tbuckley/cabot-search huggingface dataset:
Robotic versus laparoscopic surgery for middle and low rectal cancer (REAL): Short-term outcomes of a multicenter randomized controlled trial.
Authors: Jianmin Xu, Weitang Yuan, Taiyuan Li, Bo Tang, Baoqing Jia, Yanbing Zhou, Wei Zhang, Ren Zhao, Cheng Zhang, Longwei Cheng, Xiaoqiao Zhang, Fei Liang, Guodong He, Ye Wei, Qingyang Feng
Journal: Journal of Clinical Oncology (2022)

14 Background: Robotic surgery for rectal cancer is gaining popularity, but persuasive evidence on long-term oncological outcomes is lacking. This multicenter randomized controlled trial compared robotic and conventional laparoscopic surgery regarding surgical quality and long-term oncological outcomes among patients with middle and low rectal cancer. Methods: This superiority trial was undertaken at 11 hospitals in 8 Chinese provinces. Patients with middle (&gt; 7–12 cm from anal verge) or low (0–7 cm from anal verge) rectal adenocarcinoma, cT1–T3 N0–1 or ycT1–T3 Nx after preoperative radio-/chemoradiotherapy, and no evidence of distant metastasis were enrolled and randomly assigned in a 1:1 ratio to receive robotic or conventional laparoscopic surgery. Secondary (short-term) end points (surgical quality, pathological radicality, and postoperative recovery) were compared using modified intention-to-treat (mITT) analysis. Three-year locoregional recurrence rate as the primary endpoint is expected by the end of 2023. This trial was registered with ClinicalTrials.gov (NCT02817126). Results: Between July 2016 and December 2020, 1240 patients were enrolled; 1180 were included in the mITT analysis (591 in robotic and 589 in laparoscopic group). There were significantly more sphincter-preserving surgeries (low anterior resections) performed in the robotic group (83.1% vs. 76.9%, p = 0.008). With more macroscopic complete resections (95.4% vs. 91.9%, p = 0.012), robotic surgery had better integrity of the mesorectal fascia, and had lower circumferential resection margin positivity rate (4.0% vs. 7.1%, difference = -3.1%, 95% confidence interval = -6.0% to -0.5%, p = 0.023) and more lymph nodes harvested (median, 15.0 vs. 14.0, p = 0.004). Robotic surgery also reduced the open conversion rate (1.7% vs. 3.9%, p = 0.021), estimated blood loss (median, 40.0 ml vs. 50.0 ml, p &lt; 0.001), intraoperative complication rate (5.4% vs. 8.7%, p = 0.029), and 30-day postoperative complication rate (Clavien-Dindo grade II or higher, 16.1% vs. 22.9%, p = 0.003), leading to better postoperative recovery and shorter postoperative hospital stay (median, 7.0 days vs. 8.0 days, p &lt; 0.001). The 30-day postoperative mortality was similar between the two groups (0.2% vs. 0.2%, p &gt; 0.999). Conclusions: Robotic surgery for middle and low rectal cancer significantly reduced surgical injury, improved oncological radicality, and promoted postoperative recovery compared with conventional laparoscopic surgery. Clinical trial information: NCT02817126.
Recurrent Supraventricular Tachycardia
Authors: Edward G. Abinader
Journal: JAMA (1976)

After repeatedly establishing the efficacy of competitive premature atrial and ventricular stimuli in terminating supraventricular tachycardia (SVT) in a patient with recurrent and refractory SVT, a permanent right ventricular endocardial demand generator set at 81 beats per minute was implanted. During the subsequent months, many tachycardic episodes, ranging between 160 to 185 beats per minute, were promptly terminated by activating the pacemaker unit with an external magnet and competitively pacing the right ventricle. However, 16 months after implantation, magnetically induced ventricular capture failed to control the SVT. Magnetically induced competitive pacing in SVT should be reserved for the most intractable and refractory cases. (<i>JAMA</i>236:2203-2205, 1976)
Efficacy of front-line immunochemotherapy for follicular lymphoma: a network meta-analysis of randomized controlled trials
Authors: Yucai Wang, Shouhao Zhou, Xinyue Qi, Fang Yang, Matthew J. Maurer, Thomas M. Habermann, Thomas E. Witzig, Michael L. Wang, Grzegorz S. Nowakowski
Journal: Blood Cancer Journal (2022)

Abstract Front-line treatment for follicular lymphoma has evolved with the introduction of maintenance therapy, bendamustine (Benda), obinutuzumab (G), and lenalidomide (Len). We conducted a random-effects Bayesian network meta-analysis (NMA) of phase 3 randomized controlled trials (RCTs) to identify the regimens with superior efficacy. Progression-free survival (PFS) was compared between 11 modern regimens with different immunochemotherapy and maintenance strategies. G-Benda-G resulted in with the best PFS, with an HR of 0.41 compared to R-Benda, a surface under the cumulative ranking curve (SUCRA) of 0.97, a probability of being the best treatment (PbBT) of 72%, and a posterior ranking distribution (PoRa) of 1 (95% BCI 1–3). This was followed by R-Benda-R4 (HR = 0.49, PbBT = 25%, PoRa = 2) and R-Benda-R (HR = 0.60, PbBT = 3%, PoRa = 3). R-CHOP-R (HR = 0.96) and R-Len-R (HR = 0.97) had similar efficacy to R-Benda. Bendamustine was a better chemotherapy backbone than CHOP either with maintenance (R-Benda-R vs R-CHOP-R, HR = 0.62; G-Benda-G vs G-CHOP-G, HR = 0.55) or without maintenance therapy (R-Benda vs R-CHOP, HR = 0.68). Rituximab maintenance improved PFS following R-CHOP (R-CHOP-R vs R-CHOP, HR = 0.65) or R-Benda (R-Benda-R vs R-Benda, HR = 0.60; R-Benda-R4 vs R-Benda, HR = 0.49). In the absence of multi-arm RCTs that include all common regimens, this NMA provides an important and useful guide to inform treatment decisions.
Characteristics of Disease-Specific and Generic Diagnostic Pitfalls
Authors: Gordon D. Schiff, Mayya Volodarskaya, Elise Ruan, Andrea Lim, Adam Wright, Hardeep Singh, Harry Reyes Nieva
Journal: JAMA Network Open (2022)

<h3>Importance</h3> Progress in understanding and preventing diagnostic errors has been modest. New approaches are needed to help clinicians anticipate and prevent such errors. Delineating recurring diagnostic pitfalls holds potential for conceptual and practical ways for improvement. <h3>Objectives</h3> To develop the construct and collect examples of "diagnostic pitfalls," defined as clinical situations and scenarios vulnerable to errors that may lead to missed, delayed, or wrong diagnoses. <h3>Design, Setting, and Participants</h3> This qualitative study used data from January 1, 2004, to December 31, 2016, from retrospective analysis of diagnosis-related patient safety incident reports, closed malpractice claims, and ambulatory morbidity and mortality conferences, as well as specialty focus groups. Data analyses were conducted between January 1, 2017, and December 31, 2019. <h3>Main Outcomes and Measures</h3> From each data source, potential diagnostic error cases were identified, and the following information was extracted: erroneous and correct diagnoses, presenting signs and symptoms, and areas of breakdowns in the diagnostic process (using Diagnosis Error Evaluation and Research and Reliable Diagnosis Challenges taxonomies). From this compilation, examples were collected of disease-specific pitfalls; this list was used to conduct a qualitative analysis of emerging themes to derive a generic taxonomy of diagnostic pitfalls. <h3>Results</h3> A total of 836 relevant cases were identified among 4325 patient safety incident reports, 403 closed malpractice claims, 24 ambulatory morbidity and mortality conferences, and 355 focus groups responses. From these, 661 disease-specific diagnostic pitfalls were identified. A qualitative review of these disease-specific pitfalls identified 21 generic diagnostic pitfalls categories, which included mistaking one disease for another disease (eg, aortic dissection is misdiagnosed as acute myocardial infarction), failure to appreciate test result limitations, and atypical disease presentations. <h3>Conclusions and Relevance</h3> Recurring types of pitfalls were identified and collected from diagnostic error cases. Clinicians could benefit from knowledge of both disease-specific and generic cross-cutting pitfalls. Study findings can potentially inform educational and quality improvement efforts to anticipate and prevent future errors.
Antiphospholipid Antibodies Increase Endometrial Stromal Cell Decidualization, Senescence, and Inflammation via Toll‐like Receptor 4, Reactive Oxygen Species, and p38 <scp>MAPK</scp> Signaling
Authors: Mancy Tong, Teimur Kayani, Deidre M. Jones, Jane E. Salmon, Shannon Whirledge, Lawrence W. Chamley, Vikki M. Abrahams
Journal: Arthritis & Rheumatology (2022)

Miscarriage affects 1 in 7 pregnancies, and antiphospholipid autoantibodies (aPLs) are one of the biggest risk factors for recurrent pregnancy loss. While aPLs target the endometrial stroma, little is known about their impact. Endometrial stromal cells (EnSCs) undergo decidualization each menstrual cycle, priming the uterus to receive implanting embryos. Thus, appropriate decidualization and EnSC function is key for establishment of a successful pregnancy. This study was undertaken to explore the effects of aPL on EnSC decidualization, senescence, and inflammation.EnSCs under decidualizing conditions were exposed to aPL or control IgG alone or in the presence of either a Toll-like receptor 4 (TLR-4) antagonist, a p38 MAPK inhibitor, a reactive oxygen species (ROS) inhibitor, low molecular weight heparin (LMWH), or acetyl salicylic acid. Secretion of decidualization markers and inflammatory interleukin-8 were quantified by enzyme-linked immunosorbent assay, and senescence-associated β-galactosidase activity was evaluated. In a mouse model of decidualization, aPL or control IgG was administered, and uterine expression levels of decidualization and inflammatory markers were quantified by real-time quantitative polymerase chain reaction.Antiphospholipid antibodies increased human EnSC decidualization, senescence, and inflammation. This phenotype was recapitulated in the mouse model. The decidualization and inflammatory responses were partially mediated by TLR-4 and p38 MAPK, while the decidualization and senescence responses were ROS-dependent. LMWH, commonly used to treat aPL-positive women at risk of obstetric complications, reduced the ability of aPL to increase EnSC decidualization and inflammation.These findings shed new light on the pathogenesis of pregnancy complications in women with aPLs and underscore the benefit of heparin in preventing pregnancy loss in this high-risk population.
UK cancer care threatened by government incompetence
Authors: None The Lancet Oncology
Journal: The Lancet Oncology (2020)

On Oct 6, 2020, in response to questions in Parliament regarding cancer outcomes during COVID-19, the UK Health Secretary, Matt Hancock, stated the "best way to keep cancer services running is to suppress [coronavirus]". We beg to differ. The notion that cancer care provision should be contingent on the success of policies to contain COVID-19 is as offensive as it is irresponsible. Cancer care cannot be put on hold; cancer care during the pandemic should not be beyond the capacity of the UK's ostensibly world-class health system; and patients with suspected or prevalent cancer must not be denied timely access to care.
Most chilblains observed during the COVID‐19 outbreak are not linked to COVID‐19 infection
Journal: British Journal of Dermatology (2020)

COVID‐19 is an infectious disease due to a coronavirus called SARS‐CoV‐2. First cases were first reported in Wuhan, China then infection has subsequently spread to the rest of the world. Beside the main signs of the infection (fever, cough, and difficulty breathing), diverse types of skin manifestation (signs) were reported. The most frequently reported type is characterized by red / purple toes, similar to chilblains – a skin disorder usually linked to exposure to cold temperatures. These ‘acral lesions’ that have been linked to COVID‐19 are mainly observed in adolescents and young adults and are clinically described as ‘pseudochilblains’.
Predictors of microembolization during carotid stenting Nadim Al-Mubarak, Gary S. Roubin, Sriram S. Iyer, Jiri J. Vitek, Gishel New, George Dangas, Roxana Mehran, Martin B. Leon. The Lenox Hill Heart and Vascular Institute and the Cardiovascular Research Foundation, New York, NY
Journal: Journal of the American College of Cardiology (2001)
Association Between Laparoscopically Confirmed Endometriosis and Risk of Early Natural Menopause
Authors: Madhavi Thombre Kulkarni, Amy Shafrir, Leslie V. Farland, Kathryn L. Terry, Brian W. Whitcomb, A. Heather Eliassen, Elizabeth R. Bertone-Johnson, Stacey A. Missmer
Journal: JAMA Network Open (2022)

Early natural menopause (ENM) has been associated with reduced reproductive span, cardiovascular disease risk, and early mortality. The potential adverse implications of endometrioma surgery for ovarian reserve are known, yet the association of endometriosis with menopausal timing remains understudied.
Population Immunity Against COVID-19 in the United States
Authors: Seyed M. Moghadas, Pratha Sah, Affan Shoukat, Lauren Ancel Meyers, Alison P. Galvani
Journal: Annals of Internal Medicine (2021)

As of 28 July 2021, 60% of adults in the United States had been fully vaccinated against COVID-19, and more than 34 million cases had been reported. Given the uncertainty regarding undocumented infections, the population level of immunity against COVID-19 in the United States remains undetermined.To estimate the population immunity, defined as the proportion of the population that is protected against SARS-CoV-2 infection due to prior infection or vaccination.Statistical and simulation modeling to estimate overall and age-specific population immunity.United States.Simulated age-stratified population representing U.S. demographic characteristics.The true number of SARS-CoV-2 infections in the United States was inferred from data on reported deaths using age-specific infection-fatality rates (IFRs). Taking into account the estimates for vaccine effectiveness and protection against reinfection, the overall population immunity was determined as the sum of protection levels in vaccinated persons and those who were previously infected but not vaccinated.Using age-specific IFR estimates from the Centers for Disease Control and Prevention, it was estimated that as of 15 July 2021, 114.9 (95% credible interval [CrI], 103.2 to 127.4) million persons had been infected with SARS-CoV-2 in the United States. The mean overall population immunity was 62.0% (CrI, 58.4% to 66.4%). Adults aged 65 years or older were estimated to have the highest immunity level (77.2% [CrI, 76.2% to 78.6%]), and children younger than 12 years had the lowest immunity level (17.9% [CrI, 14.4% to 21.9%]).Publicly reported deaths may underrepresent actual deaths.As of 15 July 2021, the U.S. population immunity against COVID-19 may still have been insufficient to contain the outbreaks and safely revert to prepandemic social behavior.National Science Foundation, National Institutes of Health, Notsew Orm Sands Foundation, Canadian Institutes of Health Research, and Natural Sciences and Engineering Research Council of Canada.
Error in Quiz Answer Option
Authors: Mihaela Stefan, Penelope Pekow, Peter Lindenauer
Journal: JAMA Internal Medicine (2021)

Investigation titled "Association of Antibiotic Treatment With Outcomes in Patients Hospitalized for an Asthma Exacerbation Treated With Systemic Corticosteroids," 2 published online in the March 2019 issue of JAMA Internal Medicine, a quiz answer option has been updated.In Question 4, option C has been changed to "Lower risk of treatment failure."The quiz has been updated online.
Oral Contraceptive Use and the Risk of Ovarian Cancer
Journal: JAMA (1983)

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
How long should we use antiplatelet agents in emergent stenting of acute myocardial infarction? Shinya Yokoyama, Kyoichi Mizuno, Kentaroh Okamatsu, Kouji Seimiya, Masamichi Takano, Takayoshi Ohba, Masato Tomimura, Ryuta Uemura, Takeshi Ino. Department of Medicine, Chiba Hokusoh Hospital, Nippon Medical School, Imba, Chiba, Japan
Journal: Journal of the American College of Cardiology (2001)
Patient and Caregiver Experiences With and Perceptions of Risk Evaluation and Mitigation Strategy Programs With Elements to Assure Safe Use
Authors: Ameet Sarpatwari, Beatrice L. Brown, Sarah A. McGraw, Sara Z. Dejene, Abdurrahman Abdurrob, Adrian J. Santiago Ortiz, Aaron S. Kesselheim
Journal: JAMA Network Open (2022)

<h3>Importance</h3> The US Food and Drug Administration (FDA) Amendments Act of 2007 authorized the FDA to impose safety requirements on drugs with important risks, such as prescriber certification or routine laboratory testing, to ensure that the benefits of use outweighed the risks. However, little is known about patient and caregiver experiences with these Risk Evaluation and Mitigation Strategy (REMS) programs with Elements to Assure Safe Use (ETASU). <h3>Objective</h3> To understand patient and caregiver experiences with and perceptions of REMS programs with ETASU. <h3>Design, Setting, and Participants</h3> This qualitative study included semistructured qualitative phone interviews conducted between 2016 and 2017, with initial analysis performed in 2017 and reanalysis performed in 2021. Adult patients prescribed natalizumab or sodium oxybate, adult patients or caregivers of adult patients prescribed vigabatrin, and adult female patients of reproductive age prescribed riociguat were included. <h3>Main Outcomes and Measures</h3> Assessment of knowledge, decision-making, medication access, and perceptions of medical privacy. <h3>Results</h3> Among 63 participants, 46 (73%) were female. Twenty-five participants (40%) had taken natalizumab, 10 (16%) riociguat, 15 (24%) sodium oxybate, and 10 (16%) vigabatrin. One participant had taken both natalizumab and vigabatrin; 4 (6%) were caregivers of patients using vigabatrin. Most participants expressed knowledge of REMS program requirements, but many lacked the insight that these requirements were part of an FDA-mandated special safety program and expressed difficulty understanding program education materials. REMS requirements made some participants more likely to initiate treatment. However, many reported burdens accessing medication, including the need to travel to certified prescribers or pharmacies. Manufacturer access to personal health information was also controversial, although some participants expressed an altruistic desire to assist others. <h3>Conclusions and Relevance</h3> This qualitative study found that REMS programs with ETASU reassured patients and their caregivers about drug safety and helped support medication initiation. However, steps are needed to improve the quality of REMS educational materials, promote efficient medication access, and protect patient privacy.
The Cover
Authors: Krystyna Wasserman
Journal: JAMA (1985)

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
Incidence and Survival Impact of Self-Reported Symptom and Psychological Distress Among Patients with Multiple Myeloma
Authors: Joshua R Richter, Noa Biran, Dhakshila Paramanathan, Srikesh Arunajadai, Victoria DeVincenzo, Ruth Pe Benito, Brooke Gruman, Sukhi Kaur, John Hervey, Eric Schultz, Scott Paddock, Andrew L. Pecora, David H. Vesole, David Siegel, Stuart L. Goldberg
Journal: Blood (2017)