tbuckley/cabot-search huggingface dataset:
Internal Mammary and Medial Supraclavicular Irradiation in Breast Cancer
Authors: Philip M. Poortmans, Sandra Collette, Carine Kirkove, Erik Van Limbergen, Volker Budach, Henk Struikmans, Laurence Collette, Alain Fourquet, Philippe Maingon, Mariacarla Valli, Karin De Winter, Simone Marnitz, Isabelle Barillot, Luciano Scandolaro, Ernest Vonk, Carla Rodenhuis, Hugo Marsiglia, Nicola Weidner, Geertjan van Tienhoven, Christoph Glanzmann, Abraham Kuten, Rodrigo Arriagada, Harry Bartelink, Walter Van den Bogaert
Journal: New England Journal of Medicine (2015)

The effect of internal mammary and medial supraclavicular lymph-node irradiation (regional nodal irradiation) added to whole-breast or thoracic-wall irradiation after surgery on survival among women with early-stage breast cancer is unknown.We randomly assigned women who had a centrally or medially located primary tumor, irrespective of axillary involvement, or an externally located tumor with axillary involvement to undergo either whole-breast or thoracic-wall irradiation in addition to regional nodal irradiation (nodal-irradiation group) or whole-breast or thoracic-wall irradiation alone (control group). The primary end point was overall survival. Secondary end points were the rates of disease-free survival, survival free from distant disease, and death from breast cancer.Between 1996 and 2004, a total of 4004 patients underwent randomization. The majority of patients (76.1%) underwent breast-conserving surgery. After mastectomy, 73.4% of the patients in both groups underwent chest-wall irradiation. Nearly all patients with node-positive disease (99.0%) and 66.3% of patients with node-negative disease received adjuvant systemic treatment. At a median follow-up of 10.9 years, 811 patients had died. At 10 years, overall survival was 82.3% in the nodal-irradiation group and 80.7% in the control group (hazard ratio for death with nodal irradiation, 0.87; 95% confidence interval [CI], 0.76 to 1.00; P=0.06). The rate of disease-free survival was 72.1% in the nodal-irradiation group and 69.1% in the control group (hazard ratio for disease progression or death, 0.89; 95% CI, 0.80 to 1.00; P=0.04), the rate of distant disease-free survival was 78.0% versus 75.0% (hazard ratio, 0.86; 95% CI, 0.76 to 0.98; P=0.02), and breast-cancer mortality was 12.5% versus 14.4% (hazard ratio, 0.82; 95% CI, 0.70 to 0.97; P=0.02). Acute side effects of regional nodal irradiation were modest.In patients with early-stage breast cancer, irradiation of the regional nodes had a marginal effect on overall survival. Disease-free survival and distant disease-free survival were improved, and breast-cancer mortality was reduced. (Funded by Fonds Cancer; ClinicalTrials.gov number, NCT00002851.).
Management of chronic hepatitis B infection
Authors: V. Sundaram, K. Kowdley
Journal: BMJ (2015)

Hepatitis B virus (HBV) is a global health problem that can lead to cirrhosis and hepatocellular carcinoma (HCC). Although HBV vaccination has reduced the prevalence Of HBV infection, the burden of disease remains high. Treatment with antiviral drugs reduces the risk of liver disease and the development of HCC, and it can even reverse liver fibrosis. However, challenges remain regarding optimal timing, as well as the modality and duration of treatment. Currently approved drugs include pegylated interferon and nucleos(t)ide analogs. Nucleos(t)ide analogs are better tolerated and provide excellent viral suppression with a low risk of antiviral resistance, but pegylated interferon offers the benefit of a finite duration of treatment. Monitoring of hepatitis B surface antigen (HBsAg) levels may help to predict the likelihood of response to treatment, particularly for pegylated interferon. Prolonged treatment is usually needed with oral antiviral agents, and relapse is common if treatment is discontinued. New treatments that result in sustained clearance of HBV DNA and the clearance of HBsAg are needed.
Original article: The economic costs of severe anaphylaxis in France: an inquiry carried out by the Allergy Vigilance Network
Authors: J. Flabbee, N. Petit, N. Jay, L. Guénard, F. Codreanu, R. Mazeyrat, G. Kanny, D. A. Moneret‐Vautrin
Journal: Allergy (2008)

Background: The prevalence of severe anaphylaxis, between 1 and 3 per 10 000, has increased sharply over recent years, with a rate of lethality of 1%. The economic burden is unknown. Objective: The aim of this study was to estimate the economic costs of anaphylaxis, including direct costs of treatment, hospitalization, preventive and long‐care measures, and the indirect cost: absenteeism. Methods: Analysis of 402 patients of anaphylaxis declared by 384 allergists was reported to the Allergy Vigilance Network. The global cost was estimated from the national data of hospital admissions: ICD‐10 coding available for 2003, 2004 and 2005. Results: Three work/classroom days were lost per patient. Diagnosis required oral challenge with hospitalization in 18% of cases. The estimated mean total cost was 1895€ for food‐ and drug‐related anaphylaxis (5610€ for the most severe), and 4053€ for Hymenoptera anaphylaxis. National statistics recorded 2575 patients in 2005; 22% more than in 2003. The estimated annual cost was 4 789 500 €. The possible reasons for this being an under‐estimate include: data coming only from hospitalized patients, poor identification by medical teams unfamiliar with ICD‐10 codes, peri‐operative anaphylaxis being insufficiently declared, rush‐immunotherapy and maintenance treatments for Hymenoptera anaphylaxis. Similarly, the extra cost of cow milk substitutes, as well as insurance costs where deaths are followed by litigation were not taken into account. Conclusions: The mean cost of anaphylaxis was 1895–5610€ in nonfatal patients. The prevalence was under‐estimated because of many biases, leading to under‐estimation of the national cost. Further studies would be necessary to evaluate the value of preventive strategies.
Defining airflow limitation and chronic obstructive pulmonary disease: the role of outcome studies
Authors: Bruce Culver
Journal: European Respiratory Journal (2015)

A guideline to the interpretation of pulmonary function tests, published 20 years ago, made a distinction between the related tasks of " (1) the classification of the derived values with respect to a reference population… and (2) the integration of the spirometric values into the diagnosis, therapy and prognosis for an individual patient. " [1]. The first of these is very straightforward, when appropriate reference data are available, but the latter is difficult in the early stages of disease and will have a degree of uncertainty for any individual. Confusion arises when the distinction between these two aspects of interpretation is blurred. Outcome studies in high risk as well as general populations are needed to improve the recognition of early COPD <http://ow.ly/MkxvJ>
Comprehensive self management and routine monitoring in chronic obstructive pulmonary disease patients in general practice: Randomised controlled trial
Authors: Erik Bischoff, Reinier Akkermans, Jean Bourbeau, Jan Vercoulen, Chris van Weel, Tjard Schermer
Journal: European Respiratory Journal (2013)

Objective: To assess the effects of comprehensive self management and routine monitoring on quality of life, frequency and patients’ management of exacerbations, and self efficacy in COPD patients in general practice.  Design: 24 month, multicentre, investigator blinded, three arm, pragmatic, randomised controlled trial in the Netherlands.  Interventions: A comprehensive self management programme, consisting of tailored sessions with ongoing support by a practice nurse; routine monitoring, consisting of structured practice nurse consultations; or usual care alone.  Outcome measures: Primary outcome was the change at 24 months in CRQ total score. Secondary outcomes were CRQ domain scores, frequency and patients’ management of exacerbations (TEXAS), and self efficacy (CSES).  Results: 165 patients were randomized equally. At 24 months, adjusted treatment differences in mean CRQ total score were not significant. Secondary outcomes did not differ, except for exacerbation management. Compared with usual care, more exacerbations in the self management group were managed with bronchodilators (OR 2.81, 95% CI 1.16 to 6.82) and with prednisolone, antibiotics, or both (3.98, 1.10 to 15.58).  Conclusions: Comprehensive self management or routine monitoring did not show long term benefits in terms of quality of life or self efficacy over usual care alone in COPD patients in general practice. Patients in the self management group seemed to be more capable of appropriately managing exacerbations than did those in the usual care group.  Trial registration: Clinical trials NCT00128765.  Published as: BMJ 2012;345:e7642.
The novel modified polypyrimidine antitumor agent FdUMP[10] induces topoisomerase I-DNA complexes in DNA fragmentation-dependent and -independent manners.
Authors: Zhi-Yong Liao, Olivier Sordet, Hongliang Zhang, Glenda Kohlhagen, Smitha Antony, William H. Gmeiner, Yves Pommier
Journal: Cancer Research (2004)

Proc Amer Assoc Cancer Res, Volume 45, 2004

2024 

FdUMP[10] is a 10mer of FdUMP, the thymidylate synthase (TS) inhibitory metabolite of 5-fluorouracil (5-FU). We studied the mechanism by which FdUMP[10] inhibits cell growth and induces apoptosis. COMPARE analysis of the data from the NCI 60 cell line screen revealed unexpected mechanistic similarities for FdUMP[10] with camptothecins (CPTs), suggesting that FdUMP[10] possesses a mechanism of action possibly related to topoisomerase I (top1) inhibition. In this study, we found that FdUMP[10] is much more potent than 5-FU (160-fold and 600-fold, respectively) toward P388 (mouse leukemia) and HCT116 (human colon adenocarcinoma) cells. P388/CPT45 cells that are highly-resistant to CPT as a consequence of top1-deficiency are highly cross-resistant to FdUMP[10], but not to 5FU. Intense DNA fragmentation following exposure to FdUMP[10] was observed by alkaline elution in P388 and HCT116 cells. Interestingly, FdUMP[10] induced the trapping of top1-DNA complexes both in P388 and HCT116 cells when these complexes were detected with the Immuno Complex of Enzyme (ICE) bioassay. These top1-DNA complexes could only be partially reduced by co-treatment with the broad-spectrum caspase inhibitor Z-VAD.FMK in FdUMP[10] treated HCT116 cells, while Z-VAD.FMK almost had no effect on top1-DNA complexes formation in P388 cells treated with FdUMP[10]. In such case, we propose that the top1-DNA complexes result from trapping of top1 at misincorporation sites (uracil and fluorouracil incorporation) resulting from potent TS inhibition by FdUMP[10]. In conclusion, FdUMP[10] is a markedly more potent antitumor agent than 5-FU. Trapping of top1- DNA complexes in cells by FdUMP[10] could be one of the mechanisms of action. FdUMP[10] mainly targets the DNA pathway, and is mechanistically distinct from 5-FU which targets both RNA and DNA pathways. FdUMP[N] compounds may be more efficacious than 5-FU or alternative FPs in cancer chemotherapy.
Abstract 6101: Cost Effectiveness of Cardiac Computed Tomography Compared to Myocardial Perfusion Imaging (MPI) as an Effective Gatekeeper to Cardiac Catheterization in the Evaluation of Asymptomatic Firefighters with an Abnormal Treadmill Test
Authors: Matthew Budoff, Robert Karwasky, Naser Ahmadi MD Ahmadi, Cyrus A Nasserian, William W Chang, Ferdinand R Flores, John Rizzo, Candace Gunnarsson, Charles R McKay
Journal: Circulation (2008)

To identify CAD among patients who fail treadmill tests, the traditional clinical care pathway is MPI, then invasive coronary angiography (ICA). In a retrospective cohort study, we compared the direct costs for detecting CAD using the traditional clinical care pathway and an alternative that incorporates MDCT, with coronary calcium score (CCS) followed by computed tomographic angiography (CTA) and ICA. Over a 2-year period, 3,950 Los Angeles, CA Firefighters underwent wellness/fitness exams at 6 contracted medical facilities. A total of 495 cases had abnormal treadmill tests and were referred for follow-up cardiology evaluation. All cases received CCS, followed by CTA for calcium scores &gt;10, and ICA for abnormal CTA (&gt;50% obstruction in at least one vessel). MPI results were estimated based on the prior year’s experience, with abnormal MPI receiving ICA. Costs to detect CAD were calculated for both the MPI and MDCT pathways based on results for the cohort and current Medicare reimbursement costs. Sensitivity analyses were performed by varying each of the clinical and cost components of the model to “low” and “high” levels and computing net costs. Most model inputs were varied by ±50% of baseline values to gauge the robustness of the results. Among 495 cases with abnormal treadmill tests, 146 (29.5%) would have required ICA due to abnormal MPI tests; 131 (26.9%) had abnormal CCS (&gt;10) and went to CTA; 40 (8.1%) had abnormal CTA (&gt;50% stenosis) and went to ICA. ICA showed 38 (7.7%) cases of CAD. The computed cost to detect CAD was $1,376 per case for the traditional route with MPI as gatekeeper and $503 per case for CCS as gatekeeper. All sensitivity analyses showed lower costs for the MDCT compared to MPI pathways. The net cost to ICA-confirmed diagnosis of CAD is substantially lower with MDCT compared to MPI as gatekeeper to ICA.
India's medical council reintroduces ID system to tackle "ghost faculty" problem in medical colleges
Authors: C. Travasso
Journal: BMJ (2015)

The Medical Council of India has announced that it will reinstate the Radio Frequency Identification (RFID) system to identify, track, and monitor teaching faculties to tackle the “ghost faculty” problem in medical colleges and institutions.1 The system was first established in 2009 but later discontinued.

K Ramesh Reddy, a member of the council, told The BMJ that the …
Relationship between plasma amino acid levels and lung function decline in patients with COPD
Authors: Masaru Suzuki, Hironi Makita, Satoshi Konno, Katsura Nagai, Masaharu Nishimura
Journal: European Respiratory Journal (2013)

Introduction:  We have shown that the rate of annual change in FEV 1  is highly variable among patients with COPD (Nishimura, M. et al. Am J Respir Crit Care Med 2012; 185:44-52). However, few data exist on blood biomarkers predicting lung function decline in patients with COPD, while altered plasma amino acid profiles have been reported in those patients.  Aim:  To explore the relationship between plasma amino acid levels and an annual change in FEV 1  in patients with COPD in a 5-year prospective observational cohort study.  Methods:  A total of 220 subjects (GOLD 1, 27%; GOLD 2, 44%; GOLD 3, 25%; GOLD 4, 5%) who participated in the Hokkaido COPD cohort study and had at least three spirometric measurements were included for this analysis. Amino acids were profiled in baseline plasma samples by the HPLC method. The annual changes in post-bronchodilator FEV 1  were determined by a linear mixed-effects model.  Results:  Spearman’s rank correlation analysis showed that decreases in five plasma amino acid levels (taurine, proline, alanine, valine, and tyrosine), branched-chain amino acids level, and total amino acids level were significantly correlated with an annual decline in FEV 1  (p 1  independent of body mass index.  Conclusion:  We found that a deceased level of plasma proline, independent of body weight loss, was significantly associated with a rapid annual decline in FEV 1  in patients with COPD. The altered plasma amino acid profile may be important to predict natural history of COPD.
Relevance of echocardiographic composite index to improve the detection of pulmonary hypertension
Authors: Bouchra Lamia, Luis-Carlos Molano, Catherine Viacroze, Cherifa Gounane, Antoine Cuvelier, Jean-François Muir
Journal: European Respiratory Journal (2014)

Introduction and Objective : 

The transthoracic echocardiography (TTE) is indicated for the detection of pulmonary hypertension (PH). The diagnosis is unlikely or probable according to a threshold value of tricuspid regurgitation peak velocity, the estimation of the systolic pulmonary arterial pressure (SPAP) with or without TTE indices of right ventricular (RV) dysfunction. However, few data exist on the threshold values of these RV indices. Our goal is to describe echocardiographic criteria for better detection of HP.

Design : 

Ninety four patients were prospectively studied. Within one hour prior to right heart catheterization, patients underwent a 2D echocardio-Doppler and speckle tracking strain analysis.

We measured: TAPSE, right ventricular end-diastolic area (RVEDA),left ventricular end diastolic area (LVEDA), longitudinal RV global strain. The ratio RVEDA/LVEDA was calculated. ROC curves analysis defined sensitivity (Se), specificity (Sp), positive and negative predictive values (PPV, NPP) for all variables.

Results: 

Invasive mean PAP was 37 ± 12 mmHg and pulmonary artery occlusion pressure was 11 ± 3 mmHg. A cut-off value of TR peak velocity higher than 2,8 m/sec could predict PH with a Sp of 77% and a PPV of 96%A cut-off value of RV global strain lower than 12% could predict PH with a Sp of 91% and a PPV of 97% A TAPSE lower than 19 mm could predict PH with a Sp of 92% and a PPV of 98%, a RVEDA higher than 17 cm2 could predict PH with a Sp of 77% and a PPV of 95%

Conclusion: 

Screening for pulmonary hypertesnion by ETT is relevant using a combination of several indices: TR peak velocity > 2.8 m / sec and RV global strain   17 cm 2 and TAPSE <19 mm.
Graduate Medical Education
Authors: Frederick Lippman
Journal: JAMA (1993)

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
Abstract 768: CB-PIC sensitizes chemoresistant cancer cells to drugs via suppression of MDR1 and its upstream signal molecules, AKT and p38-MAPK
Authors: Duckgue Lee, Miyong Yun
Journal: Cancer Research (2014)

Abstract ATP-binding cassette (ABC) transporters including MDR1-/P-gp have been majorly targeted for drug resistant tumor therapies. In this study, we screened the compound that negatively affects MDR-1 expression in chomoresistant cancer cell lines. We found that CB-PIC, the novel synthetic compound, could decrease P-glycoprotein expression via disrupt AKT/p-38 signal pathway in paclitaxel resistant lung cancer cell, H460/PR and doxorubicin resistant breast cancer cell, MCF7/Adr with highly expressed P-glycoprotein. However, CB-PIC did not regulate enzyme activity of P-glycoprotein, while EGCG and tannic acid accumulated Rhodamine 123 intracellular region of cell via short time efflux assay. CB-PIC treatment resulted in disruption of proliferation of drug resistant cells. In addition, CB-PIC dramatically induced apoptosis in time and dose dependent manner in both paclitaxel and doxorubicin resistant cancer cells. Furthermore, CB-PIC sensitizes drug-resistant cancer cells to paclitaxel and doxorubicin by decrease of survival proteins, survivin, Mcl-1 and Bcl-2, as well as MDR1 suppression leading to accumulate the treated drug intracellular region. Taken together, CB-PIC suppresses the P-glycoprotein expression through inhibition of AKT/p-38 MAPK signaling resulting in the increase of drug sensitivity in chemoresistant cancer cells. Citation Format: Duckgue Lee, Miyong Yun. CB-PIC sensitizes chemoresistant cancer cells to drugs via suppression of MDR1 and its upstream signal molecules, AKT and p38-MAPK. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 768. doi:10.1158/1538-7445.AM2014-768
Effects Of GMI 1070, a Pan-Selectin Inhibitor, On Pain Intensity and Opioid Utilization In Sickle Cell Disease
Authors: Laura M. De Castro, Ted Wun, Sophie Lanzkron, Wally R. Smith, Kathryn L. Hassell, Abdullah Kutlar, Kim Smith-Whitley, Seungshin Rhee, Marilyn J. Telen, Helen Thackray
Journal: Blood (2013)
Abstract 19874: CCN2/CTGF as a Novel Stimulator of Proliferation and Survival of Cardiac Progenitor Cells/ Stem Cells.
Authors: Vladimir N Martinov, M. Shakil Ahmed, Einar O Vik-Mo, David Kunke, Magnar Bjoras, Havard Attramadal
Journal: Circulation (2010)

Background: Stem cell therapy is a novel tentative treatment option for myocardial infarction. Current challenges are more effective means of proliferation and survival of cardiac stem cells, as we...
Association of Chromosome Arm 9p Abnormalities With Adverse Risk in Childhood Acute Lymphoblastic Leukemia: A Report From the Children’s Cancer Group
Authors: Nyla A. Heerema, Harland N. Sather, Martha G. Sensel, Wen Liu-Mares, Beverly J. Lange, Bruce C. Bostrom, James B. Nachman, Peter G. Steinherz, Raymond Hutchinson, Paul S. Gaynon, Diane C. Arthur, Fatih M. Uckun
Journal: Blood (1999)
Lung Cancer and Cryptogenic Fibrosing Alveolitis
Authors: RICHARD HUBBARD, ANDREA VENN, SARAH LEWIS, JOHN BRITTON
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Cryptogenic fibrosing alveolitis has been reported to be associated with an increased risk of lung cancer. However, it has recently become apparent that cigarette smoking may be a risk factor for cryptogenic fibrosing alveolitis as well as for lung cancer, and so may confound the association between these conditions. We have therefore estimated the independent increase in lung cancer incidence in patients with cryptogenic fibrosing alveolitis compared with the general population in a population-based cohort study involving 890 subjects with cryptogenic fibrosing alveolitis and 5,884 control subjects drawn from the United Kingdom General Practice Research Database. The incidence of lung cancer was markedly increased among patients with cryptogenic fibrosing alveolitis (rate ratio [RR] 7.31, 95% confidence interval [95% CI] 4.47 to 11.93, p < 0.001), and adjustment for previous smoking history had little effect on this odds ratio (adjusted RR: 8.25, 95% CI 4.70 to 11.48, p < 0.001). This increase in lung cancer incidence remained when the analysis was restricted to current smokers (RR 7.36, 95% CI 1.54 to 35.19, p = 0.012). This study provides clear evidence that the incidence of lung cancer is increased in patients with cryptogenic fibrosing alveolitis, and that this effect is independent of the effect of cigarette smoking. Hubbard R, Venn A, Lewis S, Britton J. Lung cancer and cryptogenic fibrosing alveolitis: a population-based cohort study.