tbuckley/cabot-search huggingface dataset:
RESIDUAL INFLAMMATORY AND CHOLESTEROL RISK IN THE FOURIER TRIAL
Authors: Erin Ann Bohula, Robert Giugliano, Lawrence Leiter, Subodh Verma, Jeong-Gun Park, Peter Sever, Armando Lira Pineda, Narimon Honarpour, Huei Wang, Sabina Murphy, Anthony Keech, Terje Pedersen, Marc Sabatine
Journal: Journal of the American College of Cardiology (2018)
Undernutrition risk at hospital admission and length of stay among pulmonology inpatients
Authors: I. Maia, S. Xará, D. Vaz, T. Shiang, T.F. Amaral
Journal: Pulmonology (2018)

There is a lack of evidence regarding the association between the undernutrition risk at hospital admission with adverse clinical outcomes amongst pulmonology inpatients. The aim of this study was to quantify the association between undernutrition risk at hospital admission and time to discharge alive.A retrospective cohort study including patients consecutively admitted to a pulmonology unit was conducted. Undernutrition risk at hospital admission was identified using the Malnutrition Universal Screening Tool. Survival analyses (Kaplan-Meier curves and Cox regression) were carried out.The sample was composed of 683 patients. Patients who presented high undernutrition risk on hospital admission had a longer length of hospital stay (approximately 50% were discharged to home after 14 days of hospitalization). In the multivariable Cox regression, high undernutrition risk was shown to be independently associated with a lower probability of discharge alive over time (adjusted hazard ratio=0.70; 95% confidence interval: 0.55-0.90).Pulmonology inpatients with high undernutrition risk have a longer length of hospital stay and had a lower probability of being discharged to home. In particular, lung cancer patients had a lower probability of being discharged to home, which corroborates a worse prognosis for these patients.
Crown lengthening and restorative procedures in the esthetic zone
Authors: Matteo Marzadori, Martina Stefanini, Matteo Sangiorgi, Ilham Mounssif, Carlo Monaco, Giovanni Zucchelli
Journal: Periodontology 2000 (2018)

Abstract Crown lengthening is one of the most common surgical procedures in periodontal practice. Its indications include subgingival caries, crown or root fractures, altered passive eruption, cervical root resorption and short clinical abutment, and its aim is to re‐establish the biologic width in a more apical position. While the procedure in posterior areas of the dentition has been thoroughly investigated, crown lengthening performed for esthetic reasons in the anterior areas is still a matter of debate and an evidence‐based technique is not available. This paper provides accurate descriptions of the surgical and restorative phases of the esthetic crown‐lengthening procedure by answering the following questions: what is the ideal surgical flap design? how much supporting bone should be removed? how should the position of the flap margin relate to the alveolar bone at surgical closure? and how should the healing phase be managed in relation to the timing and the position of the provisional restoration with respect to the gingival margin?
Microneedle-based device for the one-step painless collection of capillary blood samples
Authors: Timothy M. Blicharz, Ping Gong, Bernard M. Bunner, Larry L. Chu, Kaela M. Leonard, Jessica A. Wakefield, Richard E. Williams, Maisam Dadgar, Carlo A. Tagliabue, Ragheb El Khaja, Stephanie L. Marlin, Ramin Haghgooie, Shawn P. Davis, Donald E. Chickering, Howard Bernstein
Journal: Nature Biomedical Engineering (2018)
The Efficacy and Safety Analysis of Carbopratin and Paclitaxel Therapy for Patients with Inoperable, Recurrent or Refractory Adenocarcinoma of the Head and Neck
Authors: T. Uomori, M. Yokoyama, E. Nara, K. Nakano, K. Ueda, N. Nishimura, S. Sakajiri, Y. Mishima, Y. Terui, S. Takahashi
Journal: Annals of Oncology (2012)
IMPACT OF AORTIC PULSATILITY RATIO AND DOUBLE PRODUCT ON INDICES OF FUNCTIONAL CORONARY STENOSIS SEVERITY IN PATIENTS UNDERGOING CORONARY INTERVENTION
Authors: Azra Mahmud, Elenezi Amirah, Mohammad Balghith, Kamal Ayub, Basil T. Saeed, Dikra Al Dobai, Majed Alshammary, Bandar Al Haddadi, Ali Alghamdi
Journal: Journal of the American College of Cardiology (2018)
Clinical prognostic impact of depth and pattern of CA19-9 response at 8 weeks of 1<sup>st</sup> line gemcitabine based chemotherapy in metastatic/unresectable pancreatic adenocarcinoma.
Authors: In-Ho Kim, Eun-gyo Jeong, Jae kyun Jeong, Myung Ah Lee
Journal: Journal of Clinical Oncology (2018)

230 Background: To evaluate the prognostic impact of depth and pattern of carbohydrate antigen (CA19-9) response at 8 weeks of first-line gemcitabine based chemotherapy in metastatic/unresectable pancreatic adenocarcinoma. Methods: We retrospectively analysed 183 patients who received first-line palliative gemcitabine based chemotherapy. The patients were stratified into 4 groups according to CA19-9 response: group A was defined as above 50% decrease, group B was below 50% decrease, group C was below&lt;50% increase, and group D was above 50% increase in CA19-9 levels. Overall survival (OS) and progression-free survival (PFS) were compared according to CA19-9 response. Results: The CA19-9 response at 8 weeks after gemcitabine based chemotherapy was significantly associated with OS and PFS (median OS and PFS: 13.2 and 6.7[group A], 10.2 and 5.4[B], 6.5 and 3.8[C], and 3.5 and 1.8[D] months, respectively; all P&lt;0.001). For responding group (A&amp;B), group A showed better OS and PFS than group B (all P&lt;0.001). For non-responding group (C&amp;D), group D showed poorer OS and PFS than group C (all P&lt;0.001). In radiologic responding group, complete and partial response by RECIST, group A&amp;B showed better OS and PFS than group C&amp;D (OS,P=0.001; PFS,P=0.003). Moreover, group A had better survival outcome than group B (OS, 14.5[A] vs 11.6[B] months,P=0.011; PFS, 8.6[A] vs 5.6[B] months,P=0.025). In stable or progressive disease by RECIST, OS was significantly prolonged in group A&amp;B than group C&amp;D (OS, 6.5 vs 3.7 months,P=0.038). Group D showed poorer OS than group C (OS, 4.2 vs 2.3 months,P=0.027). The CA19-9 response was a powerful prognostic factor for all patients in responding and non-responding by RECIST. Conclusions: The depth of CA19-9 response at 8 weeks of 1 st line gemcitabine based chemotherapy can be a powerful prognostic factor in pancreatic cancer. It also can be a prognostic factor in patients with same response on imaging study by RECIST.
Phase II study of sequential first-line pazopanib (PAZ) followed by everolimus (EVE) in patients (pts) with advanced or metastatic renal cell carcinoma (RCC) (CATChEz Study).
Authors: Paul L. de Souza, Shirley Wong, Sanjeev Sewak, Dusan Kotasek, Bhumsuk Keam, Jinsoo Chung, Noelle Erbeck, Jackie Han, Luca Dezzani, Qasim Ahmad, Paul N. Mainwaring
Journal: Journal of Clinical Oncology (2018)

648 Background: EVE following failure of sorafenib or sunitinib for RCC was first approved by the FDA in 2009. CATChEz (NCT01545817) was designed to test the activity of EVE following first-line PAZ in pts with advanced or metastatic RCC who had not received prior systemic therapy. Methods: From 2012 to 2016, pts received first-line PAZ followed by EVE until progressive disease (PD), death, unacceptable toxicity, consent withdrawal, or study termination. Pts with PD during or within 6 months of stopping PAZ were eligible for EVE. Pts off study treatment were evaluated for PD, survival, and updates on anticancer treatment every 8 weeks until death or end of study. The primary efficacy endpoint was median progression-free survival (mPFS) for the second-line EVE treatment period; secondary endpoints included other survival measures, and safety evaluations were for second-line EVE and grade 3/4 toxicities attributable to PAZ and EVE. Results: Of 74 pts who started first-line PAZ, 38 received ≥1 dose of second-line EVE. The primary endpoint of mPFS from the start of second-line EVE and the secondary endpoint of mPFS with first-line PAZ (Table) were consistent with previous reports; no unexpected adverse events (AEs) were reported. All pts had ≥1 treatment-emergent AE, 83.8% had grade ≥3 AEs, and 71.6% had serious AEs. Of 34 total deaths, 29 were due to PD and 5 were due to AEs (2 related to EVE [lower respiratory tract infection; pulmonary sepsis]; 3 unrelated to study treatment). Conclusions: Efficacy and safety outcomes were consistent with published phase III data. The CATChEz study supports sequential first-line use of PAZ followed by EVE for the treatment of pts with advanced or metastatic RCC. Clinical trial information: NCT01545817. [Table: see text]
IS GREED GOOD? Looking to the future
Authors: Anne M Rothery
Journal: BMJ (2007)

We welcome your rapid responses, whether in direct response to an article in Career Focus or as a way of sharing your own ideas. As long as it isn9t libellous or offensive, we9ll post it on our website. We print a selection of rapid reponses here and the writer of the best each month wins an <i>Oxford Handbook</i> of their choice. Letter of the month prize is donated by OUP.
Overall survival in a trial of orally administered CCR2 inhibitor CCX872 in locally advanced/metastatic pancreatic cancer: Correlation with blood monocyte counts.
Authors: David Linehan, Marcus Smith Noel, Aram F. Hezel, Andrea Wang-Gillam, Ferry Eskens, Stefan Sleijfer, Ingrid M.E. Desar, Frans Erdkamp, Johanna Wilmink, Janet Diehl, Antonia Potarca, Niky Zhao, Shichang Miao, Jun Deng, Jan Hillson, Pirow Bekker, Thomas J. Schall, Rajinder Singh
Journal: Journal of Clinical Oncology (2018)

92 Background: The CCL2-CCR2 signaling axis may facilitate migration of myeloid derived suppressor cells to pancreatic cancer resulting in an immune suppressive tumor microenvironment. CCR2 inhibition in patients with non-metastatic pancreatic cancer was previously reported to decrease tumor-infiltrating macrophages/Treg cells and increase effector T cells (Nywening et al, 2016). Here, a CCR2 specific antagonist CCX872 was used in combination with FOLFIRINOX to treat subjects with locally advanced or metastatic, non-resectable pancreatic cancer in a multi-center study. Methods: Fifty subjects (ECOG score ≤ 2) were enrolled, receiving FOLFIRINOX (fluorouracil [5-FU], leucovorin, irinotecan, oxaliplatin) once every two weeks (maximum 12 cycles) plus 150 mg CCX872 QD or BID for 12 weeks. Subjects showing at least stable disease at the end of the 12-week treatment period were eligible to CCX872 treatment until disease progression. In this ongoing study, all subjects are followed for overall survival (OS). Blood samples were taken at baseline and at intervals throughout the active treatment period for hematologic and flow cytometric analysis of circulating immune cell populations. Results: The all-subjects OS at 18 months is 29%. This compares favorably with previously published data: i.e., OS of only 18.6% at 18 months for FOLFIRINOX regimen alone (Conroy et al, 2011). Peripheral blood monocyte counts at baseline inversely correlate with OS (p = 0.0071, Hazard ratio = 1.169) with CCX872 and FOLFIRINOX combination therapy. Overall, circulating monocytes, inflammatory monocytes and monocytic myeloid derived suppressor cells were reduced by treatment. Conclusions: CCX872-B plus FOLFIRINOX resulted in an OS of 29% at 18 months with no safety issues. Better OS was associated with lower peripheral blood monocyte counts at baseline. Clinical trial information: NCT02345408.
PATIENT RISK FACTORS FOR BIOPROSTHETIC AORTIC VALVE DEGENERATION: A SYSTEMATIC REVIEW AND META-ANALYSIS OF 26,135 BIOPROSTHETIC AORTIC VALVE IMPLANTS
Authors: Ayame Ochi, Kevin Cheng, Bing Zhao, Ashutosh A. Hardikar, Kazuaki Negishi
Journal: Journal of the American College of Cardiology (2018)
Most doctors say their trust uses locums to plug rota gaps, BMA survey finds
Authors: Abi Rimmer
Journal: BMJ (2015)

Two thirds of hospital doctors say that their trust has relied on locums to fill gaps in their rotas, a BMA survey shows.

The BMA’s ninth cohort survey questioned 430 doctors who had graduated in 2006 about their career paths, of whom 375 responded. When asked about the effect of gaps in rotas, 68% of the hospital doctors who responded said that the trust they worked for generally relied …
Certificate in ultrasound from the Faculty of Sexual and Reproductive Healthcare
Authors: Deepa Jacob
Journal: BMJ (2008)

This certificate is curriculum based and has theoretical and practical components. It is a special skills module of the Faculty of Sexual Health and Reproductive Healthcare.

The certificate is aimed at doctors, nurses, and midwives who have already acquired an acceptable qualification and are working in contraception and reproductive health care. The trainees must be fully registered with the General Medical Council/Nursing and Midwifery Council and be working in sexual and reproductive health, obstetrics and gynaecology, primary care, or any other specialty related to women’s health care.

April 2008, towards the end of my fixed term specialty training appointment 2 post in …
I would like to specialise in paediatric surgery. Are there any exams that I need to take before securing a senior house officer post in this field? Also, I qualified in South Africa—do I need to follow any extra procedures?
Authors: Evelyn Ong
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>
PRESENTATION, THERAPY, AND OUTCOMES OF PATIENTS WITH MASSIVE PULMONARY EMBOLISM IN THE MODERN ERA
Authors: Eric Secemsky, Yuchiao Chang, C. Charles Jain, Joshua A. Beckman, Jay S. Giri, Michael Jaff, Kenneth Rosenfield, Rachel Rosovsky, Christopher Kabrhel, Ido Weinberg
Journal: Journal of the American College of Cardiology (2018)
SAS doctors condemn cuts to career development funding
Authors: Helen Jaques
Journal: BMJ (2013)

Staff, associate specialist, and specialty (SAS) doctors have called on Health Education England to ensure that recurrent funding is available across England for continuing professional development.

Representatives at the BMA’s annual SAS doctors conference heard how development funding for SAS doctors has been cut or is being cut across England. Kent, Surrey, and Sussex Deanery; West Midlands Deanery; and North Western Deanery …
SECONDHAND SMOKE IS LINKED TO HIGHER RISK OF NON-CARDIOVASCULAR MORTALITY BUT NOT OF CARDIOVASCULAR MORTALITY IN COMMUNITY-DWELLING OLDER ADULTS: FINDINGS FROM CARDIOVASCULAR HEALTH STUDY (CHS)
Authors: Amiya Ahmed, Evangelos Kanonidis, Apostolos Tsimploulis, Poonam Bhyan, Phillip Lam, Daniel Dooley, Marc Blackman, Charity Morgan, Prakash Deedwania, Gregg C. Fonarow, Javed Butler, Richard M. Allman, Wilbert Aronow, Ali Ahmed
Journal: Journal of the American College of Cardiology (2018)
GMC hails “historic” changes to governing council
Authors: Helen Jaques
Journal: BMJ (2012)

The General Medical Council will appoint its next chair through an open application system rather than by electing the chair from the council’s membership.

This change, described as “historic” by the GMC’s chief executive, Niall Dickson, will increase the openness and transparency of the recruitment process, enable the council to seek applicants from a much wider field, and help ensure that people with the specific qualities needed to chair the council can be appointed.

The GMC’s governing council will also halve …
Basophil FcɛRI expression is linked to time to omalizumab response in chronic spontaneous urticaria
Authors: Gustavo Deza, Marta Bertolín-Colilla, Silvia Sánchez, Dulce Soto, Ramon M. Pujol, Ramon Gimeno, Ana M. Giménez-Arnau
Journal: Journal of Allergy and Clinical Immunology (2018)
Utility of lymph node dissection for clinical node negative upper tract urothelial cell carcinoma: A multicenter study.
Authors: Zachary Hamilton, Miki Haifler, Laura-Maria Krabbe, Timothy N Clinton, Daniel Han, Stephen Ryan, Madhumitha Reddy, Charles Field, Aaron Bloch, Fang Wan, Robert Uzzo, Vitaly Margulis, Ithaar Derweesh
Journal: Journal of Clinical Oncology (2018)

474 Background: Upper tract urothelial cell carcinoma (UTUC) is an uncommon malignancy with disparate outcomes. Although use of lymph node dissection (LND) for urothelial cell carcinoma of the bladder has survival benefit even in setting of negative nodal status, therapeutic benefit of LND in the setting of clinical node negative disease for UTUC is unclear. We evaluated survival outcomes for UTUC after LND. Methods: Multicenter retrospective analysis of UTUC patients undergoing nephroureterectomy (NU) for clinical node negative, non-metastatic disease from 2001-2016 (cTis/1-T3N0M0). The cohort was divided based on pathologic lymph node status (pNx, pN0, and pN+). Primary outcome was overall survival (OS). Secondary outcome was recurrence free survival (RFS). Cox regression (CR), logistic regression (LR) and Kaplan−Meier (KMA) analyses were utilized. Results: 191 patients were analyzed (mean age 71.1 years, mean follow up 30.4 months, 27% ureteral location). LND was performed in 40.8% (78) and pN+ was noted in 11.0% (21). Mean number of nodes removed for pN0 = 6.6 and pN+ = 3.9 (p = 0.22). On CR for worsened all-cause mortality, significance was noted for ≥pT2 (OR 1.9, p = 0.031), recurrence (OR 2.3, p = 0.003), and pN+ (OR 2.8, p = 0.004). On KMA, 5 year OS stratified by pathologic node status and nuclear grade (grade 1-2 = LG; grade 3-4 = HG) noted negative survival effect associated with pN+ and HG disease (pN0 LG 85.7%, pN0 HG 41.2%, pNx LG 58.1%, pNx HG 51.1%, pN+ HG 10.7%, log-rank p &lt; 0.001). No patient with pN+ had LG disease. On LR HG disease was predicted only by increasing clinical tumor size (OR 1.3, p = 0.032). No significant difference in complications was noted between the groups (p = 0.1). Conclusions: In clinical node negative disease, LND for UTUC did not have survival benefit; however, LND for UTUC provided prognostic information without significantly increasing risk of complications. Finding of pN+ disease was associated with worsened prognosis. LND may be omitted in LG disease yet should be considered in patients with HG disease and increasing tumor size. Further investigation is requisite.
Anti-tumor efficacy of hyaluronan-based nanoparticles for the co-delivery of drugs in lung cancer
Authors: Victor Jeannot, Cony Gauche, Silvia Mazzaferro, Morgane Couvet, Laetitia Vanwonterghem, Maxime Henry, Chloé Didier, Julien Vollaire, Véronique Josserand, Jean-Luc Coll, Christophe Schatz, Sébastien Lecommandoux, Amandine Hurbin
Journal: Journal of Controlled Release (2018)
Is it possible for a doctor to work in public or international relations?
Authors: Tim Albert
Journal: BMJ (2005)

Have 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.
NATIONWIDE HOSPITAL OUTCOMES OF TIMED PERCUTANEOUS CORONARY INTERVENTION IN OCTOGENARIANS
Authors: Armaghan Y. Soomro, Saqib Abbasi, Tahir Khan, Muhammad Rehan Raza, Victoria Teslova, Ruben Kandov, Gregory Maniatis, James Lafferty, Cindy Grines
Journal: Journal of the American College of Cardiology (2018)
GP training in Denmark
Authors: Mette Rimmen
Journal: BMJ (2005)

In Denmark, we graduate from medical school after six years of study. Then we have 18 months of internship, which includes six months as a general practitioner.

GP training has recently been increased from three and a half years to five years of education. This comprises two and a half years of clinical work with three different general practitioners and two and a half years working in …
An Autoimmune Basis for Raynaud's Phenomenon
Authors: D. P. Ascherman, Y. Zang, I. Fernandez, E. S. Clark, W. N. Khan, L. Martinez, E. L. Greidinger
Journal: Arthritis & Rheumatology (2018)

Objective Raynaud's phenomenon (RP) is common in anti‐RNP–positive patients with rheumatic diseases but is not itself known to be caused by autoimmunity. The aim of this study was to assess autoantibodies that could mediate this process. Methods Antibodies derived from patient sera and from murine models of anti‐RNP autoimmunity were screened for the ability to induce RP‐like tissue ischemia and endothelial cell apoptosis in murine models and in vitro systems. Results RNP‐positive sera from RP patients and murine sera from RNP‐positive B cell adoptive transfer recipients induced RP‐like tissue ischemia and endothelial cell apoptosis. Proteomic analysis identified cytokeratin 10 (K10) as a candidate autoantigen in RP. Monoclonal anti‐K10 antibodies reproduced patterns of ischemic tissue loss and endothelial cell apoptosis; K10 knockout or depletion of anti‐K10 activity in serum was protective. Cold exposure enhanced K10 expression and in vivo tissue loss. Conclusion Anti‐K10 antibodies are sufficient to mediate RP‐like ischemia in murine models and are implicated in the pathogenesis of RP in patients with anti‐RNP autoimmunity.
Editor’s Choice: Untangling the strands
Authors: Tom Moberly
Journal: BMJ (2015)

Two articles in BMJ Careers this week look at initiatives designed to help doctors understand the health service by untangling the intertwined local and national strands of NHS culture, politics, and organisations.

Umesh Dashora and Subir Mukherjee (http://careers.bmj.com/careers/advice/SAS\_doctors\_are\_unaware\_of\_training\_opportunities) look at the issues concerning the training needs of specialty and associate specialists and the failure of many of …
How do I start general practice training? In a month I will be fully registered with the General Medical Council. Will it be easier to search for a vocational scheme or individual posts at senior house officer level?
Authors: Adam Sandell
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>