tbuckley/cabot-search huggingface dataset:
Examination of the Screener and Opioid Assessment for Patients with Pain-Short Form (SOAPP-SF) in an oncology palliative medicine clinic.
Authors: Rebecca Greiner, Danielle Boselli, Mariam Salib, Jai Narendra Patel
Journal: Journal of Clinical Oncology (2018)

196 Background: The National Comprehensive Cancer Network states opioids can be used to treat cancer pain and prescribers should identify patients at risk for opioid misuse; research in this area is limited. In the non-cancer population, SOAPP-SF is a validated tool to predict aberrant drug behavior; a score of ≥ 4 (out of 20) is considered high risk. We performed a retrospective observational study to determine the utility of the SOAPP in identifying opioid misuse in the oncology population as measured by a non-compliant toxicology screen. Methods: Consecutive consults seen during a 6-month period completed the 5-question SOAPP-SF and Edmonton Symptom Assessment System (ESAS) form. Toxicology screens assessed non-compliance (i.e., absence of prescribed medications and/or presence of non-prescribed or illegal substances). Logistic regression models estimated the associations of composite and individual SOAPP-SF scores and ESAS symptom scores with non-compliant screens. Threshold analysis were conducted to identify an optimal SOAPP-SF cutoff. Results: Of 192 consults, 64 patients providing SOAPP-SF score and toxicology screen were evaluable. Mean age was 59 ± 9.8 years: 56% were female, 34% and 62% were African American and Caucasian respectively. Median SOAPP-SF score was 2 (range: [0, 12]). Non-compliant screens were observed in 31% of patients. The area under the curve (AUC) was 0.65. The validated SOAPP-SF cutoff score of ≥ 4 was associated with a sensitivity and specificity of 0.43 and 0.79, respectively (p = 0.082). Sensitivity (0.76) and specificity (0.72) were maximized at a cutoff score of ≥ 3 (p &lt; 0.001). When evaluated individually, the SOAPP-SF question about smoking habit was associated with a non-compliant screen (p = 0.020). Increased ESAS pain scores were associated with SOAPP-SF score ≥ 3 (p = 0.013). Conclusions: SOAPP-SF can identify oncology patients at risk for opioid misuse. Preliminary analyses suggest a more appropriate threshold of identification is a score of ≥ 3 not ≥ 4. Future work will increase numbers of evaluable patients and examine other factors associated with opioid misuse.
Abstract 16692: Role of Cardiomyocyte Protease-activated Receptor-1 in Coxsackievirus B3-induced Myocarditis
Authors: Michael F Bode, Silvio Antoniak, Rashi Vora, Weeranun Bode, Alyson Auriemma, Joseph Palumbo, Nigel Mackman
Journal: Circulation (2017)

Introduction: We recently showed that protease-activated receptor (PAR)-1 deficient mice are more susceptible to coxsackievirus B3 (CVB3)-induced myocarditis due to an impaired innate immune respon...
PTH-114 Dedicated endoscopic ibd surveillance list improves adherence to guidelines
Authors: R Goldberg, S Fong, M Samaan, J DigbyBell, E Johnston, S Anderson, P Irving, J Sanderson
Journal: Gut (2017)

Introduction  Current guidelines propose surveillance colonoscopy for patients with long term colonic Crohn’s disease or ulcerative colitis. Guidelines also suggest using chromoendoscopy with targeted biopsies of abnormal areas. Previous audits have shown poor adherence to these recommendations. We report the assessment of an IBD surveillance colonoscopy programme in an IBD tertiary centre, having implemented interventions in order to improve the quality of the service provided.  Method  To assess the efficacy of introducing dedicated IBD surveillance lists along with a change in bowel preparation and the use of post-endoscopy virtual clinics on the quality of the surveillance survey. We compared 2 different periods before and after the measures were implemented (period A (pre intervention): August 2015-December 2015 and period B (post intervention): August 2016-December 2016)  Results  A total of 84 patients underwent IBD surveillance colonoscopy, 28 in period A and 56 in period B. 16 out of 28 patients (57.1%) were allocated to an IBD endoscopy list in period A and 51/56 (91%)of patients in period B. During period B, 40/51 (78.5%) were allocated to a newly established dedicated IBD chromoendoscopy surveillance list.  Chromoendoscopy was performed in 14/28 (50%) patients in Period A and in 44/56 (78.6%) patients in Period B. Dedicated surveillance list was significantly correlated with the use of chromoendoscopy (p=0.02). In addition, dedicated IBD surveillance list was correlated with targeted biopsies (p:0.009). Despite these differences, the detection of abnormal lesions was similar (18/28 (64.2%) patients in period A and in 34/56 (60.7%) in period B). Likewise, dysplasia was detected in 6/28 (21.4%) patients in period A and in 8/56 (14.3%) in period B. All cases of dysplasia were detected on targeted biopsies whereas no dysplasia was found on random biopsies. However, in both periods, lesion detection rate was significantly associated with performance of chromoendoscopy (p=0.04).  There was no significant difference in the number of patients that had good or adequate bowel preparation (BBPScale:2 or 3)( p: 0.9607) when sodium picosulphate was compared to Moviprep. There was a trend for correlation for good bowel prep (BBPS:3) and adenoma detection (p=0.082).  Significantly more follow up endoscopies were arranged once patients were channelled through a newly established IBD virtual clinic (33/40 vs 10/44 p  Conclusion  Following the implementation of a dedicated IBD surveillance, the use of chromoendoscopy and targeted biopsies has increased significantly and capacity for effective surveillance endoscopy doubled. We suggest these strategies should be considered in IBD centres to help improve the uptake and performance of an effective IBD surveillance programme.  Disclosure of Interest  None Declared
Abstract 14457: mRNA Binding Protein ZFP36L2 Regulates Cardiac DNA Damage Response Through Regulation of p53 and Helicase
Authors: Hidemichi Kouzu, Hsiang-Chun Chang, Jason Shapiro, Adam DeJesus, Meng Shang, Perry Blackshear, Hossein Ardehali
Journal: Circulation (2017)

Introduction: Cardiomyocytes are frequently exposed to DNA damage by its reactive oxygen species (ROS) rich environment, and oxidative DNA damage is reported to be responsible for postnatal cardiom...
Doctors demand to see evidence on safety of medical devices approved in Europe
Authors: Simon Bowers
Journal: BMJ (2018)

Senior doctors, consumer groups, and campaigners for transparency are urging the European Commission to force the manufacturers of high risk medical devices to make public all the evidence they hold on the safety of their products.

The calls came just days after a global investigation into the industry by the International Consortium of Investigative Journalists, The BMJ , BBC Panorama , the Guardian , and others called the Implant Files, which uncovered thousands of documents showing the rising number of malfunctions and injuries from a range of medical devices.1

A new law for medical device regulation in the European Union was passed last year and comes into effect from 2020. It sets data transparency as one of its main goals, but the European Commission, which has been the subject of intense lobbying from the device industry, has said that it plans to withhold …
Multimodal therapy for the treatment of sleep disturbance in patients with advanced cancer.
Authors: Sriram J. Yennu, Cindy L. Carmack, Dave Balachandran, Janet L. Williams, Zhanni Lu, Minjeong Park, Kenneth R. Hess, Jewel Ochoa, Eduardo Bruera
Journal: Journal of Clinical Oncology (2018)

185 Background: Poor sleep quality is frequent in patients with advanced cancer (62%), and is associated with a severe symptom distress and mortality. There are limited evidence based treatment options in advanced cancer patients.To obtain feasibility, preliminary estimates of the effects of various treatments [light therapy, melatonin, Methylphenidate] and combinations of treatments in multimodal therapy (MMT) to improve sleep quality, as measured by change in Pittsburg Sleep Quality Index (PSQI) scores from baseline to Day 15. We also examined MMT effects on FACT-G, insomnia - Insomnia severity index (ISI), actigraphy. Methods: Cancer patients with moderate sleep disturbance were eligible. Using a double-blind (patient, investigators) randomized factorial study design, eligible Pts were randomized into 1 of the 8 arms of the study which included all possible combinations of the interventions (light therapy, melatonin, and methylphenidate) and/or their corresponding placebo treatments for a duration of 2 weeks. All patients received 3 sessions of standardized CBT. Linear regression analysis was used to assess treatment effects. Results: 84% (54/ 64) randomized Pts were evaluable. At baseline, median (IQR) total PSQI was 13 (12, 15); and ISI was 18 (14, 21). There were no differences in the demographics and baseline sleep quality between groups. The adherence rates for light therapy, melatonin, and methylphenidate were 93%, 100%, and 100% respectively. Light therapy had moderate effects on sleep quality (effect size .43, P=0.017). No significant differences in ISI, FACT-G scores, and objective sleep variables between groups. There were no significant difference in adverse events by groups (P=.97). Conclusions: MMT interventions to treat sleep disturbance were feasible. Light therapy provided the best signal for improvement in sleep quality, and should proceed to large randomized control trials. Clinical trial information: NCT0168029. [Table: see text]
The Ethics of Heritable Genome Editing
Authors: Eli Y. Adashi, I. Glenn Cohen
Journal: JAMA (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 HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Annals Story Slam - Words We Learn
Authors: Joshua Wales
Journal: Annals of Internal Medicine (2018)

Web Exclusives4 December 2018Annals Story Slam - Words We LearnFREEJoshua Wales, MDJoshua Wales, MDUniversity of Toronto and Mt. Sinai Hospital, Toronto, Ontario, Canada (J.W.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/W18-0037 SectionsAboutVisual Abstract ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Video. Annals Story Slam - Words We Learn "Words We Learn," by Joshua Wales, MD (Duration 5:28)Building on the popular Annals feature “On Being a Doctor,” storytellers share stories about the experience of doctoring on video.For more videos from and information on Annals Story Slam, visit go.annals.org/StorySlam. Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: University of Toronto and Mt. Sinai Hospital, Toronto, Ontario, Canada (J.W.)Current Author Address: Joshua Wales, MD; e-mail, Joshua.[email protected]ca. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 4 December 2018Volume 169, Issue 11Page: SS1 ePublished: 4 December 2018 Issue Published: 4 December 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.Loading ...
FRI0501 Negative temporal artery biopsies: comparison between biopsy-negative gca and non-gca patients
Authors: K. Yeruva, K.J. Warrington, C.S. Crowson, M.J. Koster
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Temporal artery biopsy (TAB) plays a key role in diagnosis of giant cell arteritis (GCA). However, approximately 15%–20% of patients ultimately diagnosed with GCA have negative biopsies. Among patients with negative TAB, it is often challenging to identify patients with GCA from those with an alternate (non-GCA) diagnosis. <h3>Objectives</h3> To compare TAB-negative GCA with patients receiving a non-GCA alternate diagnosis. <h3>Methods</h3> Two cohorts were retrospectively identified through direct medical record review. The first cohort consisted of patients with TAB-negative GCA diagnosed between 1/1/1998 and 12/31/2013. The second cohort included all patients with a negative TAB performed between 1/1/2009 and 12/31/2010 in which a non-GCA alternate diagnosis was provided after a minimum of 6 months of follow up. Final diagnoses were confirmed by consensus among two rheumatologists and a physician abstractor. Baseline characteristics were compared between the two cohorts using chi-square and rank sum tests. <h3>Results</h3> 110 patients with TAB-negative GCA and 195 non-GCA patients with a negative TAB were identified. Alternate diagnoses for non-GCA patients are listed in table 1. Age, sex, number of days on glucocorticoids prior to biopsy, and biopsy length were similar in both groups. Time from first symptom to diagnosis was longer in non-GCA patients [mean (SD); 2.6 (2.5) vs 1.5 (2.1) months; p&lt;0.001] and fewer non-GCA patients fulfilled ≥3 ACR criteria for GCA (27% vs 64%; p&lt;0.001). Although headache was the primary symptom in both cohorts (66% TAB-negative GCA; 68% non-GCA), patients with biopsy-negative GCA had more frequent anorexia, fatigue, fever, polymyalgia rheumatica, temporal artery tenderness and claudication (jaw, arm, or leg). Baseline transient (5% TAB-negative GCA; 6% non-GCA; p=0.58) and permanent (3% TAB-negative GCA; 3% non-GCA; p=0.86) vision loss were infrequently observed. ESR was higher in TAB-negative GCA patients [64.0 (35.1) vs 55.2 (67.4); p=0.002] compared to non-GCA patients but CRP did not differ [44.3 (53.6) vs 43.8 (61.9); p=0.39]. <h3>Conclusions</h3> In this cohort, neither headache nor vision loss at presentation were associated with an ability to discriminate between diagnosis of TAB-negative GCA compared to patients without GCA. ACR criteria may be helpful in identifying patients with TAB-negative GCA. Among patients with negative TAB, constitutional symptoms and claudication (jaw/limb) were more frequently associated with an ultimate diagnosis of TAB-negative GCA. <h3>Disclosure of Interest</h3> None declared
Preliminary validation of the Edmonton Symptom Assessment Scale – Acute Leukemia (ESAS-AL) in patients with acute leukemia (AL).
Authors: Columbe Tricou, Kenneth Mah, Carmine Malfitano, Anne Rydall, Aaron David Schimmer, Gary Rodin, Camilla Zimmermann
Journal: Journal of Clinical Oncology (2018)

210 Background: Patients with AL have numerous symptoms resulting from their disease and its treatment. Here we report on a preliminary evaluation of an ESAS version including AL-specific symptoms (ESAS-AL). Methods: Forty-two inpatients with newly-diagnosed AL (31 AML, 11 ALL), receiving induction chemotherapy, completed baseline assessments with the ESAS-AL and the Memorial Symptom Assessment Scale (MSAS) as part of a clinical trial. The ESAS-AL includes the nine usual ESAS symptoms (rated from 0-10), as well as five symptoms reported by patients with AL in a previous longitudinal study: trouble sleeping, mouth sores, diarrhea, constipation, and itching. Correlations between each ESAS symptom and the corresponding MSAS symptom (rated 1-4) were calculated using Spearman’s correlation. Results: The mean age was 52.86 (SD 15.84). Most correlations were moderate to large and were highly significant (Table). Correlations ranged from 0.86 (ESAS-AL/MSAS Itching) to 0.20 (ESAS-AL Anxiety/MSAS Worried). Correlations for 4 physical symptoms specific to ESAS-AL (itching, diarrhea, mouth sores, and constipation) were among the highest (r s &gt;.70). Correlations between ESAS-AL trouble sleeping and MSAS difficulty sleeping and between ESAS-AL anxiety and MSAS worried were lowest (r s &lt;.30). ESAS-anxiety correlated better with MSAS nervous (r s =.61). Conclusions: Well-defined ESAS-AL physical symptoms are highly correlated with equivalent MSAS symptoms, whereas less well-defined symptoms have weaker correlations. These findings provide preliminary support for the validity of the ESAS-AL. Further data collection for larger-scale validation is ongoing. [Table: see text]
Discharge Home From Critical Care: Comparing Different Health Care Systems
Authors: Ashraf Roshdy, Jayachandran Radhakrishnan, Kevin Kiff
Journal: JAMA Internal Medicine (2018)

To the Editor We commend Stelfox and colleagues1 for their excellent work in evaluating the practice of directly discharging patients home from critical care. The authors clearly identified local practice and service structure as factors in ensuring safety in this less-than-ideal practice.
Noninvasive <sup>11</sup> C-rifampin positron emission tomography reveals drug biodistribution in tuberculous meningitis
Authors: Elizabeth W. Tucker, Beatriz Guglieri-Lopez, Alvaro A. Ordonez, Brittaney Ritchie, Mariah H. Klunk, Richa Sharma, Yong S. Chang, Julian Sanchez-Bautista, Sarah Frey, Martin A. Lodge, Steven P. Rowe, Daniel P. Holt, Jogarao V. S. Gobburu, Charles A. Peloquin, William B. Mathews, Robert F. Dannals, Carlos A. Pardo, Sujatha Kannan, Vijay D. Ivaturi, Sanjay K. Jain
Journal: Science Translational Medicine (2018)

PET reveals spatially heterogeneous rifampin brain penetration, which decreases rapidly with treatment during tuberculous meningitis.
Gastric Ulcer Mimicking Malignancy on FDG PET/CT
Authors: Shumao Zhang, Fuqiang Shao, Yue Chen
Journal: Clinical Nuclear Medicine (2018)

A 52-year-old woman with newly diagnosed cervical carcinoma was referred an F-FDG PET/CT for staging. The PET/CT images demonstrated the known carcinoma and multiple enlarged lymph nodes with increased FDG activity. In addition, there was a focus of intense FDG activity characteristic of hypermetabolic malignancy in the region of gastric antrum. Finally, this lesion was confirmed as gastric ulcer by biopsy. This patient responded well to antiulcer treatment.
British Association of Dermatologists and British Photodermatology Group guidelines for topical photodynamic therapy 2018
Authors: T.H. Wong, C.A. Morton, N. Collier, A. Haylett, S. Ibbotson, K.E. McKenna, R. Mallipeddi, H. Moseley, D.C. Seukeran, L.E. Rhodes, K.A. Ward, M.F. Mohd Mustapa, L.S. Exton, P.M. McHenry, T.A. Leslie, S. Wakelin, R.Y.P. Hunasehally, M. Cork, G.A. Johnston, F.S. Worsnop, P. Rakvit, A. Salim, B. McDonald, S.L. Chua, D. Buckley, G. Petrof, N. Callachand, T. Flavell, A.A. Salad
Journal: British Journal of Dermatology (2018)

NICE has accredited the process used
Abstract 12871: Different Trends in Increased Incidence of Myocardial Infarction and Heart Failure after 2011 Earthquake and Tsunami Disaster in Northeast Japan
Authors: Masanobu Niiyama, Motoyuki Nakamura, Fumitaka Tanaka, Satoshi Nakajima, Yumiko Okuyama, Toshiyuki Onoda, Shinji Makita, Takashi Komatsu, Yoshihiro Morino, Kiyomi Sakata
Journal: Circulation (2012)

BACKGROUND: On 11 March 2011, a magnitude 9.0 earthquake followed by a huge tsunami attacked the northeastern coast of Japan. Several previous studies have shown an increased incidence in cardiovascular disease after natural disasters. However, no reports have demonstrated the effect of such disasters on the incidence of acute myocardial infarction (MI) and acute decompensated heart failure (HF). METHODS: We surveyed incidence and clinical characteristics of patients with non-fatal MI and those with HF in the coast area hit by the catastrophic earthquake followed by tsunamis. Patients hospitalized in all hospitals located in the disaster area (southern San-riku) were surveyed retrospectively for 4 weeks before and 8 weeks after the disaster. For comparison with the previous year’s-case numbers, the same survey was conducted in the corresponding area during the equivalent 12-week periods in 2009 and 2010. Inclusion criteria for MI and HF were based on the MONICA and Framingham definitions, respectively. Su...
The implementation of a palliative care intervention during induction chemotherapy for patients with acute myeloid leukemia (AML) at a community cancer institute.
Authors: Annamaria Lattanzio-Hale, Caitlyn McNaughton, Wendy Wilson, Heather Nelson-Przywara, Shyam S. Balepur, Peter Jupin, Miriam Ryan, Shanthi Sivendran
Journal: Journal of Clinical Oncology (2018)

113 Background: Patients with hematologic malignancies are referred to palliative care less than patients with solid tumor malignancies. Clinical trials are underway at academic centers exploring early inpatient palliative care for patients newly diagnosed with AML receiving induction chemotherapy. Feasibility of such interventions have not been studied in a community setting. We structured a multi-faceted intervention for our community hematology and palliative team on the benefits of early palliative care in hematologic malignancies with the aim to increase utilization. Methods: In 2017, 24% of patients with AML admitted to Lancaster General Hospital for induction chemotherapy received an inpatient palliative consultation. Needs assessment performed on the hematology and palliative teams demonstrated a need for integration of palliative care into clinical pathways, automatic triggers for consultation, a need for increased education on AML, and creation of standard elements in inpatient consultations. Results: In the spring of 2018, we integrated palliative care into institutional AML clinical pathways such that all patients receive inpatient palliative consultation within 72 hours of admission. A consultation trigger was placed within the admission order set and is currently being incorporated into the chemotherapy treatment protocol. An educational program on AML was created and presented by the hematology team to the inpatient palliative team. This intervention included creation of minimum standards for inpatient palliative consultation including provider assessment within 72 hours of referral, two visits per week by a provider and a minimum of one visit by the interdisciplinary team during admission with a focus on symptom management, psychosocial assessments, and advanced care planning. Conclusions: We have demonstrated feasibility of creating standards for early palliative care intervention in AML patients with collaboration from the hematology and palliative teams. Next steps will include assessing whether these interventions increase uptake of palliative care utilization and specific patient outcomes.