tbuckley/cabot-search huggingface dataset:
Prospective external validation of the Predicting Out-of-OFfice Blood Pressure (PROOF-BP) strategy for triaging ambulatory monitoring in the diagnosis and management of hypertension: observational cohort study
Authors: James P Sheppard, Una Martin, Paramjit Gill, Richard Stevens, FD Richard Hobbs, Jonathan Mant, Marshall Godwin, Janet Hanley, Brian McKinstry, Martin Myers, David Nunan, Richard J McManus
Journal: BMJ (2018)

<h3>Abstract</h3> <h3>Objective</h3> To prospectively validate the Predicting Out-of-OFfice Blood Pressure (PROOF-BP) algorithm to triage patients with suspected high blood pressure for ambulatory blood pressure monitoring (ABPM) in routine clinical practice. <h3>Design</h3> Prospective observational cohort study. <h3>Setting</h3> 10 primary care practices and one hospital in the UK. <h3>Participants</h3> 887 consecutive patients aged 18 years or more referred for ABPM in routine clinical practice. All underwent ABPM and had the PROOF-BP applied. <h3>Main outcome measures</h3> The main outcome was the proportion of participants whose hypertensive status was correctly classified using the triaging strategy compared with the reference standard of daytime ABPM. Secondary outcomes were the sensitivity, specificity, and area under the receiver operator characteristic curve (AUROC) for detecting hypertension. <h3>Results</h3> The mean age of participants was 52.8 (16.2) years. The triaging strategy correctly classified hypertensive status in 801 of the 887 participants (90%, 95% confidence interval 88% to 92%) and had a sensitivity of 97% (95% confidence interval 96% to 98%) and specificity of 76% (95% confidence interval 71% to 81%) for hypertension. The AUROC was 0.86 (95% confidence interval 0.84 to 0.89). Use of triaging, rather than uniform referral for ABPM in routine practice, would have resulted in 435 patients (49%, 46% to 52%) being referred for ABPM and the remainder managed on the basis of their clinic measurements. Of these, 69 (8%, 6% to 10%) would have received treatment deemed unnecessary had they received ABPM. <h3>Conclusions</h3> In a population of patients referred for ABPM, this new triaging approach accurately classified hypertensive status for most, with half the utilisation of ABPM compared with usual care. This triaging strategy can therefore be recommended for diagnosis or management of hypertension in patients where ABPM is being considered, particularly in settings with limited resources.
Abstract 20738: Atrial Voltage Dispersion Does Indeed Predict Atrial Fibrillation in Ischemic Stroke Patients as Well as in Controls
Authors: Daniel Cortez, Maria Baturova, Arne Lindgren, Jonas Carlson, Pyotr Platonov
Journal: Circulation (2016)

Introduction: Paroxysmal atrial fibrillation (AF) may be underdiagnosed in ischemic stroke patients. Given the need for anticoagulation in these patients, missing this may place them at risk for fu...
PTU-051 Day case ‘treat and transfer’ ercp service under general anaesthesia
Authors: Y El-sherif, J Hunt, A Suddle, B Prater, D Reffitt, J Devlin, P Harrison, D Joshi
Journal: Gut (2017)

Introduction  General Anaesthesia (GA) has been increasingly used for advanced endoscopic procedures in particular ERCP (endoscopic retrograde cholangio-pancreatography). Given the increasing pressure on many hospitals, the delivery of such service on a regular basis may not always be possible. We established a new day case “treat and transfer GA ERCP” service at Kings College Hospital (KCH), NHS Foundation Trust, London, UK. The new service allows local hospitals to transfer inpatients requiring urgent GA ERCP to KCH endoscopy unit for a day case GA ERCP procedure. Patients are discharged back to their referring hospitals after four hours observation period post completion of ERCP. We describe our experience in evaluating the safety and overall feasibility of this new service.  Method  Database has been prospectively interrogated for all adult inpatients who were referred to KCH endoscopy unit for urgent ERCP under GA during the period from March 2015 to December 2016. We documented patients’ demographics, ERCP indications, American Society of Anaesthetists (ASA) status, Cotton grade of endoscopic difficulty and endoscopic and anaesthetic complications.  Results  61 patients were referred to endoscopy unit at KCH for urgent day case GA ERCP from nine referring hospitals. The main indications were failed ERCP under conscious sedation 46% (28/61), and unavailability of GA ERCP list locally 43% (26/61). 3 patients were cancelled by their local hospitals (2 patients were unstable for transfer and 1 patient required full inpatient transfer to KCH liver ITU due to progressive deterioration). After exclusion of cancelled referrals, a total of 58 ERCPs patients were transferred to KCH endoscopy unit; 64% (37/58) females with median age 57 years (range 23-90). 76% (44/58) of patients had a virgin papilla, with 39% (23/58) of patients were ASA 3 or greater. The Cotton Grade was 3 or more in 50% (29/58) of patients. ERCP was performed on all patients and completed successfully in 86% (50/58). For patients with previous failed ERCP, repeat ERCP under GA was successful in 71% (20/28). ERCP was not completed in 8 patients (anatomical distortion=5 and failed cannulation=3). All patients were safely discharged back to their referring hospitals after the short observation period post-ERCP. No complications related to anaesthesia or endoscopy were reported peri- or post- procedure.  Conclusion  Urgent inpatient transfers between hospitals for performing ERCP under GA as a day case is safe and feasible. The new GA ERCP pathway can be replicated by other UK centres.  Disclosure of Interest: None Declared
Different Population and End Point Definitions in Reproduction Analysis Based on Shared Data
Authors: Andrea Natale, Robert Stagg, Baohui Zhang
Journal: JAMA Cardiology (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 Cardiology 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 Cardiology journal
Adverse Neuropsychiatric Events and Recreational Use of Efavirenz and Other HIV-1 Antiretroviral Drugs
Authors: Dhwanil A. Dalwadi, Luis Ozuna, Brian H. Harvey, Michelle Viljoen, John A. Schetz
Journal: Pharmacological Reviews (2018)

Efavirenz is a highly effective HIV-1 antiretroviral; however, it is also frequently associated with neuropsychiatric adverse events (NPAE) that include abnormal dreams, sleep disturbances, nervousness, anxiety, depression, and dizziness. The incidence of NPAEs upon initiation of treatment with efavirenz-containing medications is high, exceeding 50% in most studies. Although the NPAEs tend to decrease after the first month in many patients, they persist for long periods of time in others. Efavirenz-based treatment is generally well-tolerated in children, although some experience persistent concentration problems, as well as sleep disturbances, psychotic reactions, and seizures. In an effort to link basic with clinical research, parameters associated with efavirenz brain exposure are discussed, and factors that increase efavirenz levels are explored in depth as they are expected to contribute to NPAE risk. These include the role of modifiable and nonmodifiable risk factors such as diet, weight, and drug-drug interactions and sex, age, and ethnicity/pharmacogenetics. In addition to NPAEs, this review explores what is known about antiretroviral (ARV) drugs being used for recreational purposes. Although multiple ARV drugs are covered, special attention is devoted to efavirenz given that the majority of reports of NPAEs and illicit use of ARV drugs concern efavirenz. The evolving molecular mechanistic basis of NPAEs and abuse of efavirenz point to a complex and polymodal receptor pharmacology. Animal studies to date primarily point to a serotonergic mechanism of action. Recently emerging associations between HIV-associated neurocognitive disorder and efavirenz use, and possible contributions of the mitochondrial-immune-inflammatory-redox cascade are explored in the context of the signaling mechanisms that appear to be involved.
Abstract 1579: IMI's CANCER-ID: Implications of liquid biopsy technology standardization for its clinical use
Authors: Klaus Pantel, Leon W. Terstappen, Barbara Baggiani, Thomas Krahn, Catherine Panabières, Evi Lianidou, Bjørn Naume, Françoise Farace, Thomas Schlange
Journal: Cancer Research (2018)

Abstract Liquid biopsies offer the opportunity to improve the diagnosis and timely adaption of therapy options to the progression and heterogeneity of cancer. The CANCER-ID (www.cancer-id.eu) consortium was established in early 2015 as part of the Innovative Medicines Initiative (IMI) and has currently 37 partners from 14 countries, including the USA and Singapore. The goal of the CANCER-ID program is to foster implementation of liquid biopsy technologies in multicenter clinical studies and the potential regulatory approval of devices or protocols in the field. Within the project best practice protocols for using technologies aiming at the enrichment, isolation and analysis of Circulating Tumor Cells (CTCs), circulating free tumor DNA (ctDNA) and microRNAs (miRNAs) are being developed and benchmarking data for the performance of different technologies are collected. To this end defined standards for the different biomarker classes are crucial and their introduction and design is being supported by CANCER-ID. Another integral part of our work is the development of integrated workflows from patient sample collection, pre-analytical sample handling, sample and bioinformatics analyses down to the actionable information guiding patient selection and personalized treatment. CANCER-ID partners are currently planning clinical studies to assess the clinical utility of analyzing PD-L1 expression on CTCs in their core indications Non-Small Cell Lung Cancer (NSCLC) and metastatic breast cancer. While the benefit of immune checkpoint inhibition has been impressively demonstrated in NSCLC, most advanced breast cancer patients do not benefit from targeting PD-1 with the exception of the triple-negative disease type. The liquid biopsy workflows established by the CANCER-ID consortium will be used to correlate CTC PD-L1 expression in patients treated with PD-1 blocking antibodies with clinical response and in parallel perform mutational load analysis in blood. The aim will be to attempt to develop a liquid biopsy-based rationale for patient selection guiding effective immune checkpoint therapies. The study plan and current status of this multicenter effort will be presented. This work is supported by IMI JU &amp; EFPIA (grand no. 115749, CANCER-ID). Samples from patients and healthy volunteers, respectively, were collected under signed informed consent. Citation Format: Klaus Pantel, Leon W. Terstappen, Barbara Baggiani, Thomas Krahn, Catherine Panabières, Evi Lianidou, Bjørn Naume, Françoise Farace, Thomas Schlange. IMI's CANCER-ID: Implications of liquid biopsy technology standardization for its clinical use [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1579.
Abstract 1333: Inactivation of NBR1 enhances sensitivity to rapamycin on human urothelial cancer cell lines through AMPK/ULK1-mediated autophagy
Authors: Myeong Joo Kim, Min Ji Cho, In Ho Chang, Young Mi Whang
Journal: Cancer Research (2018)

Abstract Rapamycin has been highly evaluated in clinical therapeutic intervention for cancer patients as a specific inhibitor of the mammalian target of rapamycin (mTOR) kinase. Rapamycin also stimulates autophagy and mitophagy to remove damaged cells as a regulator of general autophagy. Previously, we identified increased expression of mRNA levels of NBR1 (autophagy cargo receptor) by inhibiting mTOR signaling in human urothelial cancer cell lines. Therefore, we investigated whether loss of NBR1 sensitizes human urothelial cancer cells to autophagic stimulation and stress-induced mitochondrial insults by treatment with rapamycin. NBR1-deficient cells exhibited enhanced sensitivity to rapamycin that was associated with increased autophagy and mitochondrial defects. Loss of NBR1 expression altered the cellular response to rapamycin treatment, resulting in impaired ATP homeostasis and an increase in reactive oxygen species. Moreover, rapamycin treatment also induced autophagy activity through AMPK activation in NBR1-deficient cells, which was involved in blocked mTOR signaling and activated unc-51 like autophagy activating kinase 1 (ULK1). NBR1-deficient cells exhibited profound mitochondrial dysfunction in response to rapamycin treatment as evidenced by Δψm collapse, ATP depletion, ROS accumulation and apoptosis activation. Therefore, our findings provide a rationale for rapamycin treatment of NBR1-deficient human urothelial cancer through induction of autophagy activity by regulating the AMPK/mTOR signaling pathway, indicating that NBR1 can be a potential candidate for the treatment of human urothelial cancer. (NRF-2015R1A1A1A0500110 to I.H.C., NRF-2016R1D1A1B03933826 to Y.M.W., and the Korea Health Technology R&amp;D Project HI17C0710 to C.I.H.) Citation Format: Myeong Joo Kim, Min Ji Cho, In Ho Chang, Young Mi Whang. Inactivation of NBR1 enhances sensitivity to rapamycin on human urothelial cancer cell lines through AMPK/ULK1-mediated autophagy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1333.
Abstract 2164: Conditional tumor cell reprogramming: From in vitro sensitivity to in vivo PDX modeling
Authors: Yuan Long, Loc Van, Song Xi, Le Li, Yuhui Zheng, Ying Ling, Feifei Zhang, Jijun Cheng, Danyi Wen
Journal: Cancer Research (2018)

Abstract Tumor cell immortalization through conditional reprogramming, particularly from limited biopsy specimen, is an invaluable tool to generate propagating tumor cells for cell-based diagnostics, drug sensitivity assay and bio-banking in vitro. We have successfully reprogrammed primary tumor cells from a number of unreported tumor types, including lung carcinoma and adenoid cystic carcinoma, towards immortalization. The propagating cells exhibited typical colonized growth, which is well maintained upon cryo-frozen. In some cases, the cells can be passaged for multiple times and likely become useful cell lines. Like primary tumor cells, conditional reprogrammed tumor cells are reliable to test drug sensitivity in vitro. We attempt to extend conditional reprogrammed tumor cells to reconstitute and grow PDX models in vivo for testing drug efficacy. Preliminary data indicate that, in a 7-day in vivo assay utilizing hollow-fiber tubes grown subcutaneously in mouse, which we call OncoVee Mini-PDX, conditional reprogrammed tumor cells, like primary tumor cells and PDX tumor cells, can be successfully used to test drug efficacy in vivo. In summary, this study explores and evaluates applications of conditional reprogrammed tumor cells in drug efficacy tests both in vitro and in vivo. Citation Format: Yuan Long, Loc Van, Song Xi, Le Li, Yuhui Zheng, Ying Ling, Feifei Zhang, Jijun Cheng, Danyi Wen. Conditional tumor cell reprogramming: From in vitro sensitivity to in vivo PDX modeling [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 2164.
Treatment after traumatic shoulder dislocation: a systematic review with a network meta-analysis
Authors: Lauri Kavaja, Tuomas Lähdeoja, Antti Malmivaara, Mika Paavola
Journal: British Journal of Sports Medicine (2018)

Objective To review and compare treatments (1) after primary traumatic shoulder dislocation aimed at minimising the risk of chronic shoulder instability and (2) for chronic post-traumatic shoulder instability. Design Intervention systematic review with random effects network meta-analysis and direct comparison meta-analyses. Data sources Electronic databases (Ovid MEDLINE, Cochrane Clinical Trials Register, Cochrane Database of Systematic Reviews, Embase, Scopus, CINAHL, Ovid MEDLINE Epub Ahead of Print, In-Process &amp; Other Non-Indexed Citations, Ovid MEDLINE Daily, DARE, HTA, NHSEED, Web of Science) and reference lists were searched from inception to 15 January 2018. Eligibility criteria for selecting studies Randomised trials comparing any interventions either after a first-time, traumatic shoulder dislocation or chronic post-traumatic shoulder instability, with a shoulder instability, function or quality of life outcome. Results Twenty-two randomised controlled trials were included. There was moderate quality evidence suggesting that labrum repair reduced the risk of future shoulder dislocation (relative risk 0.15; 95% CI 0.03 to 0.8, p=0.026), and that with non-surgical management 47% of patients did not experience shoulder redislocation. Very low to low-quality evidence suggested no benefit of immobilisation in external rotation versus internal rotation. There was low-quality evidence that an open procedure was superior to arthroscopic surgery for preventing shoulder redislocations. Conclusions There was moderate-quality evidence that half of the patients managed with physiotherapy after a first-time traumatic shoulder dislocation did not experience recurrent shoulder dislocations. If chronic instability develops, surgery could be considered. There was no evidence regarding the effectiveness of surgical management for post-traumatic chronic shoulder instability.
Lung cancer stage-shift following a symptom awareness campaign
Authors: Martyn P T Kennedy, Leanne Cheyne, Michael Darby, Paul Plant, Richard Milton, Jonathan M Robson, Alison Gill, Puneet Malhotra, Victoria Ashford-Turner, Kirsty Rodger, Elankumaran Paramasivam, Annette Johnstone, Bobby Bhartia, Shishir Karthik, Catherine Foster, Veronica Lovatt, Francesca Hewitt, Louise Cresswell, Victoria H Coupland, Margreet Lüchtenborg, Ruth H Jack, Henrik Moller, Matthew E J Callister
Journal: Thorax (2018)

Background Lung cancer outcomes in the UK are worse than in many other developed nations. Symptom awareness campaigns aim to diagnose patients at an earlier stage to improve cancer outcomes. Methods An early diagnosis campaign for lung cancer commenced in Leeds, UK in 2011 comprising public and primary-care facing components. Rates of community referral for chest X-ray and lung cancer stage (TNM seventh edition) at presentation were collected from 2008 to 2015. Linear trends were assessed by χ 2 test for trend in proportions. Headline figures are presented for the 3 years pre-campaign (2008–2010) and the three most recent years for which data are available during the campaign (2013–2015). Findings Community-ordered chest X-ray rates per year increased from 18 909 in 2008–2010 to 34 194 in 2013–2015 (80.8% increase). A significant stage shift towards earlier stage lung cancer was seen (χ 2 (1)=32.2, p&lt;0.0001). There was an 8.8 percentage point increase in the proportion of patients diagnosed with stage I/II lung cancer (26.5% pre-campaign vs 35.3% during campaign) and a 9.3% reduction in the absolute number of patients diagnosed with stage III/IV disease (1254 pre-campaign vs 1137 during campaign). Interpretation This is the largest described lung cancer stage-shift in association with a symptom awareness campaign. A causal link between the campaign and stage-shift cannot be proven but appears plausible. Limitations of the analysis include a lack of contemporary control population.
The Objective of Local Therapy in Oligometastatic Cancer Is a Moving Target
Authors: Daniel J. Boffa
Journal: JAMA Oncology (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 Oncology 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 Oncology journal