tbuckley/cabot-search huggingface dataset:
Abstract 11845: How Early Should We Initiate Targeted Temperature Management in Comatose Cardiac Arrest Survivors?
Authors: ByungKook Lee, Dong Hun Lee, Yong Soo Cho, Kyung Woon Jeung, Yong Il Min
Journal: Circulation (2016)

Introduction: The optimal time for initiation of targeted temperature management (TTM) in comatose cardiac arrest survivors has not been elucidated. We analyzed the association of time from return of spontaneous circulation (ROSC) to initiation of TTM and induction time with outcomes in cardiac arrest survivors. Methods: A retrospective analysis of data for adult comatose cardiac arrest survivors who were treated with TTM from 2008 to 2015 was conducted. Time from ROSC to initiation of TTM was defined as pre-induction time. Pre-induction time was divided into four groups as follows: ≤120, 121-240, 241-360, and ≥361 min. Additionally, it was divided by different binary cutoffs of 120, 180, 240, 300, 360, or 420 min to identify a threshold association. The primary endpoint was neurologic outcome at discharge. Results: The study included 478 patients; of these, 121 (25.3%) died, and 317 (66.3%) were discharged with poor neurologic outcomes. The median pre-induction time was 225 min (interquartile range [IQR], 155-300 min), and it differed according to good (202 min; IQR, 150-300 min) and poor (230 min; IQR, 160-310 min) neurologic outcomes ( p =0.022). A multivariate logistic regression analysis revealed that delayed pre-induction (odds ratio [OR], 1.003; 95% confidence interval [CI], 1.001-1.005) and ≥361 min of pre-induction time (OR, 6.238; 95% CI, 1.928-19.628) compared to &lt;120 min of pre-induction time were associated with poor neurologic outcome; however, 121-240 min (OR, 2.263; 95% CI, 0.969-5.284) and 241-360 min (OR, 2.111; 95% CI, 0.866-5.147) of pre-induction time were not associated with neurologic outcome. When the cohort was divided by cutoffs of 120 min (OR, 2.288; 95% CI, 1.044-5.012) and 360 min (OR, 2.679; 95% CI, 1.133-6.332), pre-induction time remained a significant predictor of poor neurologic outcome. Good neurologic outcome groups had a longer induction time. However, induction time was not an independent predictor of neurologic outcome. Conclusions: Delayed cooling was associated with increased poor neurologic outcomes at discharge among comatose cardiac arrest survivors treated with TTM. Patients with pre-induction time over 120 or 360 min had a higher probability of poor neurologic outcome.
Triple stenting to treat a complete Wirsung-to-jejunum anastomotic leak after pancreaticoduodenectomy
Authors: Massimiliano Mutignani, Edoardo Forti, Francesco Pugliese, Alberto Tringali, Marcello Cintolo, Giulia Bonato, Lorenzo Dioscoridi
Journal: Endoscopy (2017)

Dehiscences of pancreatic–jejunal anastomoses are the commonest complication, and one of the worst, after duodenopancreatectomies [1]. The treatment is generally re-do surgery, with a residual pancreatectomy being performed in the most severe cases [1]. Endotherapy is generally not considered as an alternative in patients with complete and/or complex leaks [1]. However, endoscopic treatment of postoperative pancreatic fistulas has already been described [2] [3] [4].
Second Arterial Versus Venous Conduits for Multivessel Coronary Artery Bypass Surgery in California
Authors: Andrew B. Goldstone, Peter Chiu, Michael Baiocchi, Hanjay Wang, Bharathi Lingala, Jack H. Boyd, Y. Joseph Woo
Journal: Circulation (2017)

Whether a second arterial conduit improves outcomes after multivessel coronary artery bypass grafting remains unclear. Consequently, arterial conduits other than the left internal thoracic artery are seldom used in the United States.Using a state-maintained clinical registry including all 126 nonfederal hospitals in California, we compared all-cause mortality and rates of stroke, myocardial infarction, repeat revascularization, and sternal wound infection between propensity score-matched cohorts who underwent primary, isolated multivessel coronary artery bypass grafting with the left internal thoracic artery, and who received a second arterial conduit (right internal thoracic artery or radial artery, n=5866) or a venous conduit (n=53 566) between 2006 and 2011. Propensity score matching using 34 preoperative characteristics yielded 5813 matched sets. A subgroup analysis compared outcomes between propensity score-matched recipients of a right internal thoracic artery (n=1576) or a radial artery (n=4290).Second arterial conduit use decreased from 10.7% in 2006 to 9.1% in 2011 (P<0.0001). However, receipt of a second arterial conduit was associated with significantly lower mortality (13.1% versus 10.6% at 7 years; hazard ratio, 0.79; 95% confidence interval [CI], 0.72-0.87), and lower risks of myocardial infarction (hazard ratio, 0.78; 95% CI, 0.70-0.87) and repeat revascularization (hazard ratio, 0.82; 95% CI, 0.76-0.88). In comparison with radial artery grafts, right internal thoracic artery grafts were associated with similar mortality rates (right internal thoracic artery 10.3% versus radial artery 10.7% at 7 years; hazard ratio, 1.10; 95% CI, 0.89-1.37) and individual risks of cardiovascular events, but the risk of sternal wound infection was increased (risk difference, 1.07%; 95% CI, 0.15-2.07).Second arterial conduit use in California is low and declining, but arterial grafts were associated with significantly lower mortality and fewer cardiovascular events. A right internal thoracic artery graft offered no benefit over that of a radial artery, but did increase risk of sternal wound infection. These findings suggest surgeons should consider lowering their threshold for using arterial grafts, and the radial artery may be the preferred second conduit.
Team: A Prospective Multi-Centre Cohort Study Of Early Activity And Mobilisation In Icu
Authors: Carol Lynette Hodgson, Sue Berney, Rinaldo Bellomo, Linda Denehy, Megan Harrold, Alisa Higgins, Jeffrey J Presneill, Manoj K Saxena, Elizabeth Skinner, Heidi Buhr, P Young, Stephen Webb
Journal: American Journal of Respiratory and Critical Care Medicine (2013)
Selection Does Not Equate Consumption—Reply
Authors: Bradley P. Turnwald, Danielle Z. Boles, Alia J. Crum
Journal: JAMA Internal Medicine (2017)

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
Adherence to Mediterranean Diet and All-Cause Mortality After an Episode of Acute Heart Failure
Authors: Òscar Miró, Ramon Estruch, Francisco J. Martín-Sánchez, Víctor Gil, Javier Jacob, Pablo Herrero-Puente, Sergio Herrera Mateo, Alfons Aguirre, Juan A. Andueza, Pere Llorens, Héctor Alonso, Marta Fuentes, Cristina Gil, María José Pérez-Durá, Eva Salvo, Rosa Escoda, Carolina Xipell, Carolina Sánchez, Josep M. Gaytan, Antonio Noval, José M. Torres, Maria Luisa López-Grima, Maria Angeles Juan, Amparo Valero, Maria Àngels Pedragosa, Maria Isabel Alonso, Francisco Ruiz, Rodolfo Romero, Roberto Calvache, Carlos Morante, Maria Teresa Lorca, Ana Belen Mecina, Josep Tost, Belén de la Fuente Penco, Antònia López Sánchez, Susana Sánchez, Pascual Piñera, Raquel Torres Garate, Aitor Alquézar, Miguel Alberto Rizzi, Fernando Richard, José María Álvarez Pérez, Maria Pilar López Diez, Javier Lucas, Álex Roset, Esther Rodríguez-Adrada, Guillermo Llopis García, José Manuel Garrido, José Maria Fernández-Cañadas, Víctor Marquina, Inmaculada Jiménez, Patricia Javaloyes, Joaquin Vázquez Alvarez, Ana Alonso Morilla, Andrea Irimia
Journal: JACC Heart Failure (2017)
HBV infection and HCC: the ‘dangerous liaisons’
Authors: Antonio Bertoletti, Patrick T F Kennedy, David Durantel
Journal: Gut (2017)

Long-term relationships are somehow unpredictable. Periods of harmony are often followed by times of conflict with outcomes which are difficult to predict. This precept can apply to the relationship between HBV and human species. HBV acquired at birth or in early childhood establishes lifelong persistent infection in the majority of subjects, which is evolving, and characterised by fluctuations of virological and clinical parameters. The overall impact of these fluctuations in the development of liver fibrosis and hepatocellularcarcinoma has often puzzled clinicians and researchers studying this complex and somewhat fascinating interaction between HBV and our species. An interesting new piece of information, related to this interaction, has now been added, thanks to the work of the group of GA Kim and YS Lim, published in Gut .1 

Let’s try to first summarise the main points of this puzzle. The early phase of the HBV-host relationship is characterised by normal serum alanine aminotransferase (ALT) and high-titre viraemia. This phase has been historically considered as ‘immune tolerant’ (IT) and ‘disease-free’. Based on this clinical categorisation, excluding both immunological and interindividual virus spreading considerations, patients in this disease phase have been excluded from treatment recommendations. This early phase in natural history is then followed by a period of ALT perturbation and fluctuations of viraemia (ie, defined as immune active or HBeAg+/anti-HBe +hepatitis by new European Association for the Study of the Liver nomenclature),2 in which immunological and pathological events within the liver are considered more active and where treatment is recommended.2 

This simplified interpretation has, however, been disputed in recent years initially by work pointing out that the initial phase of HBV disease is not immunologically inert3 and that serum ALT values are a poor surrogate measurement of the strength of anti-HBV immunity.4 

More recently, the belief that events …
G Protein–Coupled Receptors Targeting Insulin Resistance, Obesity, and Type 2 Diabetes Mellitus
Authors: Darren M. Riddy, Philippe Delerive, Roger J. Summers, Patrick M. Sexton, Christopher J. Langmead
Journal: Pharmacological Reviews (2017)

G protein–coupled receptors (GPCRs) continue to be important discovery targets for the treatment of type 2 diabetes mellitus (T2DM). Many GPCRs are directly involved in the development of insulin resistance and <i>β</i>-cell dysfunction, and in the etiology of inflammation that can lead to obesity-induced T2DM. This review summarizes the current literature describing a number of well-validated GPCR targets, but also outlines several new and promising targets for drug discovery. We highlight the importance of understanding the role of these receptors in the disease pathology, and their basic pharmacology, which will pave the way to the development of novel pharmacological probes that will enable these targets to fulfill their promise for the treatment of these metabolic disorders.
Abstract 13842: Association of CHADS2VASc Score and Warfarin Use With Thromboembolic Risk Among HIV-Infected Persons With Atrial Fibrillation
Authors: Katherine H Chau, Rebecca Scherzer, Priscilla Y Hsue, Michael Shlipak
Journal: Circulation (2016)

Introduction: The prevalence of atrial fibrillation in the human immunodeficiency virus (HIV)-infected population is growing, but the association of the CHADS2VASc score with thromboembolic (TE) risk is unknown in this population. Objective: We evaluated the association of the CHADS2VASc score with TE events in HIV patients with atrial fibrillation, and the effectiveness of warfarin for TE prevention. Methods: Within the Veterans Affairs HIV Clinical Case Registry, 914 patients had an atrial fibrillation diagnosis between 1997-2011 with no prior TE events. We compared TE incidence by CHADS2VASc scores, overall and stratified by warfarin use. Using Cox proportional hazards regression, we modeled associations of CHADS2VASc scores and warfarin use with TE risk. Results: At baseline, the number of patients with CHADS2VASc scores of 0, 1, and 2+ were 208, 285, and 421 respectively; 36 patients developed TE events during a median of 3.8 years follow-up. Unadjusted event rates for CHADS2VASc score groups of 0, 1, and 2+ were 5.4, 10.0, and 8.7 per 1000 person years, respectively (hazard ratio [HR]=1.83 [95% confidence interval {CI} 0.71, 4.73] for CHADS2VASc score 1 versus 0, p =0.21; HR=1.43 [95% CI 0.55, 3.69] for CHADS2VASc score 2 or higher versus 0, p =0.46). Warfarin use was significantly associated with increased risk of TE events, even after adjusting for CHADS2VASc scores (HR=2.15 [95% CI 1.05, 4.41], p =0.037). Warfarin use per year of exposure among current users had a HR of 2.64 for TE events (95% CI 1.28, 5.45; p =0.0089). Time-updated warfarin use showed an even stronger association with increased risk of TE events (HR=6.07 [95% CI 2.95, 12.5], p &lt;0.0001). Conclusions: In this national registry of HIV-infected veterans with atrial fibrillation, CHADS2VASc scores were only weakly associated with risk of TE events, and warfarin was not effective at preventing TE events and potentially harmful. These results should raise concerns about the optimal strategy for prevention of TE events among HIV-infected persons with atrial fibrillation.
The periodontal pocket
Authors: Nikolaos Donos
Journal: Periodontology 2000 (2017)

Abstract Periodontal disease is synonymous with the presence of periodontal pockets, and very often the clinical success of periodontal therapy is based on periodontal pocket depth reduction. Therefore, in the fields of periodontology and implant dentistry, significant research effort has been placed on the etiopathogenesis, diagnosis and treatment of periodontal/peri‐implant disease and as a consequence on pocket pathology. In this volume of Periodontology 2000 , the in‐depth reviews include topics ranging from preclinical models, anatomy and structure of tissues, and molecular and bacterial components, to treatments of pockets around teeth and implants. These reviews aim to provide the readers with current and future perspectives on the different areas of research into the periodontal pocket.
Psychiatrist who saw patients after being told to stop practising is struck off
Authors: Clare Dyer
Journal: BMJ (2017)

A former consultant psychiatrist who ignored an order from the Medical Practitioners Tribunal Service to stop practising while under investigation for misconduct has been struck off the UK medical register.

Brian Harris, 77, of south Wales, came under investigation by the General Medical Council in October 2013 after being arrested on suspicion of sexually assaulting male patients. In November 2013 an interim orders panel of the Medical Practitioners Tribunal Service imposed an 18 month suspension on him.

Because his case took years to come to court his suspension was reviewed every few months, and each decision to extend it was communicated to Harris by letter. These letters came with acknowledgment slips, some of which Harris signed and returned.

Harris …
Abstract 14497: Reduction of Atherogenic Lipoprotein (a) and Apolipoprotein B in Humans With the Selective Thyroid Receptor Beta Agonist Vk2809
Authors: Steven L Schoenfeld, Brian Lian, Rochelle Hanley
Journal: Circulation (2016)

Introduction: Thyroid hormones are important modulators of many aspects of lipid homeostasis and metabolism. In humans, activation of the beta isoform of the thyroid hormone receptor (TRβ) has been...
Development and characterization of a pre-clinical model of ovarian carcinoma to investigate mechanisms of resistance to the anti-HER2/neu antibody Herceptin™
Authors: Leopoldo L. Luistro, Christian Tovar, Subal Bishayee, Pranela Rameshwar, Nicholas M. Ponzio, Steve R. Ritland
Journal: Cancer Research (2004)

1205   The HER-2 /neu  ( c-erbB2 ) gene encodes a 185-kDa transmembrane receptor tyrosine kinase that belongs to the epidermal growth factor receptor (EGFR) family, and is overexpressed in 15-30% of breast and ovarian carcinomas. Gene amplification of HER2 is associated with early metastatic relapse and shortened survival in breast cancer patients. Herceptin (trastuzumab) is a humanized monoclonal anti-HER2 antibody approved as a molecularly targeted therapy for metastatic breast cancer. In order to investigate mechanisms of acquired resistance to Herceptin, an SKOV-3 Herceptin-resistant (HR) pre-clinical human ovarian carcinoma model was developed  in vivo . SKOV-3 cells which overexpress the HER2 protein were implanted subcutaneously (sc) into female athymic  nu/nu  mice. Generation of SKOV-3 HR cells was accomplished by passaging “break-through” tumors (initially responded to Herceptin but later lost efficacy) over 3 or 4 rounds of transplantation in naive  nu/nu  mice. SKOV-3 HR cells were selected and sub-cultured  in vitro  in the continuous presence of Herceptin. Anti-proliferative assays ( 3 H-thymidine incorporation, MTT, and Coulter counter cell counts) revealed SKOV-3 HR cells were not sensitive to the effects of Herceptin. The rate of doubling of SKOV-3 HR1 (clone 1) cells in culture is about 1.5 –2x faster than parental SKOV-3 cells. Immunoblot analysis after 48 hrs of incubation with Herceptin exhibited a 59% downregulation of the HER2 protein in SKOV-3 cells. However, no such downregulation of HER2 occurred in SKOV-3 HR1 Herceptin treated cells. Transducers in the HER2 cell signaling pathway such as Akt and MAPK were likewise not downregulated in SKOV-3 HR1 cells. Cell surface HER2 receptor expression was examined by indirect fluorescence staining and FACS analysis. SKOV-3 HR1 cells expressed similar mean fluorescence intensity (MFI) as SKOV-3 cells. After Herceptin treatment for 96 hrs, MFI decreased in SKOV-3 cells by 31%, but was unaffected in SKOV-3 HR1 cells. Reintroduction  in  vivo  of SKOV-3 HR cells in  nu/nu  mice and treatment of established sc tumors with Herceptin over 4 weeks demonstrated no significant antitumor efficacy. SKOV-3 sc tumors were growth inhibited by Herceptin at the end of study (T/C = 50%; p=0.054 vs. vehicle), while SKOV-3 HR1 tumors showed no growth inhibition (T/C = 92%; p=0.734 vs. vehicle). Thus, we have developed SKOV-3 HR clones through  in vivo  selection that still overexpress HER2 but are unresponsive to Herceptin. This model will be used to further investigate potential mechanisms of acquired therapeutic resistance to the anti-HER2/ neu  antibody Herceptin.
MPs demand to know why government restricted meningitis B vaccine to infants under 1
Authors: Abi Rimmer
Journal: BMJ (2017)

MPs are calling on the government to publish a report that sets out why it decided not to offer the meningitis B vaccine to all children up to age 11.

The House of Commons Petitions Committee and Health Committee have demanded that the Department of Health publish the Cost-Effectiveness Methodology for Immunisation Programmes and Procurements (CEMIPP) report, which explains its reasoning for funding immunisation programmes.

Meningitis B vaccination was introduced into the routine immunisation programme for infants aged under 1 in September 2015. But parents whose children had been affected by meningitis B set up a petition calling for all children to …
Abstract B40: A novel activating I1171T ALK mutation in neuroblastoma responds better to ceritinib compare to the first generation inhibitor crizotinib
Authors: Joachim T. Siaw, Jikui Guan, Tommy Martinsson, Magnus Hansson, Per Kogner, Ruth Palmer
Journal: Cancer Research (2017)

Abstract Mutations in the kinase domain of Anaplastic Lymphoma Kinase (ALK) have been suggested to be important players in the genetics and progression of the childhood tumor neuroblastoma. Here we report the appearance of a novel ALK mutation in neuroblastoma together with other chromosomal aberrations that mediate neuroblastoma initiation and progression. Analyses of genomic tumor DNA from biopsy samples initially showed an 11q minus, 17q gain with a mutation of the ALK gene at protein position 1171, which mediate an amino acid change from isoleucine to threonine. We show that mutation of I1171 to threonine generates a potent gain-of-function mutant, as observed in two independent systems. Firstly, in PC12 cell lines expressing ALKI1171T display ligand independent activation of ALK, neurite outgrowth and further downstream signaling activation. Secondly, ALKI1171T meditate foci formation in a NIH3T3 transformation analysis. Finally, pharmacological inhibition of ALKI1171T employing ceritinib, an FDA approved ALK inhibitor show 14-fold better ability to abrogate ALKI1171T compared with crizotinib. Citation Format: Joachim T. Siaw, Jikui Guan, Tommy Martinsson, Magnus Hansson, Per Kogner, Ruth Palmer. A novel activating I1171T ALK mutation in neuroblastoma responds better to ceritinib compare to the first generation inhibitor crizotinib [abstract]. In: Proceedings of the AACR International Conference: New Frontiers in Cancer Research; 2017 Jan 18-22; Cape Town, South Africa. Philadelphia (PA): AACR; Cancer Res 2017;77(22 Suppl):Abstract nr B40.