tbuckley/cabot-search huggingface dataset:
Vision for the Future of Continuing Board Certification
Authors: Christopher C. Colenda, William J. Scanlon, Richard E. Hawkins
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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Prospective multicenter study of the impact of the 21-gene recurrence score (RS) assay on medical oncologist (MO) and patient (pt) adjuvant breast cancer (BC) treatment selection
Authors: S. S. Lo, J. Norton, P. B. Mumby, J. Smerage, J. Kash, H. K. Chew, D. Hayes, A. Epstein, K. S. Albain
Journal: Journal of Clinical Oncology (2007)

577 Background: The 21-gene RS assay has been validated to quantify the risk of distant recurrence in tamoxifen treated pts in N-ER+BC and predict magnitude of chemotherapy benefit. Since there is little data regarding the impact of RS on MO and pt decision making, this multi-center study was designed to prospectively examine whether RS affects MO and pt adjuvant treatment selection. Methods: MOs stated their treatment recommendation and confidence in it while pts indicated treatment choice pre and post RS assay. RS were returned to MO and pt for routine clinical care. Frequency distributions and co-frequency tables are used to display categorical distributions of nominal variables; means and standard deviations are used to summarize continuous variables. Results: 15 MOs at 1 community and 3 academic practices consecutively enrolled 93 pts (89 evaluable) with N-ER+BC. The treatment plan changed in 31.5% of MOs and 27% of pts. The frequency of treatment changes are in the table below. The largest change induced by RS results was conversion from pre-test CHT to post-test HT (22.5% of MO, 10.1% of pts). MOs stated RS results increased confidence in 68 (76%). 90% of pts felt the RS assay influenced their treatment choice; 95% were glad they took the test. Conclusion: The results of this study indicate that the RS assay does impact MO adjuvant treatment recommendations, pt treatment choice, and confidence in the treatment plan. Investigator initiated trial supported by an unrestricted clinical trial grant from Genomic Health Inc. [Table: see text] No significant financial relationships to disclose.
Cediranib suppresses homology-directed DNA repair through down-regulation of BRCA1/2 and RAD51
Authors: Alanna R. Kaplan, Susan E. Gueble, Yanfeng Liu, Sebastian Oeck, Hoon Kim, Zhong Yun, Peter M. Glazer
Journal: Science Translational Medicine (2019)

Cediranib directly suppresses homology-directed DNA repair in tumor cells and confers synthetic lethal vulnerability to PARP inhibitors.
Résultats et facteurs de risque des complications de la cholangio-pancréatografie par voie endoscopique dans le traitement de la lithiase biliaire
Authors: S Lajouad, M Kadiri, M Acharki, I Serraj, M Salihoun, N Kabbaj
Journal: Endoscopy (2019)

La CPRE est devenue le traitement standard des lithiases de la VBP. Son efficacité peut dépasser 90% des cas. Cependant, le diamètre et le nombre des calculs représentent une difficulté pour la CPRE qui limite son efficacité.
OPTIMIZING HISTOPATHOLOGICAL EVALUATION OF ENDOSCOPIC MUCOSAL RESECTION SPECIMENS OF BARRETT'S ESOPHAGUS RELATED NEOPLASIA: A RANDOMIZED TRIAL OF THREE SPECIMEN HANDLING METHODS
Authors: A Overwater, KE van der Meulen, HT Künzli, EJ Schoon, JJGHM Bergman, GM Raicu, CA Seldenrijk, BLAM Weusten
Journal: Endoscopy (2019)

Endoscopic resection (ER) is the cornerstone in the treatment of Barrett's esophagus (BE) related neoplasia. However, accurate histopathological evaluation of ER specimens can be challenging and the preferred specimen handling method remains unknown. Therefore the aim of our study was to compare three different specimen handling methods for the assessment of all clinically relevant histopathological parameters and for the time required for specimen handling.
Listeriosis in Spain based on hospitalisation records, 1997 to 2015: need for greater awareness
Authors: Zaida Herrador, Alin Gherasim, Rogelio López-Vélez, Agustín Benito
Journal: Eurosurveillance (2019)

IntroductionListeriosis is a food-borne disease of public health importance that has recently been involved in prolonged outbreaks. Despite its relevance, listeriosis is under-reported in many European countries.AimWe aimed to describe listeriosis epidemiology in Spain from 1997-2015.MethodsWe performed a retrospective study using the Spanish hospitalisation database. We calculated the mean number of hospitalisations per year and region. Pregnancy and neonatal-related listeriosis rates were computed. Relation between death and the presence of underlying health conditions was explored.ResultsBetween 1997-2015, 5,696 listeriosis hospitalisations occurred, showing a constantly increasing trend. Higher hospitalisation rates were located in the north of the country compared to southern regions. The age group ≥ 65 years old was the most represented (50%). Pregnant women and newborns accounted for 7% and 4% of hospitalisations, respectively. An underlying immunocompromising condition was present in 56.4% of patients: cancer (22.8%), diabetes mellitus (16.6%) and chronic liver disease (13.1%). Death occurred in 17% of patients, more frequently among those ≥ 65 years old (67.5%), with sepsis (39.9%) or with meningoencephalitis (19.2%).ConclusionListeriosis is an emergent public health problem in Spain that calls for targeted action. Further prevention strategies are urgently needed, including food safety education and messaging for all at-risk groups.
Neurodevelopmental effects of ante-partum and post-partum antiretroviral exposure in HIV-exposed and uninfected children versus HIV-unexposed and uninfected children in Uganda and Malawi: a prospective cohort study
Authors: Michael J Boivin, Limbika Maliwichi-Senganimalunje, Lillian W Ogwang, Rachel Kawalazira, Alla Sikorskii, Itziar Familiar-Lopez, Agatha Kuteesa, Mary Nyakato, Alex Mutebe, Jackie L Namukooli, MacPherson Mallewa, Horacio Ruiseñor-Escudero, Jim Aizire, Taha E Taha, Mary G Fowler
Journal: The Lancet HIV (2019)
ENDOSCOPIC EN BLOC MUCOSAL RESECTION OF LARGE FLAT CAECAL ADENOMA
Authors: B Staňka, J Maceček, B Baťková
Journal: Endoscopy (2019)

Videocase describes a 61-year-old woman with granular homogenous laterally spreading caecal tumor (LST-GH), size 40 × 30 mm, which was curatively treated by en bloc endoscopic mucosal resection (EMR) technique. Is not primarily designed technique for such large lesions.
SAFETY AND FEASIBILITY OF ENDOSCOPIC FULL-THICKNESS RESECTION IN COLORECTUM USING OVER THE SCOPE CLIP. A MULTICENTER SPANISH EXPERIENCE 2015 – 2018
Authors: H Uchima, D Barquero, JM Esteban, JC Espinos, JC Marín Gabriel, P Rosón, F Fernandez Cadenas, A Ortega, M López Fraile, L Mel, MA Palacio Galán, I Puig, J Rodríguez-Sánchez, J Arribas, A Fernández Simón, F Sábado, J García Lledó, E Albéniz, A Mata
Journal: Endoscopy (2019)

To study the safety and feasibility of the endoscopic full-thickness resection (EFTR) in colorectal lesions using an over-the-scope-clip.
Open access and subscription based journals have similar problems in terms of quantity and relaying science to the public
Authors: Ross Mounce
Journal: BMJ (2019)

In the Head to Head debate on whether to publish in an open access journal, Ashton and Beattie report that PLOS One accepts 70% of submissions.1 That might have been true in 2013, but a more recent and perhaps more accurate figure would be that as of 2017 PLOS One accepts about 50% of submissions, which is an equivalent rate to that of BMJ Open …
Women with moderate‐to‐severe psoriasis in Spain ( <scp>BIOBADADERM</scp> registry) show more than a 50% reduction in age‐adjusted fertility rate when compared with the general population
Authors: A. Gonzalez‐Cantero, G. Carretero, R. Rivera, C. Ferrándiz, E. Daudén, P. de la Cueva, F.J. Gómez‐García, I. Belinchón, E. Herrera‐Ceballos, D. Ruiz‐Genao, M. Ferrán, M. Alsina, J.L. Sánchez‐Carazo, O. Baniandrés, A. Sahuquillo‐Torralba, L. Rodriguez, J. Vilar, C. García, J.M. Carrascosa, M. Llamas‐Velasco, E. Herrera‐Acosta, J.L. López‐Estebaranz, R. Botella‐Estrada, M.A. Descalzo, I. García‐Doval
Journal: British Journal of Dermatology (2019)
Error in Axis in Figure 2B
Journal: JAMA Internal Medicine (2019)

Donna M. Urquhart, PhD; Anita E. Wluka, PhD; Maurits van Tulder, PhD; Stephane Heritier, PhD; Andrew Forbes, PhD; Chris Fong, MBBS; Yuanyuan Wang, PhD; Malcolm R. Sim, PhD; Stephen J. Gibson, PhD; Carolyn Arnold, MBBS; Flavia M. Cicuttini, PhD
Novel Nanochip Paves Way for Early Ovarian Cancer Detection
Authors: Jennifer Abbasi
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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Effect of Targeting Mean Arterial Pressure During Cardiopulmonary Bypass by Monitoring Cerebral Autoregulation on Postsurgical Delirium Among Older Patients
Authors: Charles H. Brown, Karin J. Neufeld, Jing Tian, Julia Probert, Andrew LaFlam, Laura Max, Daijiro Hori, Yohei Nomura, Kaushik Mandal, Ken Brady, Charles W. Hogue, Ashish Shah, Kenton Zehr, Duke Cameron, John Conte, O. Joseph Bienvenu, Rebecca Gottesman, Atsushi Yamaguchi, Michael Kraut
Journal: JAMA Surgery (2019)

<h3>Importance</h3> Delirium occurs in up to 52% of patients after cardiac surgery and may result from changes in cerebral perfusion. Using intraoperative cerebral autoregulation monitoring to individualize and optimize cerebral perfusion may be a useful strategy to reduce the incidence of delirium after cardiac surgery. <h3>Objective</h3> To determine whether targeting mean arterial pressure during cardiopulmonary bypass (CPB) using cerebral autoregulation monitoring reduces the incidence of delirium compared with usual care. <h3>Design, Setting, and Participants</h3> This randomized clinical trial nested within a larger trial enrolled patients older than 55 years who underwent nonemergency cardiac surgery at a single US academic medical center between October 11, 2012, and May 10, 2016, and had a high risk for neurologic complications. Patients, physicians, and outcome assessors were masked to the assigned intervention. A total of 2764 patients were screened, and 199 were eligible for analysis in this study. <h3>Intervention</h3> In the intervention group, the patient's lower limit of cerebral autoregulation was identified during surgery before CPB. On CPB, the patient's mean arterial pressure was targeted to be greater than that patient's lower limit of autoregulation. In the control group, mean arterial pressure targets were determined according to institutional practice. <h3>Main Outcomes and Measures</h3> The main outcome was any incidence of delirium on postoperative days 1 through 4, as adjudicated by a consensus expert panel. <h3>Results</h3> Among the 199 participants in this study, mean (SD) age was 70.3 (7.5) years and 150 (75.4%) were male. One hundred sixty-two (81.4%) were white, 26 (13.1%) were black, and 11 (5.5%) were of other race. Of 103 patients randomized to usual care, 94 were analyzed, and of 102 patients randomized to the intervention 105 were analyzed. Excluding 5 patients with coma, delirium occurred in 48 of the 91 patients (53%) in the usual care group compared with 39 of the 103 patients (38%) in the intervention group (<i>P</i> = .04). The odds of delirium were reduced by 45% in patients randomized to the autoregulation group (odds ratio, 0.55; 95% CI, 0.31-0.97;<i>P</i> = .04). <h3>Conclusions and Relevance</h3> The results of this study suggest that optimizing mean arterial pressure to be greater than the individual patient's lower limit of cerebral autoregulation during CPB may reduce the incidence of delirium after cardiac surgery, but further study is needed. <h3>Trial Registration</h3> ClinicalTrials.gov identifier:NCT00981474
Early Paralytic Agents for ARDS? Yes, No, and Sometimes
Authors: Arthur S. Slutsky, Jesús Villar
Journal: New England Journal of Medicine (2019)

Lung-protective ventilation, which includes low tidal volumes and limitation of plateau pressures, is the standard approach in patients with acute respiratory distress syndrome (ARDS).1 Almost a decade ago, the ARDS et Curarisation Systematique (ACURASYS) trial2 showed that in patients with moderate-to-severe ARDS, a strategy of 48 hours of deep sedation with muscle paralysis induced by an intravenous infusion of cisatracurium resulted in a lower incidence of barotrauma and higher adjusted overall survival at 90 days than deep sedation alone. These results were unexpected, since the intervention was performed only for the first 2 days, yet the Kaplan–Meier survival curves were . . .
Less is more: the impact of maintenance treatment adherence in severe asthma clinical trials
Authors: Claire N. McBrien, Andrew Menzies-Gow
Journal: European Respiratory Journal (2019)

Asthma is the most common long-term respiratory condition, affecting more than 300 million people worldwide and, despite concerted efforts to achieve disease control and reduce exacerbations, it claims approximately 1000 lives each day [1]. The health and financial burdens associated with asthma are increasing, both at individual and population levels. A recent study estimated the annual cost of asthma in the USA to be more than USD 80 billion, taking into account direct medical costs, mortality and loss of attendance at school and work [2]. Inadequate assessment of adherence to maintenance medication leads to loss of power and increased costs in trials of severe asthma therapy <http://bit.ly/2USoiQU>
Mode of Progression after First Line Treatment Correlates with Outcome of Chronic Lymphocytic Leukemia (CLL)
Authors: Othman Al-Sawaf, Alexandra Bazeos, Sandra Robrecht, Jasmin Bahlo, Anna Maria Fink, Julia Von Tresckow, Paula Cramer, Petra Langerbeins, Nadine Kutsch, Kathryn Humphrey, Günter Fingerle-Rowson, Stephan Stilgenbauer, Clemens-Martin Wendtner, Kirsten Fischer, Barbara F. Eichhorst, Michael Hallek, Valentin Goede
Journal: Blood (2017)
Think tanks should come out of the shadows
Authors: Rebecca Coombes
Journal: BMJ (2019)

This week we reveal a worrying network of links between the Institute of Economic Affairs, a UK think tank, and leading Conservative politicians.The IEA is a vocal opponent of public health initiatives, dismissing as "nanny state" interventions such policies as alcohol controls and sugar taxes.It is also an organisation that has taken money from the very companies whose products are widely held to be responsible for ill health epidemics, such as smoking and obesity.Perhaps most alarmingly, finds
Are single hormone receptor-positive phenotypes biologically and clinically distinct breast cancer? A population-based study
Authors: Y. Li, Y. Wu, D. Yang, H. Li, G. Ren
Journal: Annals of Oncology (2019)

Background: Steroid hormone receptors (HRs), estrogen receptor (ER) and progesterone receptor (PR), are crucial biomarkers for clinical management in breast cancer. However, limited data are available regarding single HR-positive, making it difficult for treatment decision and survival prediction in these patients. Methods: Breast cancer patients were retrieved in Surveillance, Epidemiology, and End Results database. Patients without ER, PR, or breast cancer-specific survival (BCSS) data were excluded. We stratified patients into ER+/PR+, ER+/PR-, ER-/PR+, and ER-/PR- groups. BCSS analysis was performed by Kaplan-Meier method. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: This study included 823,339 breast cancer patients (553,165 [67.18%] ER+/PR+, 100,319 [12.18%] ER+/PR-, 13,368 [1.62%] ER-/PR+, and 156,547 [19.01%] ER-/PR-). Significant differences were detected between the four groups involving age, sex, race, tumor size, lymph node status, AJCC stage, grade, histology type, and HER2 status. Survival analyses showed that the ER/PR status were significantly associated with BCSS; the estimated mean BCSS months was 261.3, 241.2, 233.6, and 227.6 for ER+/PR+, ER+/PR-, ER-/PR+, and ER-/PR-, respectively (p < 0.001). Compared with ER+/PR+, ER+/PR- (HR, 1.67; 95% CI, 1.64-1.70) and ER-/PR + (HR, 1.83; 95% CI, 1.74-1.92) patients were associated with poor BCSS. When compared with ER-/PR- (vs. ER+/PR-, HR, 1.39; 95% CI, 1.37-1.42 and vs. ER-/PR+, HR, 1.12; 95% CI, 1.08-1.16), ER+/PR- and ER-/PR+ patients had a better BCSS. ER-/PR + (HR, 1.17; 95% CI, 1.13-1.22) was significantly associated with poorer BCSS than ER+/PR-. In multivariable Cox regression analysis, when compared with ER+/PR+, the risk of breast cancer-specific death increased 37% for ER+/PR- (HR, 1.37; 95% CI, 1.34-1.39), 59% for ER-/PR + (HR, 1.59; 95% CI, 1.53-1.65), and 76% for ER-/PR- (HR, 1.76; 95% CI, 1.73-1.78) (p for trend<0.001). Conclusions: There are significant distinctions between ER+/PR+, ER+/PR-, ER-/PR+, and ER-/PR- phenotype. Importantly, the clinical and prognostic features of single HR-positive breast cancer should be re-recognized and re-oriented. Legal entity responsible for the study: Guosheng Ren. Funding: National Natural Science Foundation of China. Disclosure: All authors have declared no conflicts of interest.
Abstract 45: Trends in Cardiovascular Disease (CVD) Risk Factor Screening and Counseling: Impact of the Affordable Care Act (ACA)
Authors: Lindsay Pool, Ehimare Akhabue, Mercedes R Carnethon
Journal: Circulation (2017)

Introduction: The Affordable Care Act (ACA), signed into law in 2010, was incrementally implemented by a series of reforms including an expansion of health insurance coverage and preventive services coverage without co-pay. It is not known whether CVD preventive services have increased as a result of enhanced healthcare access. Hypothesis: We hypothesized that CVD risk factor screening and counseling would increase among US adults over the period of ACA implementation, 2011-2015. Methods: The National Health Interview Survey is a telephone survey of a random sample of the US civilian noninstitutionalized population. Respondents (n=101,243) from survey years 2011, 2013, and 2015 were asked whether, in the past year, they had a screening test for blood pressure, cholesterol, and diabetes, and counseling about diet and smoking cessation from a health professional. We calculated annual percent change (APC) for each preventive service, using weighted constant-time Cox regression models, and examined whether findings were similar across demographic groups. Results: Health insurance coverage increased from 2011-2015, primarily among lower socioeconomic status (SES) individuals and younger adults. There were significant annual increases in the prevalence of screening and counseling for each CVD risk factor (Table). Increases were larger among lower SES groups for blood pressure and cholesterol screenings. Increases were larger among younger age groups for blood pressure, cholesterol, and diabetes screenings, but were larger among older, Medicare-eligible adults for diet counseling. There were no significant differences in APC increases by gender or race. Conclusions: CVD risk factor screening and counseling increased during ACA implementation. Differential increases across SES and age groups indicate improved access to care in populations that have been previously underserved. Outreach is needed to ensure newly insured persons are aware of covered CVD preventive services.
A PROSPECTIVE, RANDOMIZED, MULTICENTER STUDY COMPARING SEMS PLACEMENT WITH AND WITHOUT BILIARY SPHINCTERECTOMY IN PATIENTS WITH MALIGNANT BILIARY OBSTRUCTION: AN INTERIM ANALYSIS
Authors: A Anderloni, A Fugazza, F D'Amico, G De Nucci, G Manes, R Maselli, B Mangiavillano, F Auriemma, PJ Belletrutti, C Hassan, AP Maydeo, A Repici
Journal: Endoscopy (2019)

Aim of the study was to investigate the outcomes of patients with malignant biliary obstruction undergoing self-expandable metallic stent (SEMS) placement with and without endoscopic sphincterotomy (ES). NCT number 03628001.
Intérêt de l'exploration par vidéocapsule colique chez les patients en attente de transplantation cardiaque
Authors: A Ravaux, G Rahmi, E Samaha, G Perrod, D Danan, O Dorval, S Khater, A Percie Du Sert, B Cholley, C Cellier
Journal: Endoscopy (2019)

Une exploration endoscopique colique fait partie du bilan standard chez les patients en attente de transplantation cardiaque afin d'éliminer un processus néoplasique. La vidéocapsule colique (VCC) est un examen non invasif qui ne nécessite pas d'anesthésie générale. Notre objectif était, pour la première fois, d'évaluer la faisabilité et la rentabilité diagnostique de cet examen chez les patients en attente de transplantation cardiaque.