tbuckley/cabot-search huggingface dataset:
Negative Pressure Wound Therapy for Surgical Site Infection Prevention Requires Further Study Before Widespread Adoption—Reply
Authors: Shaheel Mohammad Sahebally, John Patrick Burke, Deborah A. McNamara
Journal: JAMA Surgery (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 Surgery 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 Surgery journal
Evaluation of a Multifaceted Intervention to Reduce Health Disparities in Hepatitis C Screening: A Pre‐Post Analysis
Authors: Mamta K. Jain, Nicole E. Rich, Chul Ahn, Barbara J. Turner, Joanne M. Sanders, Brian Adamson, Lisa Quirk, Patrice Perryman, Noel O. Santini, Amit G. Singal
Journal: Hepatology (2019)

Hepatitis C virus (HCV) testing in persons born from 1945 to 1965 has had limited adoption despite guidelines, particularly among racial/ethnic minorities and socioeconomically disadvantaged patients, who have a higher prevalence of disease burden. We examined the effectiveness of a multifaceted intervention to improve HCV screening in a large safety‐net health system. We performed a multifaceted intervention that included provider and patient education, an electronic medical record–enabled best practice alert, and increased HCV treatment capacity. We characterized HCV screening completion before and after the intervention. To identify correlates of HCV screening, we performed logistic regression for the preintervention and postintervention groups and used a generalized linear mixed model for patients observed in both preintervention and postintervention time frames. Before the intervention, 10.1% of 48,755 eligible baby boomer patients were screened. After the intervention, 34.6% of the 34,093 eligible baby boomers were screened ( P &lt; 0.0001). Prior to the intervention, HCV screening was lower among older baby boomers and providers with large patient panels and higher in high‐risk subgroups including those with signs of liver disease (e.g., elevated transaminases, thrombocytopenia), human immunodeficiency virus–positive patients, and homeless patients. Postintervention, we observed increased screening uptake in older baby boomers, providers with larger patient panel size, and patients with more than one prior primary care appointment. Conclusion: Our multifaceted intervention significantly increased HCV screening, particularly among older patients, those engaged in primary care, and providers with large patient panels.
Computer-assisted, high-frequency, hospital-wide point prevalence surveys of hospital-acquired infections in a tertiary care hospital, the Netherlands, 2013 to 2014
Authors: H Roel A Streefkerk, Sten P Willemsen, Conrad P van der Hoeven, Margreet C Vos, Roel PAJ Verkooijen, Henri A Verbrugh
Journal: Eurosurveillance (2019)

BackgroundSurveillance of hospital-acquired infections (HAI) often relies on point prevalence surveys (PPS) to detect major deviations in the occurrence of HAI, supplemented with incidence measurements when more detailed information is needed. In a 1,320-bed university medical centre in the Netherlands, we evaluated an electronically assisted surveillance system based on frequently performed computer-assisted PPS (CAPPS).AimThe primary goals were to evaluate the performance of this method to detect trends and to determine how adjustments in the frequency with which the CAPPS are performed would affect this performance. A secondary goal was to evaluate the performance of the algorithm (nosocomial infection index (Nii)) used.MethodsWe analysed the data of 77 hospital-wide PPS, performed over a 2-year period (2013 and 2014) and including 25,056 patients.ResultsSix trends with statistical significance were detected. The probability to detect such trends rapidly decreased when PPS are performed at a lower frequency. The Nii and its dynamics strongly correlated with the presence of HAI.ConclusionPerforming computer-assisted, high frequency hospital-wide PPS, is a feasible method that will detect even subtle changes in HAI prevalence over time.
Incidental finding of Zinner syndrome in a Greek military recruit: a case report of a rare clinical entity
Authors: Evangelos N. Symeonidis, Chrysovalantis Gkekas, Ioannis Tsifountoudis, Asterios Symeonidis, Christos Georgiadis, Vasileios Kalyvas, Apostolos Malioris, Michail Papathanasiou
Journal: Military Medical Research (2019)

Zinner syndrome represents a rare congenital malformation of the urinary tract. It comprises a constellation of Wolffian duct anomalies and is almost exclusively encountered as a classic triad of seminal vesicle cysts, ejaculatory duct obstruction and renal agenesis. Patients can be either asymptomatic or symptomatic. Recently, minimally invasive surgical techniques have emerged, superseding traditional surgery for select symptomatic cases. Our case highlights the finding of a rare clinical syndrome that was incidentally detected during a routine mass screening of military recruits in the Greek Armed Forces. Herein, we present a case of a 19-year-old male who reported having a solitary right kidney when examined in a military training center of Northern Greece. No additional clinical information was available; thus, referral to a tertiary urology department for further investigation ensued. Imaging studies, namely, computed tomography and magnetic resonance imaging, revealed left renal aplasia, multiple left seminal vesicle cysts, and ejaculatory duct obstruction. Laboratory values and urinalysis were within normal range. Semen analysis was significant for cryptozoospermia. Our patient remained asymptomatic during the entire hospitalization. Long-term follow-up was recommended. Nevertheless, he declined further investigation and sought treatment in a private practice setting. This article aims to present the incidental diagnosis of a rare syndrome in a military setting. Population screening conducted in the armed forces permits the identification of undiagnosed diseases that warrant further investigation. To the best of our knowledge, this was the first report of Zinner syndrome in a military recruit and the second case cited of a Greek patient in the published literature. Regular follow-up is the key to timely intervention in conservatively managed cases.
PTH-016 Tunnel biopsy is an underutilised, simple and safe method for tissue acquisition in subepithelial tumours
Authors: Tilak Ghosh, Andreas Koutsoumpas, Ruwan Perera, Adele Melton, Elena Collantes, Barbara Braden
Journal: Endoscopy (2018)

<h3>Introduction</h3> Tissue acquisition from subepithelial lesions is most often attempted by EUS-guided fine needle aspiration/biopsy as conventional endoscopic biopsy usually fails to reach the lesion in deeper layers of the gastrointestinal wall. Tunnelled biopsy, a 'bite-on-bite' biopsy technique that penetrates the covering mucosa by repeated biopsies, enables access to tumours below the mucosa. We investigated the utilisation, safety and diagnostic yield of an intensified tunnel biopsy protocol. <h3>Methods</h3> The endoscopy reporting database was searched for patients with reported subepithelial lesions in the upper gastrointestinal tract from March 2013 to September 2017. The tunnel biopsy protocol was defined as bite-on-bite technique from the identical spot creating a submucosal tunnel, taking at least 10 passes of double biopsies with a standard biopsy forceps, while targeting the subepithelial lesion. Patient records were reviewed for histology reports, imaging studies, adverse events and readmissions after endoscopy. <h3>Results</h3> 152 patients (70 M, 82 F) were found to have at least one subepithelial lesion at upper endoscopy with a median lesion size of 12 mm (interquartile range 9–25 mm). Superficial conventional biopsies were taken in 79 patients and were diagnostic only for one lipoma (1.3%). Tunnel biopsies were taken in 71/152 patients (47.4%). Sites were oesophagus (9), stomach (58) and duodenum (4). Tunnel biopsies were diagnostic in 31/71 (43.6%), revealing 9 leiomyomas, 1 leiomyosarcoma, 7 lipomas, 2 pancreatic rests, 10 GISTs, 1 retention cysts and 1 fibrotic nodule. For lesions≥20 mm the diagnostic yield of tunnel biopsies further increased to 16/28 (57.0%). There was no major immediate adverse event or 30 day readmission related to delayed complications from the procedure. Only two of the 36 endoscopists involved in this study routinely performed tunnel biopsies from subepithelial lesions. Attempting tissue acquisition via tunnel biopsy was significantly more likely to achieve diagnostic histology than by superficial biopsies (p&lt;0.00001). <h3>Conclusions</h3> Tunnel biopsy is a simple, safe and reasonably efficient diagnostic modality for tissue acquisition in subepithelial lesions in the upper gastrointestinal tract. This technique is still underutilised and should be routinely attempted if a subepithelial lesion is detected at the index endoscopy.
ETS transcription factors as emerging drug targets in cancer
Authors: Michael Hsing, Yuzhuo Wang, Paul S. Rennie, Michael E. Cox, Artem Cherkasov
Journal: Medicinal Research Reviews (2019)

Abstract The ETS family of proteins consists of 28 transcription factors, many of which have been implicated in development and progression of a variety of cancers. While one family member, ERG, has been rigorously studied in the context of prostate cancer where it plays a critical role, other ETS factors keep emerging as potential hallmark oncodrivers. In recent years, numerous studies have reported initial discoveries of small molecule inhibitors of ETS proteins and opened novel avenues for ETS‐directed cancer therapies. This review summarizes the state of the art data on therapeutic targeting of ETS family members and highlights the corresponding drug discovery strategies.
Novel sphincterotomy device that orientates blade along the axis of the bile duct in patients with Roux-en-Y anastomosis
Authors: Mamoru Takenaka, Tomoe Yoshikawa, Ayana Okamoto, Atsushi Nakai, Kosuke Minaga, Kentaro Yamao, Masatoshi Kudo
Journal: Endoscopy (2019)

Endoscopic papillary large balloon dilation (EPLBD) following endoscopic sphincterotomy (EST) is an effective and safe treatment for common bile duct (CBD) stones in patients with Roux-en-Y anastomosis [1] [2]. However, performing EST using the conventional sphincterotomy approach in these patients is considered difficult because it has to be done in the opposite direction [3] [4]. The direction of the blade does not correspond with the correct incision direction (axis of the bile duct) in this situation. It is desirable, therefore, for the blade to be oriented in the appropriate incision direction in patients with Roux-en-Y anastomosis ([Fig. 1]).
Adherence to post-polypectomy surveillance guidelines: a systematic review and meta-analysis
Authors: Roupen Djinbachian, Anne-Julie Dubé, Madeleine Durand, Louopou Rosalie Camara, Benoit Panzini, Simon Bouchard, Daniel von Renteln
Journal: Endoscopy (2019)

Abstract Background Colorectal cancer (CRC) is a major worldwide cause of cancer-related mortality. Colonoscopy programs based on guideline-recommended surveillance intervals have been put in place to reduce the morbidity and mortality associated with CRC. We were interested to evaluate clinical practice adherence to guideline-recommended surveillance intervals, the potential extent of early repeat colonoscopies, and causes of nonadherence to guideline recommendations. Methods We performed a literature search for articles reporting on guideline adherence for surveillance colonoscopies. Exclusion criteria included inflammatory bowel disease and hereditary CRC syndrome cohorts. Primary outcome was correct interval assignment in patients undergoing surveillance colonoscopy. Groups were assessed for adherence according to their respective guideline recommendations (North American or European). Results 16 studies were included in the analysis. The mean colonoscopy surveillance interval adherence rate was 48.8 % (95 % confidence interval [CI] 37.3 – 60.4). For North American guidelines, surveillance interval assignments were adherent to guideline recommendations in 44.7 % (95 %CI 24.2 – 66.3) of patients after detection of low risk lesions and in 54.6 % (95 %CI 41.4 – 67.4) after detection of high risk lesions. For European guidelines, surveillance interval assignments were adherent to recommendations in 24.4 % (95 %CI 1.1 – 63.4) of patients after detection of low risk lesions and in 73.6 % (95 %CI 35.5 – 98.8) after detection of high risk lesions. Conclusions The worldwide adherence to surveillance colonoscopy guidelines was low, with more than 50 % of patients undergoing repeat colonoscopies either too early or too late. Early repeat colonoscopies occurred with the highest frequency for patients in whom only hyperplastic polyps or low risk adenomas were found.
Remodeling Collapsed DNA Replication Forks for Cancer Development
Authors: Sotirios K. Sotiriou, Thanos D. Halazonetis
Journal: Cancer Research (2019)

Abstract DNA replication stress is prevalent in human cancers, but absent in normal cells, suggesting that proteins involved in the cellular response to DNA replication stress could be potential therapeutic targets. SMARCAL1 and ZRANB3 are annealing helicases that mediate the repair of collapsed DNA replication forks. In a study in this issue of Cancer Research, Puccetti and colleagues report that mice lacking either SMARCAL1 or ZRANB3 activity have delayed development of MYC-induced B-cell lymphomas. Thus, inhibiting the response to DNA replication stress could benefit patients with cancer. See related article by Puccetti et al., p. 1612
Long‐Term Implantable, Flexible, and Transparent Neural Interface Based on Ag/Au Core–Shell Nanowires
Authors: Teppei Araki, Fumiaki Yoshida, Takafumi Uemura, Yuki Noda, Shusuke Yoshimoto, Taro Kaiju, Takafumi Suzuki, Hiroki Hamanaka, Kousuke Baba, Hideki Hayakawa, Taiki Yabumoto, Hideki Mochizuki, Shingo Kobayashi, Masaru Tanaka, Masayuki Hirata, Tsuyoshi Sekitani
Journal: Advanced Healthcare Materials (2019)

Abstract Neural interfaces enabling light transmittance rely on optogenetics to control and monitor specific neural activity, thereby facilitating deeper understanding of intractable diseases. This study reports the material strategy underlying an optogenetic neural interface comprising stretchable and transparent conductive tracks and capable of demonstrating high biocompatibility after long‐term (5‐month) implantation. Ag/Au core–shell nanowires contribute toward improving track performance in terms of stretchability (&lt;60% strain), transparency (&lt;83%), and electrical resistance (15 Ω sq −1 ). The neural interface integrated with gel‐coated exterior microelectrodes preserves low impedance (1.1–3.2 Ω cm 2 ) in a saline solution over the evaluated 5‐month period. Besides the use of efficient conductive materials, surface treatment using antithrombogenic polymer tends to prevent the growth of granulation tissue, thereby facilitating clear monitoring of electrocorticograms (ECoG) in a rodent during chronic implantation. The flexible and transparent neural interface pathologically exhibits noncytotoxicity and low inflammatory response while efficiently recording evoked ECoG in a nonhuman primate via optogenetic stimulation. The proposed highly reliable interface can be employed in multifaceted approaches for translational research based on chronic implants.
Quality and Safety in Healthcare, Part LIII
Authors: Jay A. Harolds
Journal: Clinical Nuclear Medicine (2019)

There is overlap between the symptoms of depression and burnout. Many of those with burnout are also depressed. If the depression is significant, the individual should be referred for therapy. However, many articles on therapy for those with burnout are flawed, and the best type of therapy for burnout is controversial. However, cognitive behavior therapy is usually helpful for the emotional exhaustion component of burnout. Counseling and/or coaching may be helpful for those having burnout without significant depression. There are lessons from positive psychology that may be utilized to help counsel those with burnout.
Michael's Testimonial
Authors: Stephen Strum
Journal: Annals of Internal Medicine (2019)

Letters2 April 2019Michael's TestimonialStephen Strum, MDStephen Strum, MDNevada City, California (S.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0044 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Danielson and Dubé's (1) words ring so true that I wonder with both amazement and embarrassment about how we so-called homo sapiens (that is, “sentient beings”) can be so hardened to the plight of those with catastrophic illness that we do not allow them to say, “I have had enough.” All of us die, but we should not have to give up our dignity in terms of how we do so or put our loved ones through a living death because others far removed from our situation lack compassion.I have been a physician for 50 years. ...Reference1. Danielson MM, Dubé K. Michael's testimonial. Ann Intern Med. 2018;169:349. [PMID: 30178018]. doi:10.7326/M18-1719 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Nevada City, California (S.S.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0044. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMichael's Testimonial Michael M. Danielson and Karine Dubé Michael's Testimonial David Killoran Michael's Testimonial Michael M. Danielson and Karine Dubé Michael's Testimonial Roger S. LaBonte Metrics 2 April 2019Volume 170, Issue 7Page: 510KeywordsConflicts of interestDisclosureHematology and oncologyHospitalizationsMemoryNursing homesPatientsQuality of life ePublished: 2 April 2019 Issue Published: 2 April 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Wnt/PCP Signaling Contribution to Carcinoma Collective Cell Migration and Metastasis
Authors: Kacey VanderVorst, Courtney A. Dreyer, Sara E. Konopelski, Hyun Lee, Hsin-Yi Henry Ho, Kermit L. Carraway
Journal: Cancer Research (2019)

Our understanding of the cellular mechanisms governing carcinoma invasiveness and metastasis has evolved dramatically over the last several years. The previous emphasis on the epithelial-mesenchymal transition as a driver of the migratory properties of single cells has expanded with the observation that carcinoma cells often invade and migrate collectively as adherent groups. Moreover, recent analyses suggest that circulating tumor cells within the vasculature often exist as multicellular clusters and that clusters more efficiently seed metastatic lesions than single circulating tumor cells. While these observations point to a key role for collective cell migration in carcinoma metastasis, the molecular mechanisms driving collective tumor cell migration remain to be discerned. Wnt/PCP (planar cell polarity) signaling, one of the noncanonical Wnt signaling pathways, mediates collective migratory events such as convergent extension during developmental processes. Wnt/PCP signaling components are frequently dysregulated in solid tumors, and aberrant pathway activation contributes to tumor cell migratory properties. Here we summarize key studies that address the mechanisms by which Wnt/PCP signaling mediate collective cell migration in developmental and tumor contexts. We emphasize Wnt/PCP component localization within migrating cells and discuss how component asymmetry may govern the spatiotemporal control of downstream cytoskeletal effectors to promote collective cell motility.
Abstract 16552: Insulin-Like Growth Factor Binding Protein 2 (IGFBP2) Positively Regulates Angiogenesis
Authors: Alexander-Francisco Bruns, Jessica Smith, Nadira Y Yuldasheva, Richard M Cubbon, Mark T Kearney, Stephen B Wheatcroft
Journal: Circulation (2017)

Introduction: Insulin-like growth factor binding proteins (IGFBP) confer temporal and spatial regulation of IGF activity in most tissues and organs. IGFBP2 has, however, also been reported to have ...
Short-term preoperative protein restriction attenuates vein graft disease via induction of cystathionine γ-lyase
Authors: Kaspar M Trocha, Peter Kip, Ming Tao, Michael R MacArthur, J Humberto Treviño-Villarreal, Alban Longchamp, Wendy Toussaint, Bart N Lambrecht, Margreet R de Vries, Paul H A Quax, James R Mitchell, C Keith Ozaki
Journal: Cardiovascular Research (2019)

Therapies to prevent vein graft disease, a major problem in cardiovascular and lower extremity bypass surgeries, are currently lacking. Short-term preoperative protein restriction holds promise as an effective preconditioning method against surgical stress in rodent models, but whether it can improve vein graft patency after bypass surgery is undetermined. Here, we hypothesized that short-term protein restriction would limit vein graft disease via up-regulation of cystathionine γ-lyase and increased endogenous production of the cytoprotective gaseous signalling molecule hydrogen sulfide.Low-density lipoprotein receptor knockout mice were preconditioned for 1 week on a high-fat high-cholesterol (HFHC) diet with or without protein prior to left common carotid interposition vein graft surgery with caval veins from donor mice on corresponding diets. Both groups were returned to a complete HFHC diet post-operatively, and vein grafts analysed 4 or 28 days later. A novel global transgenic cystathionine γ-lyase overexpressing mouse model was also employed to study effects of genetic overexpression on graft patency. Protein restriction decreased vein graft intimal/media+adventitia area and thickness ratios and intimal smooth muscle cell infiltration 28 days post-operatively, and neutrophil transmigration 4 days post-operatively. Protein restriction increased cystathionine γ-lyase protein expression in aortic and caval vein endothelial cells (ECs) and frequency of lung EC producing hydrogen sulfide. The cystathionine γ-lyase inhibitor propargylglycine abrogated protein restriction-mediated protection from graft failure and the increase in hydrogen sulfide-producing ECs, while cystathionine γ-lyase transgenic mice displayed increased hydrogen sulfide production capacity and were protected from vein graft disease independent of diet.One week of protein restriction attenuates vein graft disease via increased cystathionine γ-lyase expression and hydrogen sulfide production, and decreased early inflammation. Dietary or pharmacological interventions to increase cystathionine γ-lyase or hydrogen sulfide may thus serve as new and practical strategies to improve vein graft durability.