tbuckley/cabot-search huggingface dataset:
Diagnostic accuracy of procalcitonin as an early predictor of infection after radical gastrectomy for gastric cancer: A prospective bicenter cohort study
Authors: Hua Xiao, Peng Zhang, Yanping Xiao, Haifan Xiao, Min Ma, Changwei Lin, Jia Luo, Hu Quan, Kaixiong Tao, Gang Huang
Journal: International Journal of Surgery (2020)

To investigate the diagnostic accuracy of procalcitonin (PCT) as an early predictor of infection following radical gastrectomy to treat gastric cancer (GC).A prospective, observational, cohort study was conducted in two high-volume tertiary centers (registered under ClinicalTrials.gov). A total of 552 consecutive adult patients undergoing radical gastrectomy for GC from June 2018 to July 2019 were included. Routine blood tests (white blood cell count (WBC); neutrophil count; the neutrophil:WBC ratio, N%) and PCT were measured on post-operative day (POD) 3 and 5. Post-operative infection was recorded based on the criteria of the Center for Disease Control. The area under the curve (AUC) summarizing receiver-operating characteristic was calculated and compared for each biomarker measured.Ninety three adverse events occurred in 70 patients (12.7%), with infections being the most common (n = 37, 6.7%). With cutoff values of 0.695 ng/mL at POD 3 and 0.515 ng/mL at POD 5, specificity and negative predictive value for infections were 0.656 and 96.3%, 0.816 and 96.1%, respectively. PCT had a better AUC than the WBC and neutrophil count to detect post-operative complications, especially infections (AUC: 0.678, 0.600, 0.592, P = 0.028 and 0.017, respectively) at POD 3, but which were comparable at POD 5. Additionally, 4 of the 8 patients with PCT levels ≥3 ng/mL on POD 5 were confirmed to have an infection.PCT is a more reliable predictor than WBC and neutrophil count to detect infections following radical gastrectomy for GC. PCT levels <0.695 ng/mL at POD 3 and < 0.515 ng/mL at POD 5 makes post-operative infections very unlikely but extreme high PCT levels should alert the surgeon to the possibility of infections.
Recent trends on wound management: New therapeutic choices based on polymeric carriers
Authors: Mehmet Evren Okur, Ioannis D. Karantas, Zeynep Şenyiğit, Neslihan Üstündağ Okur, Panoraia I. Siafaka
Journal: Asian Journal of Pharmaceutical Sciences (2020)

Wound healing is an unmet therapeutic challenge among medical society since wound assessment and management is a complex procedure including several factors playing major role in healing process. Wounds can mainly be categorized as acute or chronic. It is well referred that the acute wound displays normal wound physiology while healing, in most cases, is seemed to progress through the normal phases of wound healing. On the other hand, a chronic wound is physiologically impaired. The main problem in wound management is that the majority of wounds are colonized with microbes, whereas this does not mean that all wounds will be infected. In this review, we address the problems that clinicians face to manage while treat acute and chronic wounds. Moreover, we demonstrate the pathophysiology, etiology, prognosis and microbiology of wounds. We further introduce the state of art in pharmaceutical technology field as part of wound management aiming to assist health professionals to overcome the current implications on wound assessment. In addition, authors review researches which included the use of gels and dermal films as wound healing agents. It can be said that natural and synthetic drugs or carriers provide promising solutions in order to meet the wound management standards. However, are the current strategies as desirable as medical society wish?
Ovarian-Adnexal Reporting Data System Magnetic Resonance Imaging (O-RADS MRI) Score for Risk Stratification of Sonographically Indeterminate Adnexal Masses
Authors: Isabelle Thomassin-Naggara, Edouard Poncelet, Aurelie Jalaguier-Coudray, Adalgisa Guerra, Laure S. Fournier, Sanja Stojanovic, Ingrid Millet, Nishat Bharwani, Valerie Juhan, Teresa M. Cunha, Gabriele Masselli, Corinne Balleyguier, Caroline Malhaire, Nicolas F. Perrot, Elizabeth A. Sadowski, Marc Bazot, Patrice Taourel, Raphaël Porcher, Emile Darai, Caroline Reinhold, Andrea G. Rockall
Journal: JAMA Network Open (2020)

Approximately one-quarter of adnexal masses detected at ultrasonography are indeterminate for benignity or malignancy, posing a substantial clinical dilemma.To validate the accuracy of a 5-point Ovarian-Adnexal Reporting Data System Magnetic Resonance Imaging (O-RADS MRI) score for risk stratification of adnexal masses.This multicenter cohort study was conducted between March 1, 2013, and March 31, 2016. Among patients undergoing expectant management, 2-year follow-up data were completed by March 31, 2018. A routine pelvic MRI was performed among consecutive patients referred to characterize a sonographically indeterminate adnexal mass according to routine diagnostic practice at 15 referral centers. The MRI score was prospectively applied by 2 onsite readers and by 1 reader masked to clinical and ultrasonographic data. Data analysis was conducted between April and November 2018.The primary end point was the joint analysis of true-negative and false-negative rates according to the MRI score compared with the reference standard (ie, histology or 2-year follow-up).A total of 1340 women (mean [range] age, 49 [18-96] years) were enrolled. Of 1194 evaluable women, 1130 (94.6%) had a pelvic mass on MRI with a reference standard (surgery, 768 [67.9%]; 2-year follow-up, 362 [32.1%]). A total of 203 patients (18.0%) had at least 1 malignant adnexal or nonadnexal pelvic mass. No invasive cancer was assigned a score of 2. Positive likelihood ratios were 0.01 for score 2, 0.27 for score 3, 4.42 for score 4, and 38.81 for score 5. Area under the receiver operating characteristic curve was 0.961 (95% CI, 0.948-0.971) among experienced readers, with a sensitivity of 0.93 (95% CI, 0.89-0.96; 189 of 203 patients) and a specificity of 0.91 (95% CI, 0.89-0.93; 848 of 927 patients). There was good interrater agreement among both experienced and junior readers (κ = 0.784; 95% CI, 0.743-0824). Of 580 of 1130 women (51.3%) with a mass on MRI and no specific gynecological symptoms, 362 (62.4%) underwent surgery. Of them, 244 (67.4%) had benign lesions and a score of 3 or less. The MRI score correctly reclassified the mass origin as nonadnexal with a sensitivity of 0.99 (95% CI, 0.98-0.99; 1360 of 1372 patients) and a specificity of 0.78 (95% CI, 0.71-0.85; 102 of 130 patients).In this study, the O-RADS MRI score was accurate when stratifying the risk of malignancy in adnexal masses.
A network analysis to identify pathophysiological pathways distinguishing ischaemic from non‐ischaemic heart failure
Authors: Iziah E. Sama, Rebecca J. Woolley, Jan F. Nauta, Simon P.R. Romaine, Jasper Tromp, Jozine M. ter Maaten, Peter van der Meer, Carolyn S.P. Lam, Nilesh J. Samani, Leong L. Ng, Marco Metra, Kenneth Dickstein, Stefan D. Anker, Faiez Zannad, Chim C. Lang, John G.F. Cleland, Dirk J. van Veldhuisen, Hans L. Hillege, Adriaan A. Voors
Journal: European Journal of Heart Failure (2020)

Abstract Aims Heart failure (HF) is frequently caused by an ischaemic event (e.g. myocardial infarction) but might also be caused by a primary disease of the myocardium (cardiomyopathy). In order to identify targeted therapies specific for either ischaemic or non‐ischaemic HF, it is important to better understand differences in underlying molecular mechanisms. Methods and results We performed a biological physical protein–protein interaction network analysis to identify pathophysiological pathways distinguishing ischaemic from non‐ischaemic HF. First, differentially expressed plasma protein biomarkers were identified in 1160 patients enrolled in the BIOSTAT‐CHF study, 715 of whom had ischaemic HF and 445 had non‐ischaemic HF. Second, we constructed an enriched physical protein–protein interaction network, followed by a pathway over‐representation analysis. Finally, we identified key network proteins. Data were validated in an independent HF cohort comprised of 765 ischaemic and 100 non‐ischaemic HF patients. We found 21/92 proteins to be up‐regulated and 2/92 down‐regulated in ischaemic relative to non‐ischaemic HF patients. An enriched network of 18 proteins that were specific for ischaemic heart disease yielded six pathways, which are related to inflammation, endothelial dysfunction superoxide production, coagulation, and atherosclerosis. We identified five key network proteins: acid phosphatase 5, epidermal growth factor receptor, insulin‐like growth factor binding protein‐1, plasminogen activator urokinase receptor, and secreted phosphoprotein 1. Similar results were observed in the independent validation cohort. Conclusions Pathophysiological pathways distinguishing patients with ischaemic HF from those with non‐ischaemic HF were related to inflammation, endothelial dysfunction superoxide production, coagulation, and atherosclerosis. The five key pathway proteins identified are potential treatment targets specifically for patients with ischaemic HF.
Response by Bergmark et al to Letter Regarding Article, “Metformin Use and Clinical Outcomes Among Patients With Diabetes Mellitus With or Without Heart Failure or Kidney Dysfunction: Observations From the SAVOR-TIMI 53 Trial”
Authors: Brian A. Bergmark, Deepak L. Bhatt, Darren K. McGuire, Benjamin M. Scirica
Journal: Circulation (2020)
Soundings: Privates on parade
Authors: James Owen Drife
Journal: BMJ (2006)

Regional theatre is thriving in England, especially in Yorkshire, but without much support from doctors, I'm afraid. At a concert or the opera my wife and I often bump into music loving colleagues but in theatre bars we sip our dry white wine by ourselves. Still, it gives us a chance to look around.

Regional audiences are different from those in London's west end. Ours have hardly any tourists or star-struck fans, except when a celebrity vehicle is on tour.

In Britain, unlike in mainland Europe, theatregoers do not dress up, promenade, or socialise ostentatiously in the stalls. We are down to earth and stoical, and we try hard not to look middle class.

Our theatres keep saying they want to reach beyond their traditional audience base and we do our best to help. I wear my old trainers and we never speak aloud of Noel Coward. When the box office asks if we are unwaged we look embarrassed at having to say no. And if the programme warns about nudity we are careful not to nudge each other.

Frontal nudity these days involves only male actors. Farce has always involved someone losing his trousers but now, it seems, his underpants must drop as well. There is a characteristic noise that an audience makes when this happens—a sudden shriek of female hilarity. The effects of adrenalin on the chap in the spotlight mean that neither women nor men in the audience feel threatened.

Nevertheless it is distracting, particularly for an unsuspecting doctor in the front row. You look upwards with a fixed smile, trying to indicate that you are concentrating on the dialogue and the actor's subtle facial expressions. But the lights stay on, he jumps around a bit, and you begin to wish you were back in the fertility clinic. There at least you don't have to pay to get in.

Theatre reflects contemporary society, so perhaps it is no surprise that male actors are willing to accept humiliation while their female colleagues demand respect and stay dressed. I hope the boys catch up with them soon. Meanwhile, we aren't put off. We were part of a phlegmatic Sheffield audience for The Romans in Britain and we're off there again soon for a play entitled, ominously, The Long and the Short and the Tall.
Heart(beat) to Heart(beat)
Authors: Jason Phua
Journal: JAMA Cardiology (2020)

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 Cardiology 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 Cardiology journal
A Novel Coronavirus from Patients with Pneumonia in China, 2019
Authors: Na Zhu, Dingyu Zhang, Wenling Wang, Xingwang Li, Bo Yang, Jingdong Song, Xiang Zhao, Baoying Huang, Weifeng Shi, Roujian Lu, Peihua Niu, Faxian Zhan, Xuejun Ma, Dayan Wang, Wenbo Xu, Guizhen Wu, George F Gao, Wenjie Tan
Journal: New England Journal of Medicine (2020)

In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.).
Abstract 13365: Prolonged Hospital Length of Stay After Pediatric Heart Transplantation and Its Impact on Outcomes: A PHTS Database Analysis
Authors: Dipankar Gupta, Ryan Cantor, Devin Koehl, Neha Bansal, Chesney D Castleberry, Allison Kimbro, Stephen Pophal, Kenneth O Schowengerdt, Alfred Asante-Korang, Paolo Rusconi, James K Kirklin, David L Sutcliffe
Journal: Circulation (2019)

Introduction: Length of stay (LOS) is increasingly being used as a quality metric. Currently there is no definition of prolonged LOS (PLOS) after pediatric heart transplantation (pHT). In addition,...
Plasmonic Copper Sulfide Nanoparticles Enable Dark Contrast in Optical Coherence Tomography
Authors: Riccardo Marin, José Lifante, Lucas V. Besteiro, Zhiming Wang, Alexander O. Govorov, Fernando Rivero, Fernando Alfonso, Francisco Sanz‐Rodríguez, Daniel Jaque
Journal: Advanced Healthcare Materials (2020)

Abstract Optical coherence tomography (OCT) is an imaging technique affording noninvasive optical biopsies. Like for other imaging techniques, the use of dedicated contrast agents helps better discerning biological features of interest during the clinical practice. Although bright OCT contrast agents have been developed, no dark counterpart has been proposed yet. Herein, plasmonic copper sulfide nanoparticles as the first OCT dark contrast agents working in the second optical transparency window are reported. These nanoparticles virtually possess no light scattering capabilities at the OCT working wavelength (≈1300 nm); thus, they exclusively absorb the probing light, which in turn results in dark contrast. The small size of the nanoparticles and the absence of apparent cytotoxicity support the amenability of this system to biomedical applications. Importantly, in the pursuit of systems apt to yield OCT dark contrast, a library of copper sulfide nanoparticles featuring plasmonic resonances spanning the three optical transparency windows is prepared, thus highlighting the versatility and potential of these systems in light‐controlled biomedical applications.
Abstract 13189: Effects of Marine Omega-3 Supplementation on Fatty Acids and Bioactive Lipids and Associations With Risk of Cardiovascular Disease: Secondary Analysis From the Randomized Vitamin D and Omega-3 Trial (VITAL)
Authors: Olga Demler, Yanyan Liu, Jeramie Watrous, Heike Gibson, Kim Lagerborg, Hesam Dashti, Mallory Heath, Carlos A Camargo, William S Harris, Jay G Wohlgemuth, Mahan Najhawan, Khoi Dao, James Prentice, Julia A Larsen, Olivia Okereke, Karen Costenbader, Julie E Buring, Vasan S Ramachandran, Joann E Manson, Susan Cheng, Mohit Jain, Samia Mora
Journal: Circulation (2019)

Introduction: Omega-3 fatty acid [n-3 FA] supplementation may protect against incident cardiovascular disease [CVD] but the potential mechanisms are unclear. Here, we examined effects of randomized...
Intrahepatic Biliary Ductal Dilatation
Authors: Umberto G Rossi, Maurizio Cariati
Journal: New England Journal of Medicine (2020)

A 72-year-old woman presented with weight loss, abdominal pain, and jaundice. Imaging revealed a hepatic hilar mass with marked bilateral biliary ductal dilatation. A diagnosis of cholangiocarcinoma was made.
Guided self-help to reduce psychological distress in South Sudanese female refugees in Uganda: a cluster randomised trial
Authors: Wietse A Tol, Marx R Leku, Daniel P Lakin, Kenneth Carswell, Jura Augustinavicius, Alex Adaku, Teresa M Au, Felicity L Brown, Richard A Bryant, Claudia Garcia-Moreno, Rashelle J Musci, Peter Ventevogel, Ross G White, Mark van Ommeren
Journal: The Lancet Global Health (2020)

BackgroundInnovative solutions are required to provide mental health support at scale in low-resource humanitarian contexts. We aimed to assess the effectiveness of a facilitator-guided, group-based, self-help intervention (Self-Help Plus) to reduce psychological distress in female refugees.MethodsWe did a cluster randomised trial in rural refugee settlements in northern Uganda. Participants were female South Sudanese refugees with at least moderate levels of psychological distress (cutoff ≥5 on the Kessler 6). The intervention comprised access to usual care and five 2-h audio-recorded stress-management workshops (20–30 refugees) led by briefly trained lay facilitators, accompanied by an illustrated self-help book. Villages were randomly assigned to either intervention (Self-Help Plus or enhanced usual care) on a 1:1 basis. Within 14 villages, randomly selected households were approached. Screening of women in households continued until 20–30 eligible participants were identified per site. The primary outcome was individual psychological distress, assessed using the Kessler 6 symptom checklist 1 week before, 1 week after, and 3 months after intervention, in the intention-to-treat population. All outcomes were measured at the individual (rather than cluster) level. Secondary outcomes included personally identified problems, post-traumatic stress, depression symptoms, feelings of anger, social interactions with other ethnic groups, functional impairment, and subjective wellbeing. Assessors were masked to allocation. This trial was prospectively registered at ISRCTN, number 50148022.FindingsOf 694 eligible participants (331 Self-Help Plus, 363 enhanced usual care), 613 (88%) completed all assessments. Compared with controls, we found stronger improvements for Self-Help Plus on psychological distress 3 months post intervention (β −1·20, 95% CI −2·33 to −0·08; p=0·04; d −0·26). We also found larger improvements for Self-Help Plus 3 months post-intervention for five of eight secondary outcomes (effect size range −0·30 to −0·36). Refugees with different trauma exposure, length of time in settlements, and initial psychological distress benefited similarly. With regard to safety considerations, the independent data safety management board responded to six adverse events, and none were evaluated to be concerns in response to the intervention.InterpretationSelf-Help Plus is an innovative, facilitator-guided, group-based self-help intervention that can be rapidly deployed to large numbers of participants, and resulted in meaningful reductions in psychological distress at 3 months among South Sudanese female refugees.FundingResearch for Health in Humanitarian Crises (R2HC) Programme.
Impact of functional studies on exome sequence variant interpretation in early-onset cardiac conduction system diseases
Authors: Kenshi Hayashi, Ryota Teramoto, Akihiro Nomura, Yoshihiro Asano, Manu Beerens, Yasutaka Kurata, Isao Kobayashi, Noboru Fujino, Hiroshi Furusho, Kenji Sakata, Kenji Onoue, David Y Chiang, Tuomas O Kiviniemi, Eva Buys, Patrick Sips, Micah L Burch, Yanbin Zhao, Amy E Kelly, Masanobu Namura, Yoshihito Kita, Taketsugu Tsuchiya, Bunji Kaku, Kotaro Oe, Yuko Takeda, Tetsuo Konno, Masaru Inoue, Takashi Fujita, Takeshi Kato, Akira Funada, Hayato Tada, Akihiko Hodatsu, Chiaki Nakanishi, Yuichiro Sakamoto, Toyonobu Tsuda, Yoji Nagata, Yoshihiro Tanaka, Hirofumi Okada, Keisuke Usuda, Shihe Cui, Yoshihiko Saito, Calum A MacRae, Seiji Takashima, Masakazu Yamagishi, Masa-aki Kawashiri, Masayuki Takamura
Journal: Cardiovascular Research (2020)

The genetic cause of cardiac conduction system disease (CCSD) has not been fully elucidated. Whole-exome sequencing (WES) can detect various genetic variants; however, the identification of pathogenic variants remains a challenge. We aimed to identify pathogenic or likely pathogenic variants in CCSD patients by using WES and 2015 American College of Medical Genetics and Genomics (ACMG) standards and guidelines as well as evaluating the usefulness of functional studies for determining them.We performed WES of 23 probands diagnosed with early-onset (<65 years) CCSD and analysed 117 genes linked to arrhythmogenic diseases or cardiomyopathies. We focused on rare variants (minor allele frequency < 0.1%) that were absent from population databases. Five probands had protein truncating variants in EMD and LMNA which were classified as 'pathogenic' by 2015 ACMG standards and guidelines. To evaluate the functional changes brought about by these variants, we generated a knock-out zebrafish with CRISPR-mediated insertions or deletions of the EMD or LMNA homologs in zebrafish. The mean heart rate and conduction velocities in the CRISPR/Cas9-injected embryos and F2 generation embryos with homozygous deletions were significantly decreased. Twenty-one variants of uncertain significance were identified in 11 probands. Cellular electrophysiological study and in vivo zebrafish cardiac assay showed that two variants in KCNH2 and SCN5A, four variants in SCN10A, and one variant in MYH6 damaged each gene, which resulted in the change of the clinical significance of them from 'Uncertain significance' to 'Likely pathogenic' in six probands.Of 23 CCSD probands, we successfully identified pathogenic or likely pathogenic variants in 11 probands (48%). Functional analyses of a cellular electrophysiological study and in vivo zebrafish cardiac assay might be useful for determining the pathogenicity of rare variants in patients with CCSD. SCN10A may be one of the major genes responsible for CCSD.