tbuckley/cabot-search huggingface dataset:
Management of Neuroendocrine Tumors of Unknown Origin
Authors: Ariel Polish, Maxwell T. Vergo, Mark Agulnik
Journal: Journal of the National Comprehensive Cancer Network (2011)

Neuroendocrine tumors (NETs) of unknown origin account for more than 10% of all NETs. Most of these tumors are poorly differentiated and, thus, very aggressive. Establishing the location of the primary tumor can be challenging. Workup of these NETs of unknown origin includes a thorough family history, immunohistochemistry, imaging, and OctreoScan. If the location of the primary malignancy is not determined, treatment is often initiated based on the grade and level of differentiation of the tumor, with well- and moderately differentiated tumors treated as carcinoid tumors, whereas poorly differentiated tumors are treated similarly to small cell tumors. Therapy is chosen based on symptoms and with the goal of debulking tumor when feasible and safe.
The rationale for planned reoperation after unplanned total excision of soft-tissue sarcomas.
Authors: A E Giuliano, F R Eilber
Journal: Journal of Clinical Oncology (1985)

Multimodality management of soft-tissue sarcomas of the extremity is often based on the presence or absence of residual primary disease. Reoperation is warranted or radiotherapy doses altered if the physician is aware that the tumor was incompletely excised. Most patients with soft-tissue masses undergo an initial excision before definitive therapy. These initial unplanned total excisions are usually excisional biopsies for presumably benign disease. Ninety patients were reviewed to evaluate the adequacy of unplanned total excision. All patients underwent unplanned supposed total excisions. Most patients were then treated with preoperative intraarterial Adriamycin (Adria Laboratories, Columbus, Ohio) and radiation therapy, followed by wide reexcision of the prior operative field. Forty-six patients (51.1%) had no gross residual tumor in the reoperative specimen. In two patients, there was microscopic but not macroscopic disease. Forty-four patients (48.9%) had identifiable macroscopic residual disease in the reoperative specimen. When comparing these 44 patients with visible (macroscopic) residual tumor to the remaining 46, no differences were seen in age, sex, stage, histologic type, time from excision to reoperation, or size of initial lesion. This previously unrecognized high incidence of gross residual disease must be considered when planning definitive therapy. Unplanned total excisions are inadequate to remove local disease and, despite multimodality therapy, may result in local failure. Reoperation should be a planned part of definitive management for patients with soft-tissue sarcoma of the extremity whenever the initial surgical procedure was done without a histologic diagnosis or was not planned to be a wide excision. If reoperation cannot be performed, radiotherapy doses to treat gross residual disease should be used.
Eugenic Sterilization in California
Authors: PAUL POPENOE
Journal: New England Journal of Medicine (1929)

I. A group of 838 patients in the private practice of a psychiatrist on the Pacific Coast is found to come from homes above the average of the state's population in socio-economic status, and much above the average of the patients sterilized in California state hospitals for mental disease. 2. This is selective and is not to be explained as showing that mental diseases occur more frequently in the intellectually superior part of the population. 3. The private patients are rather younger than an institutional population, and are at ages when marriage and childbirth are likely. 4. Significant differences of age and marriage rate are found between patients with various types of mental diseases. 5. Women outnumber men two to one in the classification of manic-depressive psychoses, but this is not believed to represent a genetic difference in the etiology of the disease. 6. When age is taken into account the private patients are found to have a high marriage rate. 7. The divorce rate is much higher in patients...
Tamoxifen and Chemotherapy for Axillary Node-Negative, Estrogen Receptor–Negative Breast Cancer: Findings From National Surgical Adjuvant Breast and Bowel Project B-23
Authors: Bernard Fisher, Stewart Anderson, Elizabeth Tan-Chiu, Norman Wolmark, D. Lawrence Wickerham, Edwin R. Fisher, Nikolay V. Dimitrov, James N. Atkins, Neil Abramson, Sofia Merajver, Edward H. Romond, Carl G. Kardinal, Henry R. Shibata, Richard G. Margolese, William B. Farrar
Journal: Journal of Clinical Oncology (2001)

PURPOSE: Uncertainty about the relative worth of doxorubicin/cyclophosphamide (AC) and cyclophosphamide/methotrexate/fluorouracil (CMF), as well as doubt about the propriety of giving tamoxifen (TAM) with chemotherapy to patients with estrogen receptor–negative tumors and negative axillary nodes, prompted the National Surgical Adjuvant Breast and Bowel Project to initiate the B-23 study. PATIENTS AND METHODS: Patients (n = 2,008) were randomly assigned to CMF plus placebo, CMF plus TAM, AC plus placebo, or AC plus TAM. Six cycles of CMF were given for 6 months; four cycles of AC were administered for 63 days. TAM was given daily for 5 years. Relapse-free survival (RFS), event-free survival (EFS), and survival (S) were determined by using life-table estimates. Tests for heterogeneity of outcome used log-rank statistics and Cox proportional hazards models to detect differences across all groups and according to chemotherapy and hormonal therapy status. RESULTS: No significant difference in RFS, EFS, or S was observed among the four groups through 5 years (P = .96, .8, and .8, respectively), for those aged ≤ 49 years (P = .97, .5, and .9, respectively), or for those aged ≥ 50 years (P = .7, .6, and .6, respectively). A comparison between all CMF- and all AC-treated patients demonstrated no significant differences in RFS (87% at 5 years in both groups, P = .9), EFS (83% and 82%, P = .6), or S (89% and 90%, P = .4). There were no significant differences in RFS, EFS, or S between CMF and AC in patients aged ≤ 49 or ≥ 50 years. No significant difference in any outcome was observed when chemotherapy-treated patients who received placebo were compared with those given TAM. RFS in both groups was 87% (P = .6), 87% in patients aged ≤ 49 (P = .9), and 88% and 87%, respectively (P = .4), in those aged ≥ 50 years. CONCLUSION: There was no significant difference in the outcome of patients who received AC or CMF. TAM with either regimen resulted in no significant advantage over that achieved from chemotherapy alone.
Lung function decrement with arsenic exposure to drinking groundwater along river Indus: A comparative cross-sectional study
Authors: Asad Nafees, Ambreen Qazi, Zafar Fatmi, Irfan Muhammad, Ahmed S. Haque
Journal: European Respiratory Journal (2012)

Objective  To determine the association between chronic arsenic exposure through drinking groundwater and decrement in lung function among adult individuals who do not have signs of arsenic lesions.  Methods  Comparative cross-sectional study during January to March 2009. 100 participent >15 years of age in each group i.e. exposed (>100 ug/L) and unexposed (  Results  There was a decline in mean adjusted FEV1of 154.3 ml (95 percent CI: -324.7, 16.0; p = 0.076), in mean adjusted FVC of 221.9 ml (95 percent CI: -419.5,-24.3; p = 0.028), and in FEV1/FVC ratio of 2.0 (95 percent CI: -25.3, 29.4; p = 0.884), among participants who were exposed to arsenic compared to unexposed. A separate model comprising a total of 160 participants, 60 exposed at arsenic concentration of >250 ug/L and 100 unexposed at arsenic concentration of   Conclusion  This study demonstrated that decrement in lung function is associated with chronic exposure to arsenic in drinking groundwater, occurring independently, and even before any manifestation, of arsenic skin lesions or respiratory symptoms. The study also demonstrated a dose-response effect of arsenic exposure and lung function decrement.
Abstract 3408: Coronary Calcium Predicts Events Better With Absolute Calcium Scores Than Age-gender Percentiles - The Multi-ethnic Study Of Atherosclerosis
Authors: Matthew J Budoff, Khurram Nasir, Robyn McClelland, Robert Detrano, nathan D Wong, Roger S Blumenthal, George Kondos, Hyoju Chung, Richard A Kronmal
Journal: Circulation (2007)

Background: The presence and extent of coronary artery calcium (CAC) correlates with the overall magnitude of coronary atherosclerotic plaque burden and with the development of subsequent coronary ...
Does single lung transplantation actually alleviate the donor pool
Authors: Anne Olland, Nicola Santelmo, Pierre-Emmanuel Falcoz, Christelle Cantrelle, Richard Dorent, Gilbert Massard
Journal: European Respiratory Journal (2011)

Objective: Access to lung transplantation is restricted owing to lack of donor organs. Single lung transplantation hypothetically increases the pool of lung grafts as two recipients can be treated with one donor. In this retrospective study, we evaluated how often both organs were used for single lung transplantations. If only one lung was transplanted, we analysed cause of no-use of the opposite lung.

Method: On the registry run by the “Agence de biomedicine”, we reviewed all single lung transplantations performed in France from 1998 to 2008. Causes of refusal were recorded as follows: second lung not offered by coordinators, lack of blood-group matched single lung recipient, lack of logistic support, size inadequacy regarding the recipient. We compared cause of refusal to the quality of the grafts. Definition of ideal donor included the following: age under 55 years, ventilated less than 48 hours, clean tracheal secretions, PaO2 over 300 mmHg (FiO2 100%; PEP 5cm H2O), clear chest radiograph.

Results: Lung harvest from 297 donors led to 387 single lung transplants: both lungs were used for 2 different recipients in 90 donors (180 recipients). In 207 donors, only one lung was transplanted. In 115 donors, the opposite lung was deemed unsuitable for dissymmetrical quality reasons. In the remaining 92 donors, both lungs were ideal in 34%, and acceptable in 66%. Reasons for no-use were: not offered by the coordinator in 23%, lack of blood-group matched single lung recipient in 19%, size inadequacy in 20%, team logistics in 10% of cases and miscellaneous reasons in 28%.

Conclusion: Communication on organ sharing might increase the number of available donor organs, thus reducing the death rate on waiting list.
A randomized trial comparing single-agent carboplatin with carboplatin followed by radiotherapy for advanced ovarian cancer: a North Thames Ovary Group study.
Authors: H E Lambert, G J Rustin, W M Gregory, A E Nelstrop
Journal: Journal of Clinical Oncology (1993)

PURPOSE To determine in a randomized trial of advanced ovarian carcinoma whether consolidation therapy with whole-abdominal radiotherapy (RT) after chemotherapy improves survival and disease-free survival compared with the continued chemotherapy. PATIENTS AND METHODS Two hundred fifty-four patients with advanced epithelial ovarian cancer (stages IIB to IV) were entered onto a study of five monthly courses of 400 mg/m2 of carboplatin. One hundred seventeen patients with residual disease of 2 cm or less at second-look laparotomy or laparoscopy were then randomized to receive consolidation therapy, either five further courses of carboplatin at the same dosage or whole-abdominal RT (24 Gy). There was no control arm. RESULTS Chemotherapy was well tolerated and was usually administered on an outpatient basis. Myelosuppression that was sufficient to delay chemotherapy occurred in only 3% of 1,418 courses analyzed. The main toxicity of carboplatin was nausea and vomiting, but this was easier to control than that with cisplatin. Although RT was well tolerated in the majority of the 58 patients, one patient who had been found to have multiple adhesions at second-look surgery developed fecal fistulae post-RT that resulted in the patient's death from peritonitis. Median survival for the whole group from date of surgery was 25 months. No statistical difference was found in either survival or disease-free survival between those patients who received consolidation chemotherapy and those who were treated with abdominal RT. Prognostic factors used to assess survival were stage, histology, amount of residual disease after primary surgery, and presence of tumor at second-look surgery. CONCLUSION There seems to be no significant advantage for consolidation whole-abdominal RT compared with the continuation of the same chemotherapy in the management of advanced epithelial carcinoma of the ovary, even when no macroscopic residual disease is apparent at second-look surgery.
&lt;italic&gt;Fv-2&lt;/italic&gt;: Identification and Location of a Second Gene Governing the Spleen Focus Response to Friend Leukemia Virus in Mice&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: Frank Lilly
Journal: JNCI Journal of the National Cancer Institute (1970)

The use of 2 strains of Friend virus, the F-S strain and its BALB/c-adapted variant, the F-B strain, permitted the identification of a second major gene distinguishing the DBA/2J (susceptible to both virus strains) and C57BL (resistant to both virus strains) mouse strains with respect to their spleen focus responses to the viruses. Progeny testing of (C57BL × DBA/2J) × DBA/2J backcross females showed that the new gene, Fv-2, segregates independently of the previously identified Fv-1 gene; Fv-2, with alleles Fv-2S (susceptible) and Fv-2r (resistant), is linked to dilute in linkage group II. Expression of the Fv-1 phenotype (relative spleen-focus response to F-S virus) is suppressed by homozygosity for the recessive Fv-2r allele, but the Fv-1 locus appears to exert little influence on the expression of the Fv-2 phenotype (spleen focus response to F-B virus). The possible relevance of these findings to the concept that spleen focus formation by Friend virus requires a helper virus is discussed.
Selective vs Nonselective Nonsteroidal Anti-inflammatory Drugs and Anastomotic Leakage After Colorectal Surgery
Authors: Fady Saleh, Allan Okrainec
Journal: JAMA Surgery (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 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
Patient Empowerment Programme (PEP) and Risk of Microvascular Diseases Among Patients With Type 2 Diabetes in Primary Care: A Population-Based Propensity-Matched Cohort Study
Authors: Carlos K.H. Wong, William C.W. Wong, Y.F. Wan, Anca K.C. Chan, Frank W.K. Chan, Cindy L.K. Lam
Journal: Diabetes Care (2015)

The benefit of structured diabetes education programs has been confirmed in systematic review (1) and meta-analysis (2). Although the explicit changes in glycemic control after structured education have been well established, limited evidence (3) has demonstrated the effect of structured education on diabetes-related complications. Recent studies (4,5) underwent an investigation of the effects on glycemic control and incidence of cardiovascular complication in a structured diabetes education program, Patient Empowerment Programme (PEP), versus the usual clinical practice in a Hong Kong primary care setting. Detailed description of PEP setting and mode of education delivery have been reported previously (4,5). However, whether the structured education would be associated with a lower risk of diabetic retinopathy, nephropathy, neuropathy, and composite microvascular complication events remains questionable. The aim of this population-based, propensity score–matched cohort study was to evaluate the influence of PEP implemented in primary care as compared with the alternative usual clinical practice.

This study included 13,280 patients with type 2 diabetes …
The pathology of a thorax at the men getting to the penal institutions
Authors: Kseniaya I. Aksenova
Journal: European Respiratory Journal (2011)

The goal of current research was to study a pathology of a thorax at the men getting to the penal institutions. The study has been carrying out during four years in one investigatory isolation ward in Moscow. Fluorographic examinations of all prisoners conducted on the first by three days when men have got at this place. Fluorographic films made in 29298 convicts aged 19-60 were analyzed. Abnormal fluorograms were revealed in 7.4% prisoners; the changes were tuberculosis-associated in 78% of cases. 40.4% persons of them had posttuberculous changes: calcifications in the lungs and thoracic lymph nodes, fibrosis, solid foci and 59.6% persons of them had signs of active pulmonary tuberculosis. Among a pathology of organ of the thorax which has been not bound to a tuberculosis acute pneumonia, chronic obstructive pulmonary diseases (COPD), a lung cancer prevailed. Acute pneumonias were 71%, COPD – 16.7%, lung cancer – 4.3%.
Dyspnoea, obstruction, smoking and exacerbation (DOSE) index and mortality in COPD
Authors: Josefin Sundh, Christer Janson, Karin Lisspers, Björn Ställberg, Scott Montgomery
Journal: European Respiratory Journal (2011)

Introduction:  The DOSE index was designed to assess disease severity and for clinical management of COPD, but has not been evaluated as a prognostic instrument for mortality. This study investigated associations with all cause-mortality.   Methods:  A total of 1548 patients with a diagnosis of COPD were randomly selected from 70 Swedish primary and secondary care centers. Information was collected using questionnaires and record review. The Swedish Board of Health and Welfare provided mortality data. The DOSE index was calculated using the MRC dyspnoea scale, FEV1 as percent of predicted (FEV1%pred), smoking status and exacerbation rate. Information on exacerbation rate over the last six months was used to estimate the annual rate. Some 527 patients, aged 34-75 years, were included in Cox regression analyses to estimate survival with adjustment for age, sex and heart disease.   Results:  Over five years, 110 patients (20,9%) died. Mortality was higher in patients with DOSE index ≥4, than for lower scores (42.7% vs 10.4%). This produced a hazard ratio (HR) of 4.45 (95%CI 2.99 to 6.64) after adjustment for age, sex and heart disease. When investigating the separate components in the DOSE index, the HR for a unit change in the DOSE index components was 1.81 (1.52 to 2.14) for MRC; 2.27 (1.77 to 2.92) for FEV1%pred; 0.98 (0,64 to 1.49) for smoking status and 1.72 (1.36 to 2.17) for exacerbation score; all after adjustment for age, sex and heart disease. The associations with mortality for the separate components were all statistically significant when these measures were included simultaneously in the same model.   Conclusion:  The DOSE index is associated with mortality in COPD patients.
High-dose immunosuppressive therapy for severe systemic sclerosis: initial outcomes
Authors: Peter A. McSweeney, Richard A. Nash, Keith M. Sullivan, Jan Storek, Leslie J. Crofford, Roger Dansey, Maureen D. Mayes, Kevin T. McDonagh, J. Lee Nelson, Theodore A. Gooley, Leona A. Holmberg, C. S. Chen, Mark H. Wener, Katherine Ryan, Julie Sunderhaus, Ken Russell, John Rambharose, Rainer Storb, Daniel E. Furst
Journal: Blood (2002)
Open access to economic outcome data will help to bridge the gap between clinical trials and clinical guidelines
Authors: Joseph A Ladapo, Yixin Fang, Karina W Davidson, R Scott Braithwaite
Journal: BMJ (2015)

Buoyed by a burgeoning medical culture of “appropriate use” and rising doctor awareness of the financial ruin that threatens many patients who navigate expensive treatments in pursuit of better health, medical specialist societies have grown increasingly vocal about integrating economic value in their clinical guidelines.1 These encouraging developments are, however, threatened by a worsening decline in the generalisability of randomised controlled trials, a concern supported by widening differences between the characteristics …
Safety and performance analysis of acriflavin and methylene blue for in-vivo imaging of precancerous lesions using fibred confocal fluorescence microscopy (FCFM)
Authors: Berengere Obstoy, Mathieu Salaun, Liana Veresezan, Richard Sesboüé, Pierre Bohn, Francois-Xavier Boland, Luc Thiberville
Journal: European Respiratory Journal (2013)

Introduction: FCFM allows the study of pulmonary microstructures in vivo. However, the bronchial epithelium can only be imaged using an exogenous fluorophore.

Objective: To compare methylene blue (MB) and acriflavin genotoxicity and to assess the performances of FCFM using these fluorophores for in vivo imaging of preinvasive lesions.

Methods: Genotoxicity was assessed using the comet assay on both cultured human lymphocytes and NCI-H460 cells, that had been exposed to MB or acriflavin before being illuminated at 660 or 488 nm, respectively. FCFM was performed on precancerous lesions using the hamster cheek pouch model, after topical application of the fluorophores. FCFM characteristics were analyzed according to the histology.

Results: No genotoxicity was found using 0.01% (w/v) MB after illumination at 660nm for 2 min and 15 min (5mW). By contrast, acriflavin (0.025%) led to DNA damages that increased from 2 to 15 mn of light exposure at 448 nm in both lymphocytes (83.4 to 88%, p=0.021) and NCI H460 cells (79.9 to 84.6%, p=0.045). 11 invasive carcinoma, 24 reserve cell hyperplasia, and 17 dysplasia lesions were imaged using FCFM in-vivo. Using both fluorophores, the cellular density increased from hyperplasia to high grade dysplasia (p<0.05). Using MB, the cellular diameter significantly decreased (48.9 to 13.9 µm) from hyperplasia to carcinoma (p<0.05). In this model, a cut-off diameter of 30 µm allowed the diagnosis of high-grade lesions with Se=94.7% and Sp=97%.

Conclusion: Methylene blue can be used safely to image precancerous lesions in vivo. This study does not support the use of acriflavin in humans.
Abstract 2698: Degrasyn-like symmetrical compounds: Possible therapeutic agents for multiple myeloma (MM-I)
Authors: William G. Bornmann, Zhenghong Peng, David Maxwell, Duoli Sun, Basvoju A. Bhanu, Moshe Talpaz, Nicholas Donato, Alexander Levitzki
Journal: Cancer Research (2014)

Abstract A series of degrasyn-like symmetrical compounds have been designed, synthesized, and screened against B cell malignancy (multiple myeloma, mantle cell lymphoma) cell lines. The lead compounds T5165804 and CP2005 showed higher nanomolar potency against these tumor cells in comparison to degrasyn and inhibited Usp9x activity in vitro and in intact cells. These observations suggest that this new class of compounds holds promise as cancer therapeutic agents. Citation Format: William G. Bornmann, Zhenghong Peng, David Maxwell, Duoli Sun, Basvoju A. Bhanu, Moshe Talpaz, Nicholas Donato, Alexander Levitzki. Degrasyn-like symmetrical compounds: Possible therapeutic agents for multiple myeloma (MM-I). [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 2698. doi:10.1158/1538-7445.AM2014-2698