tbuckley/cabot-search huggingface dataset:
Pharmacological treatment of inhalation injury after nuclear or radiological incidents: The Chinese and German approach
Authors: Tian-Tian Yan, Guo-An Lin, Min-Jie Wang, Andreas Lamkowski, Matthias Port, Alexis Rump
Journal: Military Medical Research (2019)

Inhalation injury is often associated with burns and significantly increases morbidity and mortality. The main toxic components of fire smoke are carbon monoxide, hydrogen cyanide, and irritants. In the case of an incident at a nuclear power plant or recycling facility associated with fire, smoke may also contain radioactive material. Medical treatments may vary in different countries, and in this paper, we discuss the similarities and differences in the treatments between China and Germany. Carbon monoxide poisoning is treated by 100% oxygen administration and, if available, hyperbaric oxygenation in China as well as in Germany. In addition, antidotes binding the cyanide ions and relieving the respiratory chain are important. Methemoglobin-forming agents (e.g., nitrites, dimethylaminophenol) or hydroxocobalamin (Vitamin B12) are options. The metabolic elimination of cyanide may be enhanced by sodium thiosulfate. In China, sodium nitrite with sodium thiosulfate is the most common combination. The use of dimethylaminophenol instead of sodium nitrite is typical for Germany, and hydroxocobalamin is considered the antidote of choice if available in cases of cyanide intoxications by fire smoke inhalation as it does not further reduce oxygen transport capacity. Systematic prophylactic use of corticosteroids to prevent toxic pulmonary edema is not recommended in China or Germany. Stable iodine is indicated in the case of radioiodine exposure and must be administered within several hours to be effective. The decorporation of metal radionuclides is possible with Ca (DTPA) or Prussian blue that should be given as soon as possible. These medications are used in both countries, but it seems that Ca (DTPA) is administered at lower dosages in China. Although the details of the treatment of inhalation injury and radionuclide(s) decorporation may vary, the general therapeutic strategy is very similar in China and Germany.
Self-medication as Part of Self-management Plans for Patients With COPD
Authors: Claudia Steurer-Stey
Journal: JAMA (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 HomeNew OnlineCurrent IssueFor Authors 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Establishment of Novel Intraoperative Monitoring and Mapping Method for the Cavernous Nerve During Robot-assisted Radical Prostatectomy: Results of the Phase I/II, First-in-human, Feasibility Study
Authors: Won Hoon Song, Ju Hyun Park, Bum Sik Tae, Sung-Min Kim, Min Hur, Jeong-Hwa Seo, Ja Hyeon Ku, Cheol Kwak, Hyeon Hoe Kim, Keewon Kim, Chang Wook Jeong
Journal: European Urology (2019)
At First Glance
Authors: Faith T. Fitzgerald
Journal: Annals of Internal Medicine (2019)

On Being a Doctor21 May 2019At First GlanceFaith T. Fitzgerald, MDFaith T. Fitzgerald, MDUniversity of California, Davis, Sacramento, California (F.T.F.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-2350 Audio Reading - “At First Glance” Audio. Michael A. Lacombe, MD, Annals Associate Editor, reads “At First Glance” by Faith T. Fitzgerald, MD Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Years ago, when I was an attending physician in our general internal medicine clinic—then located in the Cypress Building—one of the nurses told me that a man was threatening the staff at the check-in area. She asked whether she should call the campus police.“What is he doing?” I asked.“He is scaring them,” she answered.“Does he have a weapon?”“I don't think so,” she said.I went to the back door of the reception area to take a look. Leaning over the front desk was a very tall, muscular, full-bearded man with a long, braided ponytail and richly ... Author, Article, and Disclosure InformationAffiliations: University of California, Davis, Sacramento, California (F.T.F.)Corresponding Author: Faith T. Fitzgerald, MD, UC Davis Medical Center, C/O Division of General Medicine, 4150 V Street, Suite 2400, Sacramento, CA 95817; e-mail, [email protected]edu. PreviousarticleNextarticle Advertisement Audio Reading - “At First Glance” Audio. Michael A. Lacombe, MD, Annals Associate Editor, reads “At First Glance” by Faith T. Fitzgerald, MD Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 21 May 2019Volume 170, Issue 10Page: 728-729KeywordsBeesCoffeeHabitsLower back painMuscular dystrophiesOpioidsOrthopedicsSurgeryThoraxWalking ePublished: 21 May 2019 Issue Published: 21 May 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
GP who practised without indemnity insurance for six years is struck off
Authors: Clare Dyer
Journal: BMJ (2019)

A GP who worked for six years without indemnity insurance, and who provided fake information in three different appraisals to make it appear that he was covered, has been struck off the UK medical register.

Between 2014 and 2016 Augustine Onojeje-Oraka filled in the indemnity coverage sections of three appraisal forms, claiming to be covered by either the Medical Defence Union or the Medical and Dental Defence Union of Scotland, and giving false membership numbers, when in fact he knew he had not been covered since 2010.

He was reported to the GMC by NHS England in November 2016, after his lack of coverage was uncovered during an inspection of his practice in Borough, south London, …
Le taux de détection des adénomes est dépendant du patient tandis que le taux de détection des adénomes festonnés est dépendant de l'endoscopiste!
Authors: M Cavicchi, G Tharsis, P Burtin, P Cattan, F Venezia, G Tordjman, A Gillet, J Samama, K Nahon-Uzan, D Karsenti
Journal: Endoscopy (2019)

Le taux de détection des adénomes (TDA) est corrélé au risque de cancer d'intervalle et est un marqueur de qualité reconnu de la coloscopie. Plus récemment, il a été suggéré que le taux de détection des adénomes festonnés (TDAF) pourrait être un marqueur plus fin de la qualité en endoscopie (Anderson et al., 2017). Nous avons prospectivement évalué ces taux en coloscopie de routine sur une période de 2 ans.
Abstract P295: Dietary Pattern Mediates the Association Between Education Level and Metabolic Syndrome in Korean Adults
Authors: SoYoung Kwak, Garam Jo, Yoonsu Cho, Min-Jeong Shin
Journal: Circulation (2017)

Introduction: Emerging evidences have inconsistently reported that dietary components mediate the relationship between low socioeconomic status (SES) and higher cardiometabolic risk, but the findings are limited in Korean. Hypothesis: We tested the hypothesis whether the education level as a proxy for SES is associated with the prevalence of metabolic syndrome and this association is mediated by dietary pattern. Methods: We used nationally representative data from the Korea National Health and Nutritional Examination Survey (2008-2011) for cross-sectional analyses (Total number of subjects=22 607, 30-64 yrs). Dietary data were assessed using food frequency questionnaire including 63 food items and were categorized into seven food groups based on the Korea nutrient database. Metabolic syndrome was defined using revised National Cholesterol Education Program criteria. The possible mediating effect of dietary components (fruit, vegetable, red meat, milk, and soft-drink) on the association between education level and metabolic syndrome was tested using a multiple mediation model. Results: Education levels had direct and indirect effects via dietary consumption patterns on the prevalence of metabolic syndrome. Higher education level was directly associated with lower prevalence of metabolic syndrome (Odds ratio [OR]: 0.854, 95% Confidence Intervals [CIs]: 0.817-0.894). Regarding the medicating effect of dietary patterns, higher education level was indirectly associated with decreased prevalence of metabolic syndrome by high in fruit intake (OR: 0.983, 95% CIs: 0.947-0.992), red meat intake (OR: 0.991, 95% CIs: 0.985-0.996), milk intake (OR: 0.994, 95% CIs: 0.992-0.998), and by low in soft-drink intake (OR: 0.995, 95% CIs: 0.992-0.998). Gender modified the association between education level and metabolic syndrome prevalence. In women, there was significant inverse relationship between education level and the prevalence of metabolic syndrome with significant mediating effect of dietary pattern on metabolic syndrome. Conversely, mediating effect of dietary pattern was not observed in men. Conclusions: In conclusion, there was inverse association between education level and prevalence of metabolic syndrome, which is partially explained by specific dietary components in Korean adults. Our results provide information for establishing dietary guideline and nutrition policy to prevent and manage metabolic syndrome.
Heterozygous mutation in fanconi anemia genes associated with hereditary breast cancer
Authors: M. Gordiev, O. Brovkina, L.H. Shigapova, E. Shagimardanova, R.F. Enikeev, A. Nikitin, V. Petkau, A. Aksarin, E. Ovchinnikova, D. Sakaeva
Journal: Annals of Oncology (2019)

Background: Defects in DNA damage recognition and repair has been implicated in hereditary breast cancer (BC). Several studies demonstrated, that Fanconi Anemia (FA) associated genes-coding proteins and products of BRCA1/2 genes cooperate in a DNA repair pathway which is required for resistance to DNA interstrand crosslinks. Our aim was to analyze nucleotide variants in FA genes predisposing with an increased risk of hereditary cancers. Methods: Targeted NGS was performed in a cohort of 630 BC patients with strong evidence of hereditary background of cancer. The NimbleGenSeqCap EZ Choice® kit (Roche) was used for target enrichment, and sequencing was performed using Illumina MiSeq® (Illumina) following manufacturers protocol. Results: 36 (5,7%) patients had heterozygous mutations in PALB2, FANCI, FANCL, FANCC, FAM175A, FANCM, FANCG, FANCD2 genes implicated in the causation of FA. Among these variants 30,5% were pathogenic, and 69,5% had uncertain significance. All variants had strong susceptibility with BC, the combined odds ratio of having a mutation was 27,3 (95% CI 1,25–4,64;P = 0,002)Six patients carried complementary pathogenic mutations in BRCA1/2, XRCC2 or MLH3 genes. Heterozygous mutations PALB2 and FANCL were significantly associated with estrogen receptor (ER)-positive disease, while those in FANCI were associated with ER-negative BC. Mutations in FANCI and FANCL genes had an association with progesterone receptor (PR)-negative BC, and PALB2 mutations were associated with PR-positive BC. Conclusions: Heterozygous germline mutations in FA genes are strongly associated with a higher risk of BC. Triple negative BC is more common among carriers of mutations in FA genes than in common cohort of BC patients. Clinical characteristics of women with different germline mutations inBC. Legal entity responsible for the study: National BioService, Saint Petersburg, Russian Federation. Funding: Kazan Federal University. Disclosure: All authors have declared no conflicts of interest. Table29PMutationsMean age (range)HER 2+, %HER2-, %Triple negative BCLogistic likelihood ratio, test PFA genes52 (25-69)33.766,325,00,011BRCA1/242 (25-67)20,971,947,50,002All hereditary breast cancer61 (22-88)58,741,317,90,452 Open table in a new tab
Mutational Analysis of Neurokinin B and Its Receptor in Patients with Idiopathic Central Pubertal Disorders
Authors: Cintia Tusset, Sekoni Noel, Leticia Silveira, Ericka Trarbach, Elena Gianetti, Stephanie Seminara, Ursula Kaiser, Ana C. Latronico, Berenice B. Mendonca
Journal: Endocrine Reviews (2012)
Clinical Evaluation of Human Papillomavirus Screening With p16/Ki-67 Dual Stain Triage in a Large Organized Cervical Cancer Screening Program
Authors: Nicolas Wentzensen, Megan A. Clarke, Renee Bremer, Nancy Poitras, Diane Tokugawa, Patricia E. Goldhoff, Philip E. Castle, Mark Schiffman, Julie D. Kingery, Kiranjit K. Grewal, Alex Locke, Walter Kinney, Thomas S. Lorey
Journal: JAMA Internal Medicine (2019)

As cervical cancer screening transitions from Papanicolaou cytologic screening to primary human papillomavirus (HPV) testing worldwide, effective triage tests are needed to decide who among the HPV-positive women should receive further diagnostic evaluation to avoid unnecessary colposcopies and biopsies.To evaluate the performance of the p16/Ki-67 dual stain (DS) and HPV16/18 genotyping for the triage of HPV-positive women.A prospective observational study was conducted within the cervical cancer screening program at Kaiser Permanente Northern California of 3225 HPV-positive women undergoing HPV and Papanicolaou cytologic testing with a valid DS result from September 16 to October 31, 2015, with follow-up through December 31, 2018.Human papillomavirus screening with partial genotyping and cytologic triage compared with DS triage.Cervical intraepithelial neoplasia grade 3 or more severe (CIN3+) and grade 2 or more severe (CIN2+), diagnosed within 3 years after sample collection.A total of 3225 women (mean [SD] age, 37.9 [11.3] years) participated in the study. For triage of HPV-positive women with partial genotyping, DS showed better risk stratification for CIN3+ than did Papanicolaou cytologic testing, with women with positive DS results having a higher risk than women with positive Papanicolaou test results for CIN3+ (218 of 1818 [12.0%; 95% CI, 10.5%-13.5%] vs 219 of 2128 [10.3%; 95% CI, 9.0%-11.6%]; P = .005). Similarly, DS showed better risk stratification for CIN3+ compared with Papanicolaou cytologic testing in HPV-positive women, irrespective of genotyping. The greatest reassurance against CIN3+ was observed in HPV16/18-negative women with negative DS results, with a risk low enough to extend retesting intervals. Dual stain triage strategies required substantially fewer colposcopies per detection of CIN3+ compared with Papanicolaou cytologic testing, with a 32.1% (859 of 2677) reduction of colposcopies compared with the currently recommended triage strategy of HPV screening with Papanicolaou cytologic testing. Results for CIN2+ were very similar.Triage of HPV-positive women with DS was superior to Papanicolaou cytologic testing in this study, demonstrating equal immediate detection of precancerous lesions and substantially reduced referral to colposcopy. These findings suggest that DS can safely replace Papanicolaou cytologic testing as a triage strategy for primary HPV screening, and that retesting intervals in HPV16/18-negative women with negative DS results can be safely extended to 3 years.
A MULTICENTRE VALIDATION STUDY OF A NOVEL LOWER GASTROINTESTINAL BLEEDING (LGIB) SCORE-THE BIRMINGHAM (BHAM) SCORE
Authors: S Smith, A Bazarova, E Ejenavi, M Qurashi, U Shivaji, P Harvey, E Slaney, M McFarlane, G Baker, M Elnagar, S Yuzari, G George, S Ghosh, M Iacucci
Journal: Endoscopy (2019)

LGIB is common and its incidence is increasing. There have been attempts to create new risk stratification scores to predict major clinical adverse events in LGIB, however none of are widely used. We aimed to identify risk factors associated with adverse outcomes from LGIB and develop and validate a novel scoring system.
Identification of Myocardial Disarray in Patients With Hypertrophic Cardiomyopathy and Ventricular Arrhythmias
Authors: Rina Ariga, Elizabeth M. Tunnicliffe, Sanjay G. Manohar, Masliza Mahmod, Betty Raman, Stefan K. Piechnik, Jane M. Francis, Matthew D. Robson, Stefan Neubauer, Hugh Watkins
Journal: Journal of the American College of Cardiology (2019)

Myocardial disarray is a likely focus for fatal arrhythmia in hypertrophic cardiomyopathy (HCM). This microstructural abnormality can be inferred by mapping the preferential diffusion of water along cardiac muscle fibers using diffusion tensor cardiac magnetic resonance (DT-CMR) imaging. Fractional anisotropy (FA) quantifies directionality of diffusion in 3 dimensions. The authors hypothesized that FA would be reduced in HCM due to disarray and fibrosis that may represent the anatomic substrate for ventricular arrhythmia. This study sought to assess FA as a noninvasive in vivo biomarker of HCM myoarchitecture and its association with ventricular arrhythmia. A total of 50 HCM patients (47 ± 15 years of age, 77% male) and 30 healthy control subjects (46 ± 16 years of age, 70% male) underwent DT-CMR in diastole, cine, late gadolinium enhancement (LGE), and extracellular volume (ECV) imaging at 3-T. Diastolic FA was reduced in HCM compared with control subjects (0.49 ± 0.05 vs. 0.52 ± 0.03; p = 0.0005). Control subjects had a mid-wall ring of high FA. In HCM, this ring was disrupted by reduced FA, consistent with published histology demonstrating that disarray and fibrosis invade circumferentially aligned mid-wall myocytes. LGE and ECV were significant predictors of FA, in line with fibrosis contributing to low FA. Yet FA adjusted for LGE and ECV remained reduced in HCM (p = 0.028). FA in the hypertrophied segment was reduced in HCM patients with ventricular arrhythmia compared to patients without (n = 15; 0.41 ± 0.03 vs. 0.46 ± 0.06; p = 0.007). A decrease in FA of 0.05 increased odds of ventricular arrhythmia by 2.5 (95% confidence interval: 1.2 to 5.3; p = 0.015) in HCM and remained significant even after correcting for LGE, ECV, and wall thickness (p = 0.036). DT-CMR assessment of left ventricular myoarchitecture matched patterns reported previously on histology. Low diastolic FA in HCM was associated with ventricular arrhythmia and is likely to represent disarray after accounting for fibrosis. The authors propose that diastolic FA could be the first in vivo marker of disarray in HCM and a potential independent risk factor.
ENDOLUMINAL RADIOFRECUENCY ABLATION WTH SPYGLASS IN THE MANAGEMENT OF CHOLANGIOCARCINOMA
Authors: R Mansilla-Vivar, N Alonso-Lazaro, L Argüello-Viudez, M Ponce-Romero, M Bustamante-Balén, C Sanchez-Montes, V Pons-Beltrán
Journal: Endoscopy (2019)

Male patient of 38 years. Medical history: ambulatory clinical follow-up due to cryptogenic liver cirrhosis. Admitted in April 2018 for spontaneous bacterial peritonitis (SBP). During abdominal MRI admission, a lesion was reported in the hepatic hilum with hilar adenopathies compatible with cholangiocarcinoma. Due to marked portal hypertension and poor clinical improvement, a TIPS was placed 2 months after admission without clinical changes. On July 18, ERCP with SpyGlass was applied, biliary stents placement with biliary biopsy of suspicious lesion was taken. We took only one sample due easy bleeding. Pathology report: suspicious but not conclusive with cholangiocarcinoma. After that, the patient presented remarkable clinical improvement. PET-CT was performed to confirm malignant diagnosis, reporting hilar cholangiocarcinoma with tumor viability signs, with intrahepatic bile ducts dilation. Sepsis concurrent SBP and antibiotic therapy was initiated with multiple antibiotic schemes by multiresistant bacterias for 2 months. Endocarditis and other endovascular infections were ruled out. Four months after admission, oncology committee requested to repeat biliary biopsies and get adenopathies biopsy. Endoscopic ultrasound with FNA in August 2018 confirmed metastatic lymphadenopathies. In September 2018, second ERCP with SpyGlass system was performed; Endoscopic biopsy by SpyBite confirmed cholangiocarcinoma. With these findings, the patient did not meet Mayo Clinic criteria for curative resection, so endoluminal radiofrequency with Spyglass was offered as palliative treatment. An 18 mm temperature-controlled radiofrequency (RFA) catheter (ELRA STARmed, Korea) through duodenoscope working channel into the papilla of Vater was inserted. RFA was applied at 10 watts for a time period of 2 minutes under 80 °C of intraductal temperature. A temperature sensor inside the electrode provided accurate temperature measurements. The power and impedance settings were automatically made from the VIVA generator (STARmed Korea). After the procedure, patient presented mild self-limited abdominal pain for 12 hours, with no other complications 15 days after the procedure.
Abstract 14910: Shear Stress-Regulated Mir-27a/b Controls Pericyte Recruitment: Implications for Vessel Maturation
Authors: Shemsi Demolli, Konstantin Stark, Anuradha Doddaballapur, Reinier A Boon, Carmen Doebele, Annekathrin Eckert, Thomas Korff, Markus Hecker, Steffen Massberg, David Kaluza, Stefanie Dimmeler
Journal: Circulation (2013)

Vessel maturation involves the recruitment of mural cells such as pericytes or smooth muscle cells and deposition of extracellular matrix. Laminar shear stress is a major trigger for vessel maturat...
Abstract 14197: Population Trends in Percutaneous Coronary Intervention: 20 Year Results from the Swedish Coronary Angiography and Angioplasty Registry
Authors: Marieke L Fokkema, Bo Lagerqvist, Stefan K James
Journal: Circulation (2012)

Introduction Over the last 20 years, the treatment of patients with percutaneous coronary intervention (PCI) has evolved dramatically but the changing patient characteristics have not been well des...