tbuckley/cabot-search huggingface dataset:
Hope, Optimism, and Compassionate Communication
Authors: Bryan A. Sisk, Jay R. Malone
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
Obesity was associated with worse neurological outcome among Japanese patients with out-of-hospital cardiac arrest
Authors: Makoto Aoki, Shuichi Hagiwara, Kiyohiro Oshima, Masaru Suzuki, Atsushi Sakurai, Yoshio Tahara, Ken Nagao, Naohiro Yonemoto, Arino Yaguchi, Naoto Morimura
Journal: Intensive Care Medicine (2018)
Teaching improvement programme system course (TIPS)
Authors: Venkateswara Rao S Kotamraju
Journal: BMJ (2009)

TIPS is a highly sought after intensive two day course on basic teaching skills. It is run by the Medical Education Unit of Nottingham Medical School and has been popular for the past 12 years; about 950 health professionals have attended the course. TIPS is aimed at all levels of academic and clinical staff, from foundation year 1 doctors to consultants and general practitioners, and it is basically for anyone who is interested in medical education and has a flair for teaching. The course covers various aspects of basic teaching skills using a wide range of clinical and biomedical examples and lays a strong foundation for improving teaching skills. The key learning outcomes covered are:
Siglec genes confer resistance to systemic lupus erythematosus in humans and mice
Authors: Rhonda Flores, Peng Zhang, Wei Wu, Xu Wang, Peiying Ye, Pan Zheng, Yang Liu
Journal: Cellular and Molecular Immunology (2018)

A recent meta-analysis revealed the contribution of the SIGLEC6 locus to the risk of developing systemic lupus erythematosus (SLE). However, no specific Siglec (sialic acid-binding immunoglobulin-like lectin) genes (Siglecs) have been implicated in the pathogenesis of SLE. Here, we performed in silico analysis of the function of three major protective alleles in the locus and found that these alleles were expression quantitative trait loci that enhanced expression of the adjacent SIGLEC12 gene. These data suggest that SIGLEC12 may protect against the development of SLE in Asian populations. Consistent with human genetic data, we identified two missense mutations in lupus-prone B6.NZMSle1/Sle2/Sle3 (Sle1-3) mice in Siglece, which is the murine Siglec with the greatest homology to human SIGLEC12. Since the mutations resulted in reduced binding of Siglec E to splenic cells, we evaluated whether Siglece-/- mice had SLE phenotypes. We found that Siglece-/- mice showed increased autoantibody production, glomerular immune complex deposition and severe renal pathology reminiscent of human SLE nephropathy. Our data demonstrate that the Siglec genes confer resistance to SLE in mice and humans.
AORTIC TORTUOSITY IN BICUSPID AORTIC VALVE AND ITS CORRELATION WITH CLINICAL OUTCOMES
Authors: Bader Aldeen Alhafez, Van T.T. Truong, Sahand Sohrabi, Harleen Sandhu, Anthony L. Estrera, Hazim Safi, Daniel Ocazionez, Siddharth Prakash
Journal: Journal of the American College of Cardiology (2018)
Abstract P6-12-22: Sexual health in long-term breast cancer survivors
Authors: SV Soldera, M Ennis, AE Lohmann, PJ Goodwin
Journal: Cancer Research (2018)

Abstract Background Significant sexual dysfunction is reported in women with breast cancer (BC) in the years following diagnosis. It is unclear whether symptoms persist over time in BC survivors (BCS) as long-term data compared to healthy controls is lacking. We compared sexual functioning in long-term BCS to controls and explored the impact of adjuvant therapy on sexual health. Methods A cohort of women with localized BC recruited from 1989 to 1996 was prospectively followed as previously described. BCS without recurrence and controls without BC were contacted between 2005 and 2007 and answered self-reported quality of life questionnaires. Sexual health was measured with the Sexual Activity Questionnaire (SAQ). Vasomotor, gynecological and bladder symptoms were scored using the Menopausal Symptom Scale (scale ranges 0-4) based on the Breast Cancer Prevention Trial Symptom Checklist. Regression analysis was used to compare groups, with and without adjustment for age (quadratic) and menopausal status. P values &amp;lt;0.05 were considered significant. Results 248 of 285 BCS and 159 of 167 controls completed the SAQ. The median time from diagnosis of BCS was 12.5 years. BCS were slightly older (61.9 vs 59.1 years, p=0.0004) and somewhat more likely to be post-menopausal (94.4 vs 85.5%, p=0.0025) than controls. Overall, fewer BCS were sexually active than controls (45.2 vs 59.7%, p=0.0041). This difference was no longer significant when adjusted for age and menopausal status (odds ratio 0.68, p=0.075). In those sexually active, no significant differences were noted on the SAQ Pleasure and Discomfort scales.Differences in adjuvant treatment were not significantly associated with being sexually active or the SAQ subscales. BCS scored higher (worse) on the gynecological and bladder symptom scale than controls (0.66 vs 0.43, p=0.0036, adjusted difference 0.24, p=0.0029; 0.60 vs 0.41, p=0.02, adjusted difference 0.18, p=0.029 respectively), but no difference was seen in vasomotor scores. Gynecological symptom scores were greatest in BCS who received adjuvant chemotherapy. Conclusion Despite more frequent long-term gynecological and bladder symptoms, sexual health is similar in BCS and controls. Adjuvant chemotherapy is associated with persistent gynecological symptoms and interventions aimed at improving these could improve quality of life. Citation Format: Soldera SV, Ennis M, Lohmann AE, Goodwin PJ. Sexual health in long-term breast cancer survivors [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-12-22.
BMA must “act now” on stress and burnout, say doctors
Authors: Helen Jaques
Journal: BMJ (2013)

Doctors have called on the BMA to provide guidance and training to protect medical professionals from the “catastrophic” effects of stress and burnout.

The BMA’s annual representatives meeting this week heard how, although pressure has always been part of a doctor’s job, levels of stress had become worse over the past two years.

A survey of almost 1000 doctors conducted by the BMA ahead of the meeting found that four in five respondents thought that the level of pressure …
David Haslam, President of the Royal College of General Practitioners and vice chairman of the Academy of Medical Royal Colleges
Authors: Nana Seiwaa Opare
Journal: BMJ (2008)

No one is more surprised by my career than I am. None of it was really planned, but seemed like a series of opportunities disguised as accidents.

It was extraordinarily rare in my time for teachers or trainers to talk about feelings—our feelings. Doctors are members of a caring profession, but that phrase is much more than a cliche. If you care, and if the world is imperfect, then at times you will feel upset, or frightened, or lonely, or puzzled, or tearful, or angry. And no one ever seemed to discuss this, or look at the connected fact that our profession is at the top of the league for marital breakdown, depression, alcoholism, drug misuse, and suicide. It …
68Ga–Prostate-Specific Membrane Antigen Expression in Neurocysticercosis Lesions in a Patient With Prostate Carcinoma
Authors: Shelvin Kumar Vadi, Rajender Kumar, Harmandeep Singh, Shrawan Kumar Singh, Bhagwant Rai Mittal
Journal: Clinical Nuclear Medicine (2018)

Ga-prostate-specific membrane antigen (PSMA) ligand is a well-known tracer used in prostate cancer. Nevertheless, there are reports of unusual Ga-PSMA uptake in variety of benign lesions. We report a case of prostate cancer in which Ga-PSMA PET/CT revealed tracer avidity in the enhancing walls of cystic lesions in the brain consistent with the features of neurocysticercosis. The uptake of Ga-PSMA in neurocysticercosis is not known and may be attributed to angiogenesis occurring at the periphery of these lesions.
Abstract P064: Progression From Prediabetes to Diabetes in Hispanics/Latinos. Results From the Hispanic Community Health Study / Study of Latinos (HCHS/SOL)
Authors: Francisco J Pasquel, Matthew S Loop, Andy Menke, Matthew J O'Brien, Denise C Vidot, Daniela Sotres-Alvarez, Leonor Corsino, Gregory A Talavera, Linda C Gallo, Robert C Kaplan, Neil Schneiderman, Martha L Daviglus, Catherine C Cowie, Larissa Aviles-Santa
Journal: Circulation (2018)

Introduction: There is limited data on longitudinal assessments of diabetes incidence according to baseline glycemic status among Hispanics/Latinos in the US. Hypothesis: We hypothesized that diabetes risk in Hispanics/Latino adults varies by baseline glycemic status. Methods: We examined the progression to diabetes among Hispanic/Latinos enrolled in HCHS/SOL; a population-based longitudinal study of 16,415 individuals of varying Hispanic/Latino background aged 18 - 74. We used Poisson regression models that accounted for the complex sampling strategy in HCHS/SOL to compare the rates of diabetes incidence by baseline prediabetes criteria [impaired glycated hemoglobin (IA1c, 5.7-6.4%), impaired fasting glucose (IFG, 100-125 mg/dl), and impaired glucose tolerance (IGT, 140-199 mg/dl on OGTT)], as well as any of these two criteria, or all prediabetes criteria, compared to normoglycemia. Results: A total of 8014 individuals attended both Visit 1 (2008-2011) and Visit 2 (2014-2017) and were free of diabetes at Visit 1. Persons who developed diabetes were older, had lower education and had higher blood pressure, adiposity (waist circumference, BMI), dyslipidemia, HOMA-IR, and C-reactive protein (all p&lt;0.001). The proportion of participants who developed diabetes on visit 2 varied significantly according to baseline prediabetes categories (IFG 7.4±1.5%, IGT=10.6±2.0%, impaired A1c=9.0±1.1%, two criteria=23.9±1.8%, all prediabetes criteria=43.1±3.7%). After adjusting for potential confounders, including demographics and risk factors for diabetes, meeting more prediabetes criteria was associated with a significantly higher risk of diabetes compared to baseline normoglycemic status, (Table). Conclusions: Diabetes incidence among Hispanic/Latino adults varied markedly by glycemic category at baseline. Each additional criterion of prediabetes magnified in a dose-response relationship the risk of diabetes in this population.
Abstract P5-22-04: Efficacy of thoracic paravertebral block for reducing acute post-mastectomy pain
Authors: F Herazo-Maya, J Egurrola, CE Restrepo, L Torres, L Palacios, CA Ossa, M Borrero, GA Angel, JJ Marquez, S Valencia, A Perez, JC Oyola, L Lobo, R Gomez, H Garcia
Journal: Cancer Research (2018)

Abstract Background: Mastectomy is associated with acute and chronic postoperative pain. This study investigated the efficacy of thoracic paravertebral block (TPB) compared to local anesthetic of surgical wound (LASW) in breast cancer patients undergoing mastectomy. Methods: This phase 3, randomized controlled, single blind, parallel arms and superiority clinical trial aimed to evaluate the efficacy of TPB compared to LASW on acute pain at rest and motion at 24 hours post-mastectomy, measured by a visual analog scale (VAS). The study size of 60 patients is determined to have 90% power to detect a difference of 20% in acute pain in favor of TPB. In TPB group use of ultrasound was mandatory to guide puncture of intervertebral space T3 for infiltrating 0.5% bupivacaine at dose of 1.5 mg/kg. In LASW group was used bupivacaine 0.5% at dose of 1.5mg/kg on subcutaneous tissue of surgical area. VAS was used to measure surgical pain at rest and motion in 2,4,6,12 and 24 hours post-operatives for both groups. Trial Registry: ClinicalTrials.gov; Identifier:NCT02609321. Findings: From 08-2015 to 09-2016, 60 breast cancer patients were enrolled; 3 dropped off consent. Mean age was 51 year; 78% had stage II and III; and 65% receive neoadjuvant chemotherapy.There were no significant differences in the VAS pain measurement for the groups of BWT compared to LASW in the 24 hour measurement, neither at rest (P=0.6525) nor in movement (P=0.7929). There were no significant differences in both groups for repeated pain measurements (5 measures mean), total dose of opioid administration, time to first dose of opioids or adverse events. Conclusions: There were not statistical differences for post-mastectomy acute pain in first 24 hours between TPB and LASW patients. According our findings the use of TPB should not routinely recommended for breast cancer patients undergoing mastectomy. Citation Format: Herazo-Maya F, Egurrola J, Restrepo CE, Torres L, Palacios L, Ossa CA, Borrero M, Angel GA, Marquez JJ, Valencia S, Perez A, Oyola JC, Lobo L, Gomez R, Garcia H. Efficacy of thoracic paravertebral block for reducing acute post-mastectomy pain [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-22-04.
TARGETING THE ACTIVIN TYPE II RECEPTOR PATHWAY FOR HEART FAILURE THERAPY
Authors: Jason D. Roh, Pablo Quintero, Vinita Chaudhari, Ryan Hobson, Ashish Yeri, Mark Benson, Chungyang Xiao, Nicholas Houstis, Colin Platt, Vassilios Bezzerides, Brian R. Lindman, Sammy Elmariah, Robert Gerszten, Estelle Lach-Trifilieff, David Glass, Anthony Rosenzweig
Journal: Journal of the American College of Cardiology (2018)
Ensuring that every post bolsters your specialty training application
Authors: Harriet Julian, Anna Willcock
Journal: BMJ (2014)

All trainees will at some point work in posts that they believe are unrelated to their chosen specialty, and some may also decide to change career route or fail to obtain a training post in their chosen specialty first time round. <b>Harriet Julian</b> and <b>Anna Willcock</b> offer advice on how to make the most of the opportunities within any post
Performance of a clinically validated urine exosome gene expression test to predict high grade prostate cancer in men with a prior negative biopsy.
Authors: Michael Joseph Donovan, Phillipp Torkler, Mikkel Noerholm, Johan Skog, James M McKiernan
Journal: Journal of Clinical Oncology (2018)

119 Background: The over-diagnosis of low grade, indolent prostate cancer (PCa) initiates significant patient anxiety regarding treatment options and health risk. To address this clinical need, we developed and subsequently validated a noninvasive, easy to administer, supportive diagnostic test (ExoDx Prostate(IntelliScore), EPI) to guide the initial prostate biopsy decision process for men with PSA 2-10ng/mL. The EPI test is a urine exosome gene expression assay to discriminate high-grade (GS 7 PCa) from low-grade (GS 6) and benign disease, thereby potentially reducing the number of unnecessary biopsies. As many men have had prior negative/ benign biopsies, we sought to understand the performance of EPI in this selected population. Methods: Utilizing men with prior negative biopsies from two clinical trials we evaluated performance of the EPI test with respect to subsequent biopsy outcomes. We used the previously validated and alternative EPI cut-points of 15.6 and 20, respectively, to assess performance with AUC, sensitivity, and NPV. Results: A total of N = 286 patients with a prior negative biopsy; mean age 65 years, mean PSA 6.2 ng/mL, 22% positive family history, 15% African American; 32% positive biopsy rate: 20% GS6 (ISUP1) and 12% &gt; / = GS7 PCa (ISUP≥2). AUC 0.68 vs. AUC 0.59 for standard of care (i.e. PSA, age, race, family history) and AUC 0.51 for PSA alone. By comparison the EPI initial biopsy AUC was 0.71. Using the previously validated EPI cut-points of 15.6 (or alternative 20) yielded NPVs of 92% and 95%, and number of avoided biopsies of 23% and 32%, respectively, and sensitivity of 85.7% for both cut-points. Notably, EPI in the initial biopsy setting had a sensitivity of 92 vs. 87% and an NPV of 91 vs. 90%, for the 15.6 and 20 cut-points, respectively. Conclusions: The EPI test is a noninvasive, first-catch, non-DRE gene expression array that accurately discriminates low-grade and benign biopsy outcomes from high-grade prostate cancer. The test performs well in both the initial and prior negative biopsy patients and has the potential to reduce the overall number of unnecessary biopsies in both settings.
Abstract #4715: Targeting of L1CAM-mediated EGFR signaling enhances sensitization to chemotherapeutic drugs in chemorefractory cholangiocarcinoma cells
Authors: Hyun-Ho Yoon, Jeong-Ki Min, Jung Whoi Lee, Hyo Jeong Hong
Journal: Cancer Research (2009)

Chemoresistance is an unsolved clinical problem, especially in progressive diseases, thus has been targeted for treatment of tumors. Despite of their significance in cancer therapy, many crucial regulators of chemoresistance have not been identified yet. The present study identified L1CAM as a novel regulator of chemoresistance in cholangiocarcinoma and described its underlying molecular mechanisms. Specifically, we showed that in human cholangiocarcinoma cell lines, long term treatment of chemotherapeutic drug, cisplatin or gemcitabine caused a significant induction of L1CAM  in vitro  and  in vivo . The chemoresistant cells subjected to small interfering RNA (siRNA)-mediated L1CAM knock-down led to resensitization towards treatment with cisplatin. Interestingly, in the chemoresistant cells that exhibited high L1CAM expression, the EGFR was markedly activated  in vitro  and  in vivo , and its activation was reversed by the L1CAM siRNA. Furthermore, down-regulation of EGFR by siRNA and EGFR inhibitor, ZD1839, decreased the drug resistance, leading to increase in cisplatin-induced inhibition of proliferation and apoptosis. The results suggest that L1CAM-mediated chemoresistance depends on EGFR activation. In addition, we showed that L1CAM exerted the chemoresistance at least in part through EGFR-mediated ERK signaling, and increased the expression of Bcl-2 and conversely decreased Bax, resulting in the inhibition of a mitochondrial caspase pathway. Finally, chemotherapeutic drug in combination treatment with anti-L1CAM antibody showed more potent antitumor activity than each alone in nude mice bearing human cholangiocarcinoma xenograft. Taken together, the results suggest that targeting L1CAM may be important for the treatment of patient with chemorefractory cancers.   Citation Information:  In: Proc Am Assoc Cancer Res; 2009 Apr 18-22; Denver, CO. Philadelphia (PA): AACR; 2009. Abstract nr 4715.
A TERTIARY CENTRE EXPERIENCE ON ULTRASOUND-FACILITATED THROMBOLYSIS IN PATIENTS WITH PULMONARY EMBOLISM AT HIGH-RISK OR INTERMEDIATE HIGH-RISK
Authors: Cihangir Kaymaz, Ozgur Akbal, Aykun Hakgor, Fatih Yilmaz, Hacer Tokgoz, Halil Tanboga, Seda Tanyeri, Cem Dogan, Zubeyde Bayram, Sevim Turkday, Durmus Demir, Deniz Acar, Nihal Ozdemir
Journal: Journal of the American College of Cardiology (2018)
Curative intent surgery and associated overall survival variation between elderly and younger patients in the National Cancer Database.
Authors: Eric Anderson, John David, Simon Lo, Nicholas N. Nissen, Andrew Eugene Hendifar, Richard Tuli
Journal: Journal of Clinical Oncology (2018)

373 Background: Margin negative oncologic resection drastically improves survival in pancreatic cancer (PC) with low morbidity and mortality rates. Increasing age at the time of surgery may have an impact on overall survival (OS) in PC. We aimed to describe the likelihood of receiving surgery in elderly patients (EP) compared to younger patients and whether this predicted OS. Methods: Non-metastatic PC patients were identified in the National Cancer Database (NCDB). Baseline demographics, clinical, and pathologic factors were compared between patients older (EP) and younger (YP) than age 75. Kaplan-Meier survival methods were used to describe differences in OS. Cox regression methods were performed to describe the impact of multiple variables on OS. Results: From 2004-2014, there were 39,804 PC patients with median age 69 years (range 19-90) and median follow up 47.2 months. Of 12,337 (31.0%) EPs, 2598 (21.1%) underwent surgery, while 9809 of 27467 YPs (35.7%) underwent surgery (p &lt; 0.001). EP were less likely to receive surgery across clinical stages (CS, p &lt; 0.001): CS 1 - 29.5% EP vs. 55.6% YP, CS 2 - 23.4% EP vs. 40.3% YP, CS 3 - 3.1% EP vs. 7.5% YP. EP receiving surgery were more likely to have baseline medical comorbidities (38.8% vs. 35.9%, (p = 0.065) and less likely to receive chemotherapy (47.4% vs. 73.6%, (p &lt; 0.001). Improvement of median OS was seen in EPs undergoing resection (16.9 months vs. 6.4 months, p &lt; 0.001), as well as YP undergoing resection (22.8 vs. 11.2 months, p &lt; 0.001). Multivariate Cox regression revealed that surgical intervention (HR 0.47, 95% CI 0.45-0.48, p &lt; 0.001) and younger age (0.62, 0.60-0.63, p &lt; 0.001) were highly protective. Patient medical comorbidities (1.15, 1.12-1.18, p &lt; 0.001) and T stage (1.38, 1.31-1.44, p &lt; 0.001) predicted poor OS. Conclusions: EPs with PC are less likely to receive definitive surgical resection in the setting of higher or similar medical comorbidities. EPs are also less likely to receive chemotherapy for their non-metastatic disease. In spite of this, surgery portends a significant increase in median OS for these EPs. Given adequate risk stratification and functional assessment, EPs should be strongly considered for surgical resection.
COMORBIDITIES AND THE DECISION TO UNDERGO OR FOREGO DESTINATION THERAPY LEFT VENTRICULAR ASSIST DEVICE IMPLANTATION: AN ANALYSIS FROM THE DECIDE-LVAD TRIAL
Authors: Haider Warraich, Larry Allen, Laura Blue, Erin Leister, Jocelyn Thompson, Colleen Kelley McIlvennan, Kelsey Flint, Daniel Matlock, Chetan Patel
Journal: Journal of the American College of Cardiology (2018)