tbuckley/cabot-search huggingface dataset:
The identification and validation of novel aptamers for the diagnosis of oligodendroglioma
Authors: Catherine Coxon, Jane Alder, Lisa Shaw, Clare Lawrence
Journal: Neuro-Oncology (2018)

Oligodendroglioma account for nearly 12% of brain tumours (Jain et al., 2017). In the United Kingdom, 0.4 people per 100 000 per year are newly diagnosed with oligodendroglioma (Crocetti et al., 2012). Early diagnosis and treatment of oligodendroglioma is essential as patients given the appropriate chemotherapy survive on average nearly 8 years longer than patients given radiotherapy alone (Cairncross et al., 2014). Aptamers are short, single-stranded nucleotide sequences (DNA or RNA) that uniquely fold to form specific recognition molecules that selectively bind to a molecular target. Aptamers against targets are generated using a process called systematic evolution of ligands by exponential enrichment (SELEX). Since 2002, a number of aptamers have been identified that can selectively identify cancerous cells. These aptamers have been used both diagnostically and therapeutically against a range of different cancers, however, there are currently no aptamers specific to glioma tissue. This first part of this project was to find aptamers specific to the grade IV glioblastoma cell line U87MG. Previous studies have found aptamers that were able to distinguish U87MG from non-malignant cell lines but showed good binding to most highly tumorigenic cell lines (Cerchia et al., 2009; Aptekar et al., 2015). To ensure that highly specific aptamers were identified, a large number of negative controls were utilised, and two variants of the SELEX process were undertaken to ascertain whether the negative controls had to be selected against individually or if they could be pooled. Patient brain tumour samples will be obtained from the Brain Tumour North West (BTNW) tissue bank and aptamers specific to oligodendroglioma will be selected. These aptamers will be used to screen patient samples to determine if they can identify oligodendroglioma tissue and be of use diagnostically, therapeutically and as a drug delivery tool.
Health department must improve “trustworthiness” of seven day service data, Statistics Authority says
Authors: Abi Rimmer
Journal: BMJ (2016)

The Department of Health for England should improve the “trustworthiness, quality, and value” of the data it produces on seven day services, the UK Statistics Authority has said.

The authority’s director general for regulation, Ed Humpherson, wrote to the health department on 1 November after receiving a query from a member of the public about a speech made by the health secretary, Jeremy Hunt, at the Conservative Party’s conference on 4 October.1

In his speech Hunt said that “just one in 20 hospitals” were meeting a target to have highly vulnerable patients checked by a …
BMA secures protection for added years pensions
Authors: Helen Jaques
Journal: BMJ (2012)

The BMA has secured protection for members of the NHS pension scheme who pay “extra years” if they fall short of the full 40 years of contributions. Having sought legal advice after a challenge from the BMA, the Department of Health has agreed that added years contracts should not be varied or stopped as part of the wider changes planned for the NHS pension scheme from 2015.

“These are …
What postgraduate diplomas will help me to get a training post in clinical radiology?
Authors: Alan Denison
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 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. <b>www.bmjcareers.com/advicezone</b>
Pharmacogenetics and the Promise of Personalized Medicine
Authors: Marc S. Sabatine
Journal: JAMA Cardiology (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 Cardiology 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 Cardiology journal
The importance of non-regional lymph nodes in assigning risk in primary metastatic prostate cancer.
Authors: Noel Clarke, Adnan Ali, Hitesh Mistry, Alex Hoyle
Journal: Journal of Clinical Oncology (2018)

227 Background: Patients diagnosed with non-regional lymph nodes (NRLN) in isolation exhibit a more prolonged clinical course than those with bone or visceral metastases in trial data, but evaluation of survival data in general populations is sparse and their presence doesn’t feature in risk estimations based on tumour volume. Methods: The evaluation and prognostic relevance of NRLN metastasis presenting synchronously with osseous or non-ossesous metastasis in hormone-naive prostate cancer was evaluated using the Surveillance, Epidemiology and End-results (SEER) database. Patients with stage M1a-c PCa diagnosed between 2004 and 2009 were identified and included within the analysis. Kaplan Meier was used to estimate overall (OS) and cancer specific survival (CSS) rates in relation to metastatic distribution. Multivariate cox-regression models were used to identify predictors of OS and CSS. Results: Of 4869 metastatic PCa patients identified, osseous metastasis was the most common finding (65.1%); followed by non-osseous (17.5%), osseous + NRLN (7.8%), NRLN (4.9%), non-osseous + osseous (±NRLN) (2.9%) and non-osseous + NRLN (1.8%). Median follow-up was 93 mo. Median OS and CSS were 28 and 34 mo respectively. Patients with osseous + NRLN metastasis had a significantly worse median OS (30 mo vs 25 mo, p = 0.001) and CSS (37 mo vs 29 mo, p &lt; 0.001) compared to osseous only metastasis. On multivariate cox regression, osseous + NRLN metastasis was an independent predictor of OS and CSS when compared to osseous only metastasis (both p-values &lt; 0.01). Conclusions: NRLN metastasis in the presence of osseous metastasis represents a poor prognostic feature when compared to osseous metastasis alone. The current therapeutic stratification of “low vs high volume” disease does not account for this phenomenon and patients requiring aggressive therapy may not receive maximal therapeutic benefit as a consequence.
Robotic-assisted (RAMIE) x thoracoscopic esophagectomy (MIE): Comparison on safety and lymph nodal dissection in 181 cases.
Authors: Rubens Antonio Aissar Sallum, Flavio Roberto Takeda, Marco Aurelio Santo, Ivan Cecconello
Journal: Journal of Clinical Oncology (2018)

150 Background: Robotic-assisted esophagectomy (RAMIE) gained evidence among the major oncological procedures due possibilities on lymph nodal dissection. The concept of esophagectomy and extensive lymphadenectomy with low morbidity boosted by the videothoracoscopic esophagectomy(MIE) is now focused on the robotic approach. Methods: The first 37 cases of RAMIE were studied. The thoracic field performed in the prone position with three robotic arms and abdominal field idem, as performed in the upper GI robotics procedures. Conversion to open or laparoscopic procedures, morbidity and mortality as well as the length of the lymphadenectomy were evaluated. These data were compared to the first 154 cases of MIE operated by the same surgical team in those early results. Also the late survival of the MIE group is presented. Results: All except 2 RAMIE cases were Siewert I or II Adenocarcinoma, 32 post neoadjuvancy: MAGIC (7) or CROSS (25). There was no conversion to lap or open procedures. No patient received blood transfusion. One complication was observed: a partial rotation of gastroplasty in the thorax, that required thoracoscopic approach in the day 7. Mortality (90 days) was zero. Mean resected lymph nodes was 42.5 (30-76). In the MIE group, complications were: respiratory (26.2%), infectious (8.4%), cervical fistula (17.7%), vocal cord palsy (8.4%). 30 and 90 days mortality were one (0.93%) and 3 (2.8%). Mean dissected lymph nodes = 31.6 (± 14.3), 1:57 positives (± 3.21) and RAD 00:05 (± 0:09). The overall five-year survival was 69% (95% CI: 57% - 83%), 75% in stage 0 / I / II and 42% in III/IV. Conclusions: RAMIE with these technical proposal, seams to be safe without mortality. Lymph nodal achieved was equal to greater than the practiced through MIE. After those cases we started a randomized prospective trial on this issue (NCT02292914).
NHS Employers calls for an end to incremental pay increases for consultants and junior doctors
Authors: Abi Rimmer
Journal: BMJ (2015)

NHS Employers wants to bring an end to incremental pay increases for consultants and junior doctors.

The organisation set out this proposal in its submission of evidence to the Review Body on Doctors’ and Dentists’ Remuneration.1 Negotiations on contracts for consultants in England and Northern Ireland and for junior doctors across the United Kingdom were referred to the review body in October 2014 after talks between the BMA and NHS Employers stalled.2

Under the current contract, consultants’ pay increases incrementally …
Mortality Rates After the First Diagnosis of Psychotic Disorder in Adolescents and Young Adults
Authors: Gregory E. Simon, Christine Stewart, Bobbi Jo Yarborough, Frances Lynch, Karen J. Coleman, Arne Beck, Belinda H. Operskalski, Robert B. Penfold, Enid M. Hunkeler
Journal: JAMA Psychiatry (2018)

Individuals with psychotic disorders have increased mortality, and recent research suggests a marked increase shortly after diagnosis.To use population-based data to examine overall and cause-specific mortality after first diagnosis of a psychotic disorder.This cohort study used records from 5 integrated health systems that serve more than 8 million members in 5 states. Members aged 16 through 30 years who received a first lifetime diagnosis of a psychotic disorder from September 30, 2009, through September 30, 2015, and 2 comparison groups matched for age, sex, health system, and year of diagnosis were selected from all members making an outpatient visit (general outpatient group) and from all receiving a first diagnosis of unipolar depression (unipolar depression group).First recorded diagnosis of schizophrenia, schizoaffective disorder, mood disorder with psychotic symptoms, or other psychotic disorder in any outpatient, emergency department, or inpatient setting.Death within 3 years after the index diagnosis or visit date, ascertained from health system electronic health records, insurance claims, and state mortality records.A total of 11 713 members with first diagnosis of a psychotic disorder (6976 [59.6%] men and 4737 [40.4%] women; 2368 [20.2%] aged 16-17 and 9345 [79.8%] aged 18-30 years) were matched to 35 576 outpatient service users and 23 415 members with a first diagnosis of unipolar depression. During the year after the first diagnosis, all-cause mortality was 54.6 (95% CI, 41.3-68.0) per 10 000 in the psychotic disorder group compared with 20.5 (95% CI, 14.7-26.3) per 10 000 in the unipolar depression group and 6.7 (95% CI, 4.0-9.4) per 10 000 in the general outpatient group. After adjustment for race, ethnicity, and preexisting chronic medical conditions, the relative hazard of death in the psychotic disorder group compared with the general outpatient group was 34.93 (95% CI, 8.19-149.10) for self-inflicted injury or poisoning and 4.67 (95% CI, 2.01-10.86) for other type of injury or poisoning. Risk of death due to heart disease or diabetes did not differ significantly between the psychotic disorder and the general outpatient groups (hazard ratio, 0.78; 95% CI, 0.15-3.96). Between the first and third years after diagnosis, all-cause mortality in the psychotic disorder group decreased from 54.6 to 27.1 per 10 000 persons and injury and poisoning mortality decreased from 30.6 to 15.1 per 10 000 persons. Both rates, however, remained 3 times as high as in the general outpatient group (9.0 per 10 000 for all causes; 4.8 per 10 000 for injury or poisoning).Increases in early mortality underscore the importance of systematic intervention for young persons experiencing the first onset of psychosis. Clinicians should attend to the elevated suicide risk after the first diagnosis a psychotic disorder.
Apatinib in combination with S-1 as first-line treatment in patients with advanced gastric cancer: A phase II clinical trial.
Authors: Chuantao Zhang, Zimin Liu, Na Zhou, Jianli Zhang, Jingjuan Zhu, Hongying Lv, Tianjun Li, Helei Hou, Dong Liu, Jing Cong, Man Jiang, Kewei Liu, Zhumei Cui, Yanbing Zhou, Xiaochun Zhang
Journal: Journal of Clinical Oncology (2018)

71 Background: Apatinib is a standard therapy for advanced gastric cancer in third-line setting. However, the efficacy and safety of apatinib plus S-1 as first-line therapy is unknown. Here, we conducted a single center study to evaluate the efficacy and safety of it. Methods: In this phase II trial, chemotherapy-naive patients with advanced gastric cancer were enrolled between August 24, 2016 and Sept 25, 2017, at a single centers in P.R. China. The patients enrolled were assigned to S-1 plus apatinib, S-1 (40 mg m-2 depending on patient's body surface area) was given orally, twice daily for 2 consecutive weeks, followed by a 1-week rest period, and apatinib 500 mg was given once daily, every 3-week cycle. The primary endpoint was overall survival(OS). Secondary endpoints were progression-free survival(PFS), time to progress (TTP), objective response rate (ORR) and safety. On disease progression, patients had the option to receive single-agent apatinib every 3 weeks.This trial is registered with ClinicalTrials.gov , number NCT02525237. Results: Thirty eligible patients, median age 63 years (range 40-76) and median performance status 1 (ECOG 0-2) ,were enrolled, 9 patients have no evaluation or withdrew consent. Therefore, of the 21 patients the median PFS and TTP were 5.34±1.83 months [1.76–8.92] and 1.34±0.08 months[1.18–1.51], respectively. Additionally, one(4.76%) patient had a complete response, one (4.76%)patients had partial responses, 11 patients had stable disease, and 9 patients had progress of disease. The objective response rate(ORR)and the disease control rate(DCR) were 9.52%(2/21) and 57.14%(12/21),respectively. Until Sept 25.2017,the primary endpoint(OS) had not been reached. We recorded grade 3 or 4 adverse events including elevated bilirubin and/or transaminase, fatigue, abdominal pain, thrombocytopenia,et al. There were no treatment-related deaths. Conclusions: First-line chemotherapy with S-1 plus apatinib in patients with advanced gastric cancer did not reach its primary objective. However, it holds promise of becoming a standard first-line treatment for patients with advanced gastric cancer. Clinical trial information: NCT02525237.
Obstetrics and gynaecology faces oversupply of over 600 consultants, CFWI warns
Authors: Abi Rimmer
Journal: BMJ (2015)

By 2028 there will be an oversupply of 660 consultants in obstetrics and gynaecology, the Centre for Workforce Intelligence (CFWI) has calculated.

If the number of obstetrics and gynaecology trainees obtaining their certificate of completion of training (CCT) continues at the current rate the number …
Pilocarpine and artificial saliva for the treatment of xerostomia and xerophthalmia in Sjögren syndrome: a double-blind randomized controlled trial
Authors: M. Cifuentes, P. Del Barrio-Díaz, C. Vera-Kellet
Journal: British Journal of Dermatology (2018)

Sjögren syndrome (SS) is associated with xerostomia and xerophthalmia. Pilocarpine has been shown to stimulate the secretion of saliva.To investigate and compare the efficacy of pilocarpine and artificial saliva as symptomatic treatments for xerostomia and xerophthalmia in patients with SS.A double-blind randomized controlled study was performed. A total of 72 patients with SS were assigned randomly to receive 10 drops of pilocarpine (5 mg) or 10 drops of artificial saliva orally, three times daily for 12 weeks. Whole saliva and tear flow were evaluated at baseline and periodically throughout the study to provide a global assessment of dryness and to report any adverse effects.Patients receiving pilocarpine had a statistically significant improvement in their salivary flow (P < 0·001), lacrimal flow (P < 0·001) and their subjective global assessment (P < 0·001), compared with patients who received artificial saliva. The most common side-effects were sialorrhoea and nausea.Pilocarpine is more effective than artificial saliva for enhancing salivary and lacrimal secretion in patients with SS. This is the first study to compare the efficacy of pilocarpine and artificial saliva for the treatment of xerostomia and xerophthalmia in SS.
Providing safe, efficient and affordable sedation in endoscopy
Authors: Barbara Braden, Alissa Walsh
Journal: Gut (2018)

We compliment the authors of the ProSed 2 Study1 for their large-scale analysis on the safety of sedation in endoscopic procedures. The vast majority of the over 300 000 endoscopies in this study have been performed under propofol sedation administered by the endoscopic team and only 0.2% were supported by an anaesthetist.

In Germany and many other European countries, propofol is routinely administered by the endoscopist or trained endoscopy nurse according to clearly defined standards as set out in the European or German guidelines.2 3 Propofol sedation administered by non-anaesthetists is even practised widely in doctors’ surgeries with endoscopy facilities.

Currently, according to recommendations of a working party of the Royal College of Anaesthetists …
DOES THE NUMBER OF PRIOR TARGET LESION REVASCULARIZATIONS OF THE FEMOROPOPLITEAL ARTERY PREDICT FUTURE REVASCULARIZATION OF THE SAME LESION FOLLOWING ATHERECTOMY AND DRUG COATED BALLOONS?
Authors: Nicolas W. Shammas, Gail Shammas, Sue Jones-Miller, W. John Shammas
Journal: Journal of the American College of Cardiology (2018)
A MACHINE LEARNING MODEL PREDICTS INDIVIDUALS WHO IMPROVE CORONARY ARTERY PLAQUE FIBROUS CAP THICKNESS FOLLOWING HIGH-INTENSITY STATIN THERAPY
Authors: Kipp Johnson, Shameer Khader, Benjamin S. Glicksberg, Yuliya Vengrenyuk, Aparna A. Divaraniya, Li Li, Samin K. Sharma, Jagat Narula, Joel Dudley, Annapoorna Subhash Kini
Journal: Journal of the American College of Cardiology (2018)
Germline variant in <i>SLCO2B1</i> and response to abiraterone acetate plus prednisone (AA) in men with metastatic castration-resistant prostate cancer (mCRPC).
Authors: Andrew W Hahn, Darshan Patel, David Michael Gill, Camryn Froerer, Roberto Nussensveig, Austin Poole, Peter Hale, James M. Farnham, Benjamin Louis Maughan, Lisa A Cannon-Albright, Neeraj Agarwal
Journal: Journal of Clinical Oncology (2018)

311 Background: Currently, there are no predictive biomarkers of response to AA in mCRPC routinely used in the clinic. SLCO2B1 encodes a sodium-independent organic anion transporter that mediates transport of endogenous sex hormones and drugs, including AA, into tissue. Single nucleotide polymorphisms (SNPs) in SLCO2B1 are a validated predictive biomarker of response to androgen deprivation therapy in hormone sensitive prostate cancer. In a recent pre-clinical study, the AA/AG genotype for rs12422149 and the AA genotype for rs1789693 of SLCO2B1 had significantly higher mean tissue abiraterone levels. We hypothesize that the variant allele for rs12422149 and rs1789693 are predictive of improved response to AA in mCRPC. Methods: Clinical data and samples were analyzed from a prospective prostate cancer registry at the University of Utah (Salt Lake City, UT). Genotyping was performed using the Illumina OmniExpress genotyping platform. Primary endpoint was progression-free survival (PFS) on first-line AA in men with mCRPC. We performed pre-specified multivariate Cox regression analyses to assess the independent predictive value of SLCO2B1 rs12422149 and rs1789693 on PFS on AA (table). Results: 76 men with mCRPC treated with first-line AA were included. In a multivariate analysis for rs12422149, a trend towards improved median PFS was seen with the AG genotype (11.2 months) vs. the GG genotype (6.4 months) (HR 0.50, 95% CI 0.24-1.02, p=0.056). No such correlation was seen with rs1789693 genotypes. Conclusions: Consistent with pre-clinical studies, the AG genotype in rs12422149 of SLCO2B1 may be predictive of response to AA in men with mCRPC. This hypothesis-generating data needs further interrogation in larger and independent cohorts. [Table: see text]
Impact of Coronary Remodeling on Fractional Flow Reserve
Authors: Carlos Collet, Yuki Katagiri, Yosuke Miyazaki, Taku Asano, Jeroen Sonck, Robert-Jan van Geuns, Daniele Andreini, Marcio S. Bittencourt, Pieter Kitslaar, Erhan Tenekeciouglu, Jan G.P. Tijssen, Jan J. Piek, Robbert J. de Winter, Bernard Cosyns, Campbell Rogers, Christopher K. Zarins, Charles Taylor, Yoshinobu Onuma, Patrick W. Serruys
Journal: Circulation (2018)
Distress prevalence and associated risk factors within the urothelial cancer population.
Authors: Laurel Ralston, Petros Grivas
Journal: Journal of Clinical Oncology (2018)

526 Background: Prevalence of distress has been estimated as high as 40% in some cancer populations, but minimal literature exists regarding distress in bladder cancer patients. Distress has been linked with multiple negative clinical outcomes, with the Commission on Cancer now requiring standardized distress screening for cancer program accreditation. The purpose of this study is to identify prevalence of distress, associated clinical risk factors and psychosocial referral trends in the urothelial cancer population. Methods: This was a retrospective review of distress screening outcomes in bladder cancer patients seen in oncology outpatient clinic at an academic medical center between January 1, 2016-October 1, 2017. Established oncology patients are screened for distress every 30 days using the Patient Health Questionnaire-9 (PHQ-9) and/or the NCCN Distress Thermometer (DT). Questionnaires are completed on an electronic tablet at the time of check-in and linked to the Epic electronic medical record in real time. A data capture program was used to query screening outcomes and identify those who met the threshold scores (PHQ-9 &gt; 8, DT &gt; 4). Results: Of 153 patients with a primary diagnosis of bladder, 81 (53%) completed the PHQ-9 (n = 67) or NCCN distress thermometer (n = 16). The overall incidence of distress was 13.6% with an average score of 12.3 on PHQ-9 (n = 10) and 9 on DT (n = 1). Of the patients with elevated distress, there were 7 males and 4 females with an average age of 64 and 77, respectively. All were either married or widowed. Metastasis was documented in 45%. Five were on an antidepressant and only one had mood disorder previously documented in the history. Social work referral occurred for 73% of the patients. One patient had elevated distress in the 6 months subsequent to diagnosis. Of the seven now deceased patients, all had elevated distress within 6 months of death. Conclusions: At 13.6%, the prevalence of distress in urothelial cancer patients was less than that in general oncology. Metastatic disease and female gender were risk factors while documentation of a psychiatric condition was not. One unexpected finding was that all now deceased patients had endorsed elevated distress within 6 months of death.