tbuckley/cabot-search huggingface dataset:
Successes and challenges in the treatment of pediatric acute myeloid leukemia: a retrospective analysis of the AML-BFM trials from 1987 to 2012
Authors: Mareike Rasche, Martin Zimmermann, Lisa Borschel, Jean-Pierre Bourquin, Michael Dworzak, Thomas Klingebiel, Thomas Lehrnbecher, Ursula Creutzig, Jan-Henning Klusmann, Dirk Reinhardt
Journal: Leukemia (2018)

Overall survival (OS) of pediatric patients with acute myeloid leukemia (AML) increased in recent decades. However, it remained unknown whether advances in first-line treatment, supportive care, or second-line therapy mainly contributed to this improvement. Here, we retrospectively analyzed outcome and clinical data of 1940 pediatric AML patients (younger than 18 years of age), enrolled in the population-based AML-BFM trials between 1987 and 2012. While 5-year probability of OS (pOS) increased from 49 ± 3% (1987–1992) to 76 ± 4% (2010–2012; p < 0.0001), probability of event-free survival only improved from 41 ± 3% (1987–1992) to 50 ± 2% (1993–1998; p = 0.02) after introduction of high-dose cytarabine/mitoxantrone, but remained stable since then. Non-response and relapse rates stayed constant despite intensified first-line therapy (p = 0.08 and p = 0.17). Reduced fatal bleedings and leukostasis translated into fewer early deaths (8.1%vs. 2.2%; p = 0.001). Strikingly, pOS after non-response (13 ± 5% (1987–1992) vs. 43 ± 7% (2005–2010); p < 0.0001) or relapse (19 ± 4% vs. 45 ± 4%; p < 0.0001) improved. After 1999, more relapsed or refractory patients underwent hematopoietic stem cell transplantation (HSCT) with increased pOS after HSCT (29 ± 5% (1993–1998) vs. 50 ± 4% (2005–2010); p < 0.0001). Since efficacy of salvage therapy mainly contributed to better outcome in pediatric AML, our analysis indicates that a better allocation of patients, who cannot be cured with conventional chemotherapy, to an early “salvage-like” therapy is necessary.
Low-grade Inflammatory Marker Profile May Help to Differentiate Patients With LADA, Classic Adult-Onset Type 1 Diabetes, and Type 2 Diabetes
Authors: Esmeralda Castelblanco, Marta Hernández, Andrea Castelblanco, Mònica Gratacòs, Aureli Esquerda, Àngels Molló, Anna Ramírez-Morros, Jordi Real, Josep Franch-Nadal, José-Manuel Fernández-Real, Dídac Mauricio
Journal: Diabetes Care (2018)

OBJECTIVE To test whether differences in serum concentrations of adiposity-related low-grade inflammatory mediators could help to differentiate patients with latent autoimmune diabetes in adults (LADA), classic adult-onset type 1 diabetes, and type 2 diabetes. RESEARCH DESIGN AND METHODS This cross-sectional study involved 75 patients with LADA, 67 with classic adult-onset type 1 diabetes, and 390 with type 2 diabetes. Serum concentrations of adiponectin, soluble tumor necrosis factor-α receptor 2 (sTNFRII), interleukin-6, hs-CRP, and total leukocyte number were measured. To evaluate the differences of these markers among diabetes types, we performed logistic regression models and evaluated area under the receiver-operating characteristic curve (AUCROC) values. RESULTS The profile of innate immunity-related inflammatory markers correlated with metabolic syndrome components. LADA versus classic adult-onset type 1 diabetes was independently related to sTNFRII (odds ratio [OR] 1.9 [95% CI 1.01–3.97]; P = 0.047) and hs-CRP levels (OR 0.78 [95% CI 0.62–0.96]; P = 0.019), and a higher number of total leukocytes lowered the risk of LADA compared with type 2 diabetes (OR 0.98 [95% CI 0.97–0.99]; P = 0.036). The logistic regression model including explanatory biomarkers explained 35% of the variation for LADA versus classic adult-onset type 1 diabetes (AUCROC 0.83 [95% CI 0.74–0.92]; P &amp;lt; 0.001) and 15% of the variation for LADA versus type 2 diabetes (AUCROC 0.73 [95% CI 0.70–0.80]; P &amp;lt; 0.001). CONCLUSIONS Inflammatory, adiposity, and immune-related markers could help to differentiate a LADA diagnosis from that of classic adult-onset type 1 diabetes, and also LADA from that of type 2 diabetes, along with islet autoantibody positivity.
Patient-level costs of treating metastatic gastric cancer by treatment strategy.
Authors: Yunni Jeong, Alyson L. Mahar, Brandon Zagorski, Natalie Coburn
Journal: Journal of Clinical Oncology (2018)

167 Background: Half of gastric cancer patients in North America present with metastatic disease. The appropriate management of these patients is complex and few guidelines exist to definitively guide treatment; as a result, practice variation exists. This variation may lead to care inefficiencies with adverse outcomes. We therefore aimed to conduct a patient-level exploration of metastatic gastric cancer management costs, by treatment strategy, and identify predictors of cost. Methods: We performed a patient-level cost analysis of metastatic gastric cancer patients diagnosed between 2005 and 2008 using a 26-month time horizon and the healthcare system’s perspective. Clinical data was derived from a provincial chart review. Costs associated with supportive care, radiation only, chemotherapy only, chemoradiation, gastrectomy, and gastrectomy with chemotherapy +/- radiotherapy were derived using administrative data from a universal healthcare system. Costs were inflated to 2017 United States dollars (USD) Linear regression was used to identify factors predictive of cost. Results: The absolute mean costs of metastatic gastric cancer management increased with increasing level of intervention and ranged from $34,002 to $72,778 (USD); supportive care was associated with the lowest costs and gastrectomy with chemotherapy +/- radiotherapy was associated with the highest costs. Age over 70 and lower Charlson Comorbidity Index were predictors of lower costs while supportive care, radiotherapy, chemoradiation, and gastrectomy were associated with higher costs. Conclusions: Practice variation has known clinical implications, but economic impact also needs to be considered. Variation in the management of metastatic gastric cancer may reflect dissimilar resource availability between health regions as well as differential access to palliative care. Evidence-based guidelines directing appropriate care for metastatic gastric cancer patients to reduce inefficiencies in care and governmental intervention to implement equitable resource allocation to bridge gaps in care are necessary.
Abstract 17869: Self-Detection of Atrial Fibrillation in an Aged Population - The LietoAF Study
Authors: Jussi Jaakkola, Raine Virtanen, Tuija Vasankari, Marika Salminen, K.E. J Airaksinen
Journal: Circulation (2016)

Introduction: Atrial fibrillation (AF) is often asymptomatic and may remain undiagnosed until an ischemic stroke occurs. A key feature of AF is pulse irregularity. Hypothesis: We hypothesize, that ...
GP trainees should receive mental health training, says chief medical officer
Authors: Abi Rimmer
Journal: BMJ (2014)

GP trainees should receive “a period of specific mental health training,” the chief medical officer (CMO) for England, Sally Davies, has said in her annual report.1

The report, which focuses on the prevention of mental illness, said that most GPs had little or no training in dealing with patients who have experienced violence and therefore may find it difficult to help patients who are experiencing abuse. “A core part of [GP] training should include specific training for awareness about the consequences of violence on …
I am 40 years old, have passed the MRCOG exam part 1, and scored 7.5 in the International English Language Testing System (IELTS) test. What are the career opportunities for me in Australia and New Zealand?
Authors: Miriam Martin
Journal: BMJ (2004)

<i>Got 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.</i>
Pancreatic adenocarcinoma in young adults (≤45 years old): Characteristics and clinical outcomes from a Canadian center.
Authors: Antoine Desilets, Francine Aubin, Carl Amireault, Jean-Pierre M. Ayoub, Richard Letourneau, Mustapha Tehfe
Journal: Journal of Clinical Oncology (2018)

260 Background: Clinical data concerning pancreatic adenocarcinoma (PAC) in young adults is restricted. Limited evidence might suggest a worse prognosis in terms of overall survival (OS) and progression-free survival (PFS), when compared to an older population. Methods: The studied population included adults ≤45 diagnosed with a PAC (stages I to IV) between January 2006 and December 2016 at University of Montreal Health Center (CHUM), a tertiary care referral center in Canada. Clinical data was retrospectively extracted from chart review. The Kaplan Meier estimator was used for survival analyses. Results: 36 patients were identified in the study (median age 41.6, 56% males). Most patients (61%) had localized disease at diagnosis, with 22% presenting with metastases. The head of the pancreas was the primary site involved in 75% of cases. Most patients (63%) had a positive smoking history, with a median number of pack-years of 15. A personal history of cancer was present in 20% (n = 7) and 14% had a positive family history of PAC. Surgery was performed in 58% of individuals and systemic chemotherapy was offered to 89%. First-line agents included gemcitabine-based treatments (72%), FOLFIRINOX (19%) and 5-FU (9%). Despite treatment, 33% showed evidence of disease progression on initial follow-up imaging. Second-line chemotherapy was ultimately offered to 18 patients, and third-line treatments to 5. Survival data is described in the table below. Conclusions: According to our results, young patients with localized PAC may benefit from prolonged OS when compared to the literature. This could be attributed to a favourable comorbidity profile and increased surgical eligibility. Advanced stages however demonstrated a worse prognosis, with shorter OS. Young patients with PAC may also harbor a specific genetic profile, based on increased prevalence of personal and familial cancers. [Table: see text]
Gene Therapy for Vision Loss
Authors: Rebecca Voelker
Journal: JAMA (2018)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Letter in response to: concurrent aerobic plus resistance exercise versus aerobic exercise alone to improve health outcomes in paediatric obesity—a systematic review and meta-analysis
Authors: Fabricio de Souza, Márcia M M de Souza, Fabiana Schuelter Trevisol, Daisson J Trevisol
Journal: British Journal of Sports Medicine (2018)

We would like to congratulate the British Journal of Sports Medicine for the publication of the study conducted by Garcia-Hermoso et al 1 entitled ‘Concurrent aerobic plus resistance exercise versus aerobic exercise alone to improve health outcomes in paediatric obesity: a systematic review and meta-analysis’. The study investigated the effect of concurrent aerobic plus resistance training versus aerobic exercise alone on anthropometric and metabolic results in obese children and adolescents. The findings are extremely important for science because of their clinical and social relevance.

However, some methodological aspects deserve further discussion and clarification. Minor changes will also be suggested to …
Future Research Directions in Pneumonia. NHLBI Working Group Report
Authors: Charles S. Dela Cruz, Richard G. Wunderink, David C. Christiani, Stephania A. Cormier, Kristina Crothers, Claire M. Doerschuk, Scott E. Evans, Daniel R. Goldstein, Purvesh Khatri, Lester Kobzik, Jay K. Kolls, Bruce D. Levy, Mark L. Metersky, Michael S. Niederman, Roomi Nusrat, Carlos J. Orihuela, Paula Peyrani, Alice S. Prince, Julio A. Ramírez, Karen M. Ridge, Sanjay Sethi, Benjamin T. Suratt, Jacob I. Sznajder, Ephraim L. Tsalik, Allan J. Walkey, Sachin Yende, Neil R. Aggarwal, Elisabet V. Caler, Joseph P. Mizgerd
Journal: American Journal of Respiratory and Critical Care Medicine (2018)

Section:ChooseTop of pageAbstract <<Host Susceptibility to Pn...Host Response to Pneumoni...Systemic and Long-Term Co...Overarching Themes to Dir...ConclusionsReferencesCITING ARTICLES
A randomized split-scalp study comparing calcipotriol-assisted methyl aminolaevulinate photodynamic therapy (MAL-PDT) with conventional MAL-PDT for the treatment of actinic keratosis
Authors: L. Torezan, B. Grinblat, M. Haedersdal, N. Valente, C. Festa-Neto, R.M. Szeimies
Journal: British Journal of Dermatology (2018)

BackgroundTopical photodynamic therapy (PDT) is an approved treatment for actinic keratosis (AK). To enhance the efficacy of PDT for AKs, physical and chemical pretreatments have been suggested.
A Multicenter Randomized Controlled Study of Paclitaxel plus Carboplatin versus Oral Uracil-Tegafur as the Adjuvant Chemotherapy in Resected Non–Small Cell Lung Cancer
Authors: Shinichi Toyooka, Norihito Okumura, Hiroshige Nakamura, Masao Nakata, Motohiro Yamashita, Hirohito Tada, Shinsuke Kajiwara, Naoki Watanabe, Morihito Okada, Junichi Sakamoto, Motoi Aoe, Junichi Soh, Shinichiro Miyoshi, Katsuyuki Hotta, Keitaro Matsuo, Hiroshi Date
Journal: Journal of Thoracic Oncology (2018)
Most surgical trainees would not accept a subconsultant role
Authors: Abi Rimmer
Journal: BMJ (2014)

Over 70% of surgical trainees would not consider applying for a subconsultant grade role if it existed, a survey conducted by the Association of Surgeons in Training has found.

The survey, completed by 1365 surgical trainees, found that 72.4% of respondents said they would not consider a subconsultant role.1 In addition, 73.1% said that taking on such a role would have a negative effect on their career.

Most respondents …
Comprehensive analysis of AR alterations in cell free DNA from prostate cancer patients.
Authors: Elisa Ledet, Michael B. Lilly, Guru Sonpavde, Neeraj Agarwal, Rebecca J Nagy, A. Oliver Sartor
Journal: Journal of Clinical Oncology (2018)

314 Background: Somatic alterations identified in cfDNA may be associated with prognosis. Select AR alterations are associated with abiraterone/enzalutamide resistance in PCa. The goal was to characterize AR amplifications (amps) and somatic point mutations (muts) detected in cfDNA from PCa patients and to relate those changes to non-AR alterations detected in the cfDNA landscape. Methods: cfDNA data was obtained from a heterogeneous group of unique PCa pts who underwent Guardant360 testing (Guardant Health, Redwood City, CA). This assay includes next generation sequencing for full exonic coverage of 73 genes and amplifications in 18 genes. The AR amps/muts detected in cfDNA testing were reported. Results: Over 6,800 genomic alterations including AR amps/muts were identified in 892 PCa patients. Pts were a median age of 70 (range = 41-93) at testing. 49% (n = 436) had AR amp only, 32% (n = 283) had nonsynonymous (NS)-muts only, 18% (n = 165) had both amp and NS-muts; &lt; 1% (n = 8) had synonymous AR muts only. AR amps had a mean absolute copy number of 3.3 (range = 1.2-165.2). Many patients had multiple AR muts; a total of 112 unique muts were identified in the AR gene, some of which are poorly characterized. The most prevalent AR muts were L702H (n = 220), T878A (n = 129), H875Y (n = 102), W742C (n = 75), W742L (n = 34), F877L (n = 19), and T878S (n = 14). The AR muts with the highest mutant allele fraction were H875Y, T878A, and L702H. Aside from AR, among these selected pts, amps/muts were identified in 74 other genes including TP53 50% (n = 449), MYC 34% (n = 301), BRAF 32% (n = 287), PIK3CA 29% (n = 259), MET 25% (n = 224), CDK6 26% (n = 229), EGFR 24% (n = 219), FGFR1 21% (n = 189), and APC 12% (n = 112). DNA repair gene alterations were detected in combination with AR alterations, BRCA2 8% (n = 69), BRCA1 5% (n = 42), and ATM 3% (n = 28). Conclusions: To our knowledge, this is the largest dataset ever reporting AR alterations in cfDNA. Both amps and muts, were frequently found in cfDNA from PCa pts. The common AR muts were L702H, T878A, H875Y and W742C/L, which are linked to resistance to abiraterone, enzalutamide or bicalutamide. Determining the association with other somatic cfDNA alterations and clinical outcomes may be critical for conceiving optimal treatment strategies.
GREATER LIKELIHOOD OF REGRESSION OF CORONARY ATHEROSCLEROSIS WITH THE PCSK9 INHIBITOR, EVOLOCUMAB, IN PATIENTS WITH HIGHER LP(A) LEVELS
Authors: Daniel Scherer, Rishi Puri, Christie Ballantyne, Leslie Cho, Danielle Brennan, Helina Kassahun, Ransi Somaratne, Scott Wasserman, Steven Nissen, Stephen Nicholls
Journal: Journal of the American College of Cardiology (2018)
THE IMPACT OF P2Y12 INHIBITORS SWITCH IN PATIENTS WITH ACUTE CORONARY SYNDROME TREATED WITH DRUG-ELUTING STENTS PRIOR TO DISCHARGE
Authors: Ron Waksman, M. Chadi Alraies, Kyle Buchanan, Deepakraj Gajanana, Micaela Iantorno, Toby Rogers, Rebecca Torguson, Linzhi Xu, Itsik Ben-Dor, Lowell Satler, William Suddath, William S. Weintraub
Journal: Journal of the American College of Cardiology (2018)
BMA refuses to rule out providing emergency service only in protest over pensions
Authors: Helen Jaques
Journal: BMJ (2012)

The BMA has said it will consider withdrawing all labour bar an emergency service as a form of industrial action to oppose the government’s planned changes to the NHS pension scheme.

Speaking at the BMA’s annual UK consultants conference, chairman of the consultants committee Mark Porter stated that the union’s council has not ruled out polling doctors on providing an emergency only service when it holds a ballot on industrial action.

The government has proposed ending final salary pensions for NHS staff in favour …
Neuroprotective strategies for retinal disease
Authors: Machelle T. Pardue, Rachael S. Allen
Journal: Progress in Retinal and Eye Research (2018)

Diseases that affect the eye, including photoreceptor degeneration, diabetic retinopathy, and glaucoma, affect 11.8 million people in the US, resulting in vision loss and blindness. Loss of sight affects patient quality of life and puts an economic burden both on individuals and the greater healthcare system. Despite the urgent need for treatments, few effective options currently exist in the clinic. Here, we review research on promising neuroprotective strategies that promote neuronal survival with the potential to protect against vision loss and retinal cell death. Due to the large number of neuroprotective strategies, we restricted our review to approaches that we had direct experience with in the laboratory. We focus on drugs that target survival pathways, including bile acids like UDCA and TUDCA, steroid hormones like progesterone, therapies that target retinal dopamine, and neurotrophic factors. In addition, we review rehabilitative methods that increase endogenous repair mechanisms, including exercise and electrical stimulation therapies. For each approach, we provide background on the neuroprotective strategy, including history of use in other diseases; describe potential mechanisms of action; review the body of research performed in the retina thus far, both in animals and in humans; and discuss considerations when translating each treatment to the clinic and to the retina, including which therapies show the most promise for each retinal disease. Despite the high incidence of retinal diseases and the complexity of mechanisms involved, several promising neuroprotective treatments provide hope to prevent blindness. We discuss attractive candidates here with the goal of furthering retinal research in critical areas to rapidly translate neuroprotective strategies into the clinic.
Association of Psychiatric Comorbidity With Opioid Prescriptions and Long-term Opioid Therapy Among US Adolescents
Authors: Michael J. Mason
Journal: JAMA Pediatrics (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 Pediatrics 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 Pediatrics journal
Training posts could be concentrated in large acute trusts, NHS chief says
Authors: Tom Moberly
Journal: BMJ (2014)

Medical training posts could be concentrated in large acute trusts so that training requirements did not constrain service reorganisation, NHS England’s chief executive, Simon Stevens, has argued.

Speaking at the NHS Confederation’s annual conference in Liverpool this week, Stevens described as “self imposed constraints” the allocation of medical training posts and implementation of European working time restrictions.

“We do of course need high quality training for the next generation of health professionals,” he said. “We should never go back to the days of overworked and overtired junior doctors that was widespread in the 1980s. But does our historical assumption hold for all time that every NHS acute hospital needs a full complement of trainee doctors to keep services afloat?”

He said that the allocation of medical training posts may have been “a pragmatic response” to historical constraints on the number of hospital consultants. “But we’d had a 76% increase in fulltime equivalent consultants …
NO INCREASED RISK OF HEART FAILURE HOSPITALIZATION OR MAJOR CARDIOVASCULAR EVENTS OBSERVED WITH LIRAGLUTIDE IN PATIENTS WITH OR WITHOUT A HISTORY OF NEW YORK HEART ASSOCIATION CLASS II-III HEART FAILURE: RESULTS FROM THE LEADER TRIAL
Authors: Mansoor Husain, Stephen C. Bain, Johannes F.E. Mann, Michael A. Nauck, Neil Poulter, Florian M.M. Baeres, Bryan Goldman, Anne Bloch Thomsen, Steven P. Marso
Journal: Journal of the American College of Cardiology (2018)
THE ELECTROCARDIOGRAPHIC FEATURE OF ACUTE MYOCARDIAL INFARCTION COMPLICATED BY VENTRICULAR FIBRILLATION SURVIVING FROM OUT-OF-HOSPITAL CARDIOPULMONARY ARREST
Authors: Koji Sudo, Yukio Hosaka, Kazuyoshi Takahashi, Takumi Akiyama, Takahiro Hakamata, Kota Nishida, Komei Tanaka, Keiichi Tsuchida
Journal: Journal of the American College of Cardiology (2018)