tbuckley/cabot-search huggingface dataset:
Abstract 76: Testing the Feasibility of Using Telemedicine for Post-Cardiac Arrest Management in the Emergency Department
Authors: Anish K Agarwal, Sarah M Perman, David F Gaieski, Gail Delfin, Marion Leary MSN, RN, Benjamin S Abella, Brendan G Carr
Journal: Circulation (2013)

Objectives: Dissemination and implementation of post-cardiac arrest care (i.e. targeted temperature management [TTM]) has lagged across the US, and access to centers capable of delivering TTM remains limited. Telemedicine has been utilized for time sensitive conditions (acute ischemic stroke) and may provide a means for expanding clinical expertise. We sought to test the practical and technological feasibility of using emergency department (ED) based telemedicine to manage return of spontaneous circulation (ROSC) after OHCA including induction of TTM. Methods: We created a hub-spoke telemedical network between an academic level I trauma center and two affiliated EDs - each with a telemedical cart equipped with a HD-video camera, speaker, and microphone. Text- alerts notified the on-call telemedical team of OHCA in the ED. The on-call physician connected via an Internet ready laptop with the ability to: control the ED cart camera, access the EMR, lab values, and radiology images. Consults were monitored to assess connection time and clarity. Results: Over 12-weeks there were 31 OHCA alerts; 13 achieved ROSC (41.9%), 84.6% of ROSC cases utilized telemedicine; 81.8% were TTM-eligible and 100% of these cases utilized telemedicine. Mean connection time was 3.7 min (3.6 SD); mean duration was 71.7 min (SD 62.7). Mean number of connection attempts was 1.2, with no complete disconnections. Consultants ranked ability to see and hear staff/patients on a Likert scale (5, 4.7 respectively: 5= great). Staff ranked ability to see and hear the telemedical consultant similarly (4.9, 4.8). Conclusions: This ED-based telemedical pilot demonstrates the practical and technological feasibility of expanding the use of telemedicine to manage and direct protocolized post-cardiac arrest care. This pilot begins to reveal the capability of using telemedicine within the ED for improving the adherence to evidence based protocols for the management of unplanned critical illnesses.
Determinants of Early Mortality Among 37,568 Patients With Colon Cancer Who Participated in 25 Clinical Trials From the Adjuvant Colon Cancer Endpoints Database
Authors: Winson Y. Cheung, Lindsay A. Renfro, David Kerr, Aimery de Gramont, Leonard B. Saltz, Axel Grothey, Steven R. Alberts, Thierry Andre, Katherine A. Guthrie, Roberto Labianca, Guido Francini, Jean-Francois Seitz, Chris O’Callaghan, Chris Twelves, Eric Van Cutsem, Daniel G. Haller, Greg Yothers, Daniel J. Sargent
Journal: Journal of Clinical Oncology (2016)

Factors associated with early mortality after surgery and treatment with adjuvant chemotherapy in colon cancer are poorly understood. We aimed to characterize the determinants of early mortality in a large cohort of colon cancer trial participants.A pooled analysis of 37,568 patients in 25 randomized trials of adjuvant systemic therapy was conducted. Multivariable logistic regression models with several definitions of early mortality (30, 60, and 90 days, and 6 months) were constructed, adjusting for clinically and statistically significant variables. A nomogram for 6-month mortality was developed and validated.Median age among patients was 61 years, patient demographics included 54% men and 90% White, 29% and 71% had stage II and III disease, respectively, and 79%, 20%, and 1% had an Eastern Cooperative Oncology Group performance status (PS) of 0, 1, and ≥ 2, respectively. Early mortality was low: 0.3% at 30 days, 0.6% at 60 days, 0.8% at 90 days, and 1.4% at 6 months. Of those patients who died by 6 months post-random assignment, 40% had documented disease recurrence prior to death. Early disease recurrence was associated with a markedly increased risk of death during the first 6 months post-treatment (hazard ratio, 82.6; 95%CI, 66.9 to 102.1). In prognostic analyses, advanced age, male sex, poorer PS, increasing ratio of positive to examined lymph nodes, earlier decade of enrollment, and higher tumor stage and grade predicted a greater likelihood of early mortality, whereas treatment received was not strongly predictive. A multivariable model for 6-month mortality showed strong optimism-adjusted discrimination (concordance index, 0.73) and calibration.Early mortality was infrequent but more prevalent in patients with advanced age and a PS of ≥ 2, underscoring the need to carefully consider the risk-to-benefit ratio when making treatment decisions in these subgroups.
Clinical Decision Support Systems and Advanced Diagnostic Imaging—Reply
Authors: Peter S. Hussey, Katherine L. Kahn
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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
David Hedley Wilson
Authors: Michael Flowers
Journal: BMJ (2016)

David Hedley Wilson was born in Leeds and educated at Roundhay School, then at the Leeds School of Medicine. After further training in tropical medicine he worked as a missionary surgeon in the Congo for 12 years, firstly in a remote location at Pimu, and then, after further training in the UK at Stanmore’s Royal National Orthopaedic Hospital, he was appointed to the IME Teaching Hospital at Kimpese during the chaos of civil war. As well as establishing that orthopaedic unit as a highly …
Indirect costs associated with metastatic breast cancer.
Authors: Yin Wan, Xin Gao, Sonam Mehta, Zhixiao Wang, Claudio Faria, Lee Steven Schwartzberg
Journal: Journal of Clinical Oncology (2012)

74 Background: To estimate indirect costs (sick leave [SL]/short-term disability [STDI]) associated with metastatic breast cancer (MBC) compared to early stage breast cancer (EBC)/a general population without cancer (controls). Methods: The MarketScan Health and Productivity Management database (2005-2009) was used. Adult BC patients eligible for employee benefits of sick leave and/or STDI were identified. Difference in SL and STDI days was calculated between MBC patients and their propensity score matched EBC cohort or controls during a 12-month follow-up period. Indirect costs due to SL/ STDI were estimated by multiplying leave days with daily wages (2011 Bureau of Labor Statistics). Generalized linear model was used to examine the impact of MBC on indirect costs and potential cost drivers. Results: A total of 139 MBC/432 EBC/820 controls and 432 MBC/1,552 EBC/4,682 controls were eligible for SL and STDI respectively (not mutually exclusive), with a mean age of 49/51/50 years. After matching by age, payer type, region, index year and comorbidities, no difference was found in SL days between MBC and EBC cohorts. MBC patients had more STDI days and related cost than EBC patients and controls, with higher total indirect costs (SL + STDI). MBC patients also had more SL days/cost than controls (Table). Controlling for covariates, MBC patients incurred 47% more STDI cost vs. EBC patients (p=.009). Older patients (p=.002), non-HMO payers (p&lt;.05), or patients not receiving chemotherapy during follow-up (p&lt;.001) were associated with lower STDI cost. MBC patients also incurred 56% (p=.01) more SL cost and 11.6 times (p&lt;.001) more STDI cost than controls. Conclusions: Productivity loss and associated costs in MBC patients are substantially higher than EBC patients or general population. These findings underscore the economic burden of MBC from US societal perspective. [Table: see text]
High-dose platinum consisting of combined carboplatin and cisplatin in previously untreated ovarian cancer patients with residual disease.
Authors: B Lund, M Hansen, O P Hansen, H H Hansen
Journal: Journal of Clinical Oncology (1989)

A phase II trial of carboplatin, 300 mg/m2 day 1, and cisplatin, 50 mg/m2 days 2 and 3 every 4 weeks for six cycles, was performed in 42 previously untreated patients with residual disease after primary laparotomy. Overall, 79% of patients had primary residual tumor larger than 2 cm. The overall pathologic response rate (pathologic complete response [PCR] plus partial response [PPR]) in 37 evaluable patients was 62%, and in PCRs was 22%. Of the responding patients, 78% had primary residual tumor larger than 2 cm. The toxicity was cumulative but manageable, with thrombocytopenia being the main reason for dose reduction. Dose-limiting nephrotoxicity and neurotoxicity occurred in 22% and 7% of the patients, respectively. Combined high-dose platinum as a "single agent" appears to be as active as combination chemotherapy containing cisplatin, and the treatment is feasible. Further clinical trials of this combination alone or combined with other drugs are warranted.
Five years results in organ saving treatment for laryngeal cancers
Authors: S. Kamian, A. Kazemian, M. Aghili
Journal: Journal of Clinical Oncology (2008)

17037 Background: Chemoradiotherapy (CRT) or radiotherapy (RT) has been used as a definitive treatment in low-staged laryngeal cancers in the recent studies. It has been also proposed as an alternative to total laryngectomy for preserving the voice in the locally-advanced stages. Methods: From April 2001 to May 2006, patients with laryngeal cancers referred to the radiation-oncology department, who received CRT or RT as a definitive therapy for organ preservation, were enrolled in this trial. Local tumor recurrences, metastasis, survival and the need for salvage surgery were evaluated. Results: In the total of 147 cases that were included in this study, 97% had SCC. Tumor location was in glottis in 32.7% cases, supraglottis in 27.2%, subglottis in 0.7% cases. The others had tumors in 2 or 3 laryngeal regions. Chemoradiotherapy with paclitaxel alone or cisplatin ± 5FU was administered weekly or every 3 weeks in 61 patients. The others were treated with radiotherapy alone. There were twelve cases which were excluded from the analysis because of the treatment interrupt by themselves or death within the treatment course. There were 6 cases in the CRT group and 50 cases in the RT group who had early- staged disease. Forty eight patients in the CRT group and 31 cases in the RT group had locally-advanced cancers. The median time of follow up was 7 months. The mean overall survival in all of the cases were 51 months (Standard error (SE) = 4; 95% CI = 43–59) in early stages and 30 months (SE = 4; 95% CI = 22–37) in advanced stages. The mean disease free survival were 37 months (SE = 5; 95% CI = 29–48) in early-staged patients and 17 months (SE = 2; 95% CI = 13–22) in locally advanced cases. The local recurrences occurred in 12 cases (57.1%) in CRT group. There were 11 cases (40.7%) in the RT group who had local recurrence and two of them with locally-advanced disease needed salvage surgery. The average total radiation dose significantly affected the tumor control in CRT group (69.1 ± 1.7 Gy in the controlled patients versus 64.8 ± 4 Gy in the recurrent cases; P. value = 0.013). Two cases had distant metastasis to the lungs. Conclusions: It seems that radiotherapy with or without chemotherapy can be an appropriate alternative to total laryngectomy in preserving the larynx in different stages of the laryngeal cancers. No significant financial relationships to disclose.
Characteristic sign of a colonic submucosal lesion
Authors: Pazhanivel Mohan, Abdoul Hamide
Journal: BMJ (2015)

A 58 year old woman presented with lower abdominal pain, constipation for three months, and intermittent small bleeds per rectum. She had no abdominal distension, vomiting, weight loss, or family history of colonic cancer. She had hypertension and type 2 diabetes and was taking regular drugs. Blood test results were unremarkable. Ultrasound imaging of her abdomen was normal. …
DNA amplification and elevated expression of <i>CKS1B</i> is associated with reduced levels of p27<sup>Kip1</sup> and poor survival in multiple myeloma
Authors: J. Shaughnessy, F. Zhan, I. Hanamura, P. Stewart, B. Burington, J. Sawyer, E. Anaissie, G. Tricot, J. Crowley, B. Barlogie
Journal: Journal of Clinical Oncology (2005)

6500 Background: The heterogeneous survival of patients with MM, ranging from several months to greater than 10 years, suggests that specific genetic lesions may account for de novo high-risk disease. Methods: Oligonucleotide microarray-based gene expression analysis was applied to CD138-enriched plasma cells from 351 patients with newly diagnosed MM subsequently treated with Total Therapy 2 (TT2). Results: Using Log Rank tests for the effect of extreme quartile membership (i.e. Q1 or Q4) with a 2.5% false discovery rate followed by proportional hazards regression, we constructed a 30-gene risk score whose expression could segregate 20% of newly diagnosed MM cases with a median overall survival of 27 months. 47% of the genes in the risk model were derived from chromosome 1 and the third highest-ranking gene in the risk score, CKS1B, maps to a previously identified amplicon at 1q21. Given that CKS1B promotes the ubiquitinylation and proteasome degradation of p27Kip1, this gene was deemed a strong candidate disease gene. Interphase FISH revealed a strong association between CKS1B gene expression and DNA amplification in 193 cases in which both tests were performed (P < 0.0001). An independent FISH analysis of CKS1B in plasma cells from 226 additional TT2 patients confirmed the association between CKS1B DNA amplification and event-free and overall survival (P < 0.0001). Western blots of plasma cell nuclear protein from 27 newly diagnosed MM revealed a strong positive correlation between CKS1B protein and mRNA expression and inverse correlation with p27Kip1protein levels. Other candidate genes at 1q21, BCL9, MCL1, IL6R and RAB25 were at best weakly linked to survival in this analysis (FDR > 50% for inclusion). Conclusion: Gene expression patterns, predominantly involving chromosome 1, define high-risk myeloma. Specifically, overexpression and DNA amplification of CKS1B at 1q21 is correlated with low levels of its target protein the cyclin-dependent inhibitor p27Kip1 and a poor prognosis. Since 1q21 abnormalities are frequently seen many advanced cancers, it is possible that CKS1B amplification may be involved in cancer progression at large. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Quest Diagnostics Millennium
<i>eNOS</i> polymorphisms in relation to outcome in advanced HCC patients receiving sorafenib.
Authors: Andrea Casadei Gardini, Giorgia Marisi, Emanuela Scarpi, Mario Scartozzi, Luca Faloppi, Elena Tenti, Stefano Tamberi, francesco Giuseppe Foschi, Emiliano Tamburini, Giovanni Luca Frassineti, Stefano Cascinu, Paola Ulivi
Journal: Journal of Clinical Oncology (2015)

230 Background: Cancer cells adapt to hypoxic microenvironment through the activation of many molecules, including endothelial nitric oxide synthase (eNOS). Sorafenib, by blocking the vascular endothelial growth factor receptors (VEGFRs), induces an inhibition of eNOS activity with a consequent decrease of the production of nitric oxide (NO). NO is associated with an increase of tumor angiogenesis, tumor invasion and metastasis formation. In our study we analysed the role of eNOS polymorphisms in relation to clinical outcome in patients with hepatocellular carcinoma treated with sorafenib. Methods: From a database of 257 patients diagnosed with hepatocellular carcinoma from 2004 to 2014, we selected 54 patients who received sorafenib. Peripheral blood samples or FFPE tumor tissues were available for DNA extraction and genotyping analysis. Three eNOS polymorphisms (eNOS +894 G/T, eNOS VNTR 27bp 4a/b, eNOS -786 C/T) were analyzed by direct sequencing or Real Time PCR method. We analyzed 21 patients for the VNTR 4a/b polymorphism and 32 patients for -786 C/T polymorphism. All the candidate genotypes were evaluated to identify a potential correlation with overall survival (OS) (log-rank test). Results: With regard to eNOS VNTR it was observed that patients carrying the b allele (5 repetitions of 27bp) both in homozygosity (4bb) and in heterozygosity (4ab) were associated with a better OS. The variants 4aa (4 repeats of 27bp in homozygosity), 4ab and 4bb, were associated with a median OS of 5.7, 13.9 and 23.6 months, respectively (p = 0.016). For eNOS-786 the presence of the T allele both in homozygosity (TT) and in heterozygosity(TC) was associated with a statistically significant longer OS with respect to patients with CC genotype (15.6 versus 13.9 months, respectively, p = 0.031). No correlations were observed in relation to PFS (p = 0.494). Conclusions: eNOS VNTR and eNOS -786 could represent prognostic markers in patients with advanced hepatocellular carcinoma treated with sorafenib.
Increasing numbers of isoniazid-monoresistant TB in the USA
Authors: A Johnson
Journal: Thorax (2009)

In the USA between 1993 and 2003, while the incidence of multidrug resistant (MDR) tuberculosis (TB) decreased, the incidence of isoniazid-monoresistant TB (IMTB) increased. Understanding the reasons for isoniazid resistance is vital for successful TB treatment.

Data from the National Tuberculosis Surveillance System (NTSS) were collected on patients with …
문맥혈전이 동반된 간세포암종 환자에서 정맥류 출혈에 대한 경 경정맥 간내 문맥정맥 단락술의 효과
Authors: 정우진 ( Woo Jin Chung ), 장병국 ( Byung Kuk Jang ), 박경식 ( Kyung Sik Park ), 조광범 ( Kwang Bum Cho ), 황재석 ( Jae Seok Hwang ), 안성훈 ( Sung Hun Ahn ), 김용훈 ( Yong Hoon Kim ), 김영환 ( Young Hwan Kim ), 김용주 ( Yong Ju Kim )
Journal: Clinical and Molecular Hepatology (2005)

목적: 경 경정맥 간내 문맥정맥 단락술(TIPS)는 정맥류 출혈이 있는 환자에서 지혈을 위하여 흔히 시행되며 문맥혈전을 가진 간세포암종 환자의 경우에서는 금기 사항에 해당이 된다. 이 환자들에서 TIPS의 효과를 알아보고자 하였다. 대상과 방법: 1997년에서 2004년까지 정맥류 출혈을 주소로 내원한 문맥혈전이 동반된 6명의 간세포암종 환자를 대상으로 하였다. 내시경적 지혈에 실패한 환자에서 TIPS를 시행하였다. 효과적인 단락의 형성은 문맥압 차이가
Triple Therapy For Immune Thrombocytopenia: A Novel Combination Of Conventional Strategies To Safely Sustain Platelet Counts In ITP
Authors: Philip Young-Ill Choi, Soo-Chin Ng, Christine Lee, Fernando Roncolato, Xavier Badoux, Amanda J. Hugman, Sundra Ramanathan, Shir-Jing Ho, Szu-Hee Lee, Beng Chong
Journal: Blood (2013)
Clinical safety and efficacy of <sup>90</sup>yttrium resin microspheres alone in unresectable, heavily pre-treated colorectal liver metastases: results of a phase II trial
Authors: M. Cosimelli, R. Mancini, L. Carpanese, R. Sciuto, I. Sperduti, R. Golfieri, E. Giampalma, P. Cagol, S. Bacchetti, F. Izzo
Journal: Journal of Clinical Oncology (2008)

4078 Background: Selective intra-arterial radiotherapy using 90yttrium resin microspheres (SIRT) enables delivery of tumorcidal doses of radiation to hepatic tumor(s), with minimal damage to adjacent tissue. This multicenter phase II study is the first prospective evaluation of SIRT as salvage therapy for patients (pts) with colorectal liver metastases who had failed prior oxaliplatin- and irinotecan-based regimens. Methods: Pts with a life expectancy >6 months (mos) and adequate hepatic and renal function were eligible for inclusion in absence of major vascular anomalies and pulmonary shunt >10%. The gastroduodenal and right gastric arteries were embolized before injection of microspheres (median dose 1.7 GBq; range 0.9–2.2) into the proper hepatic artery by arteriography. Results: Fifty-two pts were enrolled and followed up for a median of 11 mos (range 2–27). Of 50 eligible pts, 38 (>75%) had already received ≥4 lines of chemotherapy. Approx. 60% had >4 hepatic metastases (median diameter 50mm; range 8–120mm) involving 25–50% of the liver tissue. Early and late (>48 hrs) WHO G1–2 toxic events (mostly fever and pain) were observed in 16% and 22% of pts, respectively. One responding pt died after 60 days due to liver failure. Forty-six pts were evaluable for response under RECIST criteria. One pt (2%) had a complete response (CR), 11 (22%) a partial response (PR), 12 (24%) stable disease (SD) and 22 (44%) progressive disease (PD). In responders (CR+PR+SD), the max. diam. of nodules diminished to 35mm. The Kaplan-Meyer median overall survival was 13 mos (CI 7–18), with a significant difference (p=0.0006) between responders (16 mos; CI 13–19) and PD (8 mos; CI 4–12). Two-year survival was 40.3% and 0% respectively. Median time to progression (mostly extrahepatic) was 4 mos (CI 3–5). Conclusions: In this group of heavily pretreated pts, 90yttrium microspheres produced an encouraging median survival, with acceptable toxicity, that compares favorably with phase II/III studies of chemotherapy regimens used as third- or subsequent lines of therapy. Combining SIRT with chemotherapy should be explored to reduce the risk of extrahepatic progression. No significant financial relationships to disclose.
Structure-Activity Relationships Among Some Polynuclear Hydrocarbons and Their Hydrogenated Derivatives&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: W. Lijinsky, H. Garcia, U. Saffiotti
Journal: JNCI Journal of the National Cancer Institute (1970)

Partially hydrogenated derivatives of several polynuclear hydrocarbons were tested for tumorigenic activity by both skin painting and subcutaneous injection in female Swiss mice. Contrary to previous reports, dibenz[a,c]anthracene was weakly carcinogenic, whereas its 10,11,12,13-tetrahydro derivative was inactive. Dibenz[a,j]anthracene was weakly carcinogenic by skin painting, as was 1,2,3,4-tetrahydro-dibenz[a,j]anthracene, whereas 5,6-dihydrodibenz[a,j]anthracene was much more potent than its unsaturated parent; 1,2,3,4,8,9-hexahydro-dibenz[a,j]anthracene was inactive. This pattern of carcinogenic activity contrasted sharply with that of the analogous series of dibenz[a,h]anthracene derivatives. Two benz[a]anthracene derivatives, 8,9,10,11-tetrahydro-7,12-dimethylbenz[a]anthracene and 11,12-dihydro-3-methylcholanthrene, were both carcinogenic by skin painting, though the latter compound does not have a “K-region.” The results of subcutaneous injection of single doses of dibenz[a,h]anthracene and dibenz[a,j]anthracene and of their corresponding dihydro, tetrahydro, and hexahydro derivatives showed significant tumorigenic activity only by dibenz[a,h]anthracene and 1,2,3,4-tetrahydrodibenz[a,h]anthracene, in contrast to skin painting results.