tbuckley/cabot-search huggingface dataset:
Mortality and morbidity meetings
Authors: Wade Gayed, Sidiath Liyanage
Journal: BMJ (2006)

Mortality and morbidity (M&M) meetings are often considered a chore, but have become increasingly important in the current era of clinical governance. Usually, the most junior member of the surgical team has to deal with the bulk of the preparation. While there may be slight differences in formats between different trusts and surgical specialties, the tips below …
IV prochlorperazine + diphenhydramine improved migraine pain relief more than IV hydromorphone in the ED
Authors: Alexander W. Chessman
Journal: Annals of Internal Medicine (2018)

ACP Journal Club20 March 2018IV prochlorperazine + diphenhydramine improved migraine pain relief more than IV hydromorphone in the EDAlexander W. Chessman, MDAlexander W. Chessman, MDMedical University of South Carolina, Charleston, South Carolina, USA (A.W.C.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/ACPJC-2018-168-6-028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationFriedman BW, Irizarry E, Solorzano C, et al. Randomized study of IV prochlorperazine plus diphenhydramine vs IV hydromorphone for migraine. Neurology. 2017;89:2075-82. https://pubmed.ncbi.nlm.nih.gov/29046364Clinical Impact RatingsEmergency Med: Neurology: References1 Volkow ND, Collins FS. The role of science in addressing the opioid crisis. N Engl J Med. 2017;377:391-4. [PMID: 28564549] Google Scholar2 Loder E, Weizenbaum E, Frishberg B, Silberstein S; American Headache Society Choosing Wisely Task Force. Choosing wisely in headache medicine: the American Headache Society's list of five things physicians and patients should question. Headache. 2013;53:1651-9. [PMID: 24266337] Google Scholar3 Charles A. Migraine. N Engl J Med. 2017;377:553-61. [PMID: 28792865] Google Scholar4 Derry S, Moore RA. Paracetamol (acetaminophen) with or without an antiemetic for acute migraine headaches in adults. Cochrane Database Syst Rev. 2013;4:CD008040. [PMID: 23633349]. Google Scholar5 Law S, Derry S, Moore RA. Sumatriptan plus naproxen for the treatment of acute migraine attacks in adults. Cochrane Database Syst Rev. 2016;4:CD008541. [PMID: 27096438]. Google Scholar Author, Article, and Disclosure InformationAffiliations: Medical University of South Carolina, Charleston, South Carolina, USA (A.W.C.)This article was published at Annals.org on 6 March 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 20 March 2018Volume 168, Issue 6Page: JC28KeywordsAdverse eventsEmergency departmentHeadachesMigraineNeurologyNumber needed to treatOpioidsSecondary headachesTemperature ePublished: 20 March 2018 Issue Published: 20 March 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Molecular Magnetic Resonance Imaging of Endothelial Activation in the Central Nervous System
Authors: Maxime Gauberti, Antoine P. Fournier, Fabian Docagne, Denis Vivien, Sara Martinez de Lizarrondo
Journal: Theranostics (2018)

Endothelial cells of the central nervous system over-express surface proteins during neurological disorders, either as a cause, or a consequence, of the disease.Since the cerebral vasculature is easily accessible by large contrast-carrying particles, it constitutes a target of choice for molecular magnetic resonance imaging (MRI).In this review, we highlight the most recent advances in molecular MRI of brain endothelial activation and focus on the development of micro-sized particles of iron oxide (MPIO) targeting adhesion molecules including intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1), P-Selectin and E-Selectin.We also discuss the perspectives and challenges for the clinical application of this technology in neurovascular disorders (ischemic stroke, intracranial hemorrhage, subarachnoid hemorrhage, diabetes mellitus), neuroinflammatory disorders (multiple sclerosis, brain infectious diseases, sepsis), neurodegenerative disorders (Alzheimer's disease, vascular dementia, aging) and brain cancers (primitive neoplasms, metastasis).
Correction to: Lonoctocog Alfa: A Review in Haemophilia A
Authors: Zaina T. Al-Salama, Lesley J. Scott
Journal: Drugs (2018)

The article Lonoctocog Alfa: A Review in Haemophilia A, written by Zaina T. Al-Salama and Lesley J. Scott, was originally published Online First without open access. After publication in volume 77, issue 15, pages 1677–1686 CSL Behring GmbH requested that the article be Open Choice to make the article an open access publication. Post-publication open access was funded by CSL Behring GmbH. Further details may be found at http://www.medengine.com/Redeem/CBD8F060224F2E65 . The article is forthwith distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( http://creativecommons.org/licenses/by-nc/4.0/ ), which permits any noncommercial use, duplication, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.
What are the chances for an overseas student to get an F1 placement in the foundation programme? Is the number of available placements restricted to the number of UK graduates? Or are there some places created in excess? If so, what percentage is it?
Authors: Pal Kumar
Journal: BMJ (2005)

Have a career or related problem that needs answering? Can9t find the right 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>
Abstract P131: Effect of a Social Incentive-based Gamification Intervention Using Wearable Devices and Smartphones on Physical Activity: The BE FIT Randomized Clinical Trial
Authors: Mitesh S Patel, Emelia J Benjamin, Kevin G Volpp, Caroline S Fox, Dylan S Small, Joseph M Massaro, Jane J Lee, Victoria Hilbert, Maureen Valentino, Devon H Taylor, Emily S Manders, Karen Mutalik, Jingsan Zhu, Wenli Wang, Joanne M Murabito
Journal: Circulation (2017)

Background: Social networks can influence individual health behaviors, but interventions that leverage social incentives within these networks to change health behaviors have not been well examined. The objective of this study was to test the effectiveness of a social incentive-based gamification intervention to increase physical activity in the community. Methods: The Behavioral Economics Framingham Incentive Trial (BE FIT) was a randomized clinical trial that recruited 206 adults comprising 97 groups of two or three family members in the Framingham Heart Study and occurred between December 2015 and August 2016. Participants used a wearable device or smartphone application to establish a baseline step count and selected a step goal increase for a 12-week primary intervention period and a 12-week follow-up period. Participants in both the control and intervention arms received daily feedback on their performance for 24 weeks. During the first 12 weeks, participants in the intervention arm played a game (including points, levels, and lifelines) with their family members that was designed using insights from behavioral economics to enhance social incentives such as peer support, accountability, and collaboration. The primary outcome was the mean proportion of participant-days the step goal was achieved during the primary intervention period. Secondary outcomes included the mean proportion of participant-days the step goal was achieved during the follow-up period and mean daily steps during the intervention and follow-up periods. Results: Participants in the intervention arm achieved step goals on a greater proportion of participant-days and had greater mean daily steps than the control arm during the intervention and follow-up periods (TABLE). Conclusions: Among groups of family members in a community, a social incentive-based gamification intervention was effective at increasing physical activity during the 12-week intervention period and effects were sustained during the 12-week follow-up period.
Risk stratification of gastrointestinal stromal tumors by CtBP2 and CD44 analysis.
Authors: Priya Gopie, Oana C. Rosca, Ayesha Chawla, Lin Mei, Jorge Almenara, Edmund Glass, Mikhail Dozmorov, Steven R. Grossman, Michael Idowu, Sosipatros Alexandros Boikos
Journal: Journal of Clinical Oncology (2018)

48 Background: C-terminal binding protein 2 (CtBP2) is an oncogenic transcription factor that promotes cancer stem cell (CSC) growth and self-renewal, and controls pathways for tumor initiation, progression, and response to therapy. Expression of CtBP2 is linked to aggressive behavior in ovarian cancer, while genetic or pharmacologic targeting of CtBP2 disrupts CSC growth and self-renewal. CD44 is a cell surface marker that has been linked to CSC populations in many solid tumors, though data is conflicting on its role as tumor suppressor or oncogene. Gastrointestinal stromal tumors (GIST) is an increasingly common malignancy where risk stratification is essential for guiding post-surgical adjuvant therapy. We hypothesized that CtBP2 and CD44 staining would enhance risk stratification of GIST which currently relies on purely non-molecular clinicopathologic criteria. Methods: We identified 149 GIST cases from 1990 to 2016 in the Virginia Commonwealth University Medical Center pathology archive. Clinical data for 121 patients was available. The Armed Forces Institute of Pathology (AFIP) criteria (Miettinen's criteria) was used to risk stratify GISTs using the size, site, and mitotic index of the primary tumor. Immunohistochemistry for CtBP2 and CD44 was then performed on GIST samples with adequate tumor (86, CD44; 87, CtBP2). Stains were scored 0 (negative) to 3 (maximum) by two independent pathologists. Statistical analysis (χ 2 ) correlating AFIP risk category with CD44 and CtBP2 staining was performed using PRISM6. Results: Moderate and high risk GISTs, based on AFIP criteria, significantly correlated with high CtBP2 expression (score = 3, p = 0.046) and low CD44 expression (score = 0-2, p = 0.034). Conclusions: CD44 and CtBP2 staining can be used to risk stratify GIST, and may enhance and complement current clinical risk stratification systems. Our data also suggests a potential tumor suppressive role of CD44 in GIST. Additionally, based on our findings, investigation of therapeutics that target CtBP2 in GISTs should be pursued.
So you want to be an orthopaedic surgeon?
Authors: Salah Hammouche
Journal: BMJ (2008)

“So you want to be an orthopaedic surgeon?” is a new course run by the Royal College of Surgeons of England, as one of the recently launched series of “So you want to be . . . ?” one day courses. It involves multiple interactive lectures presented by well known orthopaedic consultants. The course is designed to familiarise prospective trainees with the history of orthopaedics, its different aspects and subspecialties, and potential developments. It covers the changes in the recruitment process and orthopaedic training, and explores examinations and assessments that the trainee has to complete. The aim is to provide a better understanding of the scope of the subject and the route(s) for pursuing a career in orthopaedics.

Junior doctors who have a potential interest in trauma and orthopaedics are encouraged to attend this course. It is aimed at new graduate doctors—that is, foundation year 1 and foundation year 2. Final year medical students are welcomed as well, (it’s never too early …
Safety and efficacy of apatinib in elderly patients with advanced or metastatic gastric cancer in the post-marketing phase IV study: Subgroup analysis by age (Ahead-G201).
Authors: Lu Wen, Shukui Qin, Jin Li, Wenying Deng, Junsheng Wang, Guifang Zhang, Haijun Zhong, Tongfu Jia, Yi Ba, Yuxian Bai, Xiaoyan Lin, Mei Wang, Lin Wang, Likun Liu, Yifu He, Min Tao, Congying Xie, Feng Ye, Xiang-yuan Wu, Jianwei Yang
Journal: Journal of Clinical Oncology (2018)

126 Background: Old age is a potential negative predictor, and thus is of interest. Data from the ongoing post-marketing Phase IV trial were collected to assess the effect of age on apatinib treatment in 2000+ patients (pts) with chemotherapy-refractory advanced or metastatic gastric cancer. Methods: This subgroup analysis was stratified by age (&lt;65 or ≥65 yrs). Both incidence of adverse events (AEs) and clinical outcomes were compared. Results: 725 pts &lt;65 yrs and 312 pts ≥65 yrs were enrolled (data cut-off 2017/7/10). Differences in gender, ECOG PS, BMI, disease duration and metastatic sites were observed. 68.6% and 39.7% of pts aged ≥65 yrs experienced AEs of any grade and grade ≥3, which were not different with 70.2% and 40.0% of pts aged &lt;65 yrs. The common AE profile was similar, but elderly pts had a higher incidence of hypertension, diarrhea and bilirubin increase (Table). Pts ≥65 yrs showed a higher objective response rate (12.2% vs. 9.9%) and longer overall survival (7.82 vs. 6.05 mos); however, there was no statistical difference. The disease control rate (79.6% vs. 65.4%; p=0.002) and progression free survival (PFS) (5.71 vs. 3.22 mos; p&lt;0.001) of pts ≥65 yrs were significantly superior to pts &lt;65 yrs. Multivariate Cox regression model confirmed that age ≥65 yr was a positive prognostic factor for PFS independent of baseline and treatment characteristics (HR: 0.67 [95%CI, 0.50–0.88]). Conclusions: Pts ≥65 yr is not at increased risk of overall AEs, but hypertension, diarrhea and bilirubin increase should be closely monitored. The PFS benefit in elderly pts will be validated. Clinical trial information: NCT02426034. [Table: see text]
Loss of miR-204 expression is a key event in melanoma
Authors: Marco Galasso, Carl Morrison, Linda Minotti, Fabio Corrà, Carlotta Zerbinati, Chiara Agnoletto, Federica Baldassari, Matteo Fassan, Armando Bartolazzi, Andrea Vecchione, Gerard J. Nuovo, Gianpiero Di Leva, Stefania D’Atri, Ester Alvino, Maurizio Previati, Brian J. Nickoloff, Carlo M. Croce, Stefano Volinia
Journal: Molecular Cancer (2018)

Cutaneous melanoma (CM) is a malignancy with increasing occurrence. Its microRNA repertoire has been defined in a number studies, leading to candidates for biological and clinical relevance: miR-200a/b/c, miR-203, miR-205, miR-204, miR-211, miR-23b and miR-26a/b. Our work was aimed to validate the role of these candidate miRNAs in melanoma, using additional patients cohorts and in vitro cultures. miR-26a, miR-204 and miR-211 were more expressed in normal melanocytes, while miR-23b, miR-200b/c, miR-203 and miR-205 in epidermis and keratinocytes. None of the keratinocyte-related miRNAs was associated with any known mutation or with clinical covariates in melanoma. On the other hand, the loss of miR-204 was enriched in melanomas with NRAS sole mutation (Fisher exact test, P = 0.001, Log Odds = 1.67), and less frequent than expected in those harbouring CDKN2A mutations (Fisher exact test, P = 0.001, Log Odds − 1.09). Additionally, miR-204 was associated with better prognosis in two independent melanoma cohorts and its exogenous expression led to growth impairment in melanoma cell lines. Thus, miR-204 represents a relevant mechanism in melanoma, with potential prognostic value and its loss seems to act in the CDKN2A pathway, in cooperation with NRAS.
PERCUTANEOUS MECHANICAL HEMODYNAMIC SUPPORT AS A BRIDGE TO RECOVERY IN SEVERE TAKOTSUBO CARDIOMYOPATHY WITH PROFOUND LEFT VENTRICULAR OUTFLOW TRACT OBSTRUCTION AND CARDIOGENIC SHOCK
Authors: Sagger Mawri, Brittany Fuller, Gerald Koenig, Sachin Parikh, Mohammad Zaidan
Journal: Journal of the American College of Cardiology (2018)
I’ve accepted a specialty training post starting in August. What should I do now?
Authors: Khoon-Sheng Kok
Journal: BMJ (2014)

If you have obtained a specialty or core training post, starting in August, it is tempting to relax as all you have to do now is pass the foundation programme. But, as <b>Khoon-Sheng Kok</b> explains, you can do several things to make the most of this period to provide a stepping stone to specialty training
Abstract P4-13-04: Robotic nipple-sparing mastectomy with immediate prosthetic breast reconstruction : A preliminary study
Authors: B Sarfati, S Struk, N Leymarie, JF Honart, F Rimareix, S Delaloge, M Saghatchian, A Ghouadni, H Alkhashnam, C Mazouni, F Kolb
Journal: Cancer Research (2018)

Abstract Background: Robotic nipple-sparing mastectomy (RNSM) could be a significant advancement in the treatment of selected breast cancers and prophylaxis. The aim of this prospective study was to assess feasibility of the RNSM with immediate prosthetic breast reconstruction (IPBR) on the first 50 consecutive cases performed in Gustave Roussy. Methods: RNSM with IPBR was offered to patients with breast cup size A, B or C and ptosis grade ≤ 2. In case of oncologic surgery, RNSM was offered only if the patient fulfilled oncological indications for NSM (NAC). In case of prophylactic surgery, RNSM was offered only if a high-risk genetic mutation had been identified or if the patient was at high risk of breast cancer. The primary endpoint was the conversation rate to open technique. The duration of the surgery, the rate of postoperative complications, the length of the scar, the duration of drainage and hospital stay, the rate and duration of rehospitalization were also analyzed. Results: Of 50 RNSM with IPBR from December 2015 to April 2017, 1 case of conversion to open technique occurred (2%) because of an uncontrolled bleeding from an internal mammary perforator. Two infections occurred (4%) : one led to implant loss. There were no cases of mastectomy skin flap or NAC necrosis. No other major complications were observed. The duration of the whole procedure was reduced gradually from 214 min to 86 min. Length of scar was between 2.5 and 5 cm. Patients were discharged home between the 4th and the 10th postoperative day after the removal of the drain. Conclusion: Preliminary data attest to the feasibility, the reproducibility and the safety of this approach. However, long-term data are needed to confirm the reduced rate of skin and NAC necrosis compared to the open technique, the oncological safety and the aesthetic stability of the result. Citation Format: Sarfati B, Struk S, Leymarie N, Honart JF, Rimareix F, Delaloge S, Saghatchian M, Ghouadni A, Alkhashnam H, Mazouni C, Kolb F. Robotic nipple-sparing mastectomy with immediate prosthetic breast reconstruction : A preliminary study [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-13-04.
Outcomes of metastatic castration resistant prostate cancer (mCRPC) patients with DNA repair germline mutations (gDDR) following first taxane-based treatment.
Authors: Javier Puente, Nuria Romero-Laorden, Elena Vallespin Garcia, Josep M. Piulats, M Isabel Saez, Eva Fernandez Parra, Begona Perez Valderrama, Pablo Borrega, Ylenia Cendon, Kristina Ibáñez, Nuria Lainez, Lucia Heras, Edelmira Velez, Elena Almagro, Francisco Zambrana, Rocío García Domínguez, Jose Antonio Contreras, Pablo Lapunzina, David Olmos, Elena Castro
Journal: Journal of Clinical Oncology (2018)

247 Background: Germline DDR have been identified in up to 12% of mCRPC patients. Initial results from various retrospective series have reported discordant impact in clinical outcomes associated to these gDDR following conventional treatments. PROREPAIR-B (Castro et al ESMO 2017) is the first prospective study to address this question. In this planned sub-analysis, we report mCRPC treatment outcomes associated to taxanes. Methods: PROREPAIR-B (NCT03075735) is a prospective multicentre observational cohort study. Patients diagnosed with mCRPC, with unknown mutational status at study entry and who were going to start a first-line treatment for mCRPC were eligible. For this sub-analysis patients who received docetaxel or cabazitaxel as first-taxane were selected. The endpoints of this sub-analysis included to assess the impact of BRCA1, BRCA2, ATM and PALB2 and other gDDR on cause-specific survival (CSS), progression free survival (PFS), time to PSA progression (bPFS) and response to the first administered taxane as 1 st or 2 nd line therapy. Results: 326 (12 BRCA2, 8 ATM and 1 BRCA1 mutation carrier [gMUT]) out of 419 patients were eligible for this analysis. Diagnostic characteristic included Stage IV 51%, G8-10 60%. At the time of taxane initiation median PSA was 30.1 ng/mL, 84%, 48% and 11% of patients had bone, nodal and visceral metastases. CSS from first-taxane were not significantly different between gMUT and non-carriers (NC) (16.9 vs 23.2 m, p &gt; 0.05). However, in BRCA2 carriers was significantly shorter than in NC (13.1 vs 23.3 m, p = 0.026). Despite a trend to higher PSA response rates in gMUT compared to NC (n = 288, 63% vs 42%, p = 0.07, BRCA2 55%, p &gt; 0.05), PFS were not significantly different between both groups (7.2 vs 7.8 m, p &gt; 0.05), with a trend to shorter survival in BRCA2 carriers (4.5 vs 7.4 m, P = 0.11). Conclusions: These results suggest that DDR mutation carriers respond to taxanes with similar time to progression compared to NC, with the exception of BRCA2 carriers, who despite to the initial response to taxanes, presented worse survival outcomes. This highlights the need for close monitoring and novel therapies in this population. Clinical trial information: NCT03075735.