tbuckley/cabot-search huggingface dataset:
Association of Sociodemographic Factors With Adherence to Age-Specific Guidelines for Asymptomatic Umbilical Hernia Repair in Children
Authors: Jonathan L. Hills-Dunlap, Patrice Melvin, Dionne A. Graham, Mark A. Kashtan, Seema P. Anandalwar, Shawn J. Rangel
Journal: JAMA Pediatrics (2019)

Current guidelines recommend delaying repair of asymptomatic umbilical hernia in children until after age 4 to 5 years to allow for spontaneous closure.To examine the association of sociodemographic factors with adherence to age-specific guidelines for asymptomatic umbilical hernia repair in children.In this multicenter retrospective cohort study, children 17 years and younger who underwent umbilical hernia repair from January 2013 to June 2018 at 47 freestanding children's hospitals participating in the Pediatric Health Information System database were eligible for study inclusion. Children who underwent multiple procedures, repair of recurrent hernias, or had missing sociodemographic data were excluded.Early umbilical hernia repair was defined as repair at 3 years or younger. Emergent or urgent presentation was defined as repair performed during the same encounter or within 2 weeks of an emergency department visit, respectively. Patients were categorized by sex, race/ethnicity, insurance type, income quintile, and presence of complex chronic conditions.Multivariable mixed-effects logistic regression was used to evaluate the association of sociodemographic factors with the odds of early repair after adjusting for emergent or urgent presentation and hospital-level effects.Of the 25 877 included children, 13 817 (53.4%) were female, 14 143 (54.7%) had public insurance, and the median (interquartile range) age was 5.0 (3.0-6.0) years. Following adjustment, increased odds of early repair was associated with public insurance (public vs commercial insurance: odds ratio [OR], 1.46; 95% CI, 1.36-1.56; P < .001), lower income (lowest vs highest income quintile: OR, 1.48; 95% CI, 1.33-1.65; P < .001), and female sex (female vs male sex: OR, 1.20; 95% CI, 1.13-1.27; P < .001). Children with public insurance in the lowest income quintile had 2.2-fold increased odds of early repair compared with children with commercial insurance in the highest income quintile (OR, 2.15; 95% CI, 1.93-2.40; P < .001). Sociodemographic factors were not associated with increased odds of early repair in the subgroup of children who underwent early repair following emergent or urgent presentation.Public insurance, lower income, and female sex are independently associated with repair of asymptomatic umbilical hernias in children earlier than recommended by current guidelines. These children may be at greater risk of undergoing repair of umbilical hernias that may spontaneously close with further observation.
Cytogenetic clonal evolution in myeloproliferative neoplasms: contexts and prognostic impact among 648 patients with serial bone marrow biopsies
Authors: Ayalew Tefferi, Maura Nicolosi, Domenico Penna, Rangit Vallapureddy, Curtis A. Hanson, Animesh Pardanani, Naseema Gangat, Rhett P. Ketterling
Journal: Leukemia (2019)
Deep learning in ophthalmology: The technical and clinical considerations
Authors: Daniel S.W. Ting, Lily Peng, Avinash V. Varadarajan, Pearse A. Keane, Philippe M. Burlina, Michael F. Chiang, Leopold Schmetterer, Louis R. Pasquale, Neil M. Bressler, Dale R. Webster, Michael Abramoff, Tien Y. Wong
Journal: Progress in Retinal and Eye Research (2019)
Abstract 12896: Incidence and Outcomes for Patients Presenting With Heart Failure and Requiring Respiratory Support
Authors: P. Elliott Miller, Shanti Patel, Aparna Saha, Avirup Guha, Sumeet Pawar, Priti Poojary, Stephan Kamholz, Khurram Nasir, Tariq Ahmad, Girish N Nadkarni, Nihar Desai
Journal: Circulation (2018)

Background: Despite increasing patient complexity, little is known regarding the incidence and outcomes for patients admitted with heart failure (HF) who require respiratory support. Methods: We qu...
Defying the odds
Authors: Matija Prka
Journal: BMJ (2001)

One morning in 1997, during an outpatient clinic in Slavonski Brod in Croatia, a middle aged man came in and greeted the doctor with a broad smile. When the doctor addressed him by name I remembered the newspaper articles about a former drug addict who had suffered from cerebral palsy from early childhood and became a supermarathon runner. This was the same man, Tadija Opacak. He came for regular checkups. After this checkup I invited him for a cup of coffee and he gladly accepted. I heard his life story.

He was born as a healthy twin in 1960 in Derventa, Bosnia and Herzegovina. While his twin brother grew up normally, Tadija became ill with cerebral palsy when he was 6 months old. “I learnt to walk without assistance at the age of 4 and even then it was with a heavy dragging of the left leg and the left arm was good for nothing,” he grinned. There were seven more children in his family and they were poor. In 1962 they moved to Slavonski Brod, hoping for a better life. “I started school and was a pretty good pupil in the first four grades. The problems started when my father went abroad looking for employment.” At that time, many fathers, who were usually the breadwinners …
Upcoming direct acting antivirals for hepatitis C patients with a prior treatment failure
Authors: Tommaso Lorenzo Parigi, Maria Corina Plaz Torres, Alessio Aghemo
Journal: Clinical and Molecular Hepatology (2019)

Despite the high efficacy of direct acting antivirals (DAAs) not all patients successfully clear hepatitis C virus infection, in fact, approximately 1-3% fail to reach a sustained virological response 12 weeks after end of treatment. DAA failures are characterized by advanced liver disease, specific genotypes/subtypes and resistance associated substitutions to the DAA class they have been treated with. Current European Association for the Study of the Liver guidelines recommend three therapeutic options for such patients. The first is a 12 week course of sofosbuvir (SOF), velpatasvir (VEL) and voxilaprevir (VOX), which has shown to be effective in 90-99% of patients and was granted A1 level recommendation. The second option, reserved for patients who have predictors of failure consists in 12 weeks regimen with glecaprevir (GLE) and pibrentasvir (PIB), effective in 90-97%. Finally, although not supported by published data, for especially difficult to treat patients there should theoretically be a benefit in prolonged combinations of SOF+GLE/PIB or SOF/VEL/VOX±ribavirin. This review presents the latest evidence from both clinical trials and real-life on such therapeutic strategies.
Regulate food rather than use warnings
Authors: Elsie Ellimah
Journal: BMJ (2004)

Media reports suggest that government food watchdogs are predicting an obesity crisis and are considering putting health warnings on foods that are high in salt, sugar, and fat.1 Health warnings or highlighting the calorie content of food on the packaging could turn us into a nation of frantic calorie counters. However, obesity and the complications of obesity such as stroke and heart disease are important causes of death and serious illness in the Western …
Response to: ‘Regarding microRNA-181a-5p antisense oligonucleotides attenuate osteoarthritis in facet and knee joints’ by Liebling
Authors: Akihiro Nakamura, Jason S. Rockel, Mohit Kapoor
Journal: Annals of the Rheumatic Diseases (2019)

We wish to thank Dr Liebling for the relevant comments1 regarding our recent article in Annals of the Rheumatic Diseases entitled ‘MicroRNA-181a-5p antisense oligonucleotides attenuate osteoarthritis in facet and knee joints’.2 We are delighted that our article has gathered such interest in the scientific community and are happy to provide additional comments. In the aforementioned publication, we determined the potential of locked nucleic acid, antisense oligonucleotides against microRNA-181a-5p (LNA-miR-181a-5p ASO) as a therapy for the treatment of osteoarthritis (OA).2 The chemical modification of LNA is one of the most advanced ASO delivery systems. LNA modifications enable design of oligonucleotides that are short while maintaining high affinity and stable binding towards targets. …
Trim the fat
Authors: Teresa Pun
Journal: BMJ (2006)

Fat is associated with excess. We don't usually think twice about counselling patients on the benefits of an ideal body mass index. Perhaps we should also start thinking about trimming the fat in the medical profession. Why? Because our hospitals and medical schools are not properly accountable for their budgets. Money is spent, and things get done, but how efficiently? Does anyone know?

On the first day of my second year at medical school, I was surprised to see a plasma screen flanking the administrative offices. The screen faced passers by and showed a Power Point slide displaying the time and nothing else. Why? While …
miR‐10a‐5p is increased in atopic dermatitis and has capacity to inhibit keratinocyte proliferation
Authors: Helen Vaher, Toomas Runnel, Egon Urgard, Alar Aab, Gemma Carreras Badosa, Julia Maslovskaja, Kristi Abram, Liisi Raam, Bret Kaldvee, Tarmo Annilo, Eric R. Tkaczyk, Toivo Maimets, Cezmi A. Akdis, Külli Kingo, Ana Rebane
Journal: Allergy (2019)

miR-10a-5p has been shown to regulate cancer cell proliferation and invasiveness and endothelial cell inflammatory responses. The function of miR-10a-5p in the skin has not been previously studied. The aim of the current study was to examine miR-10a-5p expression, regulation, and function in keratinocytes (KCs) in association with atopic dermatitis (AD).The expression of miR-10a-5p and its target genes was analyzed using RT-qPCR, mRNA array analysis, in situ hybridization, and immunofluorescence. The transfection of miRNA mimics, cell cycle distribution analysis, and luciferase assays was used to study miR-10a-5p functions in human primary KCs.miR-10a-5p was found to be upregulated in lesional skin from patients with AD and in proliferating KCs. Array and pathway analysis of IL-1β-stimulated KCs revealed that miR-10a-5p inhibited many genes that affect cell cycle progression and only a few inflammation-related genes. Accordingly, fewer cells in S-phase and reduced proliferation were detected as characteristics of miR-10a-5p-transfected KCs. The influence of miR-10a-5p on cell proliferation was also evident in KCs induced by AD-related cytokines, including IL-4, IL-17, and IL-1β, as measured by the capacity to strongly suppress the expression of the proliferation marker Ki-67. Among AD-related putative direct target genes, we verified hyaluronan synthase 3, a damage-associated positive regulator of KC migration and proliferation, as a direct target of miR-10a-5p.miR-10a-5p inhibits KC proliferation and directly targets hyaluronan synthase 3 and thereby may modulate AD-associated processes in the skin.
Comment on the 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus by Fanouriakis<i>et al</i>
Authors: Nathalie Costedoat-Chalumeau, David Isenberg, Michelle Petri
Journal: Annals of the Rheumatic Diseases (2019)

We read with great interest the 2019 update of the European League Against Rheumatism (EULAR) recommendations for the management of systemic lupus erythematosus (SLE) by Fanouriakis et al .1 We believe that these recommendations may help to improve the management of SLE patients and the authors should be congratulated for their efforts. We disagree, however, on an important point. The authors state in the abstract and the recommendations that hydroxychloroquine (HCQ) is recommended for all patients with SLE (1b/A), unless contraindicated, at a dose not exceeding 5 mg/kg/real body weight (3b/C ). We fully agree with the first part of the sentence, since HCQ prevents flares, is much cheaper than other drugs widely used for SLE, protects against the occurrence of thrombotic events, diabetes, dyslipidaemia and …
Neurovascular and Cognitive Dysfunction in Hypertension
Authors: Costantino Iadecola, Rebecca F. Gottesman
Journal: Circulation Research (2019)

Hypertension has emerged as a leading cause of age-related cognitive impairment. Long known to be associated with dementia caused by vascular factors, hypertension has more recently been linked also to Alzheimer disease-the major cause of dementia in older people. Thus, although midlife hypertension is a risk factor for late-life dementia, hypertension may also promote the neurodegenerative pathology underlying Alzheimer disease. The mechanistic bases of these harmful effects remain to be established. Hypertension is well known to alter in the structure and function of cerebral blood vessels, but how these cerebrovascular effects lead to cognitive impairment and promote Alzheimer disease pathology is not well understood. Furthermore, critical questions also concern whether treatment of hypertension prevents cognitive impairment, the blood pressure threshold for treatment, and the antihypertensive agents to be used. Recent advances in neurovascular biology, epidemiology, brain imaging, and biomarker development have started to provide new insights into these critical issues. In this review, we will examine the progress made to date, and, after a critical evaluation of the evidence, we will highlight questions still outstanding and seek to provide a path forward for future studies.
Epidemiologists are not skin specialists
Authors: Dharam J Kumbhani
Journal: BMJ (2004)

Dharam J Kumbhani explains how studying epidemiology has influenced his clinical practice What does a formal training in epidemiology entail? I came to the Harvard School of Public Health to do my masters degree in clinical epidemiology right after medical school. Many people found this appalling, mainly because I was expected to follow the general trend of completing medical school and getting a good house job--like most medical students. A disbelieving aunt thought that it meant that I was going to become a skin specialist. Epidemiology programmes, at least in the United States, are mainly offered by schools of public health. Most schools require students to have taken the graduate record examination and the test of English as a foreign language, if applicable. The courses are usually a blend of epidemiology and biostatistics (box 1). You gradually begin to understand how all the numbers and ubiquitous P values in the BMJ find their way there. As part of a clinical research team, you may never be called upon to do these analyses yourself. But it helps to have a working knowledge of things. ### Box 1: Core courses #### Substantive courses (area of interest) #### Other public health related courses (optional, if interested)
Reduced Hepatocellular Carcinoma Risk vs Bleeding Risk Associated With Aspirin—In Reply
Authors: Tracey G. Simon, Andrew T. Chan
Journal: JAMA Oncology (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 Oncology 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 Oncology journal
Foreign students in the UK
Authors: Edelyn Brawidjojo
Journal: BMJ (2007)

Being a junior doctor in the United Kingdom is not easy. And it's even harder if you are from beyond the European Union. I came to the UK to study at medical school, with a dream of a better life. Not long after gaining my MB BS (bachelor of medicine, bachelor of surgery) degree, I found many obstacles to pursuing my career that were outside of my control.

Finishing medical school was like the beginning of a …
Mitochondrial Regulation of the Hippocampal Firing Rate Set Point and Seizure Susceptibility
Authors: Boaz Styr, Nir Gonen, Daniel Zarhin, Antonella Ruggiero, Refaela Atsmon, Neta Gazit, Gabriella Braun, Samuel Frere, Irena Vertkin, Ilana Shapira, Michal Harel, Leore R. Heim, Maxim Katsenelson, Ohad Rechnitz, Saja Fadila, Dori Derdikman, Moran Rubinstein, Tamar Geiger, Eytan Ruppin, Inna Slutsky
Journal: Neuron (2019)

Maintaining average activity within a set-point range constitutes a fundamental property of central neural circuits. However, whether and how activity set points are regulated remains unknown. Integrating genome-scale metabolic modeling and experimental study of neuronal homeostasis, we identified mitochondrial dihydroorotate dehydrogenase (DHODH) as a regulator of activity set points in hippocampal networks. The DHODH inhibitor teriflunomide stably suppressed mean firing rates via synaptic and intrinsic excitability mechanisms by modulating mitochondrial Ca
Kite mark for beer glasses
Authors: Alex Brooks
Journal: BMJ (2000)

Toughened glass is not reducing injuries among people in bars - because there is no industry standard that manufacturers have to conform to.

A study published in Injury Prevention (2000;6:36-40) has found that staff are more likely to injure themselves with new, toughened glasses. The authors emphasise that this does not mean that bars should return to the old annealed glasses, but that there must be a minimum …
Recent trends from the results of clinical trials on gastric cancer surgery
Authors: Takashi Kiyokawa, Takeo Fukagawa
Journal: Cancer Communications (2019)

Abstract The Japan Clinical Oncology Group has recently conducted large scale clinical trials with findings that have revealed pivotal strategies for the treatment of resectable gastric cancer surgery. These findings include the fact that D3 lymphadenectomy does not improve survival rates when compared to D2 lymphadenectomy, and it is not recommended for resectable gastric cancer. Also, a transhiatal approach is recommended, instead of the left thoraco‐abdominal approach, for the treatment of adenocarcinoma of the esophago‐gastric junction or gastric cardia which has invaded ≤ 3 cm of the esophagus. Gastrectomy with splenectomy and bursectomy had been recommended as a part of the D2 lymphadenectomy. However, the results of the recent clinical trials revealed that splenectomy should be avoided in total gastrectomy with D2 lymphadenectomy for proximal gastric cancer and that bursectomy should be avoided in gastrectomy with D2 lymphadenectomy for resectable gastric cancer. Both splenectomy and bursectomy were found to be unable to improve survival, but instead increased operative morbidity. These trials revealed that the above‐mentioned invasive and aggressive procedures did not provide sufficient survival benefits and that gastric cancer surgery may be trending from an “invasive to less invasive” and “aggressive to more conservative” approach.
T cell receptor grafting allows virological control of hepatitis B virus infection
Authors: Karin Wisskirchen, Janine Kah, Antje Malo, Theresa Asen, Tassilo Volz, Lena Allweiss, Jochen M. Wettengel, Marc Lütgehetmann, Stephan Urban, Tanja Bauer, Maura Dandri, Ulrike Protzer
Journal: Journal of Clinical Investigation (2019)

T cell therapy is a promising means to treat chronic hepatitis B virus (HBV) infection and HBV-associated hepatocellular carcinoma. T cells engineered to express an HBV-specific T cell receptor (TCR) may cure an HBV infection upon adoptive transfer. We investigated the therapeutic potential and safety of T cells stably expressing high-affinity HBV envelope– or core–specific TCRs recognizing European and Asian HLA-A2 subtypes. Both CD8+ and CD4+ T cells from healthy donors and patients with chronic hepatitis B became polyfunctional effector cells when grafted with HBV-specific TCRs and eliminated HBV from infected HepG2-NTCP cell cultures. A single transfer of TCR-grafted T cells into HBV-infected, humanized mice controlled HBV infection, and virological markers declined by 4 to 5 log or below the detection limit. Engineered T cells specifically cleared infected hepatocytes without damaging noninfected cells when, as in a typical clinical setting, only a minority of hepatocytes were infected. Cell death was compensated by hepatocyte proliferation, and alanine amino transferase levels peaking between days 5 and 7 normalized again thereafter. Cotreatment with the entry inhibitor myrcludex B ensured long-term control of HBV infection. Thus, T cells stably transduced with highly functional TCRs have the potential to mediate clearance of HBV-infected cells, causing limited liver injury.
Low-density granulocytes activate T cells and demonstrate a non-suppressive role in systemic lupus erythematosus
Authors: Saifur Rahman, Divya Sagar, Richard N Hanna, Yaima L Lightfoot, Pragnesh Mistry, Carolyne K Smith, Zerai Manna, Sarfaraz Hasni, Richard M Siegel, Miguel A Sanjuan, Roland Kolbeck, Mariana J Kaplan, Kerry A Casey
Journal: Annals of the Rheumatic Diseases (2019)

Objectives The presence of proinflammatory low-density granulocytes (LDG) has been demonstrated in autoimmune and infectious diseases. Recently, regulatory neutrophilic polymorphonuclear myeloid-derived suppressor cells (PMN-MDSC) were identified in systemic lupus erythematosus (SLE). Because LDG and PMN-MDSC share a similar phenotype with contrasting functional effects, we explored these cells in a cohort of patients with SLE. Methods LDG and normal-density granulocytes (NDG) were isolated from fresh blood of healthy donors (HD) and patients with SLE. Associations between LDG and clinical manifestations were analysed. Multicolor flow cytometry and confocal imaging were performed to immunophenotype the cells. The ability of LDG and NDG to suppress T cell function and induce cytokine production was quantified. Results LDG prevalence was elevated in SLE versus HD, associated with the interferon (IFN) 21-gene signature and disease activity. Also, the LDG-to-lymphocyte ratio associated better with SLE disease activity index than neutrophil-to-lymphocyte ratio. SLE LDG exhibited significantly heightened surface expression of various activation markers and also of lectin-like oxidised low-density lipoprotein receptor-1, previously described to be associated with PMN-MDSC. Supernatants from SLE LDG did not restrict HD CD4 + T cell proliferation in an arginase-dependent manner, suggesting LDG are not immunosuppressive. SLE LDG supernatants induced proinflammatory cytokine production (IFN gamma, tumour necrosis factor alpha and lymphotoxin alpha) from CD4 + T cells. Conclusions Based on our results, SLE LDG display an activated phenotype, exert proinflammatory effects on T cells and do not exhibit MDSC function. These results support the concept that LDG represent a distinct proinflammatory subset in SLE with pathogenic potential, at least in part, through their ability to activate type 1 helper responses.
From medical student to junior doctor: The medical handover - a good habit to cultivate
Authors: Sharmila Bernau, Sarah Aldington, Geoffrey Robinson, Richard Beasley
Journal: BMJ (2006)

The art of effective handover is a neglected topic in medical school. <b>Richard Beasley and colleagues</b> explain the importance of best practice when exchanging information between healthcare professionals, in the eighth article of our series
The Chemoattractant Receptor Ebi2 Drives Intranodal Naive CD4+ T Cell Peripheralization to Promote Effective Adaptive Immunity
Authors: Antonio P. Baptista, Anita Gola, Yuefeng Huang, Pedro Milanez-Almeida, Parizad Torabi-Parizi, Joseph F. Urban, Virginia S. Shapiro, Michael Y. Gerner, Ronald N. Germain
Journal: Immunity (2019)