tbuckley/cabot-search huggingface dataset:
Flu vaccination for staff may become contractual duty, says chief medical officer
Authors: Adrian O’Dowd
Journal: BMJ (2019)

Employers should consider making it a contractual duty for NHS staff to have the annual flu vaccination to protect vulnerable patients from catching the disease, England’s chief medical officer has suggested to MPs.

Sally Davies told the House of Commons science and technology committee that she believed that staff should be obliged to have the vaccination each year, during an evidence session on Davies’s work held on 6 June.

Asked by MPs whether it should be mandatory for all health and social care staff to get the flu vaccination, she said, “I feel strongly that, if you look at the General Medical Council and the nursing guidance, we have a duty of care to our patients and we should therefore be vaccinated.

“By steady progress, vaccination levels have gone up, but they are variable between hospitals. It would be difficult to make it mandatory . . . but I do think consideration should be given to making it a contractual duty, just like hepatitis B vaccine is. I think it won’t work, just saying you’ve got to have flu vaccine—it’s got to be a contractual obligation, as you join a hospital or something.”

Uptake figures from the latest round of flu vaccination were issued in March, showing that 70.3% of all eligible frontline healthcare workers had received their flu vaccination so far—the highest uptake to date and slightly up on last year’s 68.7%. Asked why not all staff were getting vaccinated, Davies theorised that it …
Association of Quetiapine Overuse Letters With Prescribing by Physician Peers of Targeted Recipients
Authors: Adam Sacarny, Andrew R. Olenski, Michael L. Barnett
Journal: JAMA Psychiatry (2019)

of a Randomized Clinical TrialPhysicians learn about new medical evidence from their peers. 1,2 Interventions that can stem overuse in some physicians could therefore spur systemwide change through peer networks as physicians discuss new practice styles and learn from each other.One source of overuse is antipsychotic prescribing: these drugs are widely prescribed to people with dementia even though guidelines discourage this practice. 3A randomized clinical trial of antipsychotic overuse letters that were sent by the Centers for Medicare and Medicaid Services (CMS) to high prescribers of quetiapine reduced prescribing by targeted physicians by 16% over 2 years (NCT02467933). 4 This study examines whether these letters led to changes in prescribing by peers of the original physicians, which would suggest that overuse interventions can have broader effects.
Alveolar Sarcoidosis With Intense FDG Uptake, Mimicking Multi-focal Pneumonia and Infiltrative Lung Malignancy
Authors: Kianoush Ansari-Gilani, Michael Yang, Nikhil H. Ramaiya
Journal: Clinical Nuclear Medicine (2019)

Abstract Alveolar sarcoidosis is an uncommon radiologic manifestation of pulmonary sarcoidosis which appears as infiltrative or mass-like opacities mimicking multifocal pneumonia or infiltrative lung malignancies such as multi-focal adenocarcinoma or pulmonary lymphoma. It has correlation with a more acute and symptomatic phase of thoracic sarcoidosis and therefore expected to show a more severely increased metabolic activity on FDG PET. Alveolar sarcoidosis shows a relatively rapid radiological improvement after initiation of corticosteroid therapy. Tissue diagnosis might be needed in some cases to exclude malignancy.
Comparative Analysis of Circulating Noncoding RNAs Versus Protein Biomarkers in the Detection of Myocardial Injury
Authors: Christian Schulte, Temo Barwari, Abhishek Joshi, Konstantinos Theofilatos, Anna Zampetaki, Javier Barallobre-Barreiro, Bhawana Singh, Nils A. Sörensen, Johannes T. Neumann, Tanja Zeller, Dirk Westermann, Stefan Blankenberg, Michael Marber, Christoph Liebetrau, Manuel Mayr
Journal: Circulation Research (2019)

Noncoding RNAs (ncRNAs), including microRNAs (miRNAs), circular RNAs (circRNAs), and long noncoding RNAs (lncRNAs), are proposed novel biomarkers of myocardial injury. Their release kinetics have not been explored without confounding by heparin nor has their relationship to myocardial protein biomarkers.
A wave of Foxp3+ regulatory T cell accumulation in the neonatal liver plays unique roles in maintaining self-tolerance
Authors: Mingyang Li, Weijia Zhao, Yifan Wang, Lixue Jin, Gaowen Jin, Xiuyuan Sun, Wei Wang, Ke Wang, Xi Xu, Jie Hao, Rong Jin, Wenxian Fu, Ying Sun, Yingjun Chang, Xiaojun Huang, Xuyu Zhou, Hounan Wu, Kunshan Zhang, Qing Ge
Journal: Cellular and Molecular Immunology (2019)
Protein-Losing Enteropathy
Authors: Donald A Redelmeier, Akash M Patel
Journal: New England Journal of Medicine (2023)

Protein-losing enteropathy (PLE) is a condition in which excess loss of proteins occurs through the gastrointestinal tract due to different etiologies. It should be suspected in patients with low serum proteins and in whom other causes of hypoproteinemia have been ruled out.
Helen Salisbury: The 10 minute appointment
Authors: Helen Salisbury
Journal: BMJ (2019)

GP appointments in the UK last on average 9.2 minutes, a considerably shorter time than in other rich nations, and there’s no evidence that this is because our patients are healthier or have fewer questions. A recent report by the Royal College of General Practitioners suggested that all appointments should be at least 15 minutes long.1

Very few GPs feel as though they can comfortably do a good job and provide holistic care in a 10 minute appointment. For some of my patients it takes more than a minute to walk the …
High-dimensional detection of imaging response to treatment in multiple sclerosis
Authors: Baris Kanber, Parashkev Nachev, Frederik Barkhof, Alberto Calvi, Jorge Cardoso, Rosa Cortese, Ferran Prados, Carole H. Sudre, Carmen Tur, Sebastien Ourselin, Olga Ciccarelli
Journal: npj Digital Medicine (2019)

Changes on brain imaging may precede clinical manifestations or disclose disease progression opaque to conventional clinical measures. Where, as in multiple sclerosis, the pathological process has a complex anatomical distribution, such changes are not easily detected by low-dimensional models in common use. This hinders our ability to detect treatment effects, both in the management of individual patients and in interventional trials. Here we compared the ability of conventional models to detect an imaging response to treatment against high-dimensional models incorporating a wide multiplicity of imaging factors. We used fully-automated image analysis to extract 144 regional, longitudinal trajectories of pre- and post- treatment changes in brain volume and disconnection in a cohort of 124 natalizumab-treated patients. Low- and high-dimensional models of the relationship between treatment and the trajectories of change were built and evaluated with machine learning, quantifying performance with receiver operating characteristic curves. Simulations of randomised controlled trials enrolling varying numbers of patients were used to quantify the impact of dimensionality on statistical efficiency. Compared to existing methods, high-dimensional models were superior in treatment response detection (area under the receiver operating characteristic curve = 0.890 [95% CI = 0.885-0.895] vs. 0.686 [95% CI = 0.679-0.693], P < 0.01]) and in statistical efficiency (achieved statistical power = 0.806 [95% CI = 0.698-0.872] vs. 0.508 [95% CI = 0.403-0.593] with number of patients enrolled = 50, at α = 0.01). High-dimensional models based on routine, clinical imaging can substantially enhance the detection of the imaging response to treatment in multiple sclerosis, potentially enabling more accurate individual prediction and greater statistical efficiency of randomised controlled trials.
FRI0104 Reactive arthritis in 43 iranian patients
Authors: AR Jamshidi, F Gharibdoost, M Akbarian, F Shahram, A Nadji, F Davatchi
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> Reactive arthritis refers to an acute non-purulent arthritis reactive to an infection elsewhere in the body. <h3>Objectives</h3> The aim of this study was to find the demography of reactive arthritis in Iranian patients. <h3>Methods</h3> In a five years period 43 patients who definitely were diagnosed as Reactive Arthritis were seen in our centre. All patients were classified by the European Criteria for reactive arthritis classification. 139 items were checked in every patient. The data were analysed by SPSS software. <h3>Results</h3> The age ratio was 17–45 years with a mean age of 23.8 years. Forty patients (93%) were male and the male to female ratio was 13/1. A history of infection in 1 to 4 weeks before the attack of reactive arthritis was diarrhoea in 20 (46.5%) and urethritis in 16 patients (37.2%). The clinical manifestation during the disease were: constitutional symptoms in 24 (55.8%), including fever 44.2%, weight loss 32.6%, fatigue 20.9%, lower extremity arthritis 100%, and upper extremity arthritis 48.8%. Sacroiliac involvement was seen in 37.2% of patients. The most common peripheral arthritis was seen in ankle (83.7%) and knee joints (76.7%). Achilles and Calcaneal Enthesopathy were seen in 46.5% of patients. Extra articular manifestations were seen in 37 patients (86%): eye involvement in 31 patients (55.8%) and mucocutaneous involvement in 13 patients (30.2%). Lab test: Leucocytosis were seen in 23.2%, Anaemia in 11.7%, Erythrocyte sedimentation rate &gt; 50 in 62.5%, positive CRP in 83.7% and positive HLA-B27 in 46.8% of cases. <h3>Conclusion</h3> Reactive Arthritis in Iranian patients has the same clinical manifestations as in other countries. Male to female ratio in the Iranian patient is more than in other countries. HLA-B27 is less common in Iranian patients than in other countries.
Does a Diagnosis of Community-Acquired Pneumonia in a Child Always Require Antibiotics?
Authors: Miles Weinberger
Journal: JAMA Pediatrics (2019)

To the Editor This letter is in response to the Tribble et al article, “Comparison of Antibiotic Prescribing for Pediatric Community-Acquired Pneumonia in Children’s and Non-Children’s Hospitals,”1 published online December 10, 2018.
Biomaterials: Been There, Done That, and Evolving into the Future
Authors: Buddy D. Ratner
Journal: Annual Review of Biomedical Engineering (2019)

Biomaterials as we know them today had their origins in the late 1940s with off-the-shelf commercial polymers and metals. The evolution of materials for medical applications from these simple origins has been rapid and impactful. This review relates some of the early history; addresses concerns after two decades of development in the twenty-first century; and discusses how advanced technologies in both materials science and biology will address concerns, advance materials used at the biointerface, and improve outcomes for patients.
Insights Into the Pathophysiology of Endocannabinoid Signaling in Schizophrenia
Authors: David W. Volk, David A. Lewis
Journal: JAMA Psychiatry (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 Psychiatry 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 Psychiatry journal
Longitudinal neurometabolic changes in the hippocampus of a rat model of chronic hepatic encephalopathy
Authors: Olivier Braissant, Veronika Rackayová, Katarzyna Pierzchala, Jocelyn Grosse, Valérie A. McLin, Cristina Cudalbu
Journal: Journal of Hepatology (2019)

The sequence of events in hepatic encephalopathy (HE) remains unclear. Using the advantages of in vivo 1H-MRS (9.4T) we aimed to analyse the time-course of disease in an established model of type C HE by analysing the longitudinal changes in a large number of brain metabolites together with biochemical, histological and behavioural assessment. We hypothesized that neurometabolic changes are detectable very early, and that these early changes will offer insight into the primary events underpinning HE.Wistar rats underwent bile-duct ligation (BDL) and were studied before BDL and at post-operative weeks 2, 4, 6 and 8 (n = 26). In vivo short echo-time 1H-MRS (9.4T) of the hippocampus was performed in a longitudinal manner, as were biochemical (plasma), histological and behavioural tests.Plasma ammonium increased early after BDL and remained high during the study. Brain glutamine increased (+47%) as early as 2-4 weeks post-BDL while creatine (-8%) and ascorbate (-12%) decreased. Brain glutamine and ascorbate correlated closely with rising plasma ammonium, while brain creatine correlated with brain glutamine. The increases in brain glutamine and plasma ammonium were correlated, while plasma ammonium correlated negatively with distance moved. Changes in astrocyte morphology were observed at 4 weeks. These early changes were further accentuated at 6-8 weeks post-BDL, concurrently with the known decreases in brain organic osmolytes.Using a multimodal, in vivo and longitudinal approach we have shown that neurometabolic changes are already noticeable 2 weeks after BDL. These early changes are suggestive of osmotic/oxidative stress and are likely the premise of some later changes. Early decreases in cerebral creatine and ascorbate are novel findings offering new avenues to explore neuroprotective strategies for HE treatment.The sequence of events in chronic hepatic encephalopathy (HE) remains unclear, therefore using the advantages of in vivo proton magnetic resonance spectroscopy at 9.4T we aimed to test the hypothesis that neurometabolic changes are detectable very early in an established model of type C HE, offering insight into the primary events underpinning HE, before advanced liver disease confounds the findings. These early, previously unreported neurometabolic changes occurred as early as 2 to 4 weeks after bile-duct ligation, namely an increase in plasma ammonium and brain glutamine, a decrease in brain creatine and ascorbate together with behavioural and astrocyte morphology changes, and continued to progress throughout the 8-week course of the disease.
In vitro bone-like nodules generated from patient-derived iPSCs recapitulate pathological bone phenotypes
Authors: Shunsuke Kawai, Hiroyuki Yoshitomi, Junko Sunaga, Cantas Alev, Sanae Nagata, Megumi Nishio, Masataka Hada, Yuko Koyama, Maya Uemura, Kazuya Sekiguchi, Hirotsugu Maekawa, Makoto Ikeya, Sakura Tamaki, Yonghui Jin, Yuki Harada, Kenichi Fukiage, Taiji Adachi, Shuichi Matsuda, Junya Toguchida
Journal: Nature Biomedical Engineering (2019)
Abstract 18334: Electrocardiographic Alterations After Alcohol Septal Ablation Demonstrate 1-Year Lasting Reverse Remodeling Effect
Authors: Junya Matsuda, Mitsunobu Kitamura, Morimasa Takayama, Yoshiaki Kubota, Shunichi Nakamura, Hiroshige Murata, Gen Takagi, Hitoshi Takano, Kuniya Asai, Kyoichi Mizuno
Journal: Circulation (2012)

Background: Alcohol septal ablation (ASA) is a treatment option in patients with hypertrophic obstructive cardiomyopathy (HOCM) and its refractory symptoms in spite of optimal medical therapy. The improvements of the related symptoms were derived from the acute reduction of left ventricular pressure gradieint (LVPG) and the chronic reverse remodeling. In many patients, the reverse remodeling effects have been observed for several months over. Methods: From 1998 through 2011, we performed 174 ASA procedures for drug-refractory symptomatic patients. We investigated clinical 2-years follow up and analyzed electrocardiogram (ECG) alternations from 1 month to 6months, 1 year and 2 years, to confirm the chronic effects. . Results: Out of 174 prosedures treated by ASA, excluding right bundle branch block (RBBB) and DDD or ICD therapy after ASA, total 23 patients in which we could complete 2-years follow-up were assigned to this study. Immediately after ASA, LVPG significantly improved from 68±39 to 25±28 mmHg (p&lt;0.001), associated with symptomatic improvement (NYHA class from 2.5±0.6 to 1.2±0.5, p&lt;0.001). From ECG findings, Sokolow-Lyon index reduced until 1 year later (5.0±0.4 to 4.8±0.4, p=0.005) and QRS duration significantly reduced until 6 months later (100±11 to 96±13msec, p=0.038). Conclusions: ASA improved not only the obstructive property but also the electrical abnormality in drug-refractory HOCM patients. The reduction of Sokolow-Lyon index and QRS duration suggested the reverse remodeling effects sustained 6 months to 1 year after ASA. Therefore, the effects should be monitored until 1 year from the ASA procedure.
Endoscopic fundoplication in a pediatric patient: a new concept
Authors: Amy Tyberg, Kopal Jha, Monica Gaidhane, Michel Kahaleh
Journal: Endoscopy (2019)

Endoscopic transoral incisionless fundoplication (TIF) has been shown to be efficacious and safe in the management of gastroesophageal reflux disease (GERD) [1] [2] [3], including in patients with GERD who have undergone peroral endoscopic myotomy (POEM) for achalasia [4]. However, the safety of TIF in the pediatric population is unknown. This video case report is the first to evaluate the role of TIF for the management of GERD in a pediatric patient.
Clinical Efficacy and Safety of Nivolumab: Results of a <u>M</u>ulticenter, Op<u>e</u>n-label, Single-a<u>r</u>m, Japanese Phase II study in Mal<u>i</u>gnant Pleural Meso<u>t</u>helioma (MERIT)
Authors: Morihito Okada, Takashi Kijima, Keisuke Aoe, Terufumi Kato, Nobukazu Fujimoto, Kazuhiko Nakagawa, Yuichiro Takeda, Toyoaki Hida, Kuninobu Kanai, Fumio Imamura, Satoshi Oizumi, Toshiaki Takahashi, Mitsuhiro Takenoyama, Hiroshi Tanaka, Jun Hirano, Yoshinobu Namba, Yuichiro Ohe
Journal: Clinical Cancer Research (2019)

Malignant pleural mesothelioma (MPM) is a rare and aggressive malignancy with poor prognosis. Patients with MPM who do not respond to standard first-line chemotherapy have limited treatment options. We evaluated the efficacy and safety of nivolumab, an immune checkpoint inhibitor, for the treatment of advanced or metastatic MPM.Japanese patients with unresectable, advanced, or metastatic MPM resistant or intolerant to ≤2 regimens of chemotherapy and ≥1 measurable lesion(s) were enrolled. Patients received nivolumab 240 mg intravenously every 2 weeks until progressive disease or unacceptable toxicity. The primary endpoint was objective response rate by central assessment according to the Modified Response Evaluation Criteria in Solid Tumors. Adverse events (AEs) and treatment-related AEs (TRAEs) were evaluated.Thirty-four patients were enrolled between July 2016 and October 2016. Median follow-up was 16.8 (range: 1.8-20.2) months. Ten (29%, 95% confidence interval, 16.8-46.2) patients showed a centrally assessed objective response. The objective response rates were 26% (7/27), 67% (2/3), and 25% (1/4) patients for epithelioid, sarcomatoid, and biphasic histologic subtypes, respectively. Median duration of response was 11.1 months with a 68% disease control rate. Median overall survival and progression-free survival were 17.3 and 6.1 months, respectively. The objective response rate was 40% with programmed death-ligand 1 expression ≥1% and 8% with <1%. Thirty-two patients (94%) experienced AEs and 26 (76%) experienced TRAEs.Nivolumab met the primary endpoint as second- or third-line treatment for patients with MPM and showed promising efficacy with manageable toxicity.See related commentary by Mansfield and Zauderer, p. 5438.
Medical manslaughter: police should consult “super-experts” when considering prosecuting doctors, review advises
Authors: Clare Dyer
Journal: BMJ (2019)

A cadre of super-experts to help police forces considering prosecuting doctors for gross negligence manslaughter has been recommended by an independent review commissioned by the General Medical Council.1

The review of medical manslaughter follows widespread unease over recent cases, including those of the trainee paediatrician Hadiza Bawa-Garba and the consultant surgeon David Sellu, in which individual doctors seemed to carry the can for systemic failures.

The UK-wide review, chaired by a consultant cardiac surgeon, Leslie Hamilton, also concurs with the Williams review of gross negligence manslaughter commissioned by the UK government, which recommended last year that the GMC should lose its …
Oral semaglutide versus subcutaneous liraglutide and placebo in type 2 diabetes (PIONEER 4): a randomised, double-blind, phase 3a trial
Authors: Richard Pratley, Aslam Amod, Søren Tetens Hoff, Takashi Kadowaki, Ildiko Lingvay, Michael Nauck, Karen Boje Pedersen, Trine Saugstrup, Juris J Meier
Journal: The Lancet (2019)
New trauma pathway saves hundreds of lives as Gaza struggles with gunshot wounds
Authors: Elisabeth Mahase
Journal: BMJ (2019)

The health system in Gaza is struggling to deal with the number of gunshot wounds, which make up 25% of the total casualty caseload and are the highest cause of death among casualties, according to a report from the World Health Organization.1

WHO, in collaboration with over 20 agencies, analysed trauma injuries in Gaza from March 2018 to March 2019, and reported that 277 Palestinians were killed and over 28 000 were injured.

While any health system would be overwhelmed by such an influx of trauma casualties, gunshot wounds are the most urgent concern—6872 or 25% of the total casualty caseload, the report said.

However, local innovations such …
Potential Benefit of Nonsurgical Management to Periappendicular Abscess—Reply
Authors: Paulina Salminen, Jari Mällinen, Tero Rautio
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
Association Between Haptoglobin Phenotype and Microvascular Obstruction in Patients With STEMI
Authors: Gianluca Pontone, Daniele Andreini, Andrea I. Guaricci, Marco Guglielmo, Andrea Baggiano, Giuseppe Muscogiuri, Laura Fusini, Fabio Fazzari, Claudio Berzovini, Annalisa Pasquini, Saima Mushtaq, Edoardo Conte, Nicola Cosentino, Mark G. Rabbat, Giancarlo Marenzi, Antonio L. Bartorelli, Mauro Pepi, Elena Tremoli, Cristina Banfi
Journal: JACC. Cardiovascular imaging (2018)