tbuckley/cabot-search huggingface dataset:
A prospective randomized parallel-controlled pilot trial of stereotactic body radiation therapy versus radiofrequency ablation for the management of small renal masses.
Authors: Jen Hoogenes, Anand Swaminath, Oleg Mironov, Camilla Tajzler, Raees Cassim, Braden Millan, Edward Matsumoto, Anil Kapoor
Journal: Journal of Clinical Oncology (2022)

363 Background: The potential of ablative technologies as an alternative to surgery for the treatment of small renal masses (SRMs) ≤4cm is unclear. Our objective was to evaluate the feasibility and toxicity of stereotactic body radiation therapy (SBRT) and radiofrequency ablation (RFA) for SRMs in a prospective randomized pilot trial. Methods: Patients scheduled for renal cell carcinoma (RCC) treatment at a single academic center were approached for the pilot trial, with the aim of recruiting 24 patients. Participants were assigned 1:1 to SBRT or RFA. Imaging (CT or MRI) using a renal tumor protocol is completed at 3, 6, 9, and 12 months post-procedure. Biopsies were completed prior to the procedure and at 12 months. Multiple clinical parameters were collected. Follow-up visits will occur at 6 month intervals following the trial up to 5 years. SBRT included an initial simulation session and a single image-guided treatment session with a prescribed dose of 25 Gy. RFA was conducted by either percutaneous or laparoscopic access with 2 cycles of 8 minutes duration each upon reaching target temperature. Results: Beginning in December 2019, 24 patients were recruited and randomized (SBRT = 11; RFA = 13). Eleven had SBRT, 8 RFA, 3 have not yet had treatment, and 2 became ineligible. Median age for all patients was 67 (53,85) and 17 were male. A total of 17 patients had clear cell RCC, 6 had papillary RCC (type 1), and 1 had chromophobe RCC. All patients had T1a disease. Mean procedure length (minutes) for SBRT and RFA was 15.5±7.4 and 10.5±3.9, respectively. Two patients (both SBRT) had a 12-month biopsy showing no evidence of recurrence or metastases, while two patients (1 RFA, 1 SBRT) had a 9-month CT showing no recurrence. Data are pending for the remaining patients. An early grade 2 flare-up occurred in one SBRT patient. Conclusions: Recruitment and randomization of patients with SRMs in a SBRT vs. RFA prospective trial is feasible on a timeline that allows for regular follow-up and imaging. To date, both treatment modalities have been shown to have excellent short-term safety profiles.
Abstract 341: Urine Output and Blood Urea Nitrogen Predict Mortality After Out-of-Hospital Cardiac Arrest
Authors: Jacob C Jentzer, Bradley Ternus, Gregory W Barsness, Kianoush B Kashani
Journal: Circulation (2018)

Introduction: Renal dysfunction, as defined by elevated serum creatinine, is associated with decreased survival among patients resuscitated after out-of-hospital cardiac arrest (OHCA). Less is known about other measures of renal function and outcomes after OHCA. Hypothesis: BUN and urine output will predict mortality after OHCA. Methods: Retrospective single-center cohort study of 276 adult OHCA patients treated with targeted temperature management after OHCA between December 2005 and September 2016. Fluid balance and urine output were recorded for the first 6, 12 and 24 hours. Initial laboratory values were determined from electronic records. Hospital survivors and non-survivors were compared using the Wilcoxon test, and multivariate analysis was performed to determine predictors of hospital death. Results: Mean age was 63±12 years, and 204 (73%) were male; shockable rhythm occurred in 241 (87%). Inpatient death occurred in 111 (40%). Hospital survivors had lower initial BUN (13 vs. 20 mg/dL) and creatinine (1.1 vs. 1.5 mg/dL); all p &lt;.001. Hospital survivors had higher (p &lt;.001) urine output during the first 6 hours (1,091 vs. 559 ml), 12 hours (1,583 vs. 843 ml), and 24 hours (2,215 vs. 1,294 ml). Higher initial BUN (OR 1.12, 95% CI 1.07-1.18) and creatinine (OR 3.036, 95% CI 1.65-5.59) predicted hospital mortality; all p &lt;.001. Urine output during the first 24 hours was associated with hospital mortality (OR 0.57 per each 1 L, 95% CI 0.45-0.72, p &lt;.001; AUROC 0.73, optimal cut-off 1 L). Patients with 24-hour urine output &lt;1 L were at increased risk of hospital death (66.3% vs. 26.0%, unadjusted OR 5.61, 95% CI 3.27-9.63, p &lt;.001). Initial BUN (adjusted OR 1.09, 95% CI 1.01-1.16, p=.02) and urine output during the first 24 hours (adjusted OR 0.71 per each 1 L; 95% CI 0.52-0.97, p=.03) remained predictive of hospital mortality after adjustment for patient characteristics and illness severity. Conclusions: Lower 24-hour urine output and higher initial BUN were associated with higher hospital mortality among patients resuscitated from OHCA, even after adjustment for illness severity. Serum creatinine was not a significant predictor of mortality. This emphasizes the importance of low urine output as a prognostic marker and therapeutic target after OHCA.
A Manual of Otology
Journal: JAMA (1901)

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
Assessment of SARS-CoV-2 Seropositivity During the First and Second Viral Waves in 2020 and 2021 Among Canadian Adults
Authors: Xuyang Tang, Abha Sharma, Maria Pasic, Patrick Brown, Karen Colwill, Hellen Gelband, H. Chaim Birnboim, Nico Nagelkerke, Isaac I. Bogoch, Aiyush Bansal, Leslie Newcombe, Justin Slater, Peter S. Rodriguez, Guowen Huang, Sze Hang Fu, Catherine Meh, Daphne C. Wu, Rupert Kaul, Marc-André Langlois, Ed Morawski, Andy Hollander, Demetre Eliopoulos, Benjamin Aloi, Teresa Lam, Kento T. Abe, Bhavisha Rathod, Mahya Fazel-Zarandi, Jenny Wang, Mariam Iskilova, Adrian Pasculescu, Lauren Caldwell, Miriam Barrios-Rodiles, Zahraa Mohammed-Ali, Nandita Vas, Divya Raman Santhanam, Eo Rin Cho, Kathleen Qu, Shreya Jha, Vedika Jha, Wilson Suraweera, Varsha Malhotra, Kathy Mastali, Richard Wen, Samir Sinha, Angus Reid, Anne-Claude Gingras, Pranesh Chakraborty, Arthur S. Slutsky, Prabhat Jha
Journal: JAMA Network Open (2022)

The incidence of infection during SARS-CoV-2 viral waves, the factors associated with infection, and the durability of antibody responses to infection among Canadian adults remain undocumented.
Association Between Neighborhood-Level Social Determinants of Health and Access to Pediatric Appendicitis Care
Authors: Megan E. Bouchard, Kristin Kan, Yao Tian, Mia Casale, Tracie Smith, Christopher De Boer, Samuel Linton, Fizan Abdullah, Hassan M. K. Ghomrawi
Journal: JAMA Network Open (2022)

<h3>Importance</h3> Presenting with complicated appendicitis, which is associated with higher rates of complications and readmissions compared with simple appendicitis, may indicate delayed access to care. Although both patient-level and neighborhood-level social determinants of health are associated with access to care, little is known about the association between neighborhood factors and access to acute pediatric surgical care. <h3>Objective</h3> To examine the association between neighborhood factors and the odds of presenting with complicated appendicitis and unplanned postdischarge health care use. <h3>Design, Setting, and Participants</h3> A retrospective cohort study of patients aged 18 years or younger diagnosed with appendicitis was conducted. Discharge data from October 1, 2015, to September 30, 2018, were obtained from the Pediatric Health Information System Database and linked to the Child Opportunity Index (COI) 2.0 Database. Data analysis was conducted from January 1 through July 1, 2021. <h3>Exposures</h3> The COI, a composite score of zip code neighborhood opportunity level information, divided into quintiles ranging from very low to very high opportunity. <h3>Main Outcomes and Measures</h3> Based on COI level, the main outcome was the odds of presenting with complicated appendicitis, which was defined using the Agency for Healthcare Research and Quality–specified<i>International Statistical Classification of Diseases, 10th Edition</i>,<i>Clinical Modification</i>codes. The secondary outcome was the odds of unplanned postdischarge health care use (emergency department visits and/or readmissions) for patients with simple and with complicated appendicitis. <h3>Results</h3> A total of 67 489 patients (mean [SD] age, 10.5 [3.9] years) had appendicitis, with 31 223 cases (46.3%) being complicated. A total of 1699 patients (2.5%) were Asian, 24 234 (35.9%) were Hispanic, 4447 (6.6%) were non-Hispanic Black, and 29 234 (43.3%) were non-Hispanic White; 40 549 patients (60.1%) were male; and 32 343 (47.9%) were publicly insured. Patients living in very low–COI neighborhoods had 28% higher odds of presenting with complicated appendicitis (odds ratio, 1.28; 95% CI, 1.20-1.35) compared with those in very high–COI neighborhoods. There was no significant association between COI level and unplanned postdischarge health care use (very high COI, 20.8%; very low COI, 19.1%). <h3>Conclusions and Relevance</h3> In this cohort study, children from lower-COI neighborhoods had increased odds of presenting with complicated appendicitis compared with those from higher-COI neighborhoods, even after controlling for patient-level social determinants of health factors. These findings may inform policies and programs that seek to improve access to pediatric surgical care.
Accuracy of germ cell tumor histological subtype and stage within the Canadian cancer registry.
Authors: Patrick Holland, Tim Karmas, Jennifer Merrimen, Lori Wood
Journal: Journal of Clinical Oncology (2022)

411 Background: Cancer registries are the mainstay for Canadian population-based cancer statistics and research. Data is collected in provincial and territorial registries including the Nova Scotia Cancer Registry (NSCR). The goal of this study was to determine the accuracy of the NSCR data regarding the diagnosis, primary site, histological subtype, and stage of germ cell tumors (GCT) when compared to the individual pathology reports and staging investigations from the chart. Methods: This analysis included all NSCR patients diagnosed with GCT from 2006-2015. From the NSCR, the date and method of diagnosis, primary site, histology, and stage were recorded. This data was also extracted from each patient’s chart record. Any discrepancies between the two sources were reviewed and reasons behind the discrepancies were recorded. Results: 239 unique patients were identified in the NSCR during the specified time period. Ten were excluded as no chart records were available to confirm accuracy. 229 patients make up the study cohort. Using NSCR data 57.6% had seminoma, 34.5% nonseminoma (NSGCT), and 7.9% other. Discrepancies in pathology were noted in 29 patients (12.7%) for a number of reasons including no appropriate coding option in the NSCR, multiple tumors, biopsy only specimens with misinterpretation of tumor marker elevation, and true coding error. Using NSCR staging data (available in 185 cases) 71.9% had stage I, 12.4% stage II, 11.9% stage III, and 3.8% other. Discrepancies in stage were noted in 33 patients (17.9%) with NSCR data downstaging 10 patients (5.4%) and upstaging 19 patients (10.3%) predominantly due to miscoding patients as stage IS. The site of the primary GCT was discrepant in 12 patients (5.2%) due primarily to difficulty coding post chemotherapy orchiectomy specimens and burnt out primary testicular lesions. The date of diagnosis was accurate within 1 week for all patients except one which differed by several months. Conclusions: Canadian cancer registry data is population based and used for many purposes including policy decisions and research. The NSCR higher level data such as date of diagnosis and overall pathological diagnosis appears relatively accurate. However, there are inaccuracies in more detailed information like histological subtype and stage. This study raises awareness of these gaps. It also highlights key areas for improvement in educating registry personnel who interpret and enter data about the uniqueness of GCT pathology, staging and interpretation of tumor markers.
Haemophilus epiglottitis.
Authors: L. Crome, M. Erdohazi, D. Lawson
Journal: BMJ (1968)

jects studied by Troncale et al. did in fact have a subnormal value for xylese absorption, as did individual subjects in both of the two references cited by Troncale et al., in which mean values were normal.' ' Other studies among comparable asymptomatic populations have revealed malabsorption of xylose in 68°% of those previously studied in Thailand by Sprinz et al.,' in 40% in East Pakistan,' in 68%O in West Pakistan,4 in 20% in South India,' in 57%' and in 37%?O in two separate studies in Puerto Rico, and in 100% in rural Haiti.8Thus, far from refuting previously reported findings from Thailand and elsewhere, Troncale et al. have presented cor-
Mental health implications in urologic cancer hospitalizations.
Authors: Sanjay Das, Sai Srikar Kilaru, Beth Bailey
Journal: Journal of Clinical Oncology (2022)

74 Background: Increased mortality from urologic cancers coupled with an aging population has resulted in patient care becoming more specialized to improve patient outcomes. Though family history, lifestyle behaviors, and genetics are all used to determine risk and treatment, there is a knowledge gap of whether mental illness (MI) should also be considered. Therefore, this study seeks to determine whether hospitalizations of urologic cancers plus MIs are associated with increased all-cause mortality, length of hospital stay (LOS), costs of hospitalization and nosocomial infection rates. Methods: Inpatient data from 2016-2017 was obtained from the National Inpatient Sample database. This included all hospitalizations with at least one diagnosis of urologic cancer including prostate, bladder, kidney, renal pelvis, ureteral, urethral, testicular, and penile cancers. MIs of interest were depression, anxiety, substance abuse, and schizophrenia and related disorders. Data analysis and regression models were performed using SPSS Statistics. Reported odds ratios and significance values were controlled for Age, Sex, Income, Race, Insurance, Location, Mortality Risk, and Illness Severity. Results: There were 146,706 hospitalizations involving urologic cancers between 2016-2017. For these hospitalizations, depression and anxiety were associated with a decreased likelihood of death, and all MIs were associated with increased LOS. For hospitalizations involving prostate cancer, Depression and Substance Abuse were associated with decreased likelihood of death (all-causes). Hospitalizations involving kidney cancer had increased total charges and increased LOS. Hospitalizations involving bladder cancer were associated with decreased likelihood of death, and increased LOS for all MIs except, notably, those with substance abuse. Penile Cancer hospitalizations coded for anxiety showed increased LOS, and testicular cancer hospitalizations coded for substance abuse had increased likelihood of death. Conclusions: MIs can affect hospitalization outcomes of patients with urologic cancer differently based on the type of urologic cancer. Interestingly, our analysis showed that Depression was associated a decreased likelihood of death in hospitalizations coded for Prostate Cancer and Bladder Cancer. Though unexpected, we hypothesize that this finding may be partially due to implicit bias from healthcare providers that lead to enhanced care (e.g. increased patient monitoring, better support from auxiliary units such as Social Work). However, there is an absence of research in substantiating this claim. Further research is warranted to better assess the effect of Depression on the mortality of Urologic Cancer patients, and on how to best incorporate mental health status in the overall management of these patients.
Baricitinib for relapsing giant cell arteritis: a prospective open-label 52-week pilot study
Authors: Matthew J Koster, Cynthia S Crowson, Rachel E Giblon, Jane M Jaquith, Ali Duarte-García, Eric L Matteson, Cornelia M Weyand, Kenneth J Warrington
Journal: Annals of the Rheumatic Diseases (2022)

Preclinical vascular inflammation models have demonstrated effective suppression of arterial wall lesional T cells through inhibition of Janus kinase 3 and JAK1. However, JAK inhibition in patients with giant cell arteritis (GCA) has not been prospectively investigated.
Abstract 124: Levels of Catecholamines in the Plasma of Patients With Cardiopulmonary Arrest
Authors: Kiyohiro Oshima, Shuichi Hagiwara, Masato Murata, Makoto Aoki, Jun Nakajima, Yusuke Sawada, Yuta Isshiki, Yumi Ichikawa
Journal: Circulation (2018)

Purpose: The efficacy of epinephrine (Ep) administration to patients with cardiopulmonary arrest (CPA) remains controversial, and correlation between plasma levels of catecholamines and prognosis in CPA patients is unclear. The purpose of this study is to evaluate the importance of the plasma levels of catecholamines at the time of admission to the hospital prior to the administration of Ep in CPA patients. Methods: This was a prospective, observational clinical study, approved by the ethics committee of Gunma University Hospital. Patients with CPA transferred to our hospital were enrolled prospectively between July 2014 and July 2017. The levels of catecholamines (Ep, norepinephrine [NEp], and dopamine [DOA]) and vasopressin (antidiuretic hormone [ADH]) in the plasma were measured using blood samples obtained at the time of admission to our hospital (prior to the administration of Ep). Patients were divided into two groups: the return of spontaneous circulation (ROSC)(+) group and the ROSC(-) group. The levels of these agents in the plasma and the conditions of resuscitation were compared between these two groups. Results: Blood samples were obtained from 170 patients. In 48 patients, the cause of CPA was cardiogenic and Ep was not administered prior to admission to the hospital. The ROSC(+) and ROSC(-) groups included 14 and 34 patients, respectively. The frequency of prehospital defibrillation was significantly higher in the ROSC(+) group, whereas prehospital resuscitation time was significantly shorter in the ROSC(+) group. Moreover, the levels of Ep and NEp in the plasma were significantly lower in the ROSC(+) group. Conclusions: Increased levels of Ep in the plasma may not be associated with the acquisition of ROSC in patients with cardiogenic CPA.
MOTOR NOTES FOR MEDICAL MEN
Authors: H. M. Buist
Journal: BMJ (1917)

TrTrjrmin 123 shows up the harmfulness of the indiscrinlinate charity so clear io the hearts of almost all of us, and indicates tlhc limits of the policy of lais8ez faire in social economics.His point of view is well worth tho sttu(ly of all charitablc workers and social reformers.T7he Uniforin System of Accounts,C cldsigned for the use of hospitals and other institutions by Sir HIENPRY BURDETT, K.C;B.,-now in its fourth edition, is a work invaluable to those responsible for thlle balanco sheets and general flnancial aPrangements of these places ; its nine chapters and three appendixes give full explanations of the system, its origin and.its many applications.The lbook shiould be conlsulted by all who have to koep the accounts or write the annual reports of charitable and other inistitutions of every description.Dr. WV. IT.B. STODDART has written a slhort and excel.lent account of Mcnital Nursigj,7 intended to give a pro- sp ctive imental n ¶srse soele idea of the W-ork ho or slhe contemplates.It is a practical guide to the nursinig and management of inisane pprsons, alnd contains no alnatomical or physiological details.The book may be recormneiwde to those for whom it has been writteni, and, in(eed, xvill be found of great service by alll who are brought into con- tact with insane or mlentally deficienit persons.; 6 Tueo Usiiforin System of AcCovuts foH losritals'ariPublic
Daily Load Leveling in Surgical Critical Care—The Tip of the Utilization Iceberg
Authors: Erika L. Rangel, Ali Salim
Journal: JAMA Surgery (2022)

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 Journals 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