tbuckley/cabot-search huggingface dataset:
Mortality and volume of cases in paediatric cardiac surgery
Authors: S. Bolsin
Journal: BMJ (2002)

Editor—Spiegelhalter's paper represents further statistical evidence confirming the poor quality of paediatric open heart surgery at Bristol Royal Infirmary during 1991-5.1 It finally lays to rest the argument that the low number of operations was the only contributory factor to the high death rates.2 Spiegelhalter confirms that low numbers contributed to between 12% and 17% of the excess mortality observed at Bristol Royal Infirmary. When his findings are coupled with an article confirming that Bristol was an outlier in terms of its performance as a paediatric cardiac surgical centre at this time, the justification for attempting to obtain a review of the service seems incontrovertible.3

The conclusions of the Hunter/de Leval inquiry are difficult to understand in this context unless there was some interference in the processes of the inquiry by the management of Bristol Royal Infirmary, as there was in the publication of favourable articles in the BMJ.2 The findings and judgment of the General Medical Council's inquiry are entirely vindicated by these more recent publications.

This paper is one of the final pieces of the jigsaw that was the Bristol Royal Infirmary cardiac surgery service, and it fits neatly with what is already known. There is one further piece of the puzzle, which is also the final defence of one of the surgeons (JDW). This is that the substandard paediatric cardiac surgery represented only a small fraction of his workload. This claim should now be examined, especially in the light of the findings of the investigation by Professors Nick Black, Tom Treasure, and Ken Taylor; they concluded that the risk adjusted mortality for low risk adult coronary artery surgery of one of the disgraced surgeons (code 1231) was five times that of his colleagues.4

The lesson for the future must be that all services must prospectively collect standardised outcome data for comparison with other centres and to enable performance monitoring at trainee and specialist levels, as has been introduced in Geelong.5 These goals are readily and rapidly achievable if the will to improve exists.
Abstract 17931: Cystatin C, Hemoglobin A1c and Insulin Resistance and its Effect on Mortality Among Non-diabetic Nationally Representative Population
Authors: Sandip K Zalawadiya, Vikas Veeranna, Chirag Bavishi, Sidakpal Panaich, Luis Afonso
Journal: Circulation (2012)

Introduction: No prior study has evaluated the association between Cystatin C (CysC), a renal marker of atherosclerosis, with homeostasis model assessment-estimated insulin resistance (HOMA-IR) and...
Predictive value of gain of 3q for cervical dysplasia and potential utility in the clinical management of LSIL
Authors: M. W. Kilpatrick, G. R. Jalali, J. Scamporino, A. Menzin, T. Tafas, R. Walat, P. Tsipouras
Journal: Journal of Clinical Oncology (2009)

5583 Background: Physicians need better tools for determining whether an LSIL will progress to HSIL or regress. Research demonstrates that the chromosome 3q26 region is found to be amplified in patients with cervical cancer and that the frequency of this 3q gain increases with dysplasia severity. The objective of this study was to demonstrate that 3q can be used as a risk stratification tool to identify patients likely to regress/progress. Methods: Slide-based, archival thin-layer specimens and longitudinal follow-up data for 52 patients (47 usable cases) originally diagnosed as LSIL were obtained from independent cytopathology laboratories. Slides were destained, then hybridized with a single-copy probe for the chromosome 3q26 region and a probe for the centromeric alpha-repeat sequence of chromosome 7, using standard FISH methods. Results: Of the 47 cases analyzed, 30 showed a negative FISH test result for a sensitivity of 92% (95% CI of 64, 100), specificity of 85% (95% CI of 69, 95) and a negative predictive value of 97% (95% CI of 83, 100). In a subset of cases a biopsy was obtained. Of the 32 cases with tissue diagnosis, 11 women had progressed to CIN2+, of which 10 were FISH positive; and 18 of 21 women with tissue diagnosis of ≤CIN1 were FISH negative, for a sensitivity of 91% (95% CI of 59, 100), specificity of 86% (95% CI of 64, 97) and a negative predictive value of 95% (95% CI of 74, 100). If the analysis is confined to the 36 cases for which follow-up of at least 12 months after the index LSIL was available, 26 showed a negative FISH test result for a sensitivity of 100% (95% CI of 48, 100), specificity of 84% (95% CI of 66, 95) and a negative predictive value of 100% (95% CI of 87, 100). Of the 22 cases with tissue diagnosis, 4 women had progressed to CIN2+, all FISH positive; and 16 of 18 women with ≤CIN1 were FISH negative, for a sensitivity of 100% (95% CI of 40, 100), specificity of 89% (95% CI of 65, 99) and a negative predictive value of 100% (95% CI of 79, 100). Conclusions: Analysis of 47 specimens demonstrated the ability of 3q gain to predict disease progression/regression in cytology samples. 3q gain can serve as a risk stratification tool for LSIL cases. [Table: see text]
Neuroblastoma: Case-Control Analysis of Birth Characteristics
Authors: C C Johnson, M R Spitz
Journal: JNCI Journal of the National Cancer Institute (1985)

The peak incidence of neuroblastoma during early in-fancy indicates that prenatal factors may play a role in the pathogenesis of this disease. A population-based case-control study was conducted comparing birth certificate data of 157 children who later died from neuroblastoma in Texas with 314 controls randomly selected from all Texas live births. Analysis of birth certificate data revealed a protective relative risk estimate for preterm births (<37-wk gestation), with an overall odds ratio of 0.29 (95% confidence limits of 0.10–0.86). This effect was independent of birth weight and ethnic group. A statistically significant odds ratio of 3.22 was detected for term babies whose birth weight was low. The findings suggest that the fetus is susceptible to an in utero oncogenic initiator or promoter during the last 4 weeks of gestation.
Hepatocyte mitochondrial DNA drives nonalcoholic steatohepatitis by activation of TLR9
Authors: Irma Garcia-Martinez, Nicola Santoro, Yonglin Chen, Rafaz Hoque, Xinshou Ouyang, Sonia Caprio, Mark J. Shlomchik, Robert Lee Coffman, Albert Candia, Wajahat Zafar Mehal
Journal: Journal of Clinical Investigation (2016)

Nonalcoholic steatohepatitis (NASH) is the most common liver disease in industrialized countries. NASH is a progressive disease that can lead to cirrhosis, cancer, and death, and there are currently no approved therapies. The development of NASH in animal models requires intact TLR9, but how the TLR9 pathway is activated in NASH is not clear. Our objectives in this study were to identify NASH-associated ligands for TLR9, establish the cellular requirement for TLR9, and evaluate the role of obesity-induced changes in TLR9 pathway activation. We demonstrated that plasma from mice and patients with NASH contains high levels of mitochondrial DNA (mtDNA) and intact mitochondria and has the ability to activate TLR9. Most of the plasma mtDNA was contained in microparticles (MPs) of hepatocyte origin, and removal of these MPs from plasma resulted in a substantial decrease in TLR9 activation capacity. In mice, NASH development in response to a high-fat diet required TLR9 on lysozyme-expressing cells, and a clinically applicable TLR9 antagonist blocked the development of NASH when given prophylactically and therapeutically. These data demonstrate that activation of the TLR9 pathway provides a link between the key metabolic and inflammatory phenotypes in NASH.
Evaluation of coagulation parameters in oncology patients, after cessation of chemotherapy
Authors: F. Barak, E. Perepechay, G. Lugassy
Journal: Journal of Clinical Oncology (2005)

8244 Background: Cancer patients compared to non cancer patients are prone to increased risk of recurrent thrombosis and anti coagulant associated bleeding. Thrombosis is an additional factor compromising the patients Q.O.L. The contributing factors are surgery, chemo & hormone therapy, immobility, intrinsic tumor compression, various blood components integrity of vessel wall etc. Methods: For a period of a year a number of coagulation tests was examined on a chemotherapy (CT) - receiving oncology group pts: Protein C (PC); Protein S (PS); APCR; AT III; Factor VIII (F VIII); Factor XII (F XII) Fibrinogen (Fib.) & INR. The tests were performed: first (T1) - on arrival of pts to the oncology dept, an average of 1 month after completion of surgery & repeated approximately 6–7 m. later, after cessation of CT (T2). We intended to study correlation between various factors: diagnosis, gender, underlined chronic diseases, smoking, chemotherapy and coagulation. The changes in coagulation tests were divided into 4 groups (gr.): gr.I ≥25% - 50%; II ≥51% - 75%; III≥76% - 100%; IV≥101%. The test deviation was measured in comparison to basic values on the T1(before CT started). Results: 60 pts took part in this study. 25 pts were disqualified for analysis for various reasons. The remaining 35 pts: 18 male &17 female, eligible for statistical analysis, were divided in six groups: I-Breast Ca; II - H & N; III - Lung; IV - G. I.; V - Gyn.; VI - Others. The majority being between the age of 60 - 69 with the youngest under 40 and the oldest up to the age of 85. Eight pts had Adriamycin; 25 pts - 5 FU, Platinol or Gemzar, 2 pts had Navelbine, containing regiments. In none of this pts thromboembolic events or any INR abnormalities, had been diagnosed during the study period. The results reported, conclude changes found in post CT period T2. PC: gr.I-3 pts; PS: gr.I-5 pts; APCR: pos-2 pts; AT III: gr.I-1pts, gr.II-1 pts; F VIII: gr.I-3 pts, gr.II- 1pts, gr. IV-1 pts; F XII: gr.I- 6 pts, gr.II- 3 pts; Fib: gr.I-6 pts, gr.II-2 pts, gr.III-3 pts, gr.IV-1 pts. Conclusions: This was a tentative study, demonstrated the evidence of coagulation changes in Post CT period. To confirm our results & to analyze correlation discussed above, we plan to conduct a larger prospective trial. No significant financial relationships to disclose.
Childhood Abuse and Military Experience—Important Information to Better Serve Those Who Have Served
Authors: John R. Blosnich, Robert M. Bossarte
Journal: JAMA Psychiatry (2016)

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 Psychiatry 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 Psychiatry journal
Can decreasing the serum level of CA19–9 predict the survival benefit of gemcitabine for advanced pancreatic cancer?
Authors: A. Sawaki, M. Katsurahara, K. Okubo, N. Mizuno, T. Nakamura, M. Tajika, H. Kawai, T. Toyama, K. Yamao
Journal: Journal of Clinical Oncology (2004)

4208 Background: Serum carbohydrate antigen 19–9(CA19–9) is one of the useful marker for diagnosis of pancreatic cancer (PC), but its value for evaluating the survival benefit with Gemcitabine(GEM) is not obvious. Some investigators have reported prognostic value of CA19–9 levels in both locally advanced and metastatic PC patients treated with GEM. The mean survival time (MST) of locally advanced is about twice of that of metastatic PC. We, therefore, have focused on the prognostic values limited in metastatic PC. Purpose: We evaluated the relationship between survival time and the prognostic factors including CA19–9 and carcinoembryonic antigen (CEA). Materials: Forty chemo-naive patients (mean age 60.5 years), who were required advanced PC with distant metastases, performance status(PS) of 2 or lower and no previous radiation, were consecutively treated by GEM (1000mg/m2 over 30 minutes intravenously) in our institute from April 2001 to March 2003. Retrospective evaluation by medical records was carried out. The post-serum level was defined as the value after three or four administrations. Results: Median survival of all patients is 5.1 months. We could assess thirty-two patients for CEA and CA19–9: seven patients were administrated less than 3 times due to toxicities, disease progression or patient's refusal and the tumor markers in two patients were not examined. There is a significant difference between decreasing (n=13, MST=10.2 months) and increasing (n=17, MST=3.7months) patients (p<0.001). All of the decreasing patients can survive more than six months. CA19–9 and PS showed significant differences in the prognostic factors. CEA and administrated dose of morphine did not show significant differences and trend for significant differences regarding survival by univariate analysis. Conclusion: We might predict the survival time of patients with metastatic PC treated with GEM by measuring the change of CA19–9. No significant financial relationships to disclose.
Age and Environmental Temperature as Factors Influencing Development of Kidney Tumors in Uninoculated Frogs&lt;xref ref-type="fn" rid="fn1"&gt;2&lt;/xref&gt;
Authors: Keen A. Rafferty, Jr.
Journal: JNCI Journal of the National Cancer Institute (1962)

Our previously reported finding of high spontaneous incidence of Lucké kidney tumors in frogs kept in the laboratory conflicts with the observations of others, who have reported relatively low incidences both for wild-caught and uninoculated laboratory-maintained animals. The present report deals with the influence of age and temperature on the spontaneous laboratory rate and indicates that high incidence is promoted sharply by conditions of high environmental temperature and large body size (that is, comparatively old age). Comparison of the results with those of others and with their experimental conditions indicates that all reported findings are consistent. Establishment of the fact of high incidence in uninoculated animals and the conditions under which it may be observed provide a possible method for testing whether the tumors may be transmitted by natural routes.
First in human phase I pharmacokinetic (PK) and pharmacodynamic (PD) study of KU-0059436 (Ku), a small molecule inhibitor of poly ADP-ribose polymerase (PARP) in cancer patients (p), including BRCA1/2 mutation carriers
Authors: T. A. Yap, D. S. Boss, P. C. Fong, M. Roelvink, A. Tutt, J. Carmichael, M. J. O’Connor, S. B. Kaye, J. H. Schellens, J. S. de Bono
Journal: Journal of Clinical Oncology (2007)

3529 Background: Ku is a novel, potent, orally active PARP-1 and 2 inhibitor. It induces selective cytotoxicity in cells with defective homologous recombination repair such as BRCA1/2 deficient tumor cells. Methods: Starting at 10 mg daily (qd) for 2 out of 3 weeks (w), Ku dose escalation was guided by toxicity and PK data. Cohorts of 3–6 p with advanced solid tumors were treated, with provisions for enrichment with BRCA1/2 mutation carriers. PD studies evaluated PARP functional activity in surrogate tissue, including peripheral blood mononuclear cells (PBMC), and tumor tissue when available. Results: 44 p were treated; 17 M/ 27 F; mean age 56 (range 19–82). ECOG PS =2. 11 p had BRCA1/2 mutations and 2 p had strong family histories suggesting BRCA1/2 mutations. Dose levels tested were 10, 20, 40 and 80 mg qd, then 60 and 100 mg twice daily (bid) - all for 2 out of 3 w; followed by 100, 200, 400 and 600 mg bid continuously. Dose limiting toxicity was seen in 1 of 6 p at 400 mg bid. This p had grade (G) 3 neurocognitive toxicity, nausea and vomiting, all of which resolved within 24 hours of drug discontinuation. Other Ku toxicities included G1–2 fatigue, anorexia, constipation and diarrhea. PK data supports dose proportionality up to 200mg bid; mean elimination half-life was 6 hours (range 4.6–7), mean clearance/bioavailability (F) was 4.55 L/h (range 1.8–9.1), and mean volume of distribution/F was 39.9L (range 17–92.1). PD studies indicate a significant (&gt;50%) inhibition of PARP functional activity in PBMC and tumor at doses &gt;40 mg qd. Encouraging anti-tumor activity was seen. 4 p had significant tumor marker declines, 3 of whom also had radiological evidence of response (including 1 partial response by RECIST criteria for 6 months). 7 other p had stable disease for 3 to 6 months. Several of these p had BRCA1/2 mutations and were chemotherapy resistant. Conclusions: Ku leads to significant PARP inhibition with minimal toxicity. The final dose level (600 mg bid continuously) is being tested to maximize tumor PARP inhibition. Both radiological and biochemical evidence of antitumor activity have been seen in BRCA1/2 cancer p. Exploration of Ku in phase II and combination studies is warranted. [Table: see text]
A phase II study of docetaxel-carboplatin as first line therapy in the patients with visceral metastatic breast cancer: A Bangladesh experience
Authors: M. S. Reza, Q. Chowdhury, M. A. Hai, M. A. Rahman
Journal: Journal of Clinical Oncology (2006)

10792 Background: Metastatic breast cancer is heterogeneous and treatment decisions are influenced by multiple factors. Docetaxel remains as the standard chemotherapy agent in the management of metastatic breast cancer. We conducted a phase II study to examine the efficacy and tolerability of docetaxel with carboplatin in the treatment of visceral metastatic breast cancer patients. Methods: From July 2000 to December 2004, 32 patients with; histologically/cytologically proven, bidimensionally measurable visceral (pulmonary &amp; hepatic) metastatic breast cancer, age 18–75 years with ECOG performance status 0–3, no prior chemotherapy, life expectancy &gt; 3 months, adequate bone marrow, renal, hepatic and hematological values were enrolled. It was an open-labeled, non-randomized, single-centered and prospective study. The patients received docetaxel (75 mg/m 2 ) and carboplatin AUC 5 on day 1 at an interval of 3 weeks. Outcome measures were response rates and tolerability was measured by adverse events and laboratory blood values. Results: This study consisted of 30 female and only 2 male patients. Median age was 55 years. 18 patients (56.25%) were presented with pulmonary metastases, where as there were 12 patients (66.67%) with single lung and the remaining 6 patients (33.34%) with bilateral lung metastases.14 patients (43.75%) had hepatic metastases. In total, 168 cycles chemotherapy were administered with a median of 5.25 cycles per patient, and 29/32 patients were evaluable for responses. The overall response was 62.07% with 8 complete responses and 10 partial responses. 6 patients (20.69%) had stable disease and only 5 patients (17.24%) had progressive disease. Grade 3 hematological toxicities were observed as follows: neutropenia (24%) and anemia (15.6%). Some non-hematological toxicities (including nausea, vomiting, fluid retention and peripheral neuropathy) in 15 patients (51.72%) were observed. No severe febrile neutropenia and no fatal events were observed. Conclusions: This phase II study supports the use of docetaxel-carboplatin combination in chemo naïve visceral metastatic breast cancer patients due to its very promising effects with well tolerated toxicities in Bangladeshi population. No significant financial relationships to disclose.
Human resource costs and patient time affected by the delivery of chemotherapy and neutropenia management
Authors: B. V. Fortner, T. A. Okon, L. Zhu, K. Tauer, K. Moore, D. Templeton
Journal: Journal of Clinical Oncology (2004)

6060 Background: The purpose of this study was to evaluate human resource costs and patient time associated with the delivery of chemotherapy and management of chemotherapy-induced neutropenia (CIN). Methods: 400 medical professionals were surveyed regarding human resource time associated with medical tasks, and 189 patients were surveyed regarding time and activities affected by medical visits across 20 community oncology practices. Results: Results [mean (standard deviation)] showed chemotherapy and CIN-related medical visits involve numerous types of professionals (X = 10 per practice) who execute multiple medical tasks (X = 230 per practice), resulting in substantial human resource time and expense to the practice (e.g. 1 day of chemotherapy X = 4.23(1.48) hrs, $152.55($65.89); mid-cycle lab visit X = 2.09(1.05) hrs, $48.62($28.22); 5 days of IV antibiotics X = 15.7(6.1) hrs, $415.9($213.6); 10 days of filgrastim X = 24.4(11.1) hrs, $579.30($292.60); 1 day of pegfilgrastim X = 2.40(1.12) hrs, $57.06($30.94). Furthermore, results showed that even relatively simple medical visits resulted in large disruptions of patient time and life activities before, during, and after the visit (e.g. 1 day of chemotherapy ′X = 8.19(3.93) hrs; mid-cycle lab visit X= 2.27(0.92) hrs; 5 days of IV antibiotics X = 16.31(4.92) hrs; 10 days of Filgrastim X = 23.2(9.01) hrs; 1 day of pegfilgrastim X = 2.36(1.44) hrs). Sensitivity analysis demonstrated that as rates of severe CIN increase, human resource costs and patient burden increase. At relatively high rates of CIN, prophylactic use of growth factors was predicted to be less burdensome to patients and more cost effective in terms of human resource costs. Conclusions: These data are important for understanding the cost implications of delivering chemotherapy in the community oncology setting. These data are also important for understanding the burden multiple medical visits place on patients and their caregivers and may help guide the creation of supportive care strategies that minimize unnecessary patient and caregiver burden. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Amgen Amgen Amgen