tbuckley/cabot-search huggingface dataset:
RESPOND - Raising awareness of anemia in oncology centers through computer algorithm driven guidelines: Assessment of intraclass correlation metrics for the accuracy of algorithmic definitions
Authors: J. Foubert, M. Aapro, P. Soubeyran, C. Bokemeyer, J. Van Erps, M. Muenzberg, M. Turner, K. MacDonald, I. Abraham
Journal: Journal of Clinical Oncology (2007)

19633 Background: Publication of evidence-based (EB) practice guidelines (EBPGs) does not assure their application in patient care. Computerized clinical decision support systems (CDSSs) incorporating EBPGs may promote EB decision-making about individual patients. Most CDSSs are knowledge-, not evidence-based. Effective CDSSs are those integrated into workflow, providing point of care guidance, and offering actionable recommendations. Few are validated in terms of algorithmic operationalization. RESPOND is a CDSS based on the 2006 update of the European Organisation for Research and Treatment of Cancer (EORTC) EBPGs for erythropoietic proteins in cancer-related anemia. Method: Descriptive study. Panel of five experts (three physicians, two nurses) rated the 27 algorithms derived from the EORTC EBPGs in terms of accuracy (binary: yes/no). If not judged accurate, experts were asked to explain and propose correction. Objective was to attain intraclass correlation coefficient (ICC) &gt;0.90 for each operationalization in a maximum of three iterations. Table 1 . Example of operationalization of guideline Hb, hemoglobin Results: In iteration 1, three experts agreed with all 27 sets; one disagreed with one set and one with four sets; therefore ICC = 1.00 for 22 sets; ≤0.90 for five sets. Three sets concerned additional output to be generated, and one a substantive inaccuracy; all were corrected. One set concerned a suggestion not supported by evidence, hence not incorporated. In iteration 2, all five experts agreed with all sets, thus ICC = 1.00 for 27 sets. Conclusions: The RESPOND CDSS being developed and validated is based on algorithms that accurately specify, in the form of conditional dependency rules, the EORTC EBPGs for erythropoietic proteins. [Table: see text] [Table: see text]
MRD Is an Independent Prognostic Factor in Acute Myeloid Leukemia Carrying t(8;21) Chromosomal Abnormalities
Authors: Hui Wei, Ying Wang, Dong Lin, Chunlin Zhou, Bingcheng Liu, Shaowei Qiu, Benfa Gong, Guangji Zhang, Kaiqi Liu, Shuning Wei, Xiaoyuan Gong, Yuntao Liu, Yan Li, Runxia Gu, Yingchang Mi, Jianxiang Wang
Journal: Blood (2016)
Teach Us to Care
Authors: Sarah LeLeiko Cutrona
Journal: Annals of Internal Medicine (2017)

On Being a Doctor2 May 2017Teach Us to CareSarah LeLeiko Cutrona, MD, MPHSarah LeLeiko Cutrona, MD, MPHFrom University of Massachusetts Medical School, Worcester, Massachusetts.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-1772 Audio Reading - “Teach Us to Care” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Teach Us to Care," by S.L. Cutrona. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Standing in the corridor behind our nursing station, I stare at stacks of white and blue paper, shoved (with vague attention to the alphabet) into paper cubbies. It's July, inpatient wards, and I am trying to help my intern locate the form necessary to consent a patient for blood transfusion. In 2016, computerized physician orders have not yet made it to our institution. Gracefully, my intern has accepted the fact that echocardiograms require the blue form, all insulin requires the insulin form, heparin goes on the heparin sheet, and God help you if you order an MRI. She has rapidly ...Reference1. Eliot TS. Ash Wednesday.. In: Eliot TS, eds. Selected Poems. San Diego: Harcourt Brace; 1964:84. Google Scholar Author, Article, and Disclosure InformationAffiliations: From University of Massachusetts Medical School, Worcester, Massachusetts.Corresponding Author: Sarah LeLeiko Cutrona, MD, MPH, Edith Nourse Rogers Memorial Hospital, 200 Springs Street, Building 70, Bedford, MA 01730; e-mail, Sarah.[email protected]gov. PreviousarticleNextarticle Advertisement Audio Reading - “Teach Us to Care” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Teach Us to Care," by S.L. Cutrona. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 2 May 2017Volume 166, Issue 9Page: 679KeywordsAlcoholicsBlood transfusionComputersElectronic medical recordsHeparinInpatientsInsulinSleep ePublished: 2 May 2017 Issue Published: 2 May 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Seven day access to routine care in general practice
Authors: Martin Marshall
Journal: BMJ (2017)

Public Accounts Committee exposes a disconnect between politics and evidence

Few would disagree that good access to general practice is important. It is a prerequisite for delivering safe, effective, and equitable care and fundamental to reducing pressure on hospitals. But there is little agreement about whether the current level of access is acceptable, what are reasonable public expectations, and how much additional investment is required to increase access.

Current government policy guarantees evening and weekend access to routine general practice services for all patients by 2020. Despite giving some ground in recent policy announcements,1 politicians are unlikely to back away from this commitment; they see improving access as a vote winner.

GPs disagree that improving access is a top priority for patients, and the data seem to support their view. The 2016 annual patient survey2 found that 85% of patients were able to see a GP of their choosing within a few days; 75.9% of patients were satisfied with their practice’s opening hours, and less than half were in favour of Sunday opening. Indeed, some of the …
Preclinical Evaluation of Allogeneic Anti-Bcma Chimeric Antigen Receptor T Cells with Safety Switch Domains and Lymphodepletion Resistance for the Treatment of Multiple Myeloma
Authors: Bijan Boldajipour, Roman Galetto, Cesar Sommer, Thomas Pertel, Julien Valton, Yoon Park, Annabelle Gariboldi, Amy Chen, Tao Geng, Hong H Dong, Gregory R Boucher, Thomas J Van Blarcom, Javier Chaparro-Riggers, Arvind Rajpal, Julianne Smith, Tracy Kuo, Barbra Sasu
Journal: Blood (2016)
Intramyocardial fate and effect of iron nanoparticles co-injected with MACS® purified stem cell products
Authors: Paula Müller, Ralf Gaebel, Heiko Lemcke, Frank Wiekhorst, Frauke Hausburg, Cajetan Lang, Nicole Zarniko, Bernd Westphal, Gustav Steinhoff, Robert David
Journal: Biomaterials (2017)
Clinical predictors and clinical prediction rules to estimate initial patient risk for infective endocarditis in Staphylococcus aureus bacteraemia: a systematic review and meta-analysis
Authors: Anthony D. Bai, Arnav Agarwal, Marilyn Steinberg, Adrienne Showler, Lisa Burry, George A. Tomlinson, Chaim M. Bell, Andrew M. Morris
Journal: Clinical Microbiology and Infection (2017)
The api2-malt1 fusion gene characteristic for malttype lymphoma: tumor specific gene rearrangement detected in helicobacter pylori associated gastritis
Authors: Jörg Kalla, Claudia Schaffner, German Ott, Matthias Eck, Axel Greiner, Stephan Stilgenbauer, Hartmut Döhner, Hans K. Müller-Hermelink, Peter Lichter
Journal: Blood (2000)
Contact allergy in children with atopic dermatitis: a systematic review
Authors: A.B. Simonsen, J.D. Johansen, M. Deleuran, C.G. Mortz, M. Sommerlund
Journal: British Journal of Dermatology (2017)

The importance of contact allergy in children with atopic dermatitis is frequently debated. Previously, patients with atopic dermatitis were believed to have a reduced ability to produce a type IV immunological response. However, this belief has been challenged and authors have highlighted the risk of underestimating and overlooking allergic contact dermatitis in children with atopic dermatitis. Several studies have been published aiming to shed light on this important question but results are contradictory. To provide an overview of the existing knowledge, we systematically reviewed studies that report frequencies of positive patch test reactions in children with atopic dermatitis. We identified 436 manuscripts of which 31 met the inclusion criteria. Although the literature is conflicting, it is evident that contact allergy is a common problem in children with atopic dermatitis.
Comparison of the 68Ga-DOTATATA PET/CT, FDG PET/CT, and MIBG SPECT/CT in the Evaluation of Suspected Primary Pheochromocytomas and Paragangliomas
Authors: Hongli Jing, Fang Li, Ling Wang, Zhenghua Wang, Wei Li, Li Huo, Jingjing Zhang
Journal: Clinical Nuclear Medicine (2017)

Anatomical imaging modalities including CT and MRI are the mainstay of evaluation of primary pheochromocytoma or paraganglioma. However, nuclear medicine imaging is frequently necessary to determine the nature of the lesions. The purpose of this investigation is to assess which commonly used nuclear medicine modality might have a better diagnostic value in this clinical setting.Eight patients who had been suspected of having either primary pheochromocytoma or primary paraganglioma and 1 patient with known pheochromocytoma were included in the analysis. Among the 8 patients without known diagnosis, 7 had been suggested by anatomical imaging modalities, whereas one of them presented with initial negative anatomical imaging interpretation. All of 9 patients underwent Ga-DOTATATA PET/CT, FDG PET/CT, and MIBG SPECT/CT for further evaluation. The imaging findings were compared with postsurgical pathology and follow-up.Both Ga-DOTATATA PET/CT and MIBG SPECT/CT accurately identified 9 primary tumors, whereas FDG PET/CT showed increased activity in 8 of 9 primary tumors. Both Ga-DOTATATA and FDG PET/CT are able to detect associated extra-adrenal lesions not shown on MIBG study in patients with multiple endocrine neoplasia syndrome.Ga-DOTATATA PET/CT could be the nuclear medicine imaging choice to evaluate suspected primary pheochromocytoma or paraganglioma, especially in the situation of multiple endocrine neoplasia syndrome.
How healthy are the “Healthy volunteers”? Penetrance of NAFLD in the biomedical research volunteer pool
Authors: Varun Takyar, Anand Nath, Andrea Beri, Ahmed M. Gharib, Yaron Rotman
Journal: Hepatology (2017)

Healthy volunteers are crucial for biomedical research. Inadvertent inclusion of subjects with nonalcoholic fatty liver disease (NAFLD) as controls can compromise study validity and subject safety. Given the rising prevalence of NAFLD in the general population, we sought to identify its prevalence and potential impact in volunteers for clinical trials. We conducted a cross‐sectional study of subjects who were classified as healthy volunteers between 2011 and 2015 and had no known liver disease. Subjects were classified as presumed NAFLD (pNF; alanine aminotransferase [ALT] level ≥ 20 for women or ≥ 31 for men and body mass index [BMI] &gt; 25 kg/m 2 ), healthy non‐NAFLD controls (normal ALT and BMI), or indeterminate. A total of 3160 subjects participated as healthy volunteers in 149 clinical trials (1‐29 trials per subject); 1732 of these subjects (55%) had a BMI &gt; 25 kg/m 2 and 1382 (44%) had abnormal ALT. pNF was present in 881 subjects (27.9%), and these subjects were older than healthy control subjects and had higher triglycerides, low‐density lipoprotein cholesterol, and HbA1c and lower high‐density lipoprotein cholesterol ( P &lt; 0.001 for all). The 149 trials included 101 non‐interventional, 33 interventional, and 15 vaccine trials. The impact on study validity of recruiting NAFLD subjects as controls was estimated as likely, probable, and unlikely in 10, 41, and 98 trials, respectively. The proportion of pNF subjects (28%‐29%) did not differ by impact. Only 14% of trials used both BMI and ALT for screening. ALT cutoffs for screening were based on local reference values. Grade 3‐4 ALT elevations during the study period were rare but more common in pNF subjects than in healthy control subjects (4 versus 1). Conclusion : NAFLD is common and often overlooked in volunteers for clinical trials, despite its potential impact on subject safety and validity of study findings. Increased awareness of NAFLD prevalence and stricter ALT cutoffs may ameliorate this problem. (H epatology 2017;66:825–833)
Behavioral Approach to Appropriate Antimicrobial Prescribing in Hospitals
Authors: Jonne J. Sikkens, Michiel A. van Agtmael, Edgar J. G. Peters, Kamilla D. Lettinga, Martijn van der Kuip, Christina M. J. E. Vandenbroucke-Grauls, Cordula Wagner, Mark H. H. Kramer
Journal: JAMA Internal Medicine (2017)

<h3>Importance</h3> Inappropriate antimicrobial prescribing leads to antimicrobial resistance and suboptimal clinical outcomes. Changing antimicrobial prescribing is a complex behavioral process that is not often taken into account in antimicrobial stewardship programs. <h3>Objective</h3> To examine whether an antimicrobial stewardship approach grounded in behavioral theory and focusing on preserving prescriber autonomy and participation is effective in improving appropriateness of antimicrobial prescribing in hospitals. <h3>Design, Setting, and Participants</h3> The Dutch Unique Method for Antimicrobial Stewardship (DUMAS) study was a prospective, stepped-wedge, participatory intervention study performed from October 1, 2011, through December 31, 2015. Outcomes were measured during a baseline period of 16 months and an intervention period of 12 months. The study was performed at 7 clinical departments (2 medical, 3 surgical, and 2 pediatric) in a tertiary care medical center and a general teaching hospital in the Netherlands. Physicians prescribing systemic antimicrobial drugs for any indication for patients admitted to the participating departments during the study period were included in the study. <h3>Interventions</h3> We offered prescribers a free choice of how to improve their antimicrobial prescribing. Prescribers were stimulated to choose interventions with higher potential for success based on a root cause analysis of inappropriate prescribing. <h3>Main Outcomes and Measures</h3> Appropriateness of antimicrobial prescriptions was determined using a validated approach based on guideline adherence and motivated guideline deviation and measured with repeated point prevalence surveys (6 per year). Appropriateness judgment was masked for the study period. Antimicrobial consumption was extracted from pharmacy records and measured as days of therapy per admission. We used linear and logistic mixed-model regression analysis to model outcomes over time. <h3>Results</h3> A total of 1121 patient cases with 700 antimicrobial prescriptions were assessed during the baseline period and 882 patient cases with 531 antimicrobial prescriptions during the intervention period. The mean antimicrobial appropriateness increased from 64.1% at intervention start to 77.4% at 12-month follow-up (+13.3%; relative risk, 1.17; 95% CI, 1.04-1.27), without a change in slope. No decrease in antimicrobial consumption was found. <h3>Conclusions and Relevance</h3> Use of a behavioral approach preserving prescriber autonomy resulted in an increase in antimicrobial appropriateness sustained for at least 12 months. The approach is inexpensive and could be easily transferable to various health care environments.
Tumor Penetrating Theranostic Nanoparticles for Enhancement of Targeted and Image-guided Drug Delivery into Peritoneal Tumors following Intraperitoneal Delivery
Authors: Ning Gao, Erica N Bozeman, Weiping Qian, Liya Wang, Hongyu Chen, Malgorzata Lipowska, Charles A Staley, Y Andrew Wang, Hui Mao, Lily Yang
Journal: Theranostics (2017)

The major obstacles in intraperitoneal (i.p.) chemotherapy of peritoneal tumors are fast absorption of drugs into the blood circulation, local and systemic toxicities, inadequate drug penetration into large tumors, and drug resistance. Targeted theranostic nanoparticles offer an opportunity to enhance the efficacy of i.p. therapy by increasing intratumoral drug delivery to overcome resistance, mediating image-guided drug delivery, and reducing systemic toxicity. Herein we report that i.p. delivery of urokinase plasminogen activator receptor (uPAR) targeted magnetic iron oxide nanoparticles (IONPs) led to intratumoral accumulation of 17% of total injected nanoparticles in an orthotopic mouse pancreatic cancer model, which was three-fold higher compared with intravenous delivery. Targeted delivery of near infrared dye labeled IONPs into orthotopic tumors could be detected by non-invasive optical and magnetic resonance imaging. Histological analysis revealed that a high level of uPAR targeted, PEGylated IONPs efficiently penetrated into both the peripheral and central tumor areas in the primary tumor as well as peritoneal metastatic tumor. Improved theranostic IONP delivery into the tumor center was not mediated by nonspecific macrophage uptake and was independent from tumor blood vessel locations. Importantly, i.p. delivery of uPAR targeted theranostic IONPs carrying chemotherapeutics, cisplatin or doxorubicin, significantly inhibited the growth of pancreatic tumors without apparent systemic toxicity. The levels of proliferating tumor cells and tumor vessels in tumors treated with the above theranostic IONPs were also markedly decreased. The detection of strong optical signals in residual tumors following i.p. therapy suggested the feasibility of image-guided surgery to remove drug-resistant tumors. Therefore, our results support the translational development of i.p. delivery of uPAR-targeted theranostic IONPs for image-guided treatment of peritoneal tumors.
Checkpoint Inhibitor Therapy and Graft Versus Host Disease in Allogeneic Bone Marrow Transplant Recipients of Haploidentical and Matched Products with Post-Transplant Cyclophosphamide.
Authors: Laura K Schoch, Ivan Borrello, Ephraim J. Fuchs, Javier Bolanos-Meade, Jeffrey Sean Huo, Ivana Gojo, Nina Wagner-Johnston, Gabrielle T Prince, Shannon R. McCurdy, B. Douglas Smith, Amy E. DeZern, Margaret M. Showel, David Loeb, Aziza T. Shad, Richard J Jones, Richard F. Ambinder, Douglas Gladstone
Journal: Blood (2016)
De novo hepatocellular carcinoma (HCC) in allograft liver with background of hepatitis C virus infection, cirrhosis, and previous genetically distinct HCC in native liver.
Authors: S Strautnieks, R J Thompson, A Amarapurkar, A S Knisely, B Portmann, P Rizzi, J O'Grady, S Norris
Journal: Hepatology (2001)
The Use of FDG PET-CT Imaging for the Assessment of Early Antifungal Treatment Response in Disseminated Fusariosis
Authors: Romain-David Seban, Gérald Bonardel, Mohamed Guernou, David Lussato, Mathieu Queneau
Journal: Clinical Nuclear Medicine (2017)

Fusariosis is an opportunistic infection, caused by a filamentous fungus, found on plants and in soil. The treatment of disseminated pattern, seen in immunocompromised patients with severe neutropenia, is difficult because of antifungal therapy resistance. A 12-year-old girl, who was diagnosed with B-cell acute lymphoblastic leukemia, developed multiple widespread skin papules and subcutaneous nodules, at day 20 of consolidation therapy. Histological examination with cultures of skin tissue revealed Fusarium species. Treatment was started with intravenous liposomal amphotericin B and voriconazole. To assess treatment response, FDG PET/CT performed at baseline, at 2 and 4 months, showed a partial response.
Thirty-Day Readmissions After Endovascular or Surgical Therapy for Critical Limb Ischemia
Authors: Dhaval Kolte, Kevin F. Kennedy, Mehdi H. Shishehbor, J. Dawn Abbott, Sahil Khera, Peter Soukas, Shafiq T. Mamdani, Omar N. Hyder, Douglas E. Drachman, Herbert D. Aronow
Journal: Circulation (2017)

Thirty-day readmission rates have gained increasing importance as a key quality metric. A significant number of patients are hospitalized for the management of critical limb ischemia (CLI), but limited data are available on the incidence, predictors, and causes of 30-day readmission after hospitalization for CLI.Hospitalizations for a primary diagnosis of CLI during which patients underwent endovascular or surgical therapy (revascularization and/or amputation) and were discharged alive were identified in the 2013 to 2014 Nationwide Readmissions Databases. Incidence, reasons, and costs of 30-day unplanned readmissions were determined. Hierarchical logistic regression models were used to identify independent predictors of 30-day readmissions.We included 60 998 (national estimate, 135 110) index CLI hospitalizations (mean age, 68.9±11.9 years; 40.8% women; 24.6% for rest pain, 37.2% for ulcer, and 38.2% for gangrene). The 30-day readmission rate was 20.4%. Presentation with ulcer or gangrene, age ≥65 years, female sex, large hospital size, teaching hospital status, known coronary artery disease, heart failure, diabetes mellitus, chronic kidney disease, anemia, coagulopathy, obesity, major bleeding, acute myocardial infarction, vascular complications, and sepsis were identified as independent predictors of 30-day readmission. Mode of revascularization was not independently associated with readmissions. Infections (23.5%), persistent or recurrent manifestations of peripheral artery disease (22.2%), cardiac conditions (11.4%), procedural complications (11.0%), and endocrine issues (5.7%) were the most common reasons for readmission. The inflation-adjusted aggregate costs of 30-day readmissions for CLI during the study period were $624 million.Approximately 1 in 5 patients hospitalized for CLI and undergoing revascularization is readmitted within 30 days. Risk of readmission is influenced by CLI presentation, patient demographics, comorbidities, and in-hospital complications, but not by the mode of revascularization.