tbuckley/cabot-search huggingface dataset:
Experience of skin disease and relationships with healthcare providers
Authors: E. Gilhooley, S. Daly, O. Gallagher, M. Glacken, D. McKenna
Journal: British Journal of Dermatology (2019)

A number of inequalities exist between members of the Travelling community and the general population, including health inequality. A number of obstacles to engagement with health services exist: experience or perception of discrimination, cultural barriers and health literacy (understanding health information) barriers. A positive relationship with healthcare providers can help improve the health of members of the Travelling community. The objective of this study, which was conducted in Ireland, was to explore Travellers’ experience of skin disease and their relationship with healthcare providers. The data was collected using focus groups of female members of the Irish Travelling community with experience of skin health issues. Three focus groups were held at three separate locations in the West of Ireland, with 10 participants in each group. Themes were identified from focus group transcripts. Themes included health literacy, discrimination, information inconsistency, trust and communication. We identified a number of factors that determined the quality of interactions between members of the Travelling community and their healthcare providers, as well as potential opportunities to enhance these relationships. The demonstration of ‘cultural competence’ positively impacted the quality of relationships; this means integrating cultural, social or community based beliefs and behaviours with the healthcare a person receives. A preference towards secondary or specialist services (e.g. hospital or consultant‐led, rather than GP‐level care) emerged from our focus groups; similar preferences have been shown in others studies where secondary care services have gained recognition for their non‐discriminatory approach. Factors that helped to create positive relationships included: an appreciation of varying degrees of health literacy, the provision of sufficient information tailored to an individual's needs, and a demonstration of cultural competence. Dermatologists are well placed to provide practical, customised treatment guidance, while integrating patients’ culturally based beliefs.
An Implementation Guide to Promote Sleep and Reduce Sedative-Hypnotic Initiation for Noncritically Ill Inpatients
Authors: Christine Soong, Lisa Burry, Hyung J. Cho, Evelyn Gathecha, Flora Kisuule, Cara Tannenbaum, Abi Vijenthira, Timothy Morgenthaler
Journal: JAMA Internal Medicine (2019)

Sedative-hypnotic medications are frequently prescribed for hospitalized patients with insomnia, but they can result in preventable harm such as delirium, falls, hip fractures, and increased morbidity. Furthermore, sedative-hypnotic initiation while in the hospital carries a risk of chronic use after discharge. Disrupted sleep is a major contributor to sedative-hypnotic use among patients in the hospital and other institutional settings. Numerous multicomponent studies on improving sleep quality in these settings have been described, some demonstrating an associated reduction of sedative-hypnotic prescriptions. This selected review summarizes effective interventions aimed at promoting sleep and reducing inappropriate sedative-hypnotic initiation and proposes an implementation strategy to guide quality improvement teams.
Providing Prescriptions to the Patient Who Is Leaving Against Medical Advice
Authors: Sameer Prakash, M. Tarek Naguib
Journal: JAMA Internal Medicine (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 Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Internal Medicine journal
Access to Office-Based Buprenorphine Treatment in Areas With High Rates of Opioid-Related Mortality
Authors: Tamara Beetham, Brendan Saloner, Sarah E. Wakeman, Marema Gaye, Michael L. Barnett
Journal: Annals of Internal Medicine (2019)

Background: Improving access to treatment for opioid use disorder is a national priority, but little is known about the barriers encountered by patients seeking buprenorphine–naloxone ("buprenorphine") treatment. Objective: To assess real-world access to buprenorphine treatment for uninsured or Medicaid-covered patients reporting current heroin use. Design: Audit survey ("secret shopper" study). Setting: 6 U.S. jurisdictions with a high burden of opioid-related mortality (Massachusetts, Maryland, New Hampshire, West Virginia, Ohio, and the District of Columbia). Participants: From July to November 2018, callers contacted 546 publicly listed buprenorphine prescribers twice, posing as uninsured or Medicaid-covered patients seeking buprenorphine treatment. Measurements: Rates of new appointments offered, whether buprenorphine prescription was possible at the first visit, and wait times. Results: Among 1092 contacts with 546 clinicians, schedulers were reached for 849 calls (78% response rate). Clinicians offered new appointments to 54% of Medicaid contacts and 62% of uninsured–self-pay contacts, whereas 27% of Medicaid and 41% of uninsured–self-pay contacts were offered an appointment with the possibility of buprenorphine prescription at the first visit. The median wait time to the first appointment was 6 days (interquartile range [IQR], 2 to 10 days) for Medicaid contacts and 5 days (IQR, 1 to 9 days) for uninsured–self-pay contacts. These wait times were similar regardless of clinician type or payer status. The median wait time from first contact to possible buprenorphine induction was 8 days (IQR, 4 to 15 days) for Medicaid and 7 days (IQR, 3 to 14 days) for uninsured–self-pay contacts. Limitation: The survey sample included only publicly listed buprenorphine prescribers. Conclusion: Many buprenorphine prescribers did not offer new appointments or rapid buprenorphine access to callers reporting active heroin use, particularly those with Medicaid coverage. Nevertheless, wait times were not long, implying that opportunities may exist to increase access by using the existing prescriber workforce. Primary Funding Source: National Institute on Drug Abuse.
Retroperitoneal Malignant Peripheral Nerve Sheath Tumor on 99mTc-DTPA Renal Scintigraphy
Authors: Xi Jia, Rui Gao, Yiqian Liang, Hua Liang, Aimin Yang
Journal: Clinical Nuclear Medicine (2019)

Abstract Findings of 99m Tc-DTPA renal scintigraphy of a retroperitoneal malignant peripheral nerve sheath tumor are reported here. The patient was a 48-year-old woman who presented discomfort and intermittent dull pain in the left upper quadrant of the abdomen for approximately 3 weeks.
Abstract 14924: Elevated Lipocalin-2 Protein Levels in Cerebrospinal Fluid Correlate With Disease Severity in Aneurysmal Subarachnoid Hemorrhage
Authors: Richard A Ferraro, Eileen Chang, Enda Shevlin, Moonsoo Jin, Alan Z Segal, Pina C Sanelli, Ajay Gupta, Jana Ivanidze
Journal: Circulation (2017)

Introduction: Lipocalin-2 (LCN2), secreted by activated macrophages and microglia, has been shown to induce inflammatory mediators in-vitro, as well as in mouse models of cardiovascular disease and...
Trends in Angiotensin-Converting Enzyme Inhibitor and Angiotensin II Receptor Blocker Use among Those with Impaired Kidney Function in the United States
Authors: Daniel P. Murphy, Paul E. Drawz, Robert N. Foley
Journal: Journal of the American Society of Nephrology (2019)

Although hypertension is common in CKD and evidence-based treatment of hypertension has changed considerably, contemporary and nationally representative information about use of angiotensin-converting enzyme (ACEs) inhibitors or angiotensin II receptor blockers (ARBs) in CKD is lacking.We examined ACE/ARB trends from 1999 to 2014 among 38,885 adult National Health and Nutrition Examination Survey participants with creatinine-based eGFR<60 ml/min per 1.73 m2 or urinary albumin-to-creatinine ratio ≥30 mg/g.Of 7085 participants with CKD, 34.9% used an ACE/ARB. Across four eras studied, rates of use rose significantly (rates were 25.5% in 1999-2002, 33.3% in 2003-2006, 39.0% in 2007-2010, and 40.1% in 2011-2014) but appeared to plateau after 2003. Among those with CKD, use was significantly greater among non-Hispanic white and black individuals (36.1% and 38.2%, respectively) and lower among Hispanic individuals (26.7%) and other races/ethnicities (29.3%). In age-, sex-, and race/ethnicity-adjusted models, ACE/ARB use was significantly associated with era (adjusted odds ratios [aOR], 1.41; 95% confidence interval [95% CI], 1.14 to 1.74 for 2003-2006, 1.84; 95% CI, 1.48 to 2.28 for 2007-2010, and 2.02; 95% CI, 1.61 to 2.53 for 2011-2014 versus 1999-2002); it also was significantly associated with non-Hispanic black versus non-Hispanic white race/ethnicity (aOR, 1.40; 95% CI, 1.19 to 1.66). Other multivariate associations included older age, men, elevated BMI, diabetes mellitus, treated hypertension, cardiac failure, myocardial infarction, health insurance, and receiving medical care within the prior year.Rates of ACE/ARB use increased in the early 2000s among United States adults with CKD, but for unclear reasons, use appeared to plateau in the ensuing decade. Research examining barriers to care and other factors is needed.
Prevalence and Payments for Traumatic Injury Compared With Common Acute Diseases by Episode of Care in Medicare Beneficiaries, 2008-2014
Authors: John R. Montgomery, Anne H. Cain-Nielsen, Peter C. Jenkins, Scott E. Regenbogen, Mark R. Hemmila
Journal: JAMA (2019)

This study uses Medicare Parts A and B claims data to compare hospitalizations for and spending on traumatic injury vs heart failure, pneumonia, stroke, and acute myocardial infarction in older adults between 2008 and 2014.
Receipt of Breast Milk by Gestational Age — United States, 2017
Authors: Katelyn V. Chiang, Andrea J. Sharma, Jennifer M. Nelson, Christine K. Olson, Cria G. Perrine
Journal: MMWR Morbidity and Mortality Weekly Report (2019)

Rates of receipt of breast milk among extremely preterm, early preterm, late preterm, and term infants were 71.3%, 76.0%, 77.3%, and 84.6%, respectively, among infants delivered to residents of 48 states and the District of Columbia in 2017.
David Oliver: Lessons from the Babylon Health saga
Authors: David Oliver
Journal: BMJ (2019)

The long awaited evaluation of Babylon Health’s GP at Hand service has been published.1 It found that patients had fewer health problems than conventional users of GP services, were younger, and yet were higher users of services such as NHS 111 and urgent care.2

The report noted that GP at Hand didn’t provide the full range of services that conventional general practices do and that expanding such a model would have considerable implications for IT, infrastructure, and the GP workforce. But it could “not fully assess whether GP at Hand is affordable or sustainable.”3

GP at Hand’s presence in Hammersmith and Fulham Clinical Commissioning Group has reportedly faced big and growing costs (estimated at £10m so far) from hosting GP at Hand, which supports patients living in other parts of London—putting general practice delivery …
A Myocardial Bridge or Not?—Reply
Authors: Michelle T. Lee, Clarence D. Gill, Enrique Garcia-Sayan
Journal: JAMA Cardiology (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 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
Future Directions for Corticosteroids in Treatment of Sepsis
Authors: Joanna L. Spencer-Segal
Journal: JAMA Internal Medicine (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 Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Internal Medicine journal
Cause‐Specific Mortality in Gout: Novel Findings of Elevated Risk of Non–Cardiovascular‐Related Deaths
Authors: Ana Beatriz Vargas‐Santos, Tuhina Neogi, Geraldo da Rocha Castelar‐Pinheiro, Meliha C. Kapetanovic, Aleksandra Turkiewicz
Journal: Arthritis & Rheumatology (2019)

Objective To examine cause‐specific mortality beyond cardiovascular diseases (CVDs) in patients with gout compared to the general population. Methods We included all residents of Skåne (Sweden) age ≥18 years in the year 2002. Using the Skåne Healthcare Register, we identified subjects with a new diagnosis of gout (2003–2013) and matched each person with gout with 10 comparators free of gout, by age and sex. We used information on the underlying cause of death from the Swedish Cause of Death Register (through December 31, 2014) to estimate hazard ratios (HRs, with 95% confidence intervals [95% CIs]) of mortality for specific causes of death in a multi‐state Cox model, with adjustment for potential confounders. Results Among 832,258 persons, 19,497 had a new diagnosis of gout (32% women) and were matched with 194,947 comparators. Subjects with gout had higher prevalence of chronic kidney disease, metabolic disease, and CVD. Gout was associated with 17% increased hazard of all‐cause mortality overall (HR 1.17 [95% CI 1.14–1.21]), 23% in women (HR 1.23 [95% CI 1.17–1.30]), and 15% in men (HR 1.15 [95% CI 1.10–1.19]). In terms of cause‐specific mortality, the strongest associations were seen in the relationship of gout to the risk of death due to renal disease (HR 1.78 [95% CI 1.34–2.35]), diseases of the digestive system (HR 1.56 [95% 1.34–1.83]), CVD (HR 1.27 [95% CI 1.22–1.33]), infections (HR 1.20 [95% CI 1.06–1.35]), and dementia (HR 0.83 [95% CI 0.72–0.97]). Conclusion Several non‐CV causes of mortality are increased in persons with gout, emphasizing the need for improved management of comorbidities.
Tumor cell–intrinsic EPHA2 suppresses antitumor immunity by regulating PTGS2 (COX-2)
Authors: Nune Markosyan, Jinyang Li, Yu H. Sun, Lee P. Richman, Jeffrey H. Lin, Fangxue Yan, Liz Quinones, Yogev Sela, Taiji Yamazoe, Naomi Gordon, John W. Tobias, Katelyn T. Byrne, Andrew J. Rech, Garret A. FitzGerald, Ben Z. Stanger, Robert H. Vonderheide
Journal: Journal of Clinical Investigation (2019)

Resistance to immunotherapy is one of the biggest problems of current oncotherapeutics. WhileT cell abundance is essential for tumor responsiveness to immunotherapy, factors that define the T cell inflamed tumor microenvironment are not fully understood. We conducted an unbiased approach to identify tumor-intrinsic mechanisms shaping the immune tumor microenvironment(TME), focusing on pancreatic adenocarcinoma because it is refractory to immunotherapy and excludes T cells from the TME. From human tumors, we identified EPHA2 as a candidate tumor intrinsic driver of immunosuppression. Epha2 deletion reversed T cell exclusion and sensitized tumors to immunotherapy. We found that PTGS2, the gene encoding cyclooxygenase-2, lies downstream of EPHA2 signaling through TGFβ and is associated with poor patient survival. Ptgs2 deletion reversed T cell exclusion and sensitized tumors to immunotherapy; pharmacological inhibition of PTGS2 was similarly effective. Thus, EPHA2-PTGS2 signaling in tumor cells regulates tumor immune phenotypes; blockade may represent a novel therapeutic avenue for immunotherapy-refractory cancers. Our findings warrant clinical trials testing the effectiveness of therapies combining EPHA2-TGFβ-PTGS2 pathway inhibitors with anti-tumor immunotherapy, and may change the treatment of notoriously therapy-resistant pancreatic adenocarcinoma.
Erratum for the Research Article: “mTORC1 Inhibition Is Required for Sensitivity to PI3K p110α Inhibitors in <i>PIK3CA</i> -Mutant Breast Cancer” by M. Elkabets, S. Vora, D. Juric, N. Morse, M. Mino-Kenudson, T. Muranen, J. Tao, A. B. Campos, J. Rodon, Y. H. Ibrahim, V. Serra, V. Rodrik-Outmezguine, S. Hazra, S. Singh, P. Kim, C. Quadt, M. Liu, A. Huang, N. Rosen, J. A. Engelman, M. Scaltriti, J. Baselga
Journal: Science Translational Medicine (2018)
PTB-AS, a Novel Natural Antisense Transcript, Promotes Glioma Progression by Improving PTBP1 mRNA Stability with SND1
Authors: Liyuan Zhu, Qunfang Wei, Yingjiao Qi, Xiangbin Ruan, Fan Wu, Liang Li, Junjie Zhou, Wei Liu, Tao Jiang, Jing Zhang, Bin Yin, Jiangang Yuan, Boqin Qiang, Wei Han, Xiaozhong Peng
Journal: Molecular Therapy (2019)

Glioma, the most common primary malignancy in the brain, has high recurrence and lethality rates, and thus, elucidation of the molecular mechanisms of this incurable disease is urgently needed. Poly-pyrimidine tract binding protein (PTBP1, also known as hnRNP I), an RNA-binding protein, has various mechanisms to promote gliomagenesis. However, the mechanisms regulating PTBP1 expression are unclear. Herein, we report a novel natural antisense noncoding RNA, PTB-AS, whose expression correlated positively with PTBP1 mRNA. We found that PTB-AS significantly promoted the proliferation and migration in vivo and in vitro of glioma cells. PTB-AS substantially increased the PTBP1 level by directly binding to its 3' UTR and stabilizing the mRNA. Furthermore, staphylococcal nuclease domain-containing 1 (SND1) dramatically increased the binding capacity between PTB-AS and PTBP1 mRNA. Mechanistically, PTB-AS could mask the binding site of miR-9 in the PTBP1-3' UTR; miR-9 negatively regulates PTBP1. To summarize, we revealed that PTB-AS, which maintains the PTBP1 level through extended base pairing to the PTBP1 3' UTR with the assistance of SND1, could significantly promote gliomagenesis.
The Next Stage of Buprenorphine Care for Opioid Use Disorder
Authors: Barbara Scolnick
Journal: Annals of Internal Medicine (2019)

Letters4 June 2019The Next Stage of Buprenorphine Care for Opioid Use DisorderBarbara Scolnick, MDBarbara Scolnick, MDNew Horizons, Quincy, Massachusetts (B.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0142 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I work in a buprenorphine clinic in Greater Boston. I agree with most of Martin and colleagues' (1) observations and suggestions about liberalizing the prescribing of buprenorphine for treatment of opioid dependence. However, I wish that the authors had discussed some disturbing issues that I deal with daily.Many patients request prescriptions for other medications that may be abused—specifically, amphetamine–dextroamphetamine, gabapentin, and alprazolam (2, 3). Their reasons are usually, “I have attention-deficit disorder”; “a psychiatrist used to give it to me, and it helps calm me”; and “it eases my cravings for cocaine.” We cannot turn a ...References1. Martin SA, Chiodo LM, Bosse JD, Wilson A. The next stage of buprenorphine care for opioid use disorder. Ann Intern Med. 2018;169:628-35. [PMID: 30357262]. doi:10.7326/M18-1652 LinkGoogle Scholar2. Smith BH, Higgins C, Baldacchino A, Kidd B, Bannister J. Substance misuse of gabapentin [Letter]. Br J Gen Pract. 2012;62:406-7. [PMID: 22867659] doi:10.3399/bjgp12X653516 CrossrefMedlineGoogle Scholar3. Arria AM, DuPont RL. Nonmedical prescription stimulant use among college students: why we need to do something and what we need to do. J Addict Dis. 2010;29:417-26. [PMID: 20924877] doi:10.1080/10550887.2010.509273 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: New Horizons, Quincy, Massachusetts (B.S.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0142. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Next Stage of Buprenorphine Care for Opioid Use Disorder Stephen A. Martin , Lisa M. Chiodo , Jordon D. Bosse , and Amanda Wilson The Next Stage of Buprenorphine Care for Opioid Use Disorder Robert Sherrick The Next Stage of Buprenorphine Care for Opioid Use Disorder Mark H. Duncan , Anna D. Ratzliff , Diane M. Powers , Caleb J. Banta-Green , and Andrew J. Saxon The Next Stage of Buprenorphine Care for Opioid Use Disorder Stephen A. Martin , Lisa M. Chiodo , Jordon D. Bosse , and Amanda Wilson The Next Stage of Buprenorphine Care for Opioid Use Disorder Herbert Malinoff Metrics 4 June 2019Volume 170, Issue 11Page: 819-820KeywordsCocaineConflicts of interestDisclosureDrugsOpioidsPrevention, policy, and public health ePublished: 4 June 2019 Issue Published: 4 June 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Functional Investigation of the Gene NFKBIZ and the Impact of 3'UTR Mutations in Diffuse Large B-Cell Lymphoma
Authors: Sarah E Arthur, Anja Mottok, Miguel Alcaide, Christopher Rushton, Bruno M. Grande, Daisuke Ennishi, Jordan Davidson, Kevin R Bushell, Randy D. Gascoyne, Marco A Marra, Joseph M Connors, Gregg B Morin, David W. Scott, Christian Steidl, Ryan D. Morin
Journal: Blood (2017)