tbuckley/cabot-search huggingface dataset:
Impact of hospital teaching status on stage I pancreatic cancer survival.
Authors: Andy Chan, Zachary K. Masuda, Ryan W Walters, Peter T. Silberstein, Sarah J Aurit
Journal: Journal of Clinical Oncology (2018)

257 Background: Burke et al. (2017) revealed that academic hospitals had lower patient mortality rates for common conditions compared to community-based hospitals. We conducted a retrospective study to compare survival of Stage I pancreatic cancer patients in academic versus community-based hospitals throughout the US. Methods: We identified 6,276 patients with single primary Stage IA or IB adenocarcinoma of the pancreas from the NCDB diagnosed from 2004-2012. We only included those who had a partial pancreatectomy, Whipple procedure, or no surgical intervention. In this subset, treatment was classified as none, chemotherapy, radiation, or chemoradiation; we examined the number of days from diagnosis to treatment. Unadjusted survival stratified by facility type was estimated with the Kaplan-Meier method; multivariable Cox regression was used to adjust for patient and facility level characteristics. Results: The log-rank test indicated that survival for patients who received treatment from an academic facility was significantly longer than those treated at a community-based facility (p &lt; 0.001). After adjusting for patient and facility characteristics, however, survival was no longer significantly associated with facility type (p = 0.52). Holding all else constant, patients who underwent a surgical intervention had a lower risk of death (HR = 0.44, 95% CI: 0.40 to 0.48). Chemoradiation had a lower risk than both radiation (HR = 0.75, 95% CI: 0.65 to 0.86) and chemotherapy (HR = 0.88, 95% CI: 0.82 to 0.95). Risk of death was increased for older males, those without private insurance, and patients with Stage IB adenocarcinoma. Conclusions: In the largest study examining the association between hospital teaching status and Stage I pancreatic cancer mortality, our data suggests that there is not a significantly lower mortality rate for patients at academic hospitals compared to patients at community-based hospitals. [Table: see text]
Abstract P1-13-10: Adjuvant treatment of HER2+ breast cancer: Should trastuzumab be given sequentially or concurrently with chemotherapy?
Authors: GMHE Dackus, K Jóźwiak, E Van der Wall, PJ Van Diest, M Hauptmann, S Siesling, GS Sonke, SC Linn
Journal: Cancer Research (2018)

Abstract Background Human Epidermal growth factor Receptor 2 positive (HER2+) breast cancers have a high risk of recurrence in the absence of systemic treatment. The monoclonal antibody trastuzumab in combination with chemotherapy has significantly improved survival. Randomized trials have given trastuzumab both concurrently and sequentially with chemotherapy. To date, only one study reported a comparison between concurrent and sequential trastuzumab, with a numerically but not statistically significant benefit for concurrent use. Our aim is to evaluate whether there is a difference in survival between patients who received trastuzumab sequentially to chemotherapy compared to concurrently with chemotherapy using data from the population-based, Netherlands Cancer Registry (NCR). Methods All women diagnosed in the Netherlands with a HER2+, TanyNanyM0 breast tumor between 2005 and 2007 who received both chemotherapy and trastuzumab were identified from the NCR. Kaplan Meier survival estimates and Cox regression were used to compare recurrence free survival (RFS) and overall survival (OS) by trastuzumab sequence. Hazard ratios (HR) were adjusted for grade, pathological T-stage, pathological N-stage, estrogen receptor (ER), progesterone receptor, radiotherapy, hormonal therapy and ovarian ablation. Results A total of 1,849 patients were identified, with a mean follow-up of 7.8 years. Of these, 1,260 received concurrent trastuzumab and 589 sequential trastuzumab. Most tumors were grade 3, node positive and ER+. During follow-up 358 RFS events occurred, 231 in the concurrently treated patients compared to 127 in sequentially treated patients. Regarding OS, 290 deaths were observed, 188 deaths in concurrently treated patients compared to 102 deaths in sequentially treated patients, respectively. OS and RFS were similar among sequentially versus concurrently treated patients (adjusted HR 1.11; 95% CI 0.87-1.42; P=0.420 and adjusted HR 1.15; 95% CI 0.92-1.44; P=0.209, respectively). Conclusion We observed no significant difference in OS and RFS between patients who received sequential trastuzumab compared to patients treated concurrently. Based on our results no recommendation can be made favoring either of the two treatment sequences for the adjuvant treatment of HER2+ breast cancer patients. Citation Format: Dackus GMHE, Jóźwiak K, Van der Wall E, Van Diest PJ, Hauptmann M, Siesling S, Sonke GS, Linn SC. Adjuvant treatment of HER2+ breast cancer: Should trastuzumab be given sequentially or concurrently with chemotherapy? [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 P1-13-10.
Breastfeeding Rates Improved With Financial Reward
Authors: Anita Slomski
Journal: JAMA (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 HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
LONGITUDINAL CHANGES IN PHYSICAL ACTIVITY LEVELS POSITIVELY IMPACT HIGH SENSITIVITY C-REACTIVE PROTEIN LEVELS
Authors: Marcio Sommer Bittencourt, Romulo A. Fernandes, Raphel M. Ritt-Dias, Babu Balagopal, Raquel Conceicao, Gabriel G. Cucato, Raul Santos
Journal: Journal of the American College of Cardiology (2018)
BMA asks seven questions about seven day services
Authors: Abi Rimmer
Journal: BMJ (2015)

The BMA has begun to publish advertisements in national newspapers asking seven questions about seven day NHS services. So far the BMA has published adverts in the Independent and Guardian newspapers, asking three of its seven questions. It will continue to publish questions throughout the week, with the final question appearing on Saturday.

The advertisements asked the government whether it could find the money for a seven day NHS service and whether such a service would prioritise emergency care. They …
Quantification of tumour microstructure in low and high-grade brain tumours using VERDICT MRI: an initial feasibility study
Authors: Tom Roberts, Harpreet Hyare, Ben Hipwell, Andrada Ianus, James Breen-norris, Eleftheria Panagiotaki, David Atkinson, Shonit Punwani, Jeremy Rees, Sebastian Brandner, Daniel Alexander, Simon Walker-samuel
Journal: Neuro-Oncology (2018)

or in the peritumoural oedema.FSL and MRTrix software were used for tracking, in each patient,CST (hand, foot and lips component), AF and OR using the same regions of interest.Qualitative evaluation of the agreement between the two methods was performed by two experienced observers in consensus.RESULTS: The tracts identified: Were comparable for: CST-foot in 8(5) out of 11(8) cases in groupA (B); CST-hand in 6 out of 8 cases in groupB; Had less false positives in MRTrix for: CST-hand in 7 out of 11 cases in groupA; CST-lips in 5(6) out of 8(8) cases in groupA (B); AF in 4(8) out of 7(9) cases in groupA (B); Were more accurate in FSL for: OR in 6(6) out of 6(7) cases in groupA (B).CONCLUSIONS: The accuracy of the tracts is comparable for most fascicle identification, with the exception of MRTrix presenting less false positives for AF in groupB, CST-hand in groupA and CST-lips in groupsA and B; and FSL identifying more accurately the OR in both groups.
Mesenchymal stem cells enhance NOX2-dependent reactive oxygen species production and bacterial killing in macrophages during sepsis
Authors: Razieh Rabani, Allen Volchuk, Mirjana Jerkic, Lindsay Ormesher, Linda Garces-Ramirez, Johnathan Canton, Claire Masterson, Stephane Gagnon, Kate C. Tatham, John Marshall, Sergio Grinstein, John G. Laffey, Katalin Szaszi, Gerard F. Curley
Journal: European Respiratory Journal (2018)

Human mesenchymal stem/stromal cells (MSCs) have been reported to produce an M2-like, alternatively activated phenotype in macrophages. In addition, MSCs mediate effective bacterial clearance in pre-clinical sepsis models. Thus, MSCs have a paradoxical antimicrobial and anti-inflammatory response that is not understood. Here, we studied the phenotypic and functional response of monocyte-derived human macrophages to MSC exposure in vitro . MSCs induced two distinct, coexistent phenotypes: M2-like macrophages (generally elongated morphology, CD163 + , acute phagosomal acidification, low NOX2 expression and limited phagosomal superoxide production) and M1-like macrophages characterised by high levels of phagosomal superoxide production. Enhanced phagosomal reactive oxygen species production was also observed in alveolar macrophages from a rodent model of pneumonia-induced sepsis. The production of M1-like macrophages was dependent on prostaglandin E 2 and phosphatidylinositol 3-kinase. MSCs enhanced human macrophage phagocytosis of unopsonised bacteria and enhanced bacterial killing compared with untreated macrophages. Bacterial killing was significantly reduced by blockade of NOX2 using diphenyleneiodonium, suggesting that M1-like cells are primarily responsible for this effect. MSCs also enhanced phagocytosis and polarisation of M1-like macrophages derived from patients with severe sepsis. The enhanced antimicrobial capacity (M1-like) and inflammation resolving phenotype (M2-like) may account for the paradoxical effect of these cells in sepsis in vivo .
Preoperative chronic kidney disease to predict oncological outcomes after radical cystectomy in patients with muscle-invasive bladder cancer.
Authors: Shingo Hatakeyama, Itsuto Hamano, Hayato Yamamoto, Takahiro Yoneyama, Yasuhiro Hashimoto, Toshiaki Kawaguchi, Chikara Ohyama
Journal: Journal of Clinical Oncology (2018)

427 Background: Chronic kidney disease (CKD) is common in elderly patients with bladder cancer. In addition, increasing evidence has suggested that preoperative renal insufficiency indicates poor prognosis in bladder cancer. We aimed to evaluate the impact of CKD on oncologic outcomes in muscle-invasive bladder cancer patients who underwent radical cystectomy. Methods: A total of 581 patients who underwent radical cystectomy at four medical centers between January 1995 and February 2017 were examined retrospectively. We investigated oncologic outcomes, including progression-free, cancer-specific, and overall survival (PFS, CSS, and OS, respectively) stratified by preoperative CKD status (CKD vs. non-CKD). We performed a Cox proportional hazards regression analysis using inverse probability of treatment weighting (IPTW) to evaluate the impact of preoperative CKD on prognosis and developed the prognostic factor-based risk stratification nomogram. Results: Of the 581 patients, 215 (37%) were diagnosed with CKD before radical cystectomy. Before the background adjustment, PFS, CSS, and OS after radical cystectomy were significantly lower in the CKD group compared to the non-CKD group. Background-adjusted IPTW analysis showed that preoperative CKD was significantly associated with poor PFS, CSS, and OS after radical cystectomy. The nomogram for predicting 5-year PFS and OS probability showed significant correlation with actual PFS and OS ( c-index = 0.73 and 0.77, respectively). Conclusions: Muscle-invasive bladder cancer patients with preoperative CKD had a significantly lower survival probability than those without CKD.
How Value-Based Medicare Payments Exacerbate Health Care Disparities
Authors: Rita Rubin
Journal: JAMA (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 HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Diploma of Occupational Medicine (DOccMed)
Authors: Safia Debar
Journal: BMJ (2009)

It is aimed mainly at general practitioners who are working or intend to work part time in occupational medicine.

In my GP registrar year after completing the hospital component of my vocational training scheme.

The job market has changed a lot for newly qualified GPs. I wanted to develop a specialist interest which would allow me some variation in my working week. Occupational medicine has several opportunities, and the diploma is becoming essential for any GP wishing to pursue these.

With Dame Carol Black’s recent white paper “Working for a healthier tomorrow” and changes to benefits, occupational medicine is becoming more important and relevant.

It encompasses a considerable amount …
Air Pollution and Performance-Based Physical Functioning in Dutch Older Adults
Authors: Femke de Zwart, Bert Brunekreef, Erik Timmermans, Dorly Deeg, Ulrike Gehring
Journal: Environmental Health Perspectives (2018)

Background: Functional limitations are a major cause for needing care and institutionalization among older adults. Exposure to air pollution has been suggested to be associated with increased functional limitations in older people. Objective: Our objective was to assess the association between air pollution and physical functioning in Dutch older adults. Methods: We analyzed data on performance-based (walking speed, ability to rise from a chair, putting on and taking off a cardigan, balance test) and self-reported physical functioning for 1,762 participants of the Longitudinal Aging Study Amsterdam, who participated in measurement cycles performed in 2005/2006, 2008/2009, and 2011/2012. Annual average outdoor air pollution concentrations [nitrogen dioxide (NO2), nitrogen oxides (NOx), particulate matter with diameters ≤2.5μm (PM2.5), ≤10μm (PM10), and 2.5–10μm (PMcoarse), and PM2.5 absorbance] at the home address at the start of the first measurement cycle were estimated using land-use regression models. Analyses were performed using mixed models with random participant intercepts adjusting for potential confounders. Results: Exposure to most air pollutants was associated with reduced performance-based physical functioning; for example, an interquartile range increase in NO2 exposure was associated with a 0.22 (95% confidence interval: 0.03, 0.42) lower performance test score in fully adjusted models, equivalent to the difference in performance score between participants who differed by 9 mo in age. Exposure to air pollution was generally not statistically significantly associated with self-reported functional limitations, and not associated with a faster decline in performance-based physical functioning over the study period. Conclusion: This study suggests that exposure to air pollution may adversely affect physical performance of older adults in the Netherlands. https://doi.org/10.1289/EHP2239
Chronic Disease Approaches Needed to Curb Gout’s Growing Burden
Authors: Bridget M. Kuehn
Journal: JAMA (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 HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
LONG-TERM EFFECTS OF ANGIOTENSIN CONVERTING ENZYME INHIBITOR ON LEFT VENTRICULAR EJECTION FRACTION IN DUCHENNE AND BECKER MUSCULAR DYSTROPHY: A LONGITUDINAL CARDIAC MAGNETIC RESONANCE IMAGING STUDY
Authors: Tadao Aikawa, Atsuhito Takeda, Noriko Oyama-Manabe, Masanao Naya, Hirokuni Yamazawa, Kazuhiro Koyanagawa, Yoichi M. Ito, Yuka Ishikawa, Yukitoshi Ishikawa, Toshihisa Anzai
Journal: Journal of the American College of Cardiology (2018)
PROGNOSTIC VALUE OF CHARLSON COMORBIDITY INDEX IN PATIENTS ADMITTED FOR ACUTE DECOMPENSATED HEART FAILURE WITH REDUCED OR PRESERVED LEFT VENTRICULAR EJECTION FRACTION: A PROSPECTIVE STUDY
Authors: Shunsuke Tamaki, Takahisa Yamada, Takashi Morita, Yoshio Furukawa, Yusuke Iwasaki, Masato Kawasaki, Atsushi Kikuchi, Tsutomu Kawai, Masahiro Seo, Iyo Ikeda, Eiji Fukuhara, Makoto Abe, Jun Nakamura, Kiyomi Kayama, Kazuya Tanabe, Masatsugu Kawahira, Masatake Fukunami
Journal: Journal of the American College of Cardiology (2018)
Government defends its changes to education and training
Authors: Caroline White
Journal: BMJ (2012)

The government has moved to allay MPs’ concerns that its plans for medical education and training lack clarity and a sense of urgency.

In its response this week to the parliamentary health select committee’s report on education, training, and workforce planning, published in May,1 the government hints that the MPs may have had a point.

But it says that “a great deal of progress” has been made since evidence was submitted to the committee, progress that “provides some of the detail and clarity that the committee has reasonably requested.”

In particular, it points to the establishment of Health Education England (HEE) at the end of June and the …
Consulting: Communication Skills for GPs in Training
Authors: Anna Ellis
Journal: BMJ (2006)

RCGP Midland Faculty

Two DVDs plus 54 page workbook

RCGP, 2006, £30 (available from RCGP online bookstore—www.rcgp.org.uk/acatalog.whats_new.html)

ISBN: 000000DVD2

Rating: ★★★★★/5



This is a package designed primarily for GP (general practitioner) registrars to help improve communication skills as well as pass the video component of the MRCGP (membership of the Royal College of General Practitioners) exam. The two DVDs are divided into two sections. The first DVD neatly breaks down the consultation, looking at various elements of consulting and techniques used within it, and the second DVD …
Abstract 15689: Reversal of Left Ventricular Systolic Dysfunction Following Standalone Pulmonary Vein Isolation of Atrial Fibrillation in Patients With Heart Failure With Reduced Ejection Fraction
Authors: Umashankar Lakshmanadoss, Gunjan Choudhary, Paras Dedhia, Maninder Singh, Deonna Kershner, Angie Young, David Lahoda, Pramod Deshmukh
Journal: Circulation (2013)

Background:  Congestive heart failure and atrial fibrillation (AF) often co-exist. Restoration of sinus rhythm (SR) has shown to be beneficial in heart failure with reduced ejection fraction (HFrEF). However there is no consensus on the type of ablation to be performed. We sought to see the effect of standalone pulmonary vein isolation (PVI) in this population.   Methods:  This is a retrospective study of standalone PVI, performed by a single operator. No other additional ablations were performed. LVEF was determined before PVI and again at 3 to 6 months at follow up. 24 hours holter monitor was performed at 3, 6 and 12 months after PVI and also with symptoms following PVI. Any AF after 3 months of blanking period is considered as recurrence. For symptomatic recurrence, repeat PVI was offered.   Results:  PVI was performed in 420 consecutive patients. Of these, 67 (16%) patients with long standing AF had low ejection fraction (   Conclusions:  Sixty three (63) % of AF patients with HFrEF remained in SR after standalone PVI. Standalone PVI (which may reduce procedure time) was effective in improving LVEF and NYHA in these patients with longstanding AF and HFrEF. Standalone PVI may be utilized to control rhythm even in this sicker population.