tbuckley/cabot-search huggingface dataset:
Medical schools allocate state school places
Authors: Siân Knight
Journal: BMJ (2000)

In an influential new scheme, the government is to reserve places at Guy's, King's and St Thomas's Medical School exclusively for the use of state school pupils from deprived areas. The move follows a recent report from the Sutton Trust, which criticised university access for comprehensive school students compared with that of independent schools.

From 2001, ringfenced places at the medical school will be paid for by the Higher Education Funding Council and will be offered to students who have come from educationally or socially disadvantaged backgrounds. It is unclear whether these offers will …
Caring for Ethnic Minority Elders: A Guide
Authors: Jayati Das-Munshi
Journal: BMJ (2000)

Yasmin Alibhai-Brown Age Concern/Ace Books 1998; £14.99 ISBN 0862421888

Elderly people make up about a fifth of the British population and present disproportionately to those engaged in health care. A relief then, that the charity Age Concern produces a variety of handbooks to aid health workers who are attempting to navigate the various issues surrounding this area of provision.

Caring for Ethnic Minority Elders is one such guide. The author, Yasmin AlibhaiBrown, …
Mavacamten Treatment for Obstructive Hypertrophic Cardiomyopathy
Authors: Stephen B. Heitner, Daniel Jacoby, Steven J. Lester, Anjali Owens, Andrew Wang, David Zhang, Joseph Lambing, June Lee, Marc Semigran, Amy J. Sehnert
Journal: Annals of Internal Medicine (2019)

Background: Mavacamten, an orally administered, small-molecule modulator of cardiac myosin, targets underlying biomechanical abnormalities in obstructive hypertrophic cardiomyopathy (oHCM). Objective: To characterize the effect of mavacamten on left ventricular outflow tract (LVOT) gradient. Design: Open-label, nonrandomized, phase 2 trial. (ClinicalTrials.gov: NCT02842242) Setting: 5 academic centers. Participants: 21 symptomatic patients with oHCM. Intervention: Patients in cohort A received mavacamten, 10 to 20 mg/d, without background medications. Those in cohort B received mavacamten, 2 to 5 mg/d, with β-blockers allowed. Measurements: The primary end point was change in postexercise LVOT gradient at 12 weeks. Secondary end points included changes in peak oxygen consumption (pVO2), resting and Valsalva LVOT gradients, left ventricular ejection fraction (LVEF), and numerical rating scale dyspnea score. Results: In cohort A, mavacamten reduced mean postexercise LVOT gradient from 103 mm Hg (SD, 50) at baseline to 19 mm Hg (SD, 13) at 12 weeks (mean change, −89.5 mm Hg [95% CI, −138.3 to −40.7 mm Hg]; P = 0.008). Resting LVEF was also reduced (mean change, −15% [CI, −23% to −6%]). Peak VO2 increased by a mean of 3.5 mL/kg/min (CI, 1.2 to 5.9 mL/kg/min). In cohort B, the mean postexercise LVOT gradient decreased from 86 mm Hg (SD, 43) to 64 mm Hg (SD, 26) (mean change, −25.0 mm Hg [CI, −47.1 to −3.0 mm Hg]; P = 0.020), and mean change in resting LVEF was −6% (CI, −10% to −1%). Peak VO2 increased by a mean of 1.7 mL/kg/min (SD, 2.3) (CI, 0.03 to 3.3 mL/kg/min). Dyspnea scores improved in both cohorts. Mavacamten was well tolerated, with mostly mild (80%), moderate (19%), and unrelated (79%) adverse events. The most common adverse events definitely or possibly related to mavacamten were decreased LVEF at higher plasma concentrations and atrial fibrillation. Limitation: Small size; open-label design. Conclusion: Mavacamten can reduce LVOT obstruction and improve exercise capacity and symptoms in patients with oHCM. Primary Funding Source: MyoKardia.
Urinary Sodium Profiling in Chronic Heart Failure to Detect Development of Acute Decompensated Heart Failure
Authors: Pieter Martens, Matthias Dupont, Frederik Hendrik Verbrugge, Kevin Damman, Nicolas Degryse, Petra Nijst, Carmen Reynders, Joris Penders, W.H. Wilson Tang, Jeffrey Testani, Wilfried Mullens
Journal: JACC Heart Failure (2019)
CRISPR/Cas9 Unsettle PIP4K2A and α, β, and γ Globin Genes Expression
Authors: Danaê Malimpensa, Eliel Faber, Marcus A.F. Corat, Marlous V.G. Lana, Bryan E. Strauss, Fernando F. Costa, Susan Elisabeth Jorge, Maria de Fátima Sonati
Journal: Blood (2018)
Minerva: August 2001
Authors: P Mohammed, N McLean, R Charnley, A J Thompson, H J Steen, A J M Reid
Journal: BMJ (2001)

Treating sleep apnoea may save lives. More than 200 adults with sleep apnoea were treated with nasal continuous positive airways pressure for at least three years. Their motor vehicle collision records three years before and after treatment were compared with those of a similar number of control drivers. Untreated patients had had more recorded collisions than the controls, but after the treatment the rate in both groups became equal (Thorax 2001;56:508–12). One commentator estimates that treating 500 patients for three years could prevent 180 serious crashes.

Dyspepsia guidelines commonly used in clinical practice say that referrals for endoscopy should be limited to patients over the age of 45 and those who present with “alarm” symptoms such as weight loss, recurrent vomiting, or dysphagia. But an American multivariate analysis of over 20 000 patients reports that such rules are not effective predictors of endoscopic findings: major disease was found at endoscopy in only 21% of cases (sensitivity 87%, specificity 26%). The authors recommend that more effective strategies are needed …
The Press: Vaccination scaremongering
Authors: Carolyn Edwards
Journal: BMJ (2000)

See also You should know, you're a medic: Is the MMR vaccine safe?

Vaccine scaremongering is on the increase. The problem is that more people experience vaccine side effects if mass vaccination programs are in place, even though this often leads to a very small incidence of potentially life threatening diseases. This creates the ideal environment for vaccine scare stories to flourish. The link between the measles, mumps, and rubella (MMR) vaccine and autism reported in 199812 has triggered an unrelenting stream of stories raising concerns over vaccine safety. These panic stories persist despite assurances that MMR is safe.38 In April this year, for example, the Mail on Sunday reported “a new link between MMR and autism”9 based on one study which found measles in the bowels of 24 autistic children, even though the study was deemed “uninterpretable” by the Department of Health. The new meningitis C vaccine is the most recent victim of media reports about vaccine side effects. …
Small Modifications in Technique May Yield Large Rewards After Lung Cancer Surgery
Authors: Mark K. Ferguson
Journal: JAMA Surgery (2019)

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 Surgery 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 Surgery journal
Cumulative effect of smoking on disease burden and multimorbidity in adult-onset asthma
Authors: Minna Tommola, Pinja Ilmarinen, Leena E. Tuomisto, Lauri Lehtimäki, Onni Niemelä, Pentti Nieminen, Hannu Kankaanranta
Journal: European Respiratory Journal (2019)

Smokers and patients with heavy smoking history have usually been excluded from clinical studies of asthma. Thus, little is known about the impact of lifelong, cumulative tobacco exposure on asthma [1, 2]. The effect of smoking status (never-, ex- or current smoker) on disease burden of asthma has been more commonly recognised, but the impact of smoking history in pack-years has rarely been evaluated [3–6]. The impact of smoked pack-years has been previously reported only by few studies, showing adverse effects on lung function and asthma control [5, 7–10], whereas no significant differences in healthcare use, asthma-related questionnaires or medication use were reported among ex-smokers with severe asthma when patients were categorised based on smoked pack-years [4]. Disease burden and multimorbidity in adult-onset asthma increase dose dependently with smoked pack-years <http://bit.ly/311627j> We are grateful to research nurse Aino Sepponen for her input with data management.
The Empty Chair
Authors: Helen Barratt
Journal: BMJ (2001)

Lincoln Rhyme first appeared in Jeffery Deaver's best selling book The Bone Collector, which was made into a film in 1999. Now the criminalist makes a welcome return in Deaver's latest novel, The Empty Chair.

Paralysed from the neck down after an accident, Rhyme travels to Paquenoke County, North Carolina, with his protege, former model Amelia Sachs, to undergo pioneering experimental surgery to repair his C4 vertebral fracture, which has left him able to move only his …
Use of targeted next generation sequencing to characterize tumor mutational burden and efficacy of immune checkpoint inhibition in small cell lung cancer
Authors: Biagio Ricciuti, Sasha Kravets, Suzanne E. Dahlberg, Renato Umeton, Adem Albayrak, Safiya J. Subegdjo, Bruce E. Johnson, Mizuki Nishino, Lynette M. Sholl, Mark M. Awad
Journal: Journal for ImmunoTherapy of Cancer (2019)

Clinically-available biomarkers to identify the fraction of patients with small cell lung cancer (SCLC) who respond to immune-checkpoint inhibitors (ICIs) are lacking. High nonsynonymous tumor mutational burden (TMB), as assessed by whole exome sequencing, correlates with improved clinical outcomes for patients with SCLC treated with ICIs. Whether TMB as assessed by targeted next generation sequencing (NGS) is associated with improved efficacy of ICIs in patients with SCLC is currently unknown. Here we determined whether TMB by targeted NGS is associated with efficacy of ICIs in patients with SCLC.We collected clinicopathologic data from patients with relapsed or refractory SCLC which underwent targeted NGS with TMB assessment by the Dana-Farber Cancer Institute OncoPanel platform. The relationship between TMB and clinical outcomes after treatment with ICIs was investigated.Among the 52 patients treated with ICIs, we found no significant difference in the objective response rate (ORR) between patients with a TMB above the 50th percentile ("TMB high") and those with a TMB at or below the 50th percentile ("TMB low"). The median progression-free survival (mPFS) and median overall survival (mOS) were significantly longer in patients with a high TMB compared to those with a low TMB (mPFS: 3.3 versus 1.2 months, HR: 0.37 [95% CI: 0.20-0.69], P < 0.01; mOS: 10.4 versus 2.5 months, HR: 0.38 [95% CI: 0.19-0.77], P < 0.01). The one-year PFS and OS rates improved with increasing mutational load when TMB was divided into tertiles.These findings show that targeted NGS, a readily available clinical diagnostic test, can be used to identify patients with SCLC who are most likely to benefit from treatment with immune checkpoint inhibitors.
Correlation of Milestone Restricted Mean Survival Time Ratio With Overall Survival Hazard Ratio in Randomized Clinical Trials of Immune Checkpoint Inhibitors
Authors: Zi-Xian Wang, Hao-Xiang Wu, Li Xie, Ying-Nan Wang, Lu-Ping Yang, Ming-Ming He, Hui-Yan Luo, Pei-Rong Ding, Dan Xie, Gong Chen, Yu-Hong Li, Feng Wang, Rui-Hua Xu
Journal: JAMA Network Open (2019)

<h3>Importance</h3> Immune checkpoint inhibitors (ICIs) have unique patterns of response and survival that differ from conventional chemotherapies. Novel intermediate end points are urgently required to detect the early signals of ICI activity. <h3>Objective</h3> To evaluate milestone rate (Kaplan-Meier estimates of survival probabilities at given time points) and milestone restricted mean survival time (RMST, the area under survival curves up to given time points) as potential intermediate end points for ICI trials. <h3>Data Sources</h3> Electronic databases (pre-MEDLINE, MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials) were searched for randomized clinical trials published between January 1, 2000, and December 31, 2017. <h3>Study Selection</h3> Phase 2 and phase 3 randomized clinical trials evaluating ICIs in advanced solid tumors. <h3>Data Extraction and Synthesis</h3> Two investigators extracted the data and reconstructed individual patient data to estimate the milestone rate or milestone RMST from the published Kaplan-Meier curves. <h3>Main Outcomes and Measures</h3> Trial-level milestone rates or milestone RMSTs were estimated for 6-month and 9-month progression-free survival (PFS) and 9-month and 12-month overall survival (OS). A weighted linear regression model evaluated the correlations of ratios of milestone rates or milestone RMSTs with OS hazard ratios (HRs). <h3>Results</h3> Twenty-six trials examining 8 different tumor types were identified, including 12 892 patients. Overall survival HR was correlated with the ratio of 9-month OS milestone rate (<i>R</i><sup>2</sup> = 0.45; 95% CI, 0.27-0.74), and with the ratio of 12-month OS milestone rate (<i>R</i><sup>2</sup> = 0.40; 95% CI, 0.22-0.70). The ratio of 9-month OS milestone RMST (<i>R</i><sup>2</sup> = 0.60; 95% CI, 0.28-0.74) and ratio of 12-month OS milestone RMST were correlated with OS HR (<i>R</i><sup>2</sup> = 0.64; 95% CI, 0.42-0.78). No correlations were observed between OS HR and the ratio of 6-month or 9-month PFS milestone rates or milestone RMSTs. <h3>Conclusions and Relevance</h3> Ratios of OS milestone RMSTs had a stronger correlation with OS HRs than ratios of OS milestone rates, whereas ratios of PFS milestone rates and ratios of PFS milestone RMSTs were not correlated with OS HRs. The OS milestone RMST could be further studied as an intermediate end point in future ICI trials.
Minerva: March 2002
Authors: Martin Dennis, Desikan Kamalakannan, Varadarajan Baskar, John Usher, Baldev M Singh
Journal: BMJ (2002)

Minerva enjoys a good foot massage, but results from a small, single blind trial of reflexology for irritable bowel syndrome do little to dispel her scepticism about the therapy. Reflexology made no difference—statistically or clinically—to the experience of pain, altered bowel habit, or abdominal distension ( British Journal of General Practice 2002;52:19-23). As this trial was designed in consultation with reflexology practitioners, their claims of success in cases where orthodox medicine has failed may have to be reassessed.

Patients sometimes get more than they bargained for when they're admitted to hospital. It's been suggested that on entering hospital each patient should be automatically warned about the 10% risk of nosocomial infections, because the consequences of not providing a warning might result in legal action on the issue of consent to treatment. But such warnings could result in a massive loss of confidence because hospital treatment is designed to cure or alleviate dangerous conditions, not make things worse ( Clinical Risk 2001;7:242).

Having recently needed an inhaler and discovered for herself just how tricky they can be to use, Minerva was worried to discover that …
Methodology of Evaluating the Laboratory Monitoring of Terbinafine Therapy—Reply
Authors: Deirdre A. Stolmeier, Erik J. Stratman, Thomas J. McIntee
Journal: JAMA Dermatology (2019)

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 Dermatology 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 Dermatology journal
Preliminary Results of Prophylactic Tocilizumab after Axicabtageneciloleucel (axi-cel; KTE-C19) Treatment for Patients with Refractory,Aggressive Non-Hodgkin Lymphoma (NHL)
Authors: Frederick L. Locke, Sattva S. Neelapu, Nancy L. Bartlett, Lazaros J. Lekakis, Caron A. Jacobson, Ira Braunschweig, Olalekan O. Oluwole, Tanya Siddiqi, Yi Lin, John M Timmerman, Patrick M. Reagan, Adrian Bot, John M. Rossi, Marika Sherman, Lynn Navale, Yizhou Jiang, Jeff S. Aycock, Meg Elias, Jeffrey S. Wiezorek, William Y. Go, David B. Miklos
Journal: Blood (2017)
Obstetrics and gynaecology
Authors: Klaus Morales
Journal: BMJ (2005)

Whether you like it or not, obstetrics and gynaecology is certainly one of the most important fields in medicine.



Go to www.emedicine.com/med/obstetricsgynecology.htm, and you'll get a complete A to Z list of topics on the subject. These topics will link you to articles written mostly by American professors. While reading one of them, you might also want to learn more about related issues, which you can find by simply clicking in the right hand corner of the screen. The emedicine website is organised, which makes it easier to navigate, and …
Male biological clock is ticking
Authors: Richard Tingay
Journal: BMJ (2000)

Scientists from Bristol and Brunel Universites believe that they have shown evidence for a male “biological clock.”

The study, described in Human Reproduction (2000; 15(8):1703-8), showed that conception takes longer when the man is older, irrespective of his partner's age. Out of 8000 pregnancies studied, 74% were conceived in under six months, 14% …
The tech for the next decade: promises and challenges in genome biology
Authors: Iman Hajirasouliha, Hagen U. Tilgner
Journal: Genome biology (2019)

The 19th Annual Advances in Genome Biology and Technology (AGBT) meeting came back to Marco Island, Florida, and was held in the renovated venue from 27 February to 2 March 2019. The meeting showed a variety of new technology, both in wet lab and in bioinformatics. This year's themes included single-cell technology and applications, spatially resolved gene expression measurements, new sequencing platforms, genome assembly and variation, and long and linked reads.
Vitamin D Modifies the Incidence of Graft-versus-Host Disease after Allogeneic Stem Cell Transplantation Depending on the Vitamin D Receptor (VDR) Polymorphisms
Authors: Estrella Carrillo-Cruz, José R. García-Lozano, Francisco J. Márquez-Malaver, Fermín M. Sánchez-Guijo, Isabel Montero Cuadrado, Christelle Ferra i Coll, David Valcárcel, Oriana López-Godino, Marian Cuesta, Rocío Parody, Lucía López-Corral, Miguel Alcoceba, Teresa Caballero-Velázquez, Alfonso Rodríguez-Gil, José A. Bejarano-García, Teresa Lopes Ramos, José A. Pérez-Simón
Journal: Clinical Cancer Research (2019)

The biologically active metabolite of vitamin D3, 1,25-dihydroxyvitamin D3 (vit D), has immunoregulatory properties via binding vitamin D receptor (VDR). In a prospective trial, we previously reported a reduction in the incidence of chronic GvHD (cGvHD) among patients who received vit D after allogeneic stem cell transplantation (allo-HSCT; Clinical Trials.gov: NCT02600988). Here we analyze the role of patients and donors' VDR SNPs on the immunomodulatory effect of vit D.Patients undergoing allo-HSCT were included in a prospective phase I/II clinical trial (Alovita) in three consecutive cohorts: control (without vit D), low-dose (1,000 IU/day), and high-dose (5,000 IU/day) groups. Vit D was given from day -5 until +100 after transplant. Genotyping of four SNPs of the VDR gene, FokI, BsmI, ApaI, and TaqI, were performed using TaqMan SNP genotyping assays.We observed a decrease in the incidence of overall cGvHD at 1 year after allo-HSCT depending on the use or not of vit D among patients with FokI CT genotype (22.5% vs 80%, P = 0.0004) and among those patients without BsmI/ApaI/TaqI ATC haplotype (22.2% vs 68.8%, P = 0.0005). In a multivariate analysis, FokI CT genotype significantly influenced the risk of cGvHD in patients treated with vit D as compared with the control group (HR 0.143, Pinteraction < 0.001).Our results show that the immunomodulatory effect of vit D depends on the VDR SNPs, and patients carrying the FokI CT genotype display the highest benefit from receiving vit D after allo-HSCT.
Life and loathes of a new doctor: The riddle fiddle
Authors: Stephen Goldie
Journal: BMJ (2005)

If Paula Radcliffe thought she was exhausted after the Olympic marathon in Greece this summer then she should try working a week as a receiving house officer. It seems that the recently introduced European Working Time Directive has lost something in the translation. Apparently the butcher, the baker, and the candlestick maker can only work 48 hours per week, but doctors being superhuman can do 56 hours. Despite this new law, my newly qualified colleagues and I are injecting people with morphine at 6 am after working 70-80 hours that week--legally. Paula finished the race in dehydrated delirium--much like I feel at the end of night shift. My new definition of a patient with renal failure is someone who pees less than their preregistration house officer.

According to the unfortunately named “Riddle formula” we still only work an average of 55.99 999 hours per week (average includes a projected 40 years of retirement). However, that's because the calculation only counts the time in which you are touching the floor of an NHS hospital. As a receiving house officer …