tbuckley/cabot-search huggingface dataset:
Clinical importance of the determination of tumor angiogenesis in breast carcinoma: much more than a new prognostic tool.
Authors: G Gasparini, A L Harris
Journal: Journal of Clinical Oncology (1995)

PURPOSE To review prognostic and therapeutic applications of angiogenesis research in breast carcinoma. METHODS We reviewed the (1) biologic role of angiogenesis, particularly in transformation, progression, and metastasis of breast cancer; (2) methods to detect angiogenic activity in human pathology; (3) clinical studies relating clinical outcome of patients with breast cancer to the assessment of angiogenesis; (4) predictive value of angiogenesis for response to anticancer therapies; and (5) pharmacologic characteristics of current antiangiogenic drugs. RESULTS There is mounting evidence that angiogenesis plays a relevant role in the biologic aggressiveness of breast cancer. Using either immunohistochemical or biochemical methods, several studies have shown a worse prognosis for those patients with tumors with high angiogenic activity. In some studies angiogenesis has an independent prognostic value. The most promising angiogenic inhibitors are under early-phase clinical evaluation in patients with tumors resistant to conventional therapies. Novel therapeutic strategies for breast cancer patients are presented and discussed. CONCLUSION The majority of the retrospective studies show that angiogenesis is an important new prognostic indicator in early-stage breast carcinoma. This marker should be evaluated in prospective controlled clinical trials to demonstrate whether adjuvant therapies may improve the prognosis of those patients at high risk, eg, those with highly vascularized tumors. Since invasive breast carcinoma has a well defined stromal vascular component and produces angiogenic factors, it seems reasonable to postulate that this tumor may be one of the most responsive to angiogenesis inhibitors given alone or in combination with conventional anticancer treatments.
Effect of recombinant human granulocyte-macrophage colony-stimulating factor in patients with Hodgkin's disease: a phase I/II study.
Authors: D J Hovgaard, N I Nissen
Journal: Journal of Clinical Oncology (1992)

PURPOSE As bone marrow toxicity is the major limitation of the optimal administration of chemotherapy, we investigated whether recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) could prevent myelotoxicity or accelerate hematopoietic recovery after mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) chemotherapy. PATIENTS AND METHODS Twenty-four previously untreated patients with Hodgkin's disease were included in a phase I/II study in which standard MOPP chemotherapy was followed by 5 days of GM-CSF at every other cycle. Patients were entered sequentially to receive one of four dosc levels (2, 4, 8, and 16 micrograms/kg of glycoprotein; 1.4, 2.8, 5.5, and 11.0 micrograms/kg of protein) and were randomly allocated to either 24-hour continuous intravenous (IV) infusion or twice daily subcutaneous (SC) injection of rhGM-CSF. RESULTS WBC counts (mainly neutrophils, eosinophils, and monocytes) were significantly higher in cycles with rhGM-CSF than in cycles with MOPP alone. The total number of days of leukopenia (WBC count less than or equal to 2.0 x 10(9)/L) and neutropenia (absolute neutrophil count [ANC] less than or equal to 1.0 x 10(9)/L) was reduced in cycles with rhGM-CSF from 6.3 to 0.8 days and from 5.4 to 1.0 days, respectively. All dose levels of rhGM-CSF were effective in increasing the ANC, but only at the dose levels of 8 and 16 micrograms/kg did this significantly affect the scheduling of chemotherapy. Mild and reversible adverse reactions included low-grade fever, chest/bone pain, myalgias, erythemia, headache, fatigue, and periorbital edema. CONCLUSIONS rhGM-CSF can be administered safely to patients with Hodgkin's disease and results in improved hematologic recovery after MOPP. Full-dose chemotherapy can be administered on time, resulting in an increase in the overall tolerated dose of myelosuppressive drugs when compared with historical controls. SC administration proved to be at least as effective as continuous IV infusion and should be preferred.
The role of TMPRSS6 polymorphisms in iron deficiency anemia partially responsive to oral iron treatment
Authors: Erika Poggiali, Fabio Andreozzi, Isabella Nava, Dario Consonni, Giovanna Graziadei, Maria Domenica Cappellini
Journal: American Journal of Hematology (2014)

Iron refractory iron deficiency anemia (IRIDA) is a rare hereditary disease caused by mutations in TMPRSS6 gene encoding Matriptase-2, a negative regulator of hepcidin transcription. Up to now, 53 IRIDA patients from 35 families with different ethnic origins have been reported and 41 TMPRSS6 mutations have been identified. TMPRSS6 polymorphisms are more frequent than mutations, and have been associated with variation in iron and hematologic parameters. Our study evaluated their presence in 113 subjects with iron deficiency anemia (IDA) partially responsive to oral iron therapy and in 50 healthy blood donors. Thalassemic trait was diagnosed in 38 patients. Sequencing analysis of TMPRSS6 gene revealed that the frequency of several polymorphisms was markedly different between IDA subjects and controls. In particular, the V736A TMPRSS6 polymorphism was associated to moderately lower hemoglobin, mean corpuscular volume, and mean corpuscular hemoglobin levels, and in thalassemia carriers with marked anemia and microcytosis. A new variant-H448R- and two uncommon polymorphisms -A719T and V795I- were also identified. These results indicate that TMPRSS6 polymorphisms are more frequent in subjects with persistent IDA than in healthy controls, and in thalassemia carriers V736A variant may account for lower hemoglobin and MCV levels. Further studies in larger court of patients are necessary to identify potential haplotypes and polymorphisms responsible for low response to oral iron treatment and may be useful for planning a correct iron supplementation.
Effect of Rosuvastatin on Repeat Heart Failure Hospitalizations
Authors: Jennifer K. Rogers, Pardeep S. Jhund, Ana-Cristina Perez, Michael Böhm, John G. Cleland, Lars Gullestad, John Kjekshus, Dirk J. van Veldhuisen, John Wikstrand, Hans Wedel, John J.V. McMurray, Stuart J. Pocock
Journal: JACC Heart Failure (2014)

This study sought to examine the effect of statin therapy hospitalizations for heart failure (HFH) in patients in the CORONA (Controlled Rosuvastatin Multinational Trial in Heart Failure) trial. HFH is an important, frequently recurrent event. Conventional time-to-first event analyses do not take account repeat events. We used a number of statistical approaches to examine the effect of treatment on first and repeat HFH in the CORONA trial. In the CORONA trial, 5,011 patients ≥60 years of age with chronic New York Heart Association functional classes II to IV systolic heart failure resulting from ischemia were randomized to receive rosuvastatin or placebo. Poisson, Andersen-Gill, and negative binomial methods (NB) were used to analyze the effect of rosuvastatin on HFH, and the NB and a parametric joint frailty model (JF) were used to examine this effect while accounting for the competing risk of cardiovascular (CV) death. Rosuvastatin/placebo rate ratios were calculated, both unadjusted and adjusted. A total of 1,291 patients had 1 or more HFH (750 of these had a single HFH only), and there were a total of 2,408 HFHs. The hazard ratio for the conventional time-to-first event analysis for HFH was 0.91 (95% confidence interval [CI]: 0.82 to 1.02, p = 0.105). In contrast, the NB on repeat hospitalizations gave an unadjusted RR (RR) for HFH of 0.86 (95% CI: 0.75 to 0.99, p = 0.030), adjusted 0.82 (95% CI: 0.72 to 0.92, p = 0.001), and after including CV death as the last event, adjusted RR of 0.85 (95% CI: 0.77 to 0.94, p = 0.001). The JF gave an adjusted RR of 0.82 (95% CI: 0.73 to 0.92, p = 0.001). Similar results were found in analyses of all CV hospitalizations and all-cause hospitalizations. When repeat events were included, rosuvastatin was shown to reduce the risk of HFH by approximately 15% to 20%, equating to approximately 76 fewer admissions per 1,000 patients treated over a median 33 months of follow-up. Including repeat events could increase the ability to detect treatment effects in heart failure trials.
Abstract 737: IKACh Dominantly Increases under the Condition of Atrial Electrical Remodeling: Pharmacological Consideration Using the Selective IKACh Blockers in Canine Atrial Tachypacing Model
Authors: Norio Hashimoto, Ryo Matsumoto, Norihisa Ishiwata, Toru Yamashita, Nobutomo Tsuruzoe
Journal: Circulation (2007)

Back ground and purpose: It is well-known that the increased vagal tone is a trigger of atrial fibrillation (AF). In dogs, vagal stimulation shortens atrial effective refractory period (ERP), increases ERP dispersion and promotes AF, possibly via the activation of the atrial acetylcholine-activated potassium channel. Recently, we have reported the blockers of the acetylcholine-activated potassium current (IKACh) terminated AF in canine paroxysmal AF model. However, the pathophysiological role of IKACh in the remodeled atrium seen in persistent AF patients remains unclear. The aim of this study is to evaluate the effects of the selective IKACh blockers, tertiapin and NIP-151 in the remodeled atrium induced by atrial-tachypacing (AT). Methods and results: The effects of tertiapin and NIP-151 on atrial ERP were investigated before and after 1 week of AT. Tertiapin (0.03 mg/kg, i.v.) and NIP-151 (0.3 mg/kg, i.v.) significantly prolonged the atrial ERP even before AT. The shortened atrial ERP which is associated with the electrical remodeling, was induced by AT (400 bpm) over 1 week. After AT for 1 week, the effects of tertiapin and NIP-151 significantly enhanced the prolongation of atrial ERP compared with those before AT. To evaluate whether a muscarinic M2 receptor and/or adenosine A1 receptor activates IKACh in remodeled atrium, we tested the effects of M2 receptor antagonist AF-DX116 (0.3 mg/kg, i.v.) and A1 receptor antagonist DPCPX (0.3 mg/kg, i.v.) in this model. Unlike the selective IKACh blockers, the effects of these drugs were not affected by AT for 1 week. Conclusion: Our results suggest that the constitutively activated IKACh, which is not associated with M2 receptor and/or A1 receptor, increases under the condition of atrial electrical remodeling. Therefore, the selective IKACh blockers such as tertiapin and NIP-151 might be useful for the treatment of persistent AF.
A phase II trial with Docetaxel (Taxotere™) in second line treatment with chemotherapy for advanced breast cancer
Authors: W.W. ten Bokkel Huinink, A.M. Prove, M. Piccart, W. Steward, T. Tursz, J. Wanders, H. Franklin, M. Clavel, J. Verweij, M. Alakl, M. Bayssas, S.B. Kaye
Journal: Annals of Oncology (1994)
Autologous blood stem-cell transplantation in patients with advanced Hodgkin's disease and prior radiation to the pelvic site.
Authors: M Körbling, R Holle, R Haas, W Knauf, B Dörken, A D Ho, R Kuse, H Pralle, T M Fliedner, W Hunstein
Journal: Journal of Clinical Oncology (1990)

Patients with relapsed Hodgkin's disease who respond to salvage therapy are successfully treated with cyclophosphamide, carmustine (BCNU), and etoposide (VP-16) (CBV) followed by autologus bone marrow transplantation (ABMT). Because of heavy pretreatment including radiation to the pelvic site, marrow harvest was not feasible in those patients. We therefore used blood-derived hemopoietic precursor cells as an alternative stem-cell source to rescue them after superdose chemotherapy. Hemopoietic precursor cells were mobilized into the peripheral blood either by chemotherapeutic induction of transient myelosuppression followed by an overshooting of blood stem-cell concentration, or by continuous intravenous (IV) granulocyte-macrophage colony-stimulating factor (GM-CSF) administration. The median time to reach 1,000 WBC per microliter, 500 polymorphonuclear cells (PMN) per microliter, or 20,000 platelets per microliter was 10, 20.5, and 38 days, respectively, for 50% of all patients. The platelet counts of two patients never dropped below 20,000/microL following autologous blood stem-cell transplantation (ABSCT), whereas two other patients had to be supported with platelets for 75 and 86 days posttransplant until a stable peripheral platelet count of 20,000/microL was attained. Among the 11 assessable patients, seven are in unmaintained complete remission (CR) at a median follow-up of 318 days. This is a first report on a series of ABSCTs in patients with advanced Hodgkin's disease proving that, despite prior damage to the marrow site, the circulating stem-cell pool is still a sufficient source of hemopoietic precursor cells for stem-cell rescue.
To study the severity of lung hyperinflation and bone mineral density in patients with chronic obstructive pulmonary disease (COPD)
Authors: Ekaterina Kochetova
Journal: European Respiratory Journal (2013)

Objective: To study the severity of lung hyperinflation and bone mineral density (BMD) in patients with chronic obstructive pulmonary disease (COPD). Materials and Methods: 120 patients COPD were observed. The investigated group was made by the men with long smoking experience. The average age was 60.2 ± 5.9 years. The Research of function of external breath was studied with multimodular installation of type «Master-Lab/Jaeger». Research of bone mineral density (BMD) was studied with the method x-ray absorbtiometry with the densitometer « Lunar DPX-NT».  Results: The increase of lung volumes such as functional residual capacity (FRC), residual volume (RV), total lung capacity (TLC) shows pulmonary hyperinflation. In patients with COPD of 2 nd  stage RV% was 176.6 ± 62.37, in patients with COPD of 3 rd  stage RV% was 226.19 ± 51.63, in patients with COPD of 4 th  stage RV% was 271.76 ± 60.5 (p th  stage (131.43 ± 38.9). The study showed a reliably increase in RV/TLC%, the minimum level of RV/TLC% was observed in patients with COPD of 2 nd  stage (138.51 ± 28.9), the maximum level was in patients with COPD of 4 th  stage (192.54 ± 34.41). The assessment of BMD showed that BMD of the femoral neck, BMD of trochanter and BMD of hip in patients with COPD of 2 nd  stage were significantly higher compared with those in patients with COPD of 3 rd  stage (p
Physician Counseling on Firearm Safety
Authors: Marian E. Betz, Garen J. Wintemute
Journal: JAMA (2015)

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
Analysis of atherosclerosis in patients with chronic obstructive pulmonary disease by carotid ultrasonography
Authors: Sayaka Tachibana, Shoko Sonobe, Utako Fujii, Yasuko Fuchimoto, Masaaki Shiojiri, Koji Inoue, Norihiko Nakanishi, Tomonori Moritaka, Yasufumi Yamaji, Shinya Tada, Tadashi Kamei, Nobuo Ueda
Journal: European Respiratory Journal (2011)

Rationale: Chronic obstructive pulmonary disease (COPD) is associated with an increased risk of cardiovascular events. Atherosclerosis is an independent predictor of cardiovascular disease. We tested the hypothesis that there is a close association between atherosclerosis and disease severity of COPD.

Methods: We recruited 46 subjects with COPD (45 male-1 female, 42 ex-smokers, 4 current smokers, aged (74.7±7.9)). All subjects underwent spirometry and carotid ultrasonography. The severity of COPD was determined by GOLD Staging System for COPD Severity Definition. We measured carotid intima-media thickness, and determined the maximal intima-media thickness (IMTmax) value as the indicator of atherosclerosis.

Results: Average IMTmax value in all subjects was 1.9±1.1 mm. IMTmax value was 2.2±1.2 mm in stage I (n=3), 1.7±1.0 mm in stage II (n=15), 2.0±1.1 mm in stage III (n=16), and 2.0±1.4 mm in stage IV (n=12). There were no differences of IMTmax values among the stages of COPD. IMTmax values were higher in subjects with ischemic heart disease (n=5) compared to those without ischemic heart disease (n=41) (IMTmax value: 2.7±1.6 mm vs. 1.9±1.1 mm, p<0.05). 3 subjects had lower limb arteriosclerosis obliterans (IMTmax value was 2.1±0.4 mm).

Conclusions: Atherosclerosis was not associated with disease severity of COPD. This study suggests that atherosclerosis progresses even in patients with mild COPD, especially in those who are associated with ischemic heart disease.
The NCCN Guideline for Distress Management: A Case for Making Distress the Sixth Vital Sign
Authors: Jimmie C. Holland, Barry D. Bultz
Journal: Journal of the National Comprehensive Cancer Network (2007)

Psychosocial care of patients has traditionally been seen as separate from routine medical care and has been criticized as being “soft” and lacking evidence. This traditional perspective continues in many settings, despite the fact that patients and families, when asked, state that emotional care is highly valued. The question of how to integrate psychosocial care into routine cancer care has also been an issue, partly because of the stigma associated with cancer. In 1997, the National Comprehensive Cancer Network (NCCN) established a multidisciplinary panel to examine this problem. 1 Because patient and physician attitudes toward pain can pose similar barriers to care as with distress, the panel used as a model the rating system for assessing pain that resulted in successful improvement of pain management in the United States. The rating system’s success seemed partly based on routinely using a single question to assess a patient’s pain: “How is your pain on a scale of 0 to 10?” The system uses a score of 5 or higher as the indication to reassess pain medications or refer the patient for more expert management. This system is widely used, and patient self-report of subjective symptoms is now accepted as appropriate and reliable. Pain has become the fifth vital sign, after pulse, respiration, blood pressure, and temperature, ensuring that it is evaluated as part of routine care. Drawing on this experience, the NCCN panel recommended a simple question to ask patients about psychosocial concerns. They found that distress was the best umbrella word to represent the range of emotional concerns patients with cancer experience and that it did not carry the stigma of other words sometimes used for emotional symptoms. Several studies have now validated the approach of asking, “How is your distress on a scale of 0 to 10?” and using a score of 4 or above as the trigger for further questions and possible referral to a psychosocial service. 2,3 In 2004, the Canadian Federal Government’s public health agency, Health Canada‐Canadian Strategy for Cancer Control, approved “Emotional Distress as the 6th Vital Sign.” 4 We propose that this system should also be considered in the United States to ensure that psychosocial distress is routinely assessed as part of cancer care and managed according to the NCCN distress management guidelines. This commentary outlines the potential benefits that can accrue for patients, families, and the health care system. Over 2 years beginning in 1997, the NCCN’s multidisciplinary panel de
Clinical experience of clofazimine in the treatment of MDR-TB
Authors: Jung-Wan Yoo, Jiwon Lyu, Sang Do Lee, Woo Sung Kim, Dong Soon Kim, Tae Sun Shim
Journal: European Respiratory Journal (2013)

Objective: In vitro studies have shown good activity of clofazimine against Mycobacterium tuberculosis , including multidrug-resistant strains. However,clinical experience with clofazimine in tuberculosis is scarce. We report, here,our clinical experience with 32 consecutive patients with multidrug-resistant tuberculosis (MDR-TB) treated with clofazimine-containing regimens. Methods: Record review was performed for 32 patients treated with clofazimine as part of a MDR-TB regimen. Patients were enrolled until December 2011. Data were collected on clinical and microbiological characteristics, clofazimine tolerability, and treatment outcomes. The usual dosage of clofazimine was 150mg daily. Results: Patients had isolates resistant to a median of 9 drugs(range,4-13 drugs). Clofazimine was added to MDR-TB regimens for a median duration of 7 months(range;1-22). Eleven patients discontinued clofazimine because of out of stock. At data censure(15 February 2013), one patient continued to receive clofazimine-containing regimen. Culture conversion rate was 53.1%(17/32). The treatment success and failure rates were 48.4%(15/31) and 51.6%(16/31), respectively. Of 15 treatment success cases, 10(66.7%) patients were treated with linezolid, and 3(20%) patients underwent surgical resection. Skin discoloration occurred in all patients and nine patients stopped clofazimine treatment due to adverse effects: skin discolorization(n=3), liver toxicity(n=3), and gastrointestinal disturbance(n=3). Factors for treatment success were men and concurrent use of linezolid in multivariate analysis. Conclusions: The efficacy of clofazimine in the treatment of MDR-TB was considered limited and concurrent use of linezolid may contribute to treatment success.