tbuckley/cabot-search huggingface dataset:
Prevention programmes including Nordic exercises to prevent hamstring injuries in football players (PEDro synthesis)
Authors: Matheus Oliveira Almeida, Chris G Maher, Bruno T Saragiotto
Journal: British Journal of Sports Medicine (2018)

Al Attar WSA, Soomro N, Sinclair PJ, et al . Effect of injury prevention program that include the Nordic exercise on hamstring injury rates in football players: a systematic review and meta-analysis. Sports Med 2017; 47:907–916.

Hamstring injuries are the most common non-contact injuries in sport1 and account for 40% of muscle injuries in football,2 where up to one-third recur the following season.3–5 The rehabilitation of players with hamstring injuries usually lasts more than a month, restricting the athlete’s performance and causing a financial impact on clubs.3 4 6 The Nordic hamstring (NH) exercise is a promising option to decrease the risk of hamstring injuries in athletes. However, results of randomised controlled trials have been conflicting.6–8

The aim of this review was to assess the effectiveness of injury prevention programmes that included NH exercise on reducing the incidence of hamstring injuries among football players.

Searches were conducted on Cochrane Central Register of Controlled Trials, PubMed, Medline, Embase, CINAHL (the Cumulative Index to Nursing and …
Contaminated drainage fluid and pancreatic fistula after pancreatoduodenectomy: A retrospective study
Authors: Kanefumi Yamashita, Daisuke Kato, Takamitsu Sasaki, Hironari Shiwaku, Fuminori Ishii, Shigetoshi Naito, Yuichi Yamashita, Suguru Hasegawa
Journal: International Journal of Surgery (2018)
Transfer of public health to local councils risks an exodus of consultants, warns professional body
Authors: Caroline White
Journal: BMJ (2012)

The transfer of public health from the NHS to local government next April could prompt a further fall in the number of consultants in the specialty, the Association of Directors of Public Health has warned.

Although local authorities clearly recognise the need for directors of public health, the fear is that consultants will be seen as unnecessary and expensive members of the team, Nicola Close, the association’s chief executive, told BMJ Careers.

“Consultants [in public health] tend to be more specialist, and quite a few will be needed in population health in local authorities for clinical commissioning groups [CCGs],” she explained.

But some consultants had chosen to “jump ship” and work directly for CCGs, preferring to work …
The probability of indolent versus aggressive histology based on renal tumor size: Implications for surveillance and treatment.
Authors: Bimal Bhindi, Robert Houston Thompson, Christine M. Lohse, Ross Mason, Igor Frank, Stephen A. Boorjian, John C. Cheville, Bradley C. Leibovich
Journal: Journal of Clinical Oncology (2018)

704 Background: While the probability of benign versus malignant histology based on renal tumor size has been described, this alone does not sufficiently inform decision-making in the modern era since indolent malignant tumors can be surveilled. Thus, we sought to characterize the probability of indolent versus aggressive histology based on radiographic tumor size. Methods: We evaluated patients who underwent radical or partial nephrectomy at Mayo Clinic for a pT1-2, pNx/0, M0 solid renal tumor between 1990-2010. Pathology was reviewed by one genitourinary pathologist. Benign tumors, low grade (1-2) clear cell and papillary renal cell carcinoma (RCC), and any chromophobe, clear cell papillary, mucinous tubular and spindle cell, SDH-B deficient, and tubulocystic RCC were considered indolent. All other histologies were considered aggressive, as were any malignancies with necrosis or sarcomatoid differentiation. Cancer-specific survival (CSS) was estimated using the Kaplan Meier method. Logistic regression models were used to estimate the probability of malignant and aggressive histology based on tumor size. Sex-stratified analyses were also performed. Results: Of the 2650 patients included, there were 1773 patients with indolent tumors (303 benign; 1470 malignant) and 877 with aggressive tumors. Ten-year CSS was 96% for indolent malignant tumors and 82% for aggressive tumors. The predicted probabilities of any malignant histology and aggressive malignant histology increased with tumor size (Table; 1-7cm point estimates shown). For example, a 3 cm tumor had an 87% probability of malignancy and a 27% probability of being aggressive. For any given tumor size, men had a greater probability of aggressive histology than women. Conclusions: We present tumor size-based estimates of the probability of aggressive histology for renal masses. This information should be useful for patient counseling and treatment decision-making. [Table: see text]
Neural Mechanisms of Social Cognition in Primates
Authors: Marco K. Wittmann, Patricia L. Lockwood, Matthew F.S. Rushworth
Journal: Annual Review of Neuroscience (2018)

Activity in a network of areas spanning the superior temporal sulcus, dorsomedial frontal cortex, and anterior cingulate cortex is concerned with how nonhuman primates negotiate the social worlds in which they live. Central aspects of these circuits are retained in humans. Activity in these areas codes for primates' interactions with one another, their attempts to find out about one another, and their attempts to prevent others from finding out too much about themselves. Moreover, important features of the social world, such as dominance status, cooperation, and competition, modulate activity in these areas. We consider the degree to which activity in these regions is simply encoding an individual's own actions and choices or whether this activity is especially and specifically concerned with social cognition. Recent advances in comparative anatomy and computational modeling may help us to gain deeper insights into the nature and boundaries of primate social cognition.
HYBRID CONTINUITY EQUATION USING MULTIDETECTOR CT AND ECHOCARDIOGRAPHY AIDS RECLASSIFYING SEVERITY IN PATIENTS WITH PARADOXICAL LOW FLOW LOW GRADIENT SEVERE AORTIC STENOSIS
Authors: Daniel Kupsky, Waleed Al-Darzi, Gordon Jacobsen, Karthikeyan Ananthasubramaniam
Journal: Journal of the American College of Cardiology (2018)
Global Economic Burden of Diabetes in Adults: Projections From 2015 to 2030
Authors: Christian Bommer, Vera Sagalova, Esther Heesemann, Jennifer Manne-Goehler, Rifat Atun, Till Bärnighausen, Justine Davies, Sebastian Vollmer
Journal: Diabetes Care (2018)

OBJECTIVE Despite the importance of diabetes for global health, the future economic consequences of the disease remain opaque. We forecast the full global costs of diabetes in adults through the year 2030 and predict the economic consequences of diabetes if global targets under the Sustainable Development Goals (SDG) and World Health Organization Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2020 are met. RESEARCH DESIGN AND METHODS We modeled the absolute and gross domestic product (GDP)-relative economic burden of diabetes in individuals aged 20–79 years using epidemiological and demographic data, as well as recent GDP forecasts for 180 countries. We assumed three scenarios: prevalence and mortality 1) increased only with urbanization and population aging (baseline scenario), 2) increased in line with previous trends (past trends scenario), and 3) achieved global targets (target scenario). RESULTS The absolute global economic burden will increase from U.S. $1.3 trillion (95% CI 1.3–1.4) in 2015 to $2.2 trillion (2.2–2.3) in the baseline, $2.5 trillion (2.4–2.6) in the past trends, and $2.1 trillion (2.1–2.2) in the target scenarios by 2030. This translates to an increase in costs as a share of global GDP from 1.8% (1.7–1.9) in 2015 to a maximum of 2.2% (2.1–2.2). CONCLUSIONS The global costs of diabetes and its consequences are large and will substantially increase by 2030. Even if countries meet international targets, the global economic burden will not decrease. Policy makers need to take urgent action to prepare health and social security systems to mitigate the effects of diabetes.
Histone deacetylase (HDAC) inhibitor ACY241 enhances anti-tumor activities of antigen-specific central memory cytotoxic T lymphocytes against multiple myeloma and solid tumors
Authors: Jooeun Bae, Teru Hideshima, Yu-Tzu Tai, Yan Song, Paul Richardson, Noopur Raje, Nikhil C. Munshi, Kenneth C. Anderson
Journal: Leukemia (2018)
Off the fence debate: NHS Direct
Authors: Mike Sadler
Journal: BMJ (2005)

I refer to your article entitled “Is NHS Direct a waste of time and money?”1 I was disappointed to see that not only did the article contain some basic inaccuracies but it also failed to address the fundamental question around the main purpose of the NHS Direct service.

I will deal first with the inaccuracies in the “For” column. The government did not “begat NHS Direct after buying an American software program.” The idea of a 24 hour health advice and information line was first promoted in a report on emergency services in the community by the then chief medical …
Facebook and Twitter contributed to 13 GMC complaints in 2015
Authors: Abi Rimmer
Journal: BMJ (2016)

Facebook and Twitter contributed to at least 13 complaints about doctors made to the General Medical Council (GMC) in 2015, figures obtained by BMJ Careers have shown.

Ten complaints that the GMC investigated included an allegation regarding Facebook and three included an allegation regarding Twitter.

The GMC gave the data in response to a freedom of information request from BMJ Careers. Complaints made to the GMC can feature a number of different allegations and therefore the number of allegations made to the GMC which mentioned Facebook and Twitter was higher than the overall number of complaints that included such allegations.

The 13 complaints in 2015 compares with 11 similar complaints in 2014, of which eight included an allegation regarding Facebook, and three regarding Twitter.

Previous figures have shown that in the five years up to …
Spontaneous perforation of the subvesical bile duct
Authors: Sho Kitagawa, Kana Hatayama, Keiya Okamura
Journal: Endoscopy (2018)

Subvesical bile ducts, which are frequently incorrectly termed “ducts of Luschka,” traverse within, or in close contact with, the gallbladder fossa [1]. They are one of the most common etiologies of bile leak in cholecystectomy and have gained increased clinical attention in the present laparoscopic era. Subvesical bile ducts are hardly ever detected preoperatively because their mean diameter is 2 mm [1]. Indeed, in most patients, subvesical bile duct leaks are detected postoperatively, generally during the first postoperative week [2]. This report describes a case of spontaneous perforation of the subvesical bile duct.
MARKEDLY ELEVATED PERICARDIAL FLUID LEVELS OF PERIOSTIN ARE INVOLVED IN LEFT VENTRICULAR DYSFUNCTION WITH CORONARY ARTERY DISEASE
Authors: Shoichi Miyamoto, Toshiaki Izumi, Yoshizumi Haruna, Eisaku Nakane, Hideyuki Hayashi, Yuta Seko, Kazutaka Nakasone, Kouki Kimura, Shushi Nishiwaki, Touka Hamaguchi, Fumie Takai, Manabu Morishima, Tetsuya Haruna, Moriaki Inoko, Michiya Hanyu, Masatoshi Fujita
Journal: Journal of the American College of Cardiology (2018)
O013 New therapeutic avenues in rheumatoid arthritis: exploring the role of the adiponectin-pepitem axis
Authors: S Kemble, LE Harford, HM McGettrick
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Introduction</h3> The inappropriate accumulation of leukocytes into the joint plays a significant role in the pathogenesis of rheumatoid arthritis (RA), making this process an ideal to target for therapeutic intervention. We recently identified a novel immuno-protective pathway, in which a B-cell derived peptide (PEPITEM) suppresses T-cell migration into inflamed tissues.<sup>1</sup> <h3>Objectives</h3> Here, we examined the functionality of the adiponectin-PEPITEM axis in patients with RA and in a murine model of arthritis. <h3>Methods</h3> Peripheral blood lymphocytes (PBL) were isolated from healthy controls or from treatment naive patients with a new onset of clinically apparent RA. PBL were treated with adiponectin or PEPITEM, and their ability to migrate across cytokine endothelial cells was assessed using phase-contrast microscopy. Mice with collagen induced arthritis (CIA) were treated with PEPITEM prior to disease onset or at the first signs of inflammation and disease incidence, severity and leukocyte infiltration were evaluated. <h3>Results</h3> In response to adiponectin, B-cells release PEPITEM, which limits T-cell migration across inflamed endothelium in a sphingosine-1-phosphate dependent manner. This immuno-protective pathway is lost in patients with RA, where circulating B-cells express reduced levels of adiponectin receptors compared to age-matched healthy controls, and fail to respond to adiponectin and suppress T-cell migration <i>ex vivo.</i> This defect can be rescued with exogenous PEPITEM. Administration of synthetic PEPITEM prior to disease onset prevents CIA, significantly reducing disease incidence, clinical score, leukocyte infiltration, and bone erosion when compared to controls. PEPITEM administered at the first signs of inflammation (therapeutic intervention) in CIA also reduced clinical score, leukocyte infiltration into the inflamed joint and bone erosion when compared to controls. Unlike the S1P agonist FTY720, PEPITEM therapy did not affect leukocyte movement into and out of local draining lymph node. <h3>Conclusions</h3> Patients with RA have a defect in adiponectin-PEPITEM axis, which potentially contributes to inappropriate accumulation of T-cells in the rheumatoid joint. Thus, re-establishing PEPITEM function to 'turn off' pathological recruitment of T-cells represents a novel and potentially powerful approach to treating patients with early rheumatoid arthritis. <h3>Reference</h3> . Chimen, McGettrick, et al. <i>Nat Med</i>2015;21(5):467–75. doi:10.1038/nm.3842 <h3>Acknowledgements</h3> Work funded by ARUK Career Development Fellowship and Pfizer I-CRP. <h3>Disclosure of interest</h3> S. Kemble: None declared, L. Harford: None declared, H. McGettrick Grant/research support from: Arthritis Research UK and Pfizer Research Grant
Changes in prostate cancer circulating tumor cell (CTC) numeration and gamma H2AX positivity before and after treatment with radium 223 for metastatic castrate resistant prostate cancer.
Authors: Jingsong Zhang, Jesse Mocha, Ghassan El-Haddad
Journal: Journal of Clinical Oncology (2018)

211 Background: As an alpha-particle emitting radiopharmaceutical, R is indicated for symptomatic mCRPC patients with bone predominant metastases and no visceral metastases. The current R administration dose was calculated based on body weight and decay factor. This may not be an ideal dose to individual patient (pt) with different body mass and different burdens of bone metastases. We hypothesize that changes in CTC # and the DNA damage marker, γH2AX, could serve as readout for on target effects of R and conducted a pilot prospective biomarker study. Methods: Pts who received R as standard of care for mCRPC and had a baseline CTC # of ≥ 2 were eligible. CTC samples were collected prior to and between 24 and 96 hours post dose 1, 3 and 6 of R. CTC # and γH2AX positivity were performed by Janssen Diagnostics Lab. Results: 10 pts were enrolled and all had &gt; 15 bone metastases at enrollment. 7/10 pts had prior Taxane-based chemotherapy. The median CTC # and γH2AX positivity prior to R were 21 (range: 3-250), and 33% (range: 3% to 80%) respectively. 8 pts completed all 6 doses of R; 2 pts completed 2 doses then elected to hospice due to rapid clinical decline. Among pts completed R, 4 (50%) had bone scan progression within 1 month. No decline in ALKP, PSA, CTC # or increase in gamma H2AX positivity were seen during treatment with R in these 4 pts. 2 pts had CTC # conversion to 0 after dose 3 R at week 9. Both pts had ALKP decline, but no PSA decline during treatment. 1 of these 2 pts had 100% positivity for gamma H2AX after dose 6 R and had prolonged post R PSA response with stable bone scans at last follow up 24 months after the first dose of R. Increases in CTCs’ γH2AX positivity, and &gt; 50% decline of ALKP were observed in 2 pts with germline deleterious mutations in BRCA2 and PALB2. Both pts, however, had a rapid surge in CTC # and PSA after dose 3. Despite stable bone scans, both proceeded with chemotherapy within 2 months after completing dose 6 R. Conclusions: Increase in CTC # and no increase in γH2AX positivity were associated with lack of response to R. The lack of increase in the DNA damage marker, γH2AX, in pts without declines in ALKP, PSA, and CTC # suggests their R doses may need to be increased. Clinical trial information: NCT02981797.
Parts of new Scottish GP contract could benefit English colleagues, say GPs
Authors: Abi Rimmer
Journal: BMJ (2018)

The GP contract in England should incorporate elements of the new Scottish GP contract, members of the profession have said.

In January GPs in Scotland voted by a large majority to accept a new contract.1 However, a group of GPs in Scotland resigned from the BMA in protest at the contract, which they said would have a “devastating” effect on patients in rural areas.2

The new Scottish contract …
PREDICTORS OF LDL-CHOLESTEROL AND SYSTOLIC BLOOD PRESSURE (SBP) GOAL ATTAINMENT AT ONE YEAR: INTERIM DATA FROM THE ISCHEMIA TRIAL
Authors: Jonathan D. Newman, Karen Alexander, Sean O’Brien, Xiangqiong Gu, Sajeev Govindan, Roxy Senior, Paulo Rezende, Nagaraja Moorthy, Marcin Demkow, Jose Lopez-Sendon, Olga Bockeria, Gilbert Gosselin, Neeraj Pandit, Peter Stone, William Boden, John Spertus, Gregg Stone, Judith Hochman, David Maron
Journal: Journal of the American College of Cardiology (2018)
Castleman’s Disease of the Kidney Mimicking Renal Cell Carcinoma on FDG PET/CT
Authors: Yang Wang, Aisheng Dong, Bo Yang, Jianping Lu
Journal: Clinical Nuclear Medicine (2018)

Abstract Castleman’s disease of the kidney is extremely rare. We present a case of Castleman’s disease in the left kidney with multiple para-aortic enlarged lymph nodes. Both the renal lesion and para-aortic lymph nodes showed hypervascularity on enhanced CT and minimally increased FDG uptake on FDG PET/CT, mimicking renal cell carcinoma with para-aortic nodal metastases. This case suggests that Castleman’s disease should be considered as a rare differential diagnosis in patients with a hypervascular and hypermetabolic renal lesion.
Concentrated Ambient PM2.5-Induced Inflammation and Endothelial Dysfunction in a Murine Model of Neural IKK2 Deficiency
Authors: Minjie Chen, Xiaobo Qin, Lianglin Qiu, Sufang Chen, Huifen Zhou, Yanyi Xu, Ziying Hu, Yuhao Zhang, Qi Cao, Zhekang Ying
Journal: Environmental Health Perspectives (2018)

Background: Exposure to ambient fine particulate matter (PM2.5) is associated with cardiovascular mortality, but underlying pathophysiologic mechanisms are not fully understood. Hypothalamic inflammation, characterized by the activation of Inhibitor kappaB kinase 2/Nuclear factor kappaB (IKK2/NF-κB) signaling pathway, may play an important role in the pathogenesis of cardiovascular diseases. We recently demonstrated that hypothalamic inflammation is increased in mice exposed to concentrated ambient PM2.5 (CAP). Objectives: In the present study, we used a neuron-specific IKK2 knockout mouse model to examine the role of neural IKK2 expression and hypothalamic inflammation in the pathophysiologic effects of PM2.5. Methods: We assessed inflammatory and vascular responses in Nestin-creIKK2flox/flox (IKK2Neu-KO) and littermate Nestin-creIKK2flox/+ (control) mice after 4 mo of exposure to filtered air (FA) or CAP. Results: CAP exposure was associated with significantly higher tumor necrosis factor-α (TNFα) and interleukin (IL)-6 mRNA in the hypothalamus of control mice, but not IKK2Neu-KO mice. In addition, CAP exposure–induced increases in bronchoalveolar lavage fluid (BALF) leukocytes, pulmonary macrophage infiltration and IL-6 expression, plasma TNFα and IL-1β levels, adipose macrophage infiltration and IL-1β expression, and endothelial dysfunction were reduced or absent in IKK2Neu-KO mice compared with controls. Conclusions: Our findings support a role of neural IKK2 in CAP exposure–induced local and systemic pro-inflammatory cytokine expression, pulmonary and adipose inflammation, and endothelial dysfunction, thus providing insight into pathophysiologic mechanisms that may mediate effects of PM2.5 exposure. https://doi.org/10.1289/EHP2311
The feasibility and safety of laparoscopy-assisted distal gastrectomy that was performed by trainee supervised by a technically qualified surgeon.
Authors: Takanobu Yamada, Tsutomu Hayashi, Masato Nakazono, Kentaro Hara, Hiroaki Osakabe, Shinsuke Nagasawa, Yuta Kumazu, Takashi Ogata, Takaki Yoshikawa
Journal: Journal of Clinical Oncology (2018)

183 Background: The laparoscopic gastrectomy is becoming widespread. But acquisition of its technique is challenging. We investigated whether supervision by a technically qualified surgeon (QS) affects the feasibility and safety of laparoscopic gastrectomy performed by trainee (TR). Methods: The outcomes of laparoscopy-assisted distal gastrectomy for gastric cancer performed by QS group and TR group between 2013 and 2016 were assessed. A laparoscopic surgeon qualified by the Endoscopic Surgical Skill Qualification System (Japan Society for Endoscopic Surgery) participated in surgeries that ware performed by trainee as the teaching assistant. Results: All patient characteristics were not different between QS group and TR group, except of BMI (median BMI 23.9 vs 22.2, p = 0.01). Although operation time of TR group was longer than that of QS group (median time: 248 min. vs 285 min., p = 0.01), Blood loss and number of harvested lymph nodes were not different. One patient (0.3%) in QS group and two patients (0.4%) in TR group required conversion to open surgery (p = 0.58). Postoperative complication, that was defined by Clavien-Dindo classification grade 3 and more, occurred in four patients (11.4%) in QS group and nine patients (5.4%) in TR group (p = 0.25). Complication in QS group were anastomotic leakage (n = 2) and abdominal abscess (n = 2), whereas that in TR group were anastomotic leakage (n = 3), anastomotic stenosis (n = 2), pancreatic fistula (n = 1), bowel obstruction (n = 1), pneumothorax (n = 1), and cerebral hemorrhage (n = 1). One patient in QS group (2.9%) and four patients in TR group (2.4%) underwent reoperation (p = 1.00). Postoperative mortality occurred in one cases in TR group (0.01%). Conclusions: The laparoscopy-assisted distal gastrectomy of TR group supervised by QS was feasible and safe procedure as well as that of QS group.