> = .04). Race and program location were not associated with attrition. <h3>Conclusions and Relevance</h3> Although attrition was highest during the internship year, late attrition persists, particularly among women and among residents in large programs. These results provide a framework for timing of interventions in graduate surgical training that target residents most at risk for late attrition.
Complications With Insulin Pump Therapy vs Insulin Injection Therapy—Reply
Authors: Beate Karges, Elisabeth Binder, Joachim Rosenbauer
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 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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
DIAGNOSIS OF ARRHYTHMOGENIC RIGHT VENTRICULAR DYSPLASIA/CARDIOMYOPATHY IN ATHLETES USING CARDIAC MAGNETIC RESONANCE IMAGING
Authors: Csilla Czimbalmos, Ibolya Csecs, Nora Sydo, Petra Merkely, Orsolya Kiss, Zsofia Dohy, Attila Toth, Ferenc I. Suhai, Bela Merkely, Hajnalka Vago
Journal: Journal of the American College of Cardiology (2018)
Massive haemoptysis TB or not TB
Authors: Macarena R Vial, Benjamin Horwitz, Cristobal Ramos, Karen Czischke, Georgie Eapen, Horiana B Grosu
Journal: Thorax (2018)

A young lifelong non-smoking patient presented to the emergency department after an episode of haemoptysis following a 2-month history of weight loss, cough and fever. He had a history of pulmonary tuberculosis during childhood, for which he completed 6 months of treatment. An initial non-contrast CT of the thorax revealed a right lower lobe opacity suggestive of necrotising pneumonia with an endobronchial lesion in the bronchus intermedius and associated mediastinal and hilar lymphadenopathy (figure 1). A subsequent CT angiogram revealed bilateral hypertrophic bronchial arteries and a 6 mm intrapulmonary pseudoaneurysm arising from the right bronchial artery (BA), forming …
Comparison of navigated and conventional high tibial osteotomy for the treatment of osteoarthritic knees with varus deformity: A meta-analysis
Authors: Zhi-Peng Wu, Pei Zhang, Jian-zhong Bai, Yuan Liang, Peng-Tao Chen, Jin-Shan He, Jing-Cheng Wang
Journal: International Journal of Surgery (2018)
Serodiagnosis of Borrelia miyamotoi disease by measuring antibodies against GlpQ and variable major proteins
Authors: J. Koetsveld, N.M. Kolyasnikova, A. Wagemakers, O.A. Stukolova, D. Hoornstra, D.S. Sarksyan, M.G. Toporkova, A.J. Henningsson, D. Hvidsten, W. Ang, R. Dessau, A.E. Platonov, J.W. Hovius
Journal: Clinical Microbiology and Infection (2018)
Treatment Selection in Depression
Authors: Zachary D. Cohen, Robert J. DeRubeis
Journal: Annual Review of Clinical Psychology (2018)

Mental health researchers and clinicians have long sought answers to the question "What works for whom?" The goal of precision medicine is to provide evidence-based answers to this question. Treatment selection in depression aims to help each individual receive the treatment, among the available options, that is most likely to lead to a positive outcome for them. Although patient variables that are predictive of response to treatment have been identified, this knowledge has not yet translated into real-world treatment recommendations. The Personalized Advantage Index (PAI) and related approaches combine information obtained prior to the initiation of treatment into multivariable prediction models that can generate individualized predictions to help clinicians and patients select the right treatment. With increasing availability of advanced statistical modeling approaches, as well as novel predictive variables and big data, treatment selection models promise to contribute to improved outcomes in depression.
Incidental Detection of a Melanoma by 18F-Fluorocholine PET/CT Performed for Evaluation of Primary Hyperparathyroidism
Authors: Anne Marij Geertruida Burgers, Maurits Wondergem, Friso Martijn van der Zant, Remco Johannes Jacob Knol
Journal: Clinical Nuclear Medicine (2018)

An 80-year-old woman was evaluated with F-fluorocholine PET/CT in suspicion of a parathyroid adenoma. No focal parathyroid tracer uptake suggestive of adenoma was found, and instead a unilateral multinodular goiter without elevated F-fluorocholine uptake was diagnosed. In addition, focal uptake was found in a cutaneous nodule dorsally on the right shoulder. Upon pathological evaluation, this proved to be a malignant melanoma.
CRISPR-Cas9 genome engineering: Treating inherited retinal degeneration
Authors: Erin R. Burnight, Joseph C. Giacalone, Jessica A. Cooke, Jessica R. Thompson, Laura R. Bohrer, Kathleen R. Chirco, Arlene V. Drack, John H. Fingert, Kristan S. Worthington, Luke A. Wiley, Robert F. Mullins, Edwin M. Stone, Budd A. Tucker
Journal: Progress in Retinal and Eye Research (2018)
IMPACT OF MYOCARDIAL EXTRACELLULAR VOLUME ASSESSED BY CARDIAC MAGNETIC RESONANCE T1 MAPPING ON SYSTOLIC AND DIASTOLIC FUNCTION OF THE HEART
Authors: Naka Saito, Shingo Kato, Naoki Asahina, Naoki Iinuma, Shintaro Minegishi, Daisuke Kamimura, Tatsuya Nakachi, Kazuki Fukui, Masami Kosuge, Kazuo Kimura, Kouichi Tamura
Journal: Journal of the American College of Cardiology (2018)
Prenatal Exposure to Phthalates and the Development of Eczema Phenotypes in Male Children: Results from the EDEN Mother–Child Cohort Study
Authors: Munawar Hussain Soomro, Nour Baiz, Claire Philippat, Celine Vernet, Valerie Siroux, Cara Nichole Maesano, Shreosi Sanyal, Remy Slama, Carl-Gustaf Bornehag, Isabella Annesi-Maesano
Journal: Environmental Health Perspectives (2018)

Background: Contradictory results exist regarding the importance of early-life exposure to phthalates for development of childhood eczema. Objectives: We evaluated the association between maternal urinary concentrations of phthalate metabolites between the 24th and 28th week of gestation and occurrence of eczema in their sons up to 5 y of age, according to allergic sensitization as assessed by total immunoglobulin E (IgE) in a subsample of individuals. Methods: Data on health outcomes and background factors were collected using five standardized annual questionnaires completed by parents at the children's ages of 1–5 y, and their associations with phthalate metabolite urinary concentrations were assessed in 604 mother–son pairs with adjusted multiple logistic regression and Cox's survival model. Several eczema phenotypes were considered. Atopic status was assessed at 5 y of age in 293 boys through total IgE assessment. Results: At 5 y of age, the prevalence of ever eczema was 30.4%. Metabolites of di-isobutyl phthalate (DiBP) and di-isononyl phthalate (DiNP) were positively associated with early-onset (0–24 mo of age) eczema (15.7%) and late-onset (24–60 mo of age) eczema (14.7%). Applying the Cox's model showed a significant association of occurrence of eczema in the first 5 y of life with DiBP and DiNP metabolites. Among IgE-sensitized boys, metabolites of di-n-butyl phthalate (DBP) and DiBP were significantly associated with ever eczema {hazard ratio (HR)=1.67 [95% confidence interval (CI): 1.10, 2.54], p=0.01 and HR=1.87 (95% CI: 1.01, 3.48), p=0.04, respectively}. Conclusions: Occurrence of eczema in early childhood may be influenced by prenatal exposure to certain phthalates in boys. Further investigations are needed to confirm this observation. https://doi.org/10.1289/EHP1829
Basra the bride
Authors: Saher Lalani
Journal: Annals of Internal Medicine (2018)

Ad Libitum20 March 2018Basra the brideSaher Lalani, MPHSaher Lalani, MPHFrom Toronto, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-2386 Audio Reading - “Basra the bride” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Basra the bride," by S. Lalani. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail An olive hand turned,the doorknobof the examination roomand gentle breeze sweptparticles on the floor.Gracefully, she tip-toed,and sat on the patient chair.Warmth of her presence,radiated from insidethe embroidered burqa.Hazel eyes staredthroughthe netted peephole.Hesitantly, she lifted,the lengthy black veil.Arched eyebrows,bruised with cuts and bloodlike the intricate hennastained on her dainty palms.The physician's fingers wiped,the beads of tears on her cheeks.Gazing into her eyes,I caught a glimpseof her strengthsurpassing the yearsof an innocent child bride. Author, Article, and Disclosure InformationAffiliations: From Toronto, Canada.Current Author Address: Saher Lalani, MPH; e-mail, [email protected]com. PreviousarticleNextarticle Advertisement Audio Reading - “Basra the bride” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Basra the bride," by S. Lalani. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 20 March 2018Volume 168, Issue 6Page: 450KeywordsBlood ePublished: 20 March 2018 Issue Published: 20 March 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Adiponectin receptor agonist AdipoRon decreased ceramide, and lipotoxicity, and ameliorated diabetic nephropathy
Authors: Sun Ryoung Choi, Ji Hee Lim, Min Young Kim, Eun Nim Kim, Yaeni Kim, Beom Soon Choi, Yong-Soo Kim, Hye Won Kim, Kyung-Min Lim, Min Jeong Kim, Cheol Whee Park
Journal: Metabolism (2018)
What are the career options in homoeopathy like?
Authors: Kathy Ryan
Journal: BMJ (2004)

<i>Got a career or related 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:</i>
Over 70% of doctors thought GMC investigation damaged their health, survey finds
Authors: Abi Rimmer
Journal: BMJ (2014)

Over 70% of doctors investigated by the General Medical Council believed it had a detrimental effect on their health, a survey has found.

A survey conducted by the Medical Protection Society (MPS), which provides legal and ethical advice to medical professionals, looked at the experiences of 180 doctors who had been investigated by the GMC in the past five years. The survey found that …
Doctors demand evidence that appraisal improves patient safety
Authors: Abi Rimmer
Journal: BMJ (2016)

Doctors have demanded evidence that appraisal and revalidation improve the safety of patients and increase their confidence in the profession.

Delegates at the BMA’s annual representatives meeting in Belfast on Tuesday 21 June voted in favour of a motion calling for a “critical and peer-reviewed assessment of the appraisal process to ensure it is fit for purpose.” The motion demanded that there be “robust and peer-reviewed evidence that appraisal and revalidation processes are actually producing outcomes of improved …
MSc in sports and exercise medicine
Authors: Vivien Shuen
Journal: BMJ (2007)

Credit: PHOTOS.COM



FURTHER INFORMATION 

Marina Skinner, Course Administrator, Centre for Sports Medicine, C Floor, West Block, Queen's Medical Centre, Nottingham NG7 2UH. www.nottingham.ac.uk/orthopaedics/sports-medicine. Tel. 0115 823 1111; sports.med@nottingham.ac.uk

This is a one year full time or two year part time taught postgraduate programme for doctors and physiotherapists who have an interest in sports and exercise medicine (SEM). The course is presented by the Centre for Sports Medicine within the Department of Orthopaedic and Accident Surgery at the University of Nottingham.

I did the course in the 2005-6 academic year as a full time student after completing my basic surgical training. …