tbuckley/cabot-search huggingface dataset:
Should 18F-FDG PET/CT Be Routinely Performed in the Clinical Staging of Locally Advanced Gastric Adenocarcinoma?
Authors: Pilar Perlaza, Jaime Ortín, Mario Pagès, Elvira Buxó, Gloria Fernández-Esparrach, Patrick M. Colletti, Domenico Rubello, Maria Mayoral, Nuria Sánchez, Cristina Ruiz, Angels Ginés, David Fuster
Journal: Clinical Nuclear Medicine (2018)

The aim of this study was to evaluate F-FDG PET/CT compared with conventional imaging techniques in the clinical management of patients with locally advanced gastric cancer (LAGC).A prospective study between January 2010 and December 2011 in patients with suspected LAGC was conducted in our hospital. F-FDG PET/CT, contrast-enhanced CT (CECT), endoscopic ultrasound, and laparoscopy were performed in all cases. Standard whole-body F-FDG PET/CT images were obtained centered on the stomach at 1 and 2 hours after injection of 4.0 MBq/kg of F-FDG. Findings were confirmed by histopathology or by imaging follow-up in nonoperable patients.Fifty consecutive patients with confirmed LAGC (20 women, 30 men) with a mean ± SD age of 65.7 ± 12.1 years were included. Using Lauren classification, 24 patients were intestinal subtype, and 26 were diffuse subtype. Thirty-five patients with locoregional lymph node involvement and 22 with distant metastases were confirmed as peritoneal metastases (n = 15), retroperitoneal (n = 2) or mediastinal lymph nodes (n = 1), and liver (n = 3) or bone metastases (n = 1). Patients with signet ring carcinoma showed significantly less F-FDG uptake (P = 0.001). SUVmax correlated with tumor grading (P < 0.05). Standard and delayed F-FDG PET/CT and CECT images identified LAGC in 24, 27, and 28 of 30 patients, respectively. The sensitivity and specificity for F-FDG PET/CT and CECT to detect metastases were 68% and 100% and 64% and 93%, respectively. Contrast-enhanced CT and F-FDG PET/CT diagnosed only 6 of the 15 patients with confirmed peritoneal metastases. The impact in therapeutic management of F-FDG PET/CT and CECT was 24% and 22%, respectively. Kaplan-Meier survival curves for the LGAC showed a significant correlation between SUVmax and overall survival using an SUVmax threshold of less than 3.96 (P = 0.04).F-FDG PET/CT should be recommended for staging of LAGC; however, F-FDG PET/CT and CECT cannot replace laparoscopy to rule out peritoneal metastases. Delayed F-FDG PET/CT images show an increase of F-FDG uptake in most cases, improving LAGC detection. The grade of F-FDG uptake represents a significant prognostic tool in this series.
Overexpression of Hexokinase 2 is epigenetically regulated by frequent hypomethylation in glioblastoma multiforme
Authors: Daniel Blakeway, Katherine Karakoula, Mark Morris, Farjana Rowther, Lawrence Eagles, John Darling, Tracy Warr
Journal: Neuro-Oncology (2018)

HK2 has a prominent role in glycolysis, acting as the rate-limiting step in the pathway. HK2 is highly expressed in many cancers, with overexpression associated with drug resistant phenotypes. In parallel, its inhibition has improved the effectiveness of anticancer agents. Evidence indicates that HK2 is epigenetically silenced in normal tissue, and hypomethylation is the driving factor of increased expression in tumours, suggesting HK2 as a potential genetic modifier and therapeutic target. This study determines the role of methylation and its association with expression levels of HK2 in glioblastoma multiforme (GBM) fresh frozen biopsies and patient-derived GBM short-term cultures, by pyrosequencing and quantitative PCR. Anti-proliferative effects of HK2 inhibitors and their mechanism of action was investigated by cytotoxicity assays and FACS analysis. Hypomethylation was seen in all GBM biopsies(n=85) compared to normal brain tissue; average methylation of 4.6% compared to 26% respectively (p< 0.0001). Hypomethylation was also in all culture samples(n=9). An increase in HK2 expression was detected, ranging between 6 to >1000fold change in GBM biopsies(n=50) and 30 to >1000 in cultures(n=10), compared to normal brain tissue. There was a strong correlation between methylation and level of expression (p< 0.0001) as biopsies with HK2 expression greater than the mean fold change additionally displayed hypomethylation levels below <3% methylation. The anti-proliferative effects of the HK2 inhibitor bromopyruvic acid (BPA) were determined in GBM cultures(n=12). BPA induced anti-proliferative effects and increased apoptotic levels in cultures. Elevated expression of HK2 (>mean fold change) was associated with greater sensitivity to BPA. Significantly higher levels of apoptosis were induced after treatment with BPA at ID50 in cultures expressing high HK2 (>mean fold change) (p< 0.0014). This study establishes a strong correlation between hypomethylation and increased expression of HK2. Furthermore, demonstrating the potential of HK2 inhibitors as a novel therapy in a significant subset of GBM.
Medical Overuse of Prostate-Specific Antigen Testing and Overprescription of Antibiotics
Authors: Filipe Prazeres
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
PREDICTORS OF LEFT MAIN CORONARY ARTERY STENT DIMENSIONS: AN EXCEL TRIAL INTRAVASCULAR ULTRASOUND SUBSTUDY
Authors: Akiko Fujino, Akiko Maehara, Gary Mintz, Adrian Banning, Béla Merkely, Imre Ungi, Ad J. van Boven, Manu Prabhakar, Zixuan Zhang, Arie Pieter Kappetein, Joseph F. Sabik, Patrick W. Serruys, Gregg Stone
Journal: Journal of the American College of Cardiology (2018)
RELATIONSHIP OF BREAST ARTERY CALCIFICATION TO CORONARY ARTERY STENOSIS: IS MAMMOGRAPHY THE NEW SCREENING TEST FOR CORONARY ARTERY STENOSIS IN WOMEN?
Authors: Tanuka Datta, Ivan Pena, Ashley Inciardi, Amanda Kappler, Rachel F. Brem, Ramesh Mazhari, Andrew Choi, Brian Choi, Jannet Lewis
Journal: Journal of the American College of Cardiology (2018)
Synchronous Detection of Male Breast Cancer and Prostatic Cancer in a Patient With Suspected Prostatic Carcinoma on 68Ga-PSMA PET/CT Imaging
Authors: Rajender Kumar, Bhagwant Rai Mittal, Anish Bhattacharya, Harmandeep Singh, Shrawan Kumar Singh
Journal: Clinical Nuclear Medicine (2018)

Abstract The male breast cancer is very less common as compared with the female breast cancer. We report a case of 64-year-old man who presented with the history of lower urinary tract symptoms. The digital rectal examination revealed hard and nodular prostate, and serum prostate-specific antigen level was 23.4 ng/mL. 68 Ga-labeled prostate-specific membrane antigen PET/CT revealed prostate-specific membrane antigen–expressing lesions in the prostate, axillary tail of the right breast, and axillary lymph nodes. Histology from prostate revealed prostate carcinoma, whereas fine-needle aspiration from the breast revealed invasive ductal carcinoma of the breast.
Benefits and costs of home pedometer assisted physical activity in patients with COPD. A preliminary randomized controlled trial
Authors: K. Widyastuti, D.N. Makhabah, A.Rima Setijadi, Y.S. Sutanto, None Suradi, N. Ambrosino
Journal: Pulmonology (2018)

There are barriers to providing pulmonary rehabilitation for chronic obstructive pulmonary disease (COPD) such as the high number of patients, difficult access to health facilities and high costs of programs. Pedometers can monitor and improve physical activity (PA). The aim of this study was to evaluate benefits and costs of home pedometer assisted PA, as compared to a standard outpatient supervised exercise training program in patients with COPD. Patients were randomly assigned either to home pedometer assisted PA (Group 1), or to a six-week outpatient standard supervised exercise training program (Group 2). Patients of Group 1 had to walk at home for 6 weeks, at least 30 min daily at the fastest step pace as possible, to achieve a weekly 10% increase in their average daily steps up to more than 6500. Pre and post programs we assessed: the six minute walking distance (6MWT: primary outcome), daily steps count, the Medical Research Council scale (MRC), the COPD assessment test score, and the BODE index (body-mass index, airflow obstruction, dyspnea, exercise capacity). Costs of programs were also evaluated. Out of 40 patients, 18 in both groups (mean (standard deviation)) age: 68.3 (6.7) and 61.2 (6.7) years; FEV1: 1.1 (0.5) and 0.9 (0.4) liters in Group 1 and 2 respectively completed the study. At the end of the program 44.5% patients of Group 1 had reached the target daily steps, in 26.6 (9.5) days. Following the programs, both groups showed significant improvements in all outcome measures, except BODE. The home program was cheaper (p = 0.0001), with a mean 76.3 euros saving per patient. Home pedometer assisted PA may be a useful and cheaper alternative to outpatient supervised exercise training programs in patients with COPD.
I am contemplating temporary work in Spain. How do I go about registering as a doctor there?
Authors: Jo Constable
Journal: BMJ (2004)

Got a career or related problem that needs answering? Can't find the right person to point you in the right direction? Log on to the Advice Zone ( www.bmjcareers.com/advicezone ) 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.
INCIDENCE, CHARACTERISTICS, TRENDS AND CLINICAL OUTCOMES IN PATIENTS WITH ATRIAL FIBRILLATION COMPLICATED BY NON ST ELEVATION MYOCARDIAL INFARCTION
Authors: Gbolahan Ogunbayo, Le Dung Ha, Ayman Elbadawi, Odunayo Olorunfemi, Deola Saheed, Yousef Darrat, Maya Guglin, Adrian Messerli, Ahmed Abdel-Latif, Susan Smyth, Claude Elayi
Journal: Journal of the American College of Cardiology (2018)
Erratum: 2011 in reflection
Authors: Asher Mullard
Journal: Nature Reviews Drug Discovery (2012)

Nature Reviews Drug Discovery 11, 6–8 (2012) | doi: 10.1038/nrd3643 Daclatasvir was originally misidentified as an NS5A protease inhibitor, when it is an NS5A replication complex inhibitor. This has been corrected in the online version of the article.
Cardiac Resynchronization Therapy in Patients With Heart Failure and Narrow QRS Complexes
Authors: Bhupendar Tayal, John Gorcsan, Jeroen J. Bax, Niels Risum, Niels Thue Olsen, Jagmeet P. Singh, William T. Abraham, Jeffrey S. Borer, Kenneth Dickstein, Daniel Gras, Henry Krum, Josep Brugada, Michele Robertson, Ian Ford, Johannes Holzmeister, Frank Ruschitzka, Peter Sogaard
Journal: Journal of the American College of Cardiology (2018)
Correlation of lung cancer mutational profile with immune profile.
Authors: Antonios Papanicolau-Sengos, Sarabjot Pabla, Grace K. Dy, Marc S. Ernstoff, Igor Puzanov, Jeffrey M. Conroy, Mary Nesline, Sean T. Glenn, Blake Burgher, Jonathan Andreas, Vincent Giamo, Maochun Qin, Felicia L. Lenzo, Mark Gardner, Carl Morrison
Journal: Journal of Clinical Oncology (2018)

146 Background: The association between neoplasm mutational and immune profiles has not been well-characterized. Methods: We collected 26 lung cancer formalin-fixed paraffin embedded (FFPE) samples which had been tested with a comprehensive mutation profile to detect clinically actionable mutations, and a comprehensive immune gene expression profile, which interrogates PD-L1 immunohistochemistry (IHC), PD-L1/2 copy number, CD3/CD8 IHC, microsatellite instability status, mutational burden, and the expression profile of 54 immune-related genes. The ranking of gene expression and 7 immune phenotypes was compared to a reference population. Six cases were positive for an activating KRAS mutation and 2 cases were positive for an activating EGFR mutation. Principal component analysis was performed to determine the association of EGFR/KRAS mutations with the measured immune landscape. Results: The proinflammatory immune phenotype was significantly correlated with KRAS mutation positive samples (first principal component, R squared = 0.53, p &lt; 0.05). Similarly, CD38 expression was correlated with KRAS mutation (R squared = 0.47, p &lt; 0.05). CD137, KLRD1, and DDX58 expression was significantly correlated with EGFR positive samples (second principal component, R squared = 0.47, 0.37, 0.35 respectively, p &lt; 0.05 in all cases). Unsupervised hierarchical clustering of the samples resulted in three distinct clusters, EGFR positive, KRAS positive, and EGFR negative/KRAS negative. In the KRAS positive cluster, high proinflammatory immune phenotype, VISTA moderate expression, presence of CD3/CD8 tumor infiltrating lymphocytes (TILs), and low KLRD1 were overrepresented (p &lt; 0.05), while low VISTA and proinflammatory moderate immune phenotype were significantly underrepresented (p &lt; 0.05). In the EGFR positive cluster DDX58 high, very low TILs, and very low CD8 were significantly (p &lt; 0.05) overrepresented. Conclusions: KRAS mutation positivity is significantly associated with a proinflammatrory immune phenotype and CD3/CD8 infiltration. KRAS positive, EGFR positive, and KRAS/EGFR negative clusters are immunophenotypically distinct. A higher number of specimens is necessary to verify and expand these findings.
I am a 50 year old self employed UK trained GP. I started in Nottingham then spent 13 years in New Zealand. I want to return to the UK. Are there any professional requirements apart from renewing my GMC registration?
Authors: Judith Harvey
Journal: BMJ (2007)

Have a career or related problem that needs answering? Can't 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. [www.bmjcareers.com/advicezone][1] [1]: http://www.bmjcareers.com/advicezone
Surface‐Enhanced Raman Scattering for Rapid Detection and Characterization of Antibiotic‐Resistant Bacteria
Authors: Daniel D. Galvan, Qiuming Yu
Journal: Advanced Healthcare Materials (2018)

Abstract As the prevalence of antibiotic‐resistant bacteria continues to rise, biosensing technologies are needed to enable rapid diagnosis of bacterial infections. Furthermore, understanding the unique biochemistry of resistance mechanisms can facilitate the development of next generation therapeutics. Surface‐enhanced Raman scattering (SERS) offers a potential solution to real‐time diagnostic technologies, as well as a route to fundamental, mechanistic studies. In the current review, SERS‐based approaches to the detection and characterization of antibiotic‐resistant bacteria are covered. The commonly used nanomaterials (nanoparticles and nanostructured surfaces) and surface modifications (antibodies, aptamers, reporters, etc.) for SERS bacterial detection and differentiation are discussed first, and followed by a review of SERS‐based detection of antibiotic‐resistant bacteria from environmental/food processing and clinical sources. Antibiotic susceptibility testing and minimum inhibitory concentration testing with SERS are then summarized. Finally, recent developments of SERS‐based chemical imaging/mapping of bacteria are reviewed.
Identification of prognostic biomarkers for gastric cancer by gene expression analysis
Authors: Y. Yamada, T. Arao, K. Nishio, F. Koizumi, D. Saito, T. Gotoda, T. Shimoda, H. Taniguchi, K. Shirao, N. Saijo, M. Sasako
Journal: Journal of Clinical Oncology (2007)

4623 Background: Endoscopic biopsy before chemotherapy provides an excellent opportunity for studying biomarkers related to therapy-induced tumor responses or overall survival. This study was designed to identify prognostic biomarkers in patients with unresected gastric cancer. Methods: Samples were taken from histologically proved primary gastric cancers in 40 patients before chemotherapy. Microarray analysis was performed using Affymetrix HG-U133Plus2.0 GeneChips after RNA quality checks of the samples. Correlations between gene expression data and survival time were statistically evaluated with a univariate Cox proportional-hazards model. Identified genes were validated by real time RT-PCR analysis in same 40 test-set samples. Then, PCR-validated genes were evaluated for independent samples (validation set) to predict survival. Results: We obtained 185 candidate genes that were significantly associated with survival (p&lt;0.005) on univariate testing in the 40 test-set sample. Real time RT-PCR analysis identified 5 genes that were reproducibly related to survival on the log-rank test (p&lt;0.01). PCR analysis with each of these 5 genes discriminated short-term survivors with a sensitivity of 71% and a specificity of 46–77% in the test set. For the independent 19-sample validation set, single-gene PCR analysis had a sensitivity of 50–81% and a specificity of 38–62%. A multi-gene prediction panel will be evaluated. Conclusions: Gene expression profiling by microarray and real time RT-PCR is useful for predicting overall survival in gastric cancer. No significant financial relationships to disclose.
One in six health and social care employees left sector in wake of NHS reforms
Authors: Helen Jaques
Journal: BMJ (2013)

One in six employees of organisations affected or abolished by the government’s NHS reforms were made redundant or resigned voluntarily after the Health and Social Care Act was passed.

In April 2012, 46 301 staff members were employed by the NHS, local government, public health, the Department of Health, and the department’s arm’s length bodies. By March 2013, 7421 of these employees had left their roles. 

These departures, equating to 16.0% …
Setting up your own blog
Authors: Kieran Walsh
Journal: BMJ (2006)

Diaries have always been with us. From Samuel Pepys describing the great fire of London to Alan Clarke gossiping about Whitehall's inner workings, we have always loved writing our own diaries and reading other people's. In the past, diaries were often published after the writer's death or towards the end of their career but with the advent of blogging anyone can start publishing their diaries online. …
A meta-analysis on individual data of bone-targeting radio-isotopes in men with bone metastases from castration-resistant prostate cancer.
Authors: Safae Aarab Terrisse, Chris C. Parker, Karamouza Eleni, A. Oliver Sartor, Nicholas James, Sarah Pirrie, Laurence Collette, Bertrand F. Tombal, Jad Chahoud, Sigbjørn Smeland, Bjørn Erisktein, Jean-Pierre Pignon, Karim Fizazi, Gwénaël Le Teuff
Journal: Journal of Clinical Oncology (2018)

352 Background: Among bone-targeted radio-isotopes (RI), Radium-223 (an α-emitter) is the only one with clearly demonstrated overall survival (OS) benefit in men with castration-resistant prostate cancer (CRPC). The aim of this meta-analysis is to estimate the OS impact of RI in men with CRPC. Methods: An individual patient data meta-analysis was carried out from randomized trials with inclusion period 1993-2013. Eligible trials included more than 50 patients, mandated bone metastases from CRPC and randomly evaluated RI. Endpoints were OS (primary), symptomatic skeletal events (SSE) and toxicity. A fixed-effect model was used. The log-rank test stratified by trial was used to estimate individual and overall hazard ratios (HR). Subset analyses were performed by the type of radiation (α vs. β emission) and by trial comparison: RI + Chemotherapy (CT) vs. CT, RI+ External beam radiotherapy (EBRT) vs. EBRT, RI vs. EBRT. Results: From 9 identified trials, data from 6 trials comprising 2081 patients (min: 64, max: 921) were collected with 2 trials representing 80% of data. The data from 3 trials (n = 341) were not available. The overall effect on OS favoured RI with HR = 0.86 [0.77-0.95] but high heterogeneity between trials (p &lt; 0.001, I 2 = 79.6%). The overall effect of α- emitters on OS (HR = 0.70 [0.58; 0.83], 2 trials, n = 985) significantly differed from that of β-emitters (HR = 0.96 [0.84; 1.10], n = 4 trials, n = 1096) (interaction p = 0.0041). The overall effect on SSE favoured RI with HR = 0.81 [0.69-0.93] (4 trials, n = 1806) with marked between trial heterogeneity (p = 0.08, I² = 55.3%) and a significant difference (p = 0.02) by the type of RI (α-emitters: HR = 0.65 [0.52-0.82]-2 trials, β-emitters: HR = 0.93 [0.77-1.13]-2 trials). Conclusions: In men with metastatic CRPC a significant improvement of OS and SSE was obtained with bone targeted α-emitter radio isotopes, but not with β-emitter. However, some between trial heterogeneity of effects on OS need further investigations.
Rates of change in FEV<sub>1</sub> and <i>D</i><sub>LCO</sub> as potential indicators for mTOR inhibitor therapy in premenopausal lymphangioleiomyomatosis patients
Authors: Angelo M. Taveira-DaSilva, Patricia Julien-Williams, Amanda M. Jones, Mario Stylianou, Joel Moss
Journal: European Respiratory Journal (2018)

The value of rates of change in forced expiratory volume in 1 s (FEV 1 ) and diffusing capacity of the lung for carbon monoxide ( D LCO ) to predict disease progression, and initiation of mTOR (mechanistic target of rapamycin) inhibitor therapy has not been evaluated. In 84 premenopausal lymphangioleiomyomatosis patients, individual rates of change in FEV 1 and D LCO and their 95% confidence intervals were used to derive subsequent lowest values of FEV 1 and D LCO that would prompt initiation of sirolimus therapy. These treatment criteria were compared with a criterion based on FEV 1 or D LCO ≤70% predicted. In 12 patients undergoing sirolimus therapy both methods for determining the optimal point for initiation of therapy were evaluated. 27 and 35 patients who experienced greater than expected rates of change in FEV 1 and D LCO , respectively, would have been excluded from therapy based on an FEV 1 or D LCO &gt;70% pred. 25 of the 84 patients were eventually treated, but only when FEV 1 or D LCO were ≤70% pred. Applying such treatment criteria to 12 patients undergoing sirolimus therapy would have delayed treatment for many years. Premenopausal females in whom FEV 1 or D LCO are declining at rates above the expected based on their individual rates of decline, should be considered for sirolimus therapy before the FEV 1 or D LCO falls to ≤70% pred.