tbuckley/cabot-search huggingface dataset:
Abstract P3-01-16: How hot is enough for accurate sentinel lymph node axillary staging in breast cancer?
Authors: MH Lee, SH Kang, J Cho
Journal: Cancer Research (2018)

Abstract Purpose: Sentinel lymph node (SLN) biopsy is a well-established procedure for staging of the axilla in early-stage breast cancer and has replaced axillary lymph node dissection as the standard of care in patients with clinically lymph node–negative axilla. No consensus exists about the number of sentinel lymph nodes (SLNs) that should be removed based on radioactivity counts in breast cancer, although the “10% rule” is often used. In order to determine the frequency with which the hottest SLN 'fails' to be pathologically positive, and to determine which criteria best define the radioactive lymph node to be removed, we reviewed and analyzed our cases in which more than one SLN was detected and where there was also at least one pathologically positive node. Methods: We retrospectively studied 1062 breast cancer patients who underwent lymphoscintigraphy by injection of radioactive colloid and SLN biopsy between 2006 and 2015, with intraoperative determination of radioactive counts of nodes by a gamma probe. Results: A total of 247 patients (23.3%) had more than 1 SLN removed (mean 2.29); 53 patients (21.5%) had nodal metastases. Of the node-positive patients, the hottest SLN was positive in 90.6% (48 of 53). The lowest radioactive count of a positive SLN was 32% of that of the hottest node. Conclusions: In our study, most positive SLNs had the highest radioactivity and the hottest lymph node was not the pathologically positive node only in 9.4 %. Our institutional experience indicates that to obtain an acceptable false-negative rate, nodes should be removed until the 10% rule is met. Citation Format: Lee MH, Kang SH, Cho J. How hot is enough for accurate sentinel lymph node axillary staging in breast cancer? [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 P3-01-16.
Abstract P4-06-16: Frequency of pathogenic mutation in patients at high risk for hereditary breast cancer
Authors: H-C Shin, T-K Yoo, H-B Lee, H-G Moon, D-Y Noh, W Han
Journal: Cancer Research (2018)

Abstract Background: Next-generation sequencing technology allows the simultaneous sequencing of multiple target genes. We developed a gene panel containing 64 genes which were associated with various hereditary cancers. This study was performed to evaluate the frequency of pathogenic mutations associated with hereditary cancer among Korean patients at high risk hereditary breast cancer using multi-gene sequencing panel. Methods: A total of 252 breast cancer patients with high-risk hereditary cancer were included. Among them, 179 patients (71.0%) had multiple primary cancers including breast cancer, 27 patients (10.7%) were diagnosed with bilateral breast cancer at age 40 or younger. Thirty-five patients (13.9%) had breast cancer family history of more than 2 relatives. With the 64-gene panel, sequence variants were detected by next-generation sequencing technology. Results: Sixty seven patients (26.8%) were found to have 77 germline pathogenic mutations, 12 in BRCA1, 13 in BRCA2, 9 in CDH1, 3 in FH, 5 in MSH2, 2 in MSH6, 4 in NAT1, 6 in PTCH1, 3 in RAD51, 7 in RET, 4 in SPINK1, 3 in TP53 and one each in ALK, BRIP1, CHEK2, MLH2, MUTYH, and PTEN. In 20 patients (4.0%), 2 (n=9) or 3 (n=1) pathogenic mutations were detected. In 227 patients with BRCA1/2 negative, CDH1 (n=7), RET (n=7), PTCH1 (n=5), and MSH2 (n=5) were the most prevalent pathogenic mutations. Conclusions: The 64 gene panel detected germline pathogenic mutations in 26.8% of Korean breast cancer patients with feature of hereditary cancer. Mutations of BRCA1, BRCA2, CDH1, RET, and PTCH1 were the most prevalent variants.Mutation carriers were considered as high risk to develop malignancy and recommended to receive genetic counseling and intensive cancer screening. Citation Format: Shin H-C, Yoo T-K, Lee H-B, Moon H-G, Noh D-Y, Han W. Frequency of pathogenic mutation in patients at high risk for hereditary breast cancer [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 P4-06-16.
Methotrexate-Associated B-Cell Lymphoproliferative Disease in a Patient With Cutaneous T-Cell Lymphoma
Authors: Andrea D. Maderal, Janine C. Malone, Jeffrey P. Callen
Journal: JAMA Dermatology (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 Dermatology 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 Dermatology journal
Only a quarter of first CCGs are fully authorised
Authors: Helen Jaques
Journal: BMJ (2012)

Only eight of the 34 clinical commissioning groups (CCGs) in the first wave to be signed off by the NHS Commissioning Board have met all 119 authorisation criteria.

The remaining 26 have been authorised with conditions that they are expected to meet by March next year, before they take up their statutory responsibilities in April 2013.

Most of the CCGs given conditional authorisation have five or fewer conditions to meet across the six authorisation domains. But one CCG needs to meet 14 conditions be fully authorised, and …
How should I train for a career in accident and emergency (A&amp;E), and where can I do a specific A&amp;E rotation?
Authors: Stephen Hearns
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.
The parasitic 68-mer peptide FhHDM-1 inhibits mixed granulocytic inflammation and airway hyperreactivity in experimental asthma
Authors: Akane Tanaka, Venkata Sita Rama Raju Allam, Jennifer Simpson, Natalia Tiberti, Jenna Shiels, Joyce To, Maria Lund, Valery Combes, Sinead Weldon, Cliff Taggart, John P. Dalton, Simon Phipps, Maria B. Sukkar, Sheila Donnelly
Journal: Journal of Allergy and Clinical Immunology (2018)
Junior doctors are better prepared than before, says GMC
Authors: Abi Rimmer
Journal: BMJ (2014)

Foundation doctors are better prepared to start treating patients than they have been in the past, a report from the General Medical Council has found.

The report, which includes data from the regulator’s annual national training surveys, said that doctors in the first year of their foundation training (F1) were less likely to think that they had been forced to cope with clinical problems beyond their competence or experience than in the past. In 2009 around half (51%) of the 5175 F1 doctors who responded to the national training survey said that they felt they …
Multicenter extension and switch study evaluating the safety of long-term treatment with abiraterone acetate fine particle formulation (AAFP) in patients with metastatic castration-resistant prostate cancer (mCRPC): The STAAR-E study.
Authors: Richard Levin, Robert Given, Paul R. Nemeth, Bill Bosch, Jillian Chapas-Reed, William K. Oh
Journal: Journal of Clinical Oncology (2018)

181 Background: The STAAR-study results showed novel AAFP 500 mg is therapeutically equivalent to originator abiraterone acetate (OAA) 1000 mg in men with mCRPC (Stein et al. Urologic Oncol). This STAAR-extension study evaluates the safety of ≤ 1 year of additional AAFP treatment in men with mCRPC. Methods: Patients were enrolled in the extension if they had: 1) mCRPC; 2) successfully completed 84 days of treatment with either AAFP + methylprednisolone (MP) or OAA + prednisone (PDN) in the STAAR-study; and 3) received their last dose of STAAR-study treatment &lt; 45 days of starting this extension study. All patients continued or switched to AAFP 500 mg QD + 4 mg MP BID. Serum testosterone and PSA levels are measured at 6 and 12 months. Safety evaluations include adverse event (AE) incidence, clinical laboratory test results, and vital signs. Results: 20 patients were enrolled in the ongoing study (11 were switched to AAFP from OAA and 9 continued on AAFP). Median age is 76.5 years, and median AAFP treatment duration (STAAR + STAAR-E) is 178 days as of 8/16/17. Ten patients have been treated with AAFP &gt; 9 months; 3 of these for &gt; 1 year. Three patients discontinued due to progressive disease (n=1), fatigue (n=1), and a fall (non-AAFP related) resulting in death (n=1). No adverse events related to liver enzyme or bilirubin increases have been reported (Table). Conclusions: In this extension study in men with mCRPC, the safety profile of AAFP, regardless of prior treatment with OAA or AAFP, is consistent with that of OAA reported in the literature. Based on these results, longer-term treatment with AAFP + MP has acceptable safety, and patients on OAA + PDN treatment can switch to AAFP + MP successfully. Clinical trial information: NCT02962284. [Table: see text]
Chronic breathlessness: re-thinking the symptom
Authors: Olivia K. Faull, Lucy Marlow, Sarah L. Finnegan, Kyle T.S. Pattinson
Journal: European Respiratory Journal (2018)

Is chronic breathlessness a symptom or a syndrome? Although hotly debated [1–5], we would like to suggest an alternative viewpoint. Here, we speculate that the argument over chronic breathlessness being considered as either a symptom or syndrome both holds us within a reductionist framework, and somewhat misses the point. Chronic breathlessness, symptom or syndrome: are we asking the right question? <http://ow.ly/qJSX30hRpFq>
THALLIUM-201 SPECT PERFORMED IN CONJUNCTION WITH TC 99M PYP IMPROVES QUANTIFICATION AND DIAGNOSTIC ACCURACY OFTC 99M PYP UPTAKE FOR ASSESSMENT OF PATIENTS WITH SUSPECTED CARDIAC AMYLOIDOSIS
Authors: Balaji Tamarappoo, Yuka Otaki, Yoav Arnson, Mark Hyun, Heidi Gransar, Sean Hayes, John Friedman, Louise Thomson, Piotr Slomka, Damini Dey, Jignesh Patel, Daniel Berman
Journal: Journal of the American College of Cardiology (2018)
Editor’s Choice: Keeping relationships on track
Authors: Tom Moberly
Journal: BMJ (2015)

This week BMJ Careers looks at how doctors can reflect on their relationships with patients—and maintain their relationships if something goes wrong.

Gordon McDavid considers the importance of doctors saying sorry when errors occur in the course of patient care (http://careers.bmj.com/careers/advice/The\_value\_of\_saying\_sorry). Data on complaints indicate that an apology is not being offered often enough to satisfy patients …
Abstract P162: The Association Between Hypertension and Incident Heart Failure by Race and Gender
Authors: Matthew Mefford, George Howard, Raegan Durant, Nancy Dunlap, Parag Goyal, Monika Safford, Paul Muntner, Emily Levitan
Journal: Circulation (2018)

Background: Hypertension is a major risk factor for heart failure (HF), but associations of hypertension with HF may vary by race and gender. Objective: To assess race and gender differences in the association between hypertension and incident HF hospitalization in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Methods: REGARDS participants without suspected baseline HF (n = 25,759) were followed from study entry in 2003-2007 through 2014 with adjudication of incident HF hospitalizations (n = 855). Hypertension was defined as systolic or diastolic blood pressure ≥ 140/90 mmHg or self-reported antihypertensive medication use. Cox regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CIs) for the association between hypertension and HF hospitalization in subgroups separately by race or gender, with each subgroup model adjusted for race, gender, age, income, region of residence, health insurance, body mass index, smoking, history of coronary heart disease, diabetes, reduced estimated glomerular filtration rate, total cholesterol, statin use, physical activity, perceived stress, and depressive symptoms. Results: The mean age of the population was 64.5 years, 40.0% were black and 55.0% were female. The prevalence of hypertension was 57.1% and more common among blacks (69.3%) compared to whites (48.9%) but similar among males (56.5%) and females (57.6%). Over a median follow-up of 8.4 years, incidence rates for HF hospitalization were 4.19, 4.46, 5.14 and 4.29 per 1,000 person-years for whites, blacks, males and females, respectively. After multivariable adjustment, the association between hypertension and HF was stronger among blacks versus whites (HR 2.28 vs HR 1.50, p-interaction=0.04) and similar among males and females (HR 1.61 vs HR 1.83, p-interaction=0.19). ( Figure ) Conclusion: Hypertension may be a stronger risk factor for incident HF among blacks versus whites. This finding may be due to disparities in hypertension severity, control, or duration.
GPs need “coherent” picture of future care models, says NHS Alliance
Authors: Matthew Limb
Journal: BMJ (2015)

GPs still need to get a “coherent” picture of how they will work in the future under the government’s proposed new models of care, the NHS Alliance has said.

Its chairman, Michael Dixon, said that there was still no clear plan for primary care in the implementation of NHS England’s Five Year Forward View . He said that ideas for new vanguard organisations (www.england.nhs.uk/ourwork/futurenhs/new-care-models) were “exciting” but that there was “no connected thought” between politicians, the Department of Health, NHS England, clinical commissioning groups, …
Physical activity and longevity: how to move closer to causal inference
Authors: Kaitlin H Wade, Rebecca C Richmond, George Davey Smith
Journal: British Journal of Sports Medicine (2018)

Kujala provides an insightful review contesting epidemiological findings that increased physical activity (PA) lengthens the life span,1 arguing that intervention (randomised controlled trial (RCT) and experimental) studies do not support PA causing a reduced risk of death and highlighting several limitations in previous observational studies that may have led to spurious conclusions.

The review coincides with the publication of findings from the large-scale Prospective Urban Rural Epidemiologic (PURE) study (n=130 843), which identified a graded lower rate of mortality among those individuals achieving moderate and high levels of PA compared with those with low PA (HR 0.80; 95% CI 0.74 to 0.87 and 0.65; 95% CI 0.60 to 0.70; P for trend <0.0001).2 While this study is undeniably an impressive endeavour, collecting prospective data on participants from 17 countries, the conclusion to support increased forms of PA levels for all individuals (irrespective of age, gender or country of origin) has major public health implications. The findings are, as so often, qualified by the study, being unable to fully assert a causal (rather than correlational) role for PA levels in reducing mortality.

Kujala emphasises how epidemiological study designs are vulnerable to limitations that may skew or distort observational associations and impede the distinction between correlation and causation. Such distortions of observed relationships may arise due to confounding by measured/unmeasured lifestyle, behavioural and biological factors (such as higher fitness, lower body mass index (BMI), genetic variation and socioeconomic factors) correlated with both the exposure (here, PA) and outcome (here, longevity). If not appropriately accounted for, confounding factors make the ascertainment of underlying causal mechanisms and pathways exceptionally complex. Such was illustrated by Jerry Morris’ London busmen study revisited by Kujala, where confounding by baseline adiposity biased findings that bus conductors had lower risk of coronary heart disease than their less-active driver counterparts …
GP access pilots must not be a waste of NHS funds, says BMA
Authors: Abi Rimmer
Journal: BMJ (2014)

The government’s GP access fund pilot must be properly evaluated to ensure it represents an appropriate use of NHS resources, the BMA has said.

The Department of Health for England has announced that 1147 general practices in England will receive funding as part of the access pilot. A £50m fund has been developed to increase access to primary care, and the pilots aim to offer schemes such as seven day opening and 8 am to 8 pm opening to 7.5 million patients.

Chaand Nagpaul, chairman of the BMA’s General Practitioners Committee, …
PRIOR HEART FAILURE (HF) HOSPITALIZATION AND 30-DAY AND 1-YEAR OUTCOMES IN PATIENTS WITH HF AND PRESERVED EJECTION FRACTION (HFPEF)
Authors: Lakshmi Suma Tummala, Fahad Lodhi, Helen Sheriff, Cherinne Arundel, Phillip Lam, Steven Singh, Charles Faselis, Prakash Deedwania, Gregg C. Fonarow, Ali Ahmed
Journal: Journal of the American College of Cardiology (2018)
Abstract P2-04-06: Changes of DNA methylation in the development of breast cancer
Authors: C He, N Lin, A Shendre, G Jiang, H Lin, J Wan, Y Liu
Journal: Cancer Research (2018)

Abstract Aberrant DNA methylation plays an important role in breast cancer initiation and progression via inactivation of tumor suppressor genes and activation of oncogenes. To better understand the changes of DNA methylation in the development of breast cancer, we analyzed genome-wide DNA methylation DNA data in breast tumor, adjacent normal tissue, and normal breast tissue from healthy women. Using the IIILumina MethylationEPIC array, we investigated approximately 850,000 CpG sites. After quality control, 747,803 probes were retained and included the further analysis. To identify DNA methylation markers associated with breast cancer, we performed differential methylation analysis using ChAMP package implemented in Bioconductor. We identified 590 CpG sites that were differentially methylated (P&amp;lt;1X10-4) between tumor and normal, and 637 between tumor and adjacent normal tissue samples. Further pathway analyses revealed that changes in DNA methylation between tumor and normal breast tissue were mainly involved in neurogenesis and neuro differentiation, oxidative stress, insulin secretion and epithelial morphogenesis; while changes in DNA methylation between tumor and adjacent normal tissue were mainly involved in angiogenesis, cell morphogenesis, and cell component movement. We further validated our findings using RNA-seq data. Our results suggested distinct DNA methylation changes involved in different biological pathways, reflecting potential causal and reactive biological mechanisms in the initiation and the progression of breast cancer. Citation Format: He C, Lin N, Shendre A, Jiang G, Lin H, Wan J, Liu Y. Changes of DNA methylation in the development of breast cancer [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 P2-04-06.
The Impact of Implementation of the European Association of Urology Guidelines Panel Recommendations on Reporting and Grading Complications on Perioperative Outcomes after Robot-assisted Radical Prostatectomy
Authors: Giorgio Gandaglia, Carlo Andrea Bravi, Paolo Dell’Oglio, Elio Mazzone, Nicola Fossati, Simone Scuderi, Daniele Robesti, Francesco Barletta, Luca Grillo, Steven Maclennan, James N’Dow, Francesco Montorsi, Alberto Briganti
Journal: European Urology (2018)
Is it mandatory to complete the three parts of the MRCP exam in order to be able to apply for an SHO post in dermatology or would MRCP part 1 be enough?
Authors: John Lear
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>
Role of p21-activated kinase (PAK) in K-RAS mutant human colorectal cancer models
Authors: R.C. Orsini, V. D'Amato, R. Rosa, C. Di Mauro, P. Ciciola, A. Servetto, F. Napolitano, R. Marciano, S. De Placido, R. Bianco
Journal: Annals of Oncology (2018)
CARDIOMYOPATHY BRIDGED TO HEART TRANSPLANT WITH AMBULATORY EXTRACORPOREAL MEMBRANE OXYGENATION IN A PERIPARTUM PATIENT
Authors: Syed Yaseen Naqvi, Ayhan Yoruk, Eva Pressman, Courtney Olson-Chen, Sunil Prasad, Bryan Barrus, Igor Gosev, Jeffrey Alexis, Sabu Thomas
Journal: Journal of the American College of Cardiology (2018)