tbuckley/cabot-search huggingface dataset:
Survival after surgery for metastatic small bowel compared to pancreatic neuroendocrine tumors.
Authors: Seth Jason Concors, Brett Ecker, Andrew Sinnamon, Douglas L. Fraker, Giorgos Karakousis, Charles M. Vollmer, Robert Roses
Journal: Journal of Clinical Oncology (2018)

221 Background: Surgical management of small bowel (mSBNET) and pancreatic (mPNET) neuroendocrine tumors with hepatic metastases remains controversial. Previous studies, often drawn from single institution experiences, combine outcomes mSBNET and mPNET cohorts, despite ample evidence indicating discreet biology and natural history. This study aimed to define and contrast survival outcomes after surgery in patients with mSBNET and mPNET using a large national dataset. Methods: Patients with hepatic metastases from SBNET and PNET who underwent surgical (n = 1063; n = 556, respectively) or non-surgical management (n = 456; n = 2593, respectively) were identified in the National Cancer Database (1998-2014). Surgical and non-surgical cohorts were matched (1:1) by propensity scores based on the likelihood of receiving surgery and survival hazard. Kaplan-Meier estimates of overall survival (OS) were compared. Results: After adjustment for potential cofounders (age, Charleston comorbidity index, tumor differentiation and administration of chemotherapy or radiotherapy), nonsurgical management was associated with poorer survival in SBNET (HR 2 95%CI 1.5-2.7) and in PNET (HR 3.6, 98%CI 2.8-4.5). In the propensity matched cohort, there was a significant survival advantage for patients who received surgery for both SBNET and PNET (p &lt; 0.001). In SBNET, mean survival in the non-surgical cohort was 33.9 months (SD 1.3, 95%CI 31.5-36.4), and 39.3 months in the surgical cohort (SD 0.8, 95%CI 36.1-39.1). In PNET, mean survival in the non-surgical cohort was 32.7 months (SD 1.6, 95%CI 29.5-35.8), and 55.1 months in the surgical cohort (SD 1.4, 95%CI 52.4-57.7). Conclusions: Surgical selection or management are associated with a survival advantage in both mPNET and mSBNET; this advantage is greater in mPNET. The relative contributions of patient selection and therapeutic benefit require further elucidation.
Factor Analysis Defines Distinct Upper and Lower Gastrointestinal Symptom Groups Compatible With Rome IV Criteria in a Population-based Study
Authors: Egbert Clevers, William E. Whitehead, Olafur S. Palsson, Ami D. Sperber, Hans Törnblom, Lukas Van Oudenhove, Jan Tack, Magnus Simrén
Journal: Clinical Gastroenterology and Hepatology (2018)
TEMPORAL TRENDS AND DIFFERENCES IN CLINICAL OUTCOMES AFTER ACUTE MYOCARDIAL INFARCTION IN PATIENTS WITH TYPE 1 VERSUS TYPE 2 DIABETES MELLITUS: A CROSS SECTIONAL ANALYSIS FROM THE NATIONAL INPATIENT SAMPLE 2000-2010
Authors: Parasuram Krishnamoorthy, Akshaya Gopalakrishnan, Sarah Amanullah, Vincent Figueredo, Aman Amanullah
Journal: Journal of the American College of Cardiology (2018)
Conducting a multisite videoconference
Authors: Amen Sibtain
Journal: BMJ (2007)

The advent of videoconferencing facilities enables multidisciplinary teams (MDT) to meet without everyone travelling to a single site. Although this has obvious advantages, it can be difficult to make electronic MDTs effective and maintain the feeling of involvement. In addition, poor quality equipment or lines, and excessive background noise, can leave you feeling that you have to shout to make yourself heard and give you a headache that lasts all day. Careful attention to a few points helps make a multisite MDT run more smoothly.
AUTOMATED ASSESSMENT OF LEFT VENTRICULAR SYSTOLIC FUNCTION PREDICTS FUNCTIONAL AND CLINICAL OUTCOMES AFTER ACUTE MYOCARDIAL INFARCTION
Authors: Katsuomi Iwakura, Atsunori Okamura, Yasushi Koyama, Koichi Inoue, Mutsumi Iwamoto, Hiroyuki Nagai, Yuko Hirao, Koji Tanaka, Takafumi Oka, Yuichi Ninomiya, Tomohiro Yamasaki, Masato Okada, Akinori Sumiyoshi, Hiroyuki Inoue, Ryo Nakamaru, Takamasa Tanaka, Kohtaro Takayasu, Kota Tanaka, Ryo Kitagaki, Kenshi Fujii
Journal: Journal of the American College of Cardiology (2018)
Doctors Academy revision course for the DOHNS part B exam
Authors: Benjamin Stew
Journal: BMJ (2012)

The course is aimed at those taking their diploma of otolaryngology—head and neck surgery (DOHNS) part B exam. These may include surgical trainees and general practitioners who have an interest in ear, nose, and throat surgery (ENT). The DOHNS qualification is now considered essential for those applying for a national training number (specialty training level 3 in ENT). Those completing their membership of the Royal College of Surgeons (MRCS) part A and DOHNS part B examinations will be given MRCS (ENT) accreditation by the college.

I did my DOHNS as a second year surgical core trainee and attended this course before the part B examination.

The course is run by the Doctors Academy (UK), a not for profit organisation that provides a range of educational activities and clinical skills …
GMC urges employers to do more to support continuing professional development
Authors: Helen Jaques
Journal: BMJ (2013)

Employers should do more to ensure that doctors have the time and resources to complete continuing professional development (CPD) activities, research by the General Medical Council has concluded.

A study commissioned by the GMC found that many organisations take little interest in the training needs of the doctors they employ, leaving it up to doctors and their supervisors to decide on their CPD. Doctors not in conventional posts, such as locums and doctors not in training …
A mutational signature associated with alcohol consumption and prognostically significantly mutated driver genes in esophageal squamous cell carcinoma
Authors: X.C. Li, M.Y. Wang, M. Yang, H.J. Dai, B.F. Zhang, W. Wang, X.L. Chu, X. Wang, H. Zheng, R.F. Niu, W. Zhang, K.X. Chen
Journal: Annals of Oncology (2018)

Esophageal squamous cell carcinoma (ESCC) is often diagnosed at an advanced and incurable stage. Information on driver genes and prognosticators in ESCC remains incomplete. The objective was to elucidate significantly mutated genes (SMGs), mutational signatures, and prognosticators in ESCC.Three MutSig algorithms (i.e. MutSigCV, MutSigCL and MutSigFN) and '20/20+' ratio-metric were employed to identify SMGs. Nonnegative matrix factorization was used to decipher mutational signatures. Kaplan-Meier survival analysis, multivariate Cox and logistic regression models were applied to analyze association between mutational features and clinical parameters.We identified 26 SMGs, including 8 novel (NAV3, TENM3, PTCH1, TGFBR2, RIPK4, PBRM1, USP8 and BAP1) and 18 that have been previously reported. Three mutational signatures were identified to be prevalent in ESCC including clocklike C>T at CpG, APOBEC overactive C>T at TpCp[A/T], and a signature featured by T>C substitution. The T>C mutational signature was significantly correlated with alcohol consumption (OR: 3.59; 95% CI: 2.30-5.67; P < 0.001). This alcohol consumption signature was also observed in liver cancer and head and neck squamous cell carcinoma, and its mutational activity was substantially higher in samples with mutations in TP53. Survival analysis revealed that TENM3 mutations (HR: 5.54; CI: 2.68-11.45; P < 0.001) and TP53 hotspot mutation p.R213* (HR: 3.37; CI: 1.73-8.06; P < 0.001) were significantly associated with shortened survival outcome. The association remained statistically significant after controlling for age, gender, TNM stage and tumor grade.We have uncovered several new SMGs in ESCC and defined an alcohol consumption related mutational signature. TENM3 mutations and the TP53 hotspot mutation p.R213* are independent prognosticators for poor survival in ESCC.
The prognostic role of neutrophil-to-lymphocyte ratio trends during therapy in esophageal cancer.
Authors: Yaseen Al Lawati, Jose Luis Ramirez-Garcialuna, Juan Carlos Molina Franjola, Donavan Pham, Elena Skothos, Carmen L. Mueller, Jonathan D. Spicer, Thierry Alcindor, Lorenzo Ferri
Journal: Journal of Clinical Oncology (2018)

17 Background: Neutrophil-to-lymphocyte ratio (NLR) has been identified as a biomarker for a number of malignancies, with higher ratios being associated with poorer oncologic outcomes. Rather than purely an indicator of advanced disease there is emerging evidence that neutrophils are directly implicated in facilitating cancer progression, and thus alterations and trends of neutrophil counts and NLR during different phases of treatment may reflect a change in oncologic outcome that is as important, or more so, as the absolute count or NLR at baseline. The aim of this study is to investigate the prognostic role of neutrophil-to-lymphocyte ratio trends during the treatment trajectory of patients with esophageal adenocarcinoma. Methods: This is a retrospective study of patients who underwent esophagectomy for esophageal adenocarcinoma between 2005-2016. NLR was measured at three time points: baseline, during neoadjuvant chemotherapy (NAC), and in the late postoperative period. Primary outcomes were overall (OS) and disease-free survival (DFS). Results: 333 patients met our inclusion criteria. Mean age was 65.6 years and 82% of patients were males. The majority of patients had locally advanced disease; 75% had clinical T3 disease and 59% had clinical N-positive disease. NAC was administered in 65.6% of patients. Increasing NLR trends between baseline and late postoperative periods was associated with worse OS (3-year OS 56.1% vs. 71.9%, p=0.045). Patients in the high NLR group before and after treatment did worse than those who moved from high to low groups (3-year OS 42.8% vs. 69.2%, p=&lt;0.0001, 3-year DFS 32.3% vs. 61.8%, p=0.0001). High NLR at baseline and in the postoperative stage is associated with worse OS (3-year OS: 57% vs. 75.7% for baseline and 44.1% vs. 74.9% for postoperative NLR; p=0.0038 and &lt;0.0001, respectively) and DFS (3-year DFS: 52.4% vs. 60.9% for baseline and 34.9% vs. 59.9% for postoperative NLR; p=0.03 and &lt;0.0001, respectively). Patients with complete pathological response to NAC had lower mean baseline NLR (3.2 vs. 4.9 p=0.009). Conclusions: Changes in NLR during treatment may provide a clearer picture about survival outcomes and the role of neutrophils in cancer progression.
TRANSTHORACIC ECHOCARDIOGRAPHY TO ASSESS FOR VALVULAR HEART DISEASE: APPROPRIATE USE CRITERIA AND ECHOCARDIOGRAPHY FINDINGS
Authors: Tamryn Law, Zachary Bouck, Cindy Yin, Gillian Nesbitt, Amer Johri, Kibar Yared, Jeremy Edwards, Mark Hansen, Rory Weiner, Sacha Bhatia
Journal: Journal of the American College of Cardiology (2018)
CHARACTERISTICS AND PREDICTORS FOR MAINTAINING SINUS RHYTHM AT LEAST 10-YEAR AFTER SUCCESSFUL PERCUTANEOUS MITRAL BALLOON VALVOTOMY IN SEVERE MITRAL STENOSIS PATIENTS
Authors: In-Jeong Cho, Hyuk-Jae Chang, Sang-Eun Lee, Darae Kim, Jong-Ho Nam, Chi Young Shim, Geu-Ru Hong
Journal: Journal of the American College of Cardiology (2018)
Link between gut‐microbiome derived metabolite and shared gene‐effects with hepatic steatosis and fibrosis in NAFLD
Authors: Cyrielle Caussy, Cynthia Hsu, Min‐Tzu Lo, Amy Liu, Ricki Bettencourt, Veeral H. Ajmera, Shirin Bassirian, Jonathan Hooker, Ethan Sy, Lisa Richards, Nicholas Schork, Bernd Schnabl, David A. Brenner, Claude B. Sirlin, Chi‐Hua Chen, Rohit Loomba
Journal: Hepatology (2018)

Previous studies have shown that gut‐microbiome is associated with nonalcoholic fatty liver disease (NAFLD). We aimed to examine if serum metabolites, especially those derived from the gut‐microbiome, have a shared gene‐effect with hepatic steatosis and fibrosis. This is a cross‐sectional analysis of a prospective discovery cohort including 156 well‐characterized twins and families with untargeted metabolome profiling assessment. Hepatic steatosis was assessed using magnetic‐resonance‐imaging proton‐density‐fat‐fraction (MRI‐PDFF) and fibrosis using MR‐elastography (MRE). A twin additive genetics and unique environment effects (AE) model was used to estimate the shared gene‐effect between metabolites and hepatic steatosis and fibrosis. The findings were validated in an independent prospective validation cohort of 156 participants with biopsy‐proven NAFLD including shotgun metagenomics sequencing assessment in a subgroup of the cohort. In the discovery cohort, 56 metabolites including 6 microbial metabolites had a significant shared gene‐effect with both hepatic steatosis and fibrosis after adjustment for age, sex and ethnicity. In the validation cohort, 6 metabolites were associated with advanced fibrosis. Among them, only one microbial metabolite, 3‐(4‐hydroxyphenyl)lactate, remained consistent and statistically significantly associated with liver fibrosis in the discovery and validation cohort (fold‐change of higher‐MRE versus lower‐MRE: 1.78, P &lt; 0.001 and of advanced versus no advanced fibrosis: 1.26, P = 0.037, respectively). The share genetic determination of 3‐(4‐hydroxyphenyl)lactate with hepatic steatosis was R G :0.57,95%CI:0.27‐0.80, P &lt; 0.001 and with fibrosis was R G :0.54,95%CI:0.036‐1, P = 0.036. Pathway reconstruction linked 3‐(4‐hydroxyphenyl)lactate to several human gut‐microbiome species. In the validation cohort, 3‐(4‐hydroxyphenyl)lactate was significantly correlated with the abundance of several gut‐microbiome species, belonging only to Firmicutes, Bacteroidetes and Proteobacteria phyla, previously reported as associated with advanced fibrosis. Conclusion : This proof of concept study provides evidence of a link between the gut‐microbiome and 3‐(4‐hydroxyphenyl)lactate that shares gene‐effect with hepatic steatosis and fibrosis. (H epatology 2018).
TRANSCATHETER AORTIC VALVE IMPLANTATION IN NONAGENARIANS: LONG-TERM COHORT ANALYSIS FROM A PIONEERED CENTER
Authors: Guillaume Avinee, Eric Durand, Sokoloff Anastasia, Christophe Tron, Nicolas Bettinger, Najime Bouhzam, Jean-Nicolas Dacher, Fabrice Bauer, Pierre-Yves Litzler, G. Alain Cribier, Helene Eltchaninoff
Journal: Journal of the American College of Cardiology (2018)
Contract changes will affect all consultants, warns BMA
Authors: Abi Rimmer
Journal: BMJ (2015)

All consultants in England and Northern Ireland will be affected by a “contract variation” proposed by the government, the BMA has warned.

A letter to BMA members from representatives of the BMA’s Consultants Committee has warned that the government wanted to introduce a “contract variation” for consultants that would remove clinical excellence awards and decrease starting salaries. In an accompanying video …
Human Neonatal Rotavirus Vaccine (RV3-BB) to Target Rotavirus from Birth
Authors: Julie E. Bines, Jarir At Thobari, Cahya Dewi Satria, Amanda Handley, Emma Watts, Daniel Cowley, Hera Nirwati, James Ackland, Jane Standish, Frances Justice, Gabrielle Byars, Katherine J. Lee, Graeme L. Barnes, Novilia S. Bachtiar, Ajeng Viska Icanervilia, Karen Boniface, Nada Bogdanovic-Sakran, Daniel Pavlic, Ruth F. Bishop, Carl D. Kirkwood, Jim P. Buttery, Yati Soenarto
Journal: New England Journal of Medicine (2018)

A strategy of administering a neonatal rotavirus vaccine at birth to target early prevention of rotavirus gastroenteritis may address some of the barriers to global implementation of a rotavirus vaccine.
Getting on in medicine
Authors: Graham Easton
Journal: BMJ (2004)

If you can manage to get yourself a good trainer, learn how to survive unsociable hours, and understand the quaint customs of doctors, I reckon you are well on the way to a successful medical career. This week we can help with all three.

Day one in the job, and you realise that your new boss has all the training skills of Basil Fawlty. He's barking …
Switching Reference Medicines to Biosimilars: A Systematic Literature Review of Clinical Outcomes
Authors: Hillel P. Cohen, Andrew Blauvelt, Robert M. Rifkin, Silvio Danese, Sameer B. Gokhale, Gillian Woollett
Journal: Drugs (2018)

To evaluate the possibility that switching from reference biologic medicines to biosimilars could lead to altered clinical outcomes, including enhanced immunogenicity, compromised safety, or diminished efficacy for patients, a systematic literature review was conducted of all switching studies between related biologics (including biosimilars).
Drivers of Low-Value Care
Authors: Erin E. Hahn, Michael K. Gould
Journal: JAMA Internal Medicine (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 Internal Medicine 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 Internal Medicine journal
Tumor Cystic Necrosis Following Peptide Receptor Radionuclide Therapy in Neuroendocrine Tumors
Authors: Rahul Ladwa, Hooi Wen Hong, David Wyld, David A. Pattison, Matthew Burge
Journal: Clinical Nuclear Medicine (2018)

The response assessment to peptide receptor radionuclide therapy (PRRT) in neuroendocrine tumors is complex. We present the case of a 49-year-old man with metastatic rectal neuroendocrine tumor whose clinical symptoms and response evaluation criteria in solid tumors suggested progressive disease following PRRT. However, Ga-DOTA-(Tyr3)-octreotate PET/CT showed a partial scintigraphic response with absence of F-FDG PET/CT uptake consistent with tumor cystic necrosis. Long-term follow-up confirmed ongoing tumor response to treatment. Utilizing all modalities of response assessment seems to be important in correctly judging the benefit from PRRT and will need to be incorporated when developing response assessment tools.
ANEMIA AND PERIPROCEDURAL DROP IN HEMOGLOBIN AS A RISK FACTOR FOR CONTRAST-INDUCED ACUTE KIDNEY INJURY IN PATIENTS UNDERGOING CORONARY ANGIOGRAM (CA) AND/OR PERCUTANEOUS CORONARY INTERVENTION (PCI)
Authors: Jayakumar Sreenivasan, Min Zhuo, Muhammad Khan, Setri Fugar, Heyi Li, Parth Desai, Axi Patel, Ahmed Kolkailah, Neha Yadav
Journal: Journal of the American College of Cardiology (2018)
Introduction to Radiology Day—Peninsula Radiology Academy
Authors: Howard Tat-Chun Chan, Grant Mitchell
Journal: BMJ (2008)

There have been great advances in diagnostic imaging technology over the past three decades. These changes include improvements in imaging technology such as ultrasound, computed tomography, magnetic resonance imaging, and nuclear medicine. Meanwhile the techniques in interventional radiology are expanding rapidly and allow minimally invasive procedures as well as lifesaving treatments to be performed in high risk patients. Although clinical radiology plays an essential role in medicine, it has not always been popular compared with other specialties. The Introduction to Radiology Day has provided me with an excellent opportunity to understand the role of the radiologist and to choose radiology as a career.

Foundation doctors, …
A second year pilot for foundation year 2
Authors: Mike Walzman, Maggie Allen, Dan Higman
Journal: BMJ (2005)

August 2005 will see all graduates from UK medical schools enter a two year foundation programme. <i>Mike Walzman</i>, <i>Maggie Allen</i>, and <i>Dan Higman</i> report on their experiences of the Coventry and Warwickshire Foundation School
I am considering leaving medicine. I would like to use my degree and experience in some form though. What examples of jobs have other medics gone into?
Authors: Sabina Dosani
Journal: BMJ (2007)

Have a career related problem that needs answering? Can9t find the 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>
LONG-TERM THERAPY WITH ELAMIPRETIDE NORMALIZES SIRTUIN-3 PROTEIN LEVELS IN ISOLATED MITOCHONDRIA OF LEFT VENTRICULAR MYOCARDIUM OF DOGS WITH CHRONIC HEART FAILURE
Authors: Ramesh C. Gupta, Vinita Singh-Gupta, Kristina Castle, Hani N. Sabbah
Journal: Journal of the American College of Cardiology (2018)
Neurophysiological mechanisms of exertional dyspnoea in fibrotic interstitial lung disease
Authors: Michele R. Schaeffer, Christopher J. Ryerson, Andrew H. Ramsook, Yannick Molgat-Seon, Sabrina S. Wilkie, Satvir S. Dhillon, Reid A. Mitchell, A. William Sheel, Nasreen Khalil, Pat G. Camp, Jordan A. Guenette
Journal: European Respiratory Journal (2018)

Our understanding of the mechanisms of dyspnoea in fibrotic interstitial lung disease (ILD) is incomplete. The aims of this study were two-fold: 1) to determine whether dyspnoea intensity is better predicted by neural respiratory drive (NRD) or neuromechanical uncoupling (NMU) of the respiratory system in fibrotic ILD, and 2) to examine the effect of breathing 60% oxygen on NRD, NMU and dyspnoea ratings.Fourteen patients with fibrotic ILD were included. Visit 1 comprised a familiarisation incremental cycle exercise test, Visit 2 comprised a normoxic incremental cycling test to address Aim 1, and Visits 3 and 4 consisted of constant-load cycling while breathing room air or 60% oxygen to address Aim 2. Diaphragmatic electromyography (EMGdi) was used as a surrogate of NRD. NMU was calculated as the ratio between EMGdi (%max) and tidal volume (%vital capacity).On adjusted analysis, NMU and its constituents were all significantly associated with dyspnoea ratings during incremental cycling, with EMGdi having the strongest correlation. The between-treatment change in dyspnoea ratings during constant load cycling was only correlated with change in exercise endurance time and NMU.Dyspnoea more strongly reflected the level of EMGdi than NMU in fibrotic ILD. However, the improvement in dyspnoea with 60% oxygen was better predicted by improvements in NMU.
Magnetic resonance cholangiogram patterns and clinical profiles of ketamine-related cholangiopathy in drug users
Authors: Wai-Kay Seto, Siu-King Mak, Keith Chiu, Varut Vardhanabhuti, Ho-Fai Wong, Heng-Tat Leong, Paul S.F. Lee, Y.C. Ho, Chi-Kei Lee, Ka-Shing Cheung, Man-Fung Yuen, Wai K. Leung
Journal: Journal of Hepatology (2018)