tbuckley/cabot-search huggingface dataset:
Randomized Trial of Platelet-Transfusion Thresholds in Neonates
Authors: Anna Curley, Simon J. Stanworth, Karen Willoughby, Susanna F. Fustolo-Gunnink, Vidheya Venkatesh, Cara Hudson, Alison Deary, Renate Hodge, Valerie Hopkins, Beatriz Lopez Santamaria, Ana Mora, Charlotte Llewelyn, Angela D’Amore, Rizwan Khan, Wes Onland, Enrico Lopriore, Karin Fijnvandraat, Helen New, Paul Clarke, Timothy Watts
Journal: New England Journal of Medicine (2018)

Platelet transfusions are commonly used to prevent bleeding in preterm infants with thrombocytopenia. Data are lacking to provide guidance regarding thresholds for prophylactic platelet transfusions in preterm neonates with severe thrombocytopenia.In this multicenter trial, we randomly assigned infants born at less than 34 weeks of gestation in whom severe thrombocytopenia developed to receive a platelet transfusion at platelet-count thresholds of 50,000 per cubic millimeter (high-threshold group) or 25,000 per cubic millimeter (low-threshold group). Bleeding was documented prospectively with the use of a validated bleeding-assessment tool. The primary outcome was death or new major bleeding within 28 days after randomization.A total of 660 infants (median birth weight, 740 g; and median gestational age, 26.6 weeks) underwent randomization. In the high-threshold group, 90% of the infants (296 of 328 infants) received at least one platelet transfusion, as compared with 53% (177 of 331 infants) in the low-threshold group. A new major bleeding episode or death occurred in 26% of the infants (85 of 324) in the high-threshold group and in 19% (61 of 329) in the low-threshold group (odds ratio, 1.57; 95% confidence interval [CI], 1.06 to 2.32; P=0.02). There was no significant difference between the groups with respect to rates of serious adverse events (25% in the high-threshold group and 22% in the low-threshold group; odds ratio, 1.14; 95% CI, 0.78 to 1.67).Among preterm infants with severe thrombocytopenia, those randomly assigned to receive platelet transfusions at a platelet-count threshold of 50,000 per cubic millimeter had a significantly higher rate of death or major bleeding within 28 days after randomization than those who received platelet transfusions at a platelet-count threshold of 25,000 per cubic millimeter. (Funded by the National Health Service Blood and Transplant Research and Development Committee and others; Current Controlled Trials number, ISRCTN87736839 .).
Abstract 11501: An Assessment of Unmet Needs and Outcomes Important to Patients With Heart Failure
Authors: Kristen M Richards, Rahul Sasane, Stuart Turner, Andrew V Thach, Carolyn M Brown
Journal: Circulation (2015)

Introduction: Heart failure (HF) is a progressively debilitating disease resulting in functional disability and lower quality of life. Besides responses to quality of life (QoL) scales, the literature contains few studies regarding HF patient-reported outcomes. Given the advances in pharmacological management, as well as other advances in the delivery of health-related services and information impacting the HF patient, additional insight is needed to understand and respond to patients’ perspectives of HF. Objectives: To identify outcomes that are important to patients with HF and to assess their perceived unmet needs regarding the effective management of HF. Methods: Focus groups (FGs) were conducted with HF patients in Austin, TX. A diverse sample of HF patients was recruited in terms of disease severity and history, HF treatments, gender, ethnicity and socioeconomic status. A FG guide with open-ended questions was used to explore three areas: disease burden, important outcomes of treatment and care, and strategies to address unmet need. A grounded theory approach was used to inductively analyze and identify the categories/themes that emerged from the data. Results: Four FGs were conducted with a total of 29 HF patients. Most patients were male (58.6%) and Caucasian (41.4%) or African American (37.9%) and aged 60.2±10.3 years. The mean number of years since being diagnosed with HF was 5.4±5.6. A total of eight major themes emerged from the data: 1) burden of daily living impacts of HF, 2) important elements of HF treatment, 3) indicators that care is being managed well, 4) negative aspects of medication, 5) dealing with other health issues, 6) different types of HF treatments, 7) unmet treatment and support needs, and 8) self-education. Conclusions: Several outcomes important to HF patients emerged, from physical limitations (e.g., limited recreational pastimes) to psychological issues (e.g., self-control in life). These outcomes were typically related to patients’ daily quality of living. Several unmet needs emerged, including financial assistance, reduced pill burden of prescribed therapies, and improved collaboration and communication among healthcare providers.
Recommendations for reporting on emerging optical imaging agents to promote clinical approval
Authors: Willemieke S. Tummers, Jason M Warram, Nynke S. van den Berg, Sarah E. Miller, Rutger-Jan Swijnenburg, Alexander L. Vahrmeijer, Eben L. Rosenthal
Journal: Theranostics (2018)

Intraoperative fluorescence imaging is particularly well-suited for surgical applications due to its inherently high sensitivity, resolution, and ability to provide images in real-time.To date, the intraoperative observation of fluorescence has largely been subjective.With the need to show objective evidence in order to demonstrate the benefit of this technique, quantitative data needs to be provided to overseeing regulatory bodies.Standardization of fluorescence imaging protocols would improve reproducibility and minimize inter-and intra-institution variance.This would allow studies to be conducted using the same injection techniques, imaging times, reconstruction methods, and analyses.Here, we provide recommendations for standardized methodologies with the goal of setting a minimum requirement for reporting fluorescence-guided surgery results based on both qualitative and (semi-) quantitative data collection.Clinical trials using fluorescence-guided surgery should present results of three critical elements; 1) intra-operative imaging, 2) specimen mapping and pathology correlation, and 3) target validation.Qualitative analyses should consist of a bright field image, black-and-white fluorescence image, pseudo-colored fluorescence overlay image, and/or heat-map whereby fluorescence signal intensity differences are displayed on a color spectrum.Quantitative analyses should include 1) intraoperative data (consisting of images or video, raw numeric values and ratios); 2) specimen mapping, for correlation of fluorescence with the presence of disease (performed using fresh tissue); and 3) target validation (designed to determine fluorescence intensity relative to receptor density of a specific area).Including the aforementioned methods of both qualitative and quantitative analyses will ensure that trial results are comparable and could be collated in future studies to expedite FDA approval.
Trainee doctor is suspended for 12 months for faking signatures over competencies
Authors: Clare Dyer
Journal: BMJ (2018)

A trainee doctor who used a senior nurse’s computer account to sign off assessments of his work in her name has been suspended from the UK medical register for 12 months.

In December 2016, Joon Faii Ong was a foundation year 1 trainee working at Lister Hospital, Stevenage. As part of his training he was obliged to gain proficiency in 15 core procedures. Trainees who feel confident performing a core procedure may ask a senior member of staff to observe them and, if they are considered competent, sign a positive assessment on their e-portfolio.

The ward sister working with Ong on the short stay unit that day, Rebecca Klinnert, told a medical practitioners’ tribunal that he had asked her a …
What is the Association With Dissociation?—Reply
Authors: Ravindranath Tiruvoipati, David Pilcher, Michael Bailey
Journal: JAMA Neurology (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 Neurology 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 Neurology journal
Association with outcomes and response to treatment of trimethylamine N‐oxide in heart failure: results from BIOSTAT‐CHF
Authors: Toru Suzuki, Yoshiyuki Yazaki, Adriaan A. Voors, Donald J.L. Jones, Daniel C.S. Chan, Stefan D. Anker, John G. Cleland, Kenneth Dickstein, Gerasimos Filippatos, Hans L. Hillege, Chim C. Lang, Piotr Ponikowski, Nilesh J. Samani, Dirk J. van Veldhuisen, Faiez Zannad, Aeilko H. Zwinderman, Marco Metra, Leong L. Ng
Journal: European Journal of Heart Failure (2018)
FRI0378 Antiphospholipid syndrome in patients with acute myocardial infarction
Authors: M. Jordhani, J. Seiti, V. Duraj, D. Ruci
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Antiphospholipid syndrome (APS) is a known cause of thrombotic disorders, including Acute Myocardial Infarction (AMI). Although the incidence of APS in AMI patients it's not known, it can be an important cause of myocardial infarction especially in young patients. <h3>Objectives</h3> The aim of this study is to evaluate the relationship between antiphospholipid syndrome and acute myocardial infarction in patients presented at cardiac emergency and cardiac reanimation at UHC Mother Teresa, Tirana, Albania <h3>Methods</h3> This is an observational study which included all patients from 23 to 45 years old presented as Acute Myocardial Infarction at our hospital from 10 december 2016–10 december 2017. In this period, there were diagnosed with AMI 61 patients fulfilling the inclusion criteria of the study: 37 males and 24 females. Besides the usual laboratory tests, all patients included in the study were completed with the titration of APS autoantibodies (Anti-cardiolipin, Lupus anticoagulant, β2 glycoprotein 1 antibodies). If positive, according to diagnosis guidelines, the tests were repeated after 12 weeks. <h3>Results</h3> Of 61 patients with AMI, 17 patients were positive for Antiphospholipid Syndrome at the first test and after 12 weeks, APS ws confirmed in 15 patients (24.6%): 10 females (67%) and 5 males (33%). Three of the patients diagnosed with APS underwent to a second Percutaneous transluminal coronary angioplasty due to rapid occlusion of stents placed in concomitant stenotic coronary arteries. <h3>Conclusions</h3> From this study it was found that Antiphospholipid syndrome in relatively young patients hospitalised for Acute myocardial infarction is a concomitant- causing disorder in a quarter of the patients included in our study. This implies that in young patients it should be kept in mind that APS could be the reason of the problem. <h3>Disclosure of Interest</h3> None declared
Co-delivery of paclitaxel and cisplatin in poly(2-oxazoline) polymeric micelles: Implications for drug loading, release, pharmacokinetics and outcome of ovarian and breast cancer treatments
Authors: Xiaomeng Wan, James J. Beaudoin, Natasha Vinod, Yuanzeng Min, Naoki Makita, Herdis Bludau, Rainer Jordan, Andrew Wang, Marina Sokolsky, Alexander V. Kabanov
Journal: Biomaterials (2018)
Biallelic PRDM12 mutations in MiTES
Authors: C. Moss, S.M. Srinivas, N. Sarveswaran, M. Nahorski, V.K. Gowda, F.M. Browne, G. Woods
Journal: British Journal of Dermatology (2018)

Mid‐face Toddler Excoriation Syndrome (MiTES) is a newly recognised condition in which apparently healthy children persistently scratch their faces in a localised area centred on the bridge of the nose. The problem starts in the first year of life and results in deep wounds and severe scarring. It can easily be mistaken for child abuse. The cause was unknown, but a clue came from a paper published in 2015 describing 11 families with congenital insensitivity to pain who had mutations in a newly recognised gene called PRDM12, which codes for a protein essential to the development of pain‐receptor nerves. Most patients with PRDM12 mutations suffer mutilating damage to their extremities because they lack the pain responses essential to avoid injury. However, one of the 11 families was more mildly affected, the 5 affected siblings having a condition described as “perinasal picking” which appeared the same as MiTES. Therefore this team from England, India and Ireland analysed PRDM12 in 5 new cases of MiTES. Four children, 2 of whom were siblings, had the same PRDM12 mutation as in the earlier report while no mutation was found in the fifth child. In most cases the parents were related and carried the mutation on one gene while the affected child had it on both. This study confirms MiTES as a genetic disorder, caused in some cases by recessive mutations in PRDM12. This new finding will help our understanding, and hopefully management, of children with this distressing and disfiguring condition.
Neuro–Immune Cell Units: A New Paradigm in Physiology
Authors: Cristina Godinho-Silva, Filipa Cardoso, Henrique Veiga-Fernandes
Journal: Annual Review of Immunology (2018)

The interplay between the immune and nervous systems has been acknowledged in the past, but only more recent studies have started to unravel the cellular and molecular players of such interactions. Mounting evidence indicates that environmental signals are sensed by discrete neuro-immune cell units (NICUs), which represent defined anatomical locations in which immune and neuronal cells colocalize and functionally interact to steer tissue physiology and protection. These units have now been described in multiple tissues throughout the body, including lymphoid organs, adipose tissue, and mucosal barriers. As such, NICUs are emerging as important orchestrators of multiple physiological processes, including hematopoiesis, organogenesis, inflammation, tissue repair, and thermogenesis. In this review we focus on the impact of NICUs in tissue physiology and how this fast-evolving field is driving a paradigm shift in our understanding of immunoregulation and organismal physiology.
Prospective observational study on fertility preservation in young early breast cancer patients: The PREFER (Pregnancy and Fertility) trial.
Authors: Matteo Lambertini, Paola Anserini, Valeria Fontana, Annalisa Abate, Fausta Sozzi, Franco Merlo, Paolo Pronzato, Claudia Bighin, Alessia Levaggi, Alessia D'Alonzo, Sara Giraudi, Giuseppina Iacono, Loredana Miglietta, Francesca Poggio, Lucia Del Mastro
Journal: Journal of Clinical Oncology (2013)

e17548 Background: Approximately 4.5% of breast cancers are diagnosed in women younger than 40 years. Chemotherapy (CT)-induced loss of fertility is a major concern for young patients. Different strategies are available to attempt to preserve ovarian function. We evaluated feasibility and patient preferences of 3 different strategies: oocyte cryopreservation (OC), ovarian tissue cryopreservation (OTC) and temporary ovarian suppression with the administration of LHRH analogue (LHRHa) during CT. Methods: From March 2010 to January 2013 49 breast cancer patients younger than 45 years (median age: 38 [range 25-45]), referred to our institution. They were offered the possibility to reduce the gonadotoxic effects of anticancer treatments: the oncologist proposed both the administration of LHRHa during CT, and a reproductive counselling performed by the gynecologist, where OC and OTC were discussed. The first analysis was planned after 2 years; preliminary data are presented. Results: The majority of patients (42 [85.7%]) accepted the treatment with LHRHa, started at least 1 week before CT. Thirty-eight patients (77.6%) refused the reproductive counselling; the main reason for refusal was previous pregnancies (19 patients [38.8%]). Out of 11 patients (22.4%) who accepted the reproductive counselling, only 3 (6.1%) accepted to undergo OC and 1 (2.0%) OTC. The reasons for refusal were: not eligible for comorbidities 3 patients [6.1%]), fear of delaying cancer treatment (2 patients [4.1%]), fear of the ovarian stimulation required (1 patients [2.0%]) and low successful rate of the technique (1 patients [2.0%]). The 3 patients undergoing OC received a controlled ovarian stimulation with the use of daily injections of recombinant FSH: median length of stimulation was 9 days (range, 8 to 9 days); peak estradiol levels ranged from 280 to 521 pg/ml. An average of 13.3 ± 5.7 oocytes was retrieved, and 8.3 ± 3.1 oocytes cryopreserved per patient. Conclusions: This preliminary analysis suggests that the majority of patients (85.7%) accept the administration of LHRHa during CT and approximately 8.2% of patients undergoes surgical fertility preservation techniques.
Three-Year Outcomes With Hypofractionated Versus Conventionally Fractionated Whole-Breast Irradiation: Results of a Randomized, Noninferiority Clinical Trial
Authors: Simona F. Shaitelman, Xiudong Lei, Alastair Thompson, Pamela Schlembach, Elizabeth S. Bloom, Isidora Y. Arzu, Daniel Buchholz, Gregory Chronowski, Tomas Dvorak, Emily Grade, Karen Hoffman, George Perkins, Valerie K. Reed, Shalin J. Shah, Michael C. Stauder, Eric A. Strom, Welela Tereffe, Wendy A. Woodward, Diana N. Amaya, Yu Shen, Gabriel N. Hortobagyi, Kelly K. Hunt, Thomas A. Buchholz, Benjamin D. Smith
Journal: Journal of Clinical Oncology (2018)

The adoption of hypofractionated whole-breast irradiation (HF-WBI) remains low, in part because of concerns regarding its safety when used with a tumor bed boost or in patients who have received chemotherapy or have large breast size. To address this, we conducted a randomized, multicenter trial to compare conventionally fractionated whole-breast irradiation (CF-WBI; 50 Gy/25 fx + 10 to 14 Gy/5 to 7 fx) with HF-WBI (42.56 Gy/16 fx + 10 to 12.5 Gy/4 to 5 fx).
Racial Disparities in Patient Characteristics and Survival After Acute Myocardial Infarction
Authors: Garth N. Graham, Philip G. Jones, Paul S. Chan, Suzanne V. Arnold, Harlan M. Krumholz, John A. Spertus
Journal: JAMA Network Open (2018)

<h3>Importance</h3> Black patients experience worse outcomes than white patients following acute myocardial infarction (AMI). <h3>Objective</h3> To examine the degree to which nonrace characteristics explain observed survival differences between white patients and black patients following AMI. <h3>Design, Setting, and Participants</h3> This cohort study used the extensive socioeconomic and clinical characteristics from patients recovering from an AMI that were prospectively collected at 31 hospitals across the contiguous United States between 2003 and 2008 for the Prospective Registry Evaluating Myocardial Infarction: Events and Recovery registry and the Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients’ Health Status registry. Survival was assessed using data from the National Death Index. Data were analyzed from December 2016 to July 2018. <h3>Main Outcomes and Measures</h3> Patient characteristics were categorized into 8 domains, and the degree to which each domain discriminated self-identified black patients from white patients was determined by calculating propensity scores associated with black race for each domain as well as cumulatively across all domains. The final propensity score was associated with 1- and 5-year mortality rates. <h3>Results</h3> Among 6402 patients (mean [SD] age, 60 [13] years; 2127 [33.2%] female; 1648 [25.7%] black individuals), the 5-year mortality rate following AMI was 28.9% (476 of 1648) for black patients and 18.0% (856 of 4754) for white patients (hazard ratio, 1.72; 95% CI, 1.54-1.92;<i>P</i> &lt; .001). Most categories of patient characteristics differed substantially between black patients and white patients. The cumulative propensity score discriminated race, with a C statistic of 0.89, and the propensity scores were associated with 1- and 5-year mortality rates (hazard ratio for the 75th percentile of the propensity score vs 25th percentile, 1.72; 95% CI, 1.43-2.08;<i>P</i> &lt; .001). Patients in the lowest propensity score quintile associated with being a black individual (regardless of whether they were of white or black race) had a 5-year mortality rate of 15.5%, while those in the highest quintile had a 5-year mortality rate of 31.0% (<i>P</i> &lt; .001). After adjusting for the propensity associated with being a black patient, there was no significant mortality rate difference by race (adjusted hazard ratio, 1.09; 95% CI, 0.93-1.26;<i>P</i> = .37) and no statistical interaction between race and propensity score (<i>P</i> = .42). <h3>Conclusions and Relevance</h3> Characteristics of black patients and white patients differed significantly at the time of admission for AMI. Those characteristics were associated with an approximately 3-fold difference in 5-year mortality rate following AMI and mediated most of the observed mortality rate difference between the races.
Reporting and Dissemination of Clinical Trials in Neurology
Authors: Konark Malhotra, Appaji Rayi, David S. Liebeskind
Journal: JAMA Neurology (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 Neurology 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 Neurology journal
Erratum to “Polymersome delivery of siRNA and antisense oligonucleotides”
Authors: Younghoon Kim, Manorama Tewari, J. David Pajerowski, Shenshen Cai, Shamik Sen, Jason H. Williams, Shashank R. Sirsi, Gordon J. Lutz, Dennis E. Discher
Journal: Journal of Controlled Release (2009)