tbuckley/cabot-search huggingface dataset:
Patients (pts) with acute myeloid leukemia (AML) and mutant RAS benefit from high-dose cytarabine (HDAC) intensification: A Cancer and Leukemia Group B (CALGB) study
Authors: A. Neubauer, K. Maharry, G. Marcucci, K. Mrózek, R. J. Mayer, R. A. Larson, E. T. Liu, C. D. Bloomfield
Journal: Journal of Clinical Oncology (2005)

6514 Background: Mutations in RAS genes occur in 15–25% of AML pts. In vitro data suggest RAS mutations enhance sensitivity to cytarabine (Ara-C). We examined whether RAS mutation status impacts response to Ara-C in vivo. Methods: 110 AML pts enrolled on CALGB 8525 and randomized to 4 cycles of 1 of 3 consolidation doses of i.v. Ara-C after achieving complete remission were analyzed for N- and K-RAS mutations by single-strand DNA conformation polymorphism and direct sequencing analyses. Results: 18 pts (16%) had mutated RAS (mutRAS). They were less often Caucasian (P=.02) and had lower % BM blasts (P=.02), but similar presenting age, sex, platelets, leukocyte count, % blood blasts, cytogenetic groups [core binding factor (CBF) vs others] and FAB subtypes to wild-type RAS (wtRAS) pts. With 11.1 yrs median follow-up, cumulative incidence of relapse (CIR) was lower with CBF AML (P=.004), consolidation with HDAC (400 mg/m2/d x 5d or 3g/m2 q12h on days 1, 3 and 5) vs low-dose Ara-C (LDAC) (100 mg/m2/d x 5d) (P=.003), but not with RAS status (P=.36). MutRAS pts assigned to HDAC had lowest likelihood of relapse (Table). Multivariable analysis to predict CIR confirmed a significant interaction of consolidation therapy and RAS status (P=.013). MutRAS pts receiving HDAC were less likely to relapse than mutRAS pts treated with LDAC and wtRAS pts treated with LDAC or HDAC. After controlling for this interaction, CBF (vs others, P=.003), HDAC (vs LDAC, P=.07), and wtRAS (vs mutRAS, P=.051), were all important predictors of lower CIR. Conclusion: AML pts carrying mutRAS benefit from higher Ara-C doses more than pts with wtRAS and, similarly to CBF AML pts, should receive consolidation with HDAC. No significant financial relationships to disclose.
Household transmissibility and other characteristics of seasonal oseltamivir-resistant influenza A(H1N1) viruses, Germany, 2007-8
Authors: U Buchholz, S Brockmann, S Duwe, B Schweiger, M an der Heiden, B Reinhardt, S Buda
Journal: Eurosurveillance (2010)

During the influenza season 2007-8, the proportion of seasonal influenza A(H1N1) viruses resistant to the neuraminidase inhibitor oseltamivir increased worldwide. We conducted an investigation to compare patients infected with oseltamivir-resistant (ose-R) and oseltamivir- susceptible (ose-S) influenza A(H1N1) viruses regarding risk factors for resistance and the capability to transmit in the household setting. Within a cohort of 396 laboratory confirmed influenza patients from sentinel physicians we conducted a nested case-control study among patients infected with A(H1N1). Thirty patients in the cohort were infected with influenza B, none with influenza A(H3N2) and 366 with A(H1N1). Of the 366 A(H1N1) viruses 52 (14%) were ose-R. Demographic characteristics, oseltamivir exposure, travel history and outcome were not significantly different between ose-S and ose-R patients. Among 133 households in the nested case-control study, secondary household attack rates in households with ose-R cases and households with ose-S cases were similar (23 versus 26%; p-value=0.54). Ose-R household status and occurrence of secondary cases were associated with an odds ratio of 0.85 (95% confidence interval 0.38-1.88). We conclude that seasonal ose-R influenza A(H1N1) viruses have transmitted well in the household setting.
Delivery Models for High-Risk Older Patients
Authors: Brian W. Powers, Arnold Milstein, Sachin H. Jain
Journal: JAMA (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 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
Exploring the palliative care needs of Hispanic immigrant mothers with advanced cancer.
Authors: Rafael Alonso Saldana, Eliza Park, Devon Check, Katherine Elizabeth Reeder-Hayes, Deborah Mayer
Journal: Journal of Clinical Oncology (2014)

135 Background: Hispanics are the fastest growing demographic group in the United States and cancer is the leading cause of death in this population. Hispanic immigrants encounter a number of challenges when confronting end-of-life care: geographical and cultural separation from families; language and educational barriers; fear of discrimination; and in the case of undocumented immigrants, fear of deportation. The experiences of Hispanic patients with advanced cancer who are parents of dependent-age children are essentially unknown. Therefore, we used qualitative methods to identify the palliative care and end-of-life needs of this unique population. Methods: We recruited five Spanish-speaking, Hispanic mothers with metastatic cancer to complete a semi-structured interview about their experiences. The interviews addressed coping with advanced illness, sources of distress, parenting changes, medical decision-making strategies, and communication about illness. Data were analyzed using traditional content analysis techniques. Results: Participants were all female, ages 34-43 year old. On average, they had 3.4 children and 8.2 years of education. Common themes were: (1) the financial burden of cancer; (2) low social support for parenting and household responsibilities; (3) lack of perceived role in medical decision-making; (4) and religion as primary source of coping and hope. We also identified several communication barriers in conducting a palliative care study with this population. Conclusions: Future palliative care studies can improve Spanish-speaking Hispanics’ comprehension by incorporating Spanish vocabulary into the interviews and providing greater explanation of concepts such as shared decision-making, cancer staging, palliative care, and hospice. Greater awareness of financial concerns and insufficient social support may help oncology providers and researchers develop interventions to help Hispanic parents with advanced cancer. Further studies are needed to learn more about the unmet needs of end-of-life care for this demographic group.
Refugee children
Authors: M. Hodes
Journal: BMJ (1998)

War and persecution have resulted in large migrations, and current estimates suggest there are 23 million refugees in the world.1 About 120 000 of them are in Britain, mostly living in inner London, where they constitute significant minorities. At least 40% (50 000) are aged under 18 years, and they include increasing numbers of unaccompanied refugee children—nearly 500 in 1995. Despite their growing numbers, these children's mental health needs and service provision have received little attention.

Studies from the United States, mostly in refugee children from South East Asia but more recently those from former Yugoslavia, indicate that serious psychiatric disorder is present in 40-50%.2-4 Since refugee children will have been exposed to similar stressors wherever they find refuge, it is reasonable to take that figure as an estimate of prevalence in Britain. This is far higher than the estimates of psychiatric …
Screening Performance for Frailty Among Older Patients With Cancer: A Cross-Sectional Observational Study of Two Approaches
Authors: Toru Okuyama, Koji Sugano, Shinsuke Iida, Takashi Ishida, Shigeru Kusumoto, Tatsuo Akechi
Journal: Journal of the National Comprehensive Cancer Network (2015)

Objectives: To investigate the screening performance for frailty of the Vulnerable Elders Survey-13 (VES-13) and the 2-step approach consisting of the VES-13 plus the anhedonia (loss of interest or pleasure) item from Patient Health Questionnaire-9 (PHQ-9) among older patients with newly diagnosed cancer. Methods: This study involved 106 consecutive inpatients aged 65 years or older, newly diagnosed with malignant lymphoma or multiple myeloma, just before chemotherapy initiation. The participants were administered the VES-13, and also underwent a comprehensive geriatric assessment (CGA), including for depression and 6 other geriatric conditions, using validated measures, just before initiation of chemotherapy. We defined frailty as the presence of 2 or more geriatric conditions as determined by the CGA. Receiver operating characteristic analysis was performed. The 2-step screening approach was examined by post hoc analysis. Results: The average age of the subjects was 74 years. Among the 106 subjects, 50% met the criteria for frailty. Using a cutoff score of 2 to 3 on the VES-13, a sensitivity and negative predictive value (NPV) of 72% of the screening tool was obtained for the condition of frailty. When the second step of the screening, consisting of the VES-13 plus anhedonia, was applied to the VES-13–negative patients, the sensitivity and NPV improved to 90% and 88%, respectively. Conclusions: The 2-step approach exhibited better screening performance for frailty among patients with cancer than existing methods. Large prospective studies are required in the future to confirm this ability of the 2-step approach.
The potential for lost productivity in lung cancer patients
Authors: D. Zawisza, C. Pepe, N. Mittmann, R. Feld, F. Shepherd, N. Leighl
Journal: Journal of Clinical Oncology (2006)

6093 Background: Lung cancer significantly impacts on a patient’s personal and professional life. Little is known about lung cancer patients’ lost productivity, which in turn has an important effect on society. We undertook this descriptive study to learn about lost productivity experienced by lung cancer patients and their caregivers. Methods: 40 consecutive patients attending outpatient lung clinics at a major cancer centre completed questionnaires assessing demographic details, patient and caregiver productivity, and quality of life (EQ5D, FACT-L). Results: 52.5% of respondents were male. Median age was 67 years (range 36 -81). Median disclosed income was $20,000–$39,999; 46.2% had pursued post-secondary training. 70% were ex-smokers, 40% had NSCLC, 27% SCLC, while a third did not know their diagnosis. Treatments received included IV chemotherapy (62.5%), oral therapy (20%), radiation (55%), surgery (42.5%) and 5% no treatment. Over 25% were working full-time prior to diagnosis, 40% were retired. None were able to continue full-time employment; 20% required disability or sick leave. 8 (20%) were able to work part-time. Of those still working, a median of 14 h were missed due to illness in the preceding 3 weeks, with a median of 32 h worked in that period. Patients reported an overall moderate (5/10) impact on their productivity and a significant (6/10) impact on their daily activities attributable to their cancer. Only 8.5% of patients received paid assistance, while 76% had their spouse, relative or friend as an unpaid caregiver. In the preceding 3 weeks, caregivers who assisted patients provided a median 24h of care; 25% of caregivers missed a median 12h of work. Overall, mobility, self-care and anxiety/depression were rated as mildly affected (1/3), while daily activities and pain/discomfort were rated as moderately affected (2/3). Median overall health state rated by the respondents was 60 {scale 0(worst)-100(best)}. Quality of life overall was poor - FACT-L median score was 93.2 (range 50 to 125). Conclusion: Lung cancer negatively impacts work productivity and significantly impairs activity. While many lung cancer patients are retired, there is a significant burden on caregivers, which may result in a substantial burden to society in lost productivity. No significant financial relationships to disclose.
A Novel Reduced-Toxicity Myeloablative Conditioningusing Full-Dose Busulfan and Melphalan For Cord Blood Transplantation Provides Durable Engraftment and Remission Without Increasing Non-Relapse Mortality In Advanced Myeloid Malignancies
Authors: Hisashi Yamamoto, Naoyuki Uchida, Kousei Kageyama, Daisuke Kaji, Sachie Wada, Aya Nishida, Hikari Ota, Kazuya Ishiwata, Masanori Tsuji, Shinsuke Takagi, Go Yamamoto, Yuki Asano-Mori, Koji Izutsu, Atsushi Wake, Shuichi Taniguchi
Journal: Blood (2013)
Carboplatin and recurrent childhood brain tumors.
Authors: J C Allen, R Walker, E Luks, M Jennings, S Barfoot, C Tan
Journal: Journal of Clinical Oncology (1987)

Carboplatin, a cisplatin analogue, was administered as an intravenous (IV) one-hour infusion in a 4-consecutive weekly dose schedule to 44 patients with recurrent childhood brain tumors. Twenty-four patients were registered on our phase I, and 20 on our phase II studies. The maximum tolerable dose derived from our phase I study was 210 mg/m2/wk in patients with solid tumors, and the recommended dose for subsequent pediatric phase II studies was 175 mg/m2/wk. This dose was administered to 14 patients in the phase I and all 20 patients in the phase II study. Nine of 36 (25%) evaluable patients in the combined studies experienced objective responses for a median duration of 10+ months. Seven of nine responders had received prior cisplatin. Disease-specific response rates were as follows: medulloblastoma, six of 14 (43%) with three complete (CR) and three partial responses (PR); pineoblastoma, one of one (PR); germinoma, one of two (CR); and brainstem glioma, one of eight (13%) (PR). Carboplatin had mild emetic effects but no significant auditory or renal toxicity. Thrombocytopenia (less than 49,000) was encountered in nine of 28 (32%) evaluable trials at a dose of 175 mg/m2/wk. Because of its low potential for auditory, renal, and emetic toxicity, ease of administration, and high disease-specific activity, carboplatin deserves further study in multiagent phase II and III trials, especially in chemotherapy-sensitive diseases such as medulloblastoma.
A long-term follow-up study of survival in stage I (T1N0M0) and stage II (T1N1M0) breast carcinoma.
Authors: P R Rosen, S Groshen, P E Saigo, D W Kinne, S Hellman
Journal: Journal of Clinical Oncology (1989)

This study was undertaken to investigate the long-term survival and the probability of "cure" in a group of 644 patients treated by mastectomy for T1 breast carcinoma. After a median follow-up of 18.2 years, 23% were dead of recurrent breast carcinoma, 3% were alive with recurrent disease, and 74% had not experienced a recurrence. The probability of recurrence was directly related to the initial extent of the disease. Overall, 16% of recurrences and 25% of deaths due to disease occurred in the second decade of follow-up. The proportion of recurrences detected in the second decade was inversely related to the stage of the primary tumor at diagnosis. When stratified by tumor size, T1N0M0 patients with tumors 1.0 cm or less in diameter had a significantly better 20-year recurrence-free survival (86%) than did T1N0M0 patients with tumors 1.1 to 2.0 cm (69%). When observed and expected survival curves were compared by the method of Brinkley and Haybittle, it appeared that 80% of T1N0M0 patients with tumors 1 cm or less might be cured at 20 years, whereas for those in the 1.1- to 2-cm group, the proportion cured was indeterminate, but might be as high as 70%. A potentially cured group could not be identified among T1N1M0 patients, but an estimated 52% of these patients did not have a recurrence within the nearly 20-year follow-up period. These data are important when one considers the proper role of adjuvant therapy for stage I disease. Patients with tumors larger than 1 cm and those with axillary lymph node metastases may have an improved recurrence-free survival as a result of systemic adjuvant treatment, while women in the T1N0M0 group with an especially favorable recurrence-free survival, particularly those with tumors 1 cm in diameter or smaller, might be spared adjuvant therapy.
Time course and prognosis of local recurrence following primary radiation therapy for early breast cancer.
Authors: J R Harris, A Recht, R Amalric, R Calle, R M Clark, J G Reid, J M Spitalier, J R Vilcoq, S Hellman
Journal: Journal of Clinical Oncology (1984)

The frequency, time course, and prognosis of local recurrence following primary radiation therapy in 152 patients with early breast cancer treated before 1967 were examined. Local recurrence occurred at a constant rate over the first 14 years after treatment. The crude 15-year local recurrence rate was 22%. Of the 30 patients who developed an isolated local recurrence and underwent definitive secondary surgery, the 10-year freedom from distant relapse rate was 50%. These results indicate that breast cancer patients treated by primary radiation therapy require long-term follow-up to detect curable local recurrences.
Abstract 19514: Race and Willingness to Participate in Cardiovascular Clinical Research
Authors: Xiaotao Zhang, Lydia A Bazzano, Stephen G Gavin, Stephanie Gaudreau, Joseph Breault
Journal: Circulation (2014)

African Americans (AA) are underrepresented in clinical trials in the United States for a variety of reasons. The majority of studies examining this issue were conducted &gt;10 years ago and since then, efforts have been implemented to improve AA enrollment in research. We took advantage of the cardiovascular research data of a large community academic center in New Orleans, Louisiana to examine whether race was associated with participation in cardiovascular research. We used a nested case control design with 80% power to detect a doubling in odds of non-participation. Individuals could be included if they were offered participation in any of the 4 largest studies conducted in 2012, were White or AA and were American citizens (n=974). Median income household income was inferred using postal codes. Cases were defined as individuals who declined to participate and did not sign a consent form. Controls were defined as individuals who agreed to participate and signed a consent form. We identified 100 cases and selected 200 controls matched on age (within 1 year) and sex using a random selection algorithm. Of the 974 eligible for analysis, mean (SD) age was 65 (14) years, median household income in thousands was 51.92 (19.9), and 65.3% were men. Of those who agreed to participate, 32.2% were AA while of those who refused, 31.0% were AA. The unadjusted Mantel-Haenszel odds ratio for non-participation by race was 1.06 (95% CI: 0.60 to 1.94) for AA individuals compared to their White age and sex matched counterparts. Using multivariable conditional logistic regression, the odds ratio for participation in a study was 1.04 (95% CI: 0.56 to 1.92) for AA as compared to their White age and sex matched counterparts, after adjustment for median household income, employment, and marital status. Our findings suggest that, at a large community academic center, race does not significantly affect willingness to participate in cardiovascular research independent of age, gender, socioeconomic and marital status.
Abstract 10624: Long-term Clinical Outcome After Primary Stenting for Subclavian Artery Disease
Authors: Yusuke Tomoi, Yoshimitsu Soga, Masashi Iwabuchi, Hiroyoshi Yokoi, Masakiyo Nobuyoshi
Journal: Circulation (2012)

Background: Little is known about long-term clinical outcomes after endovascular therapy (EVT) for subclavian artery disease (SCD). The aim of this study was to investigate the long-term clinical o...
Pharmacokinetics (PK) of the liposomal encapsulated fraction as well as released doxorubicin after intravenous infusion of liposomal doxorubicin
Authors: R. A. Hilger, H. Richly, M. Grubert, C. Oberhoff, M. E. Scheulen, D. Strumberg, S. Seeber
Journal: Journal of Clinical Oncology (2005)

2093 Background: The clinical utility of doxorubicin is limited by toxicity that may preclude adequate dosing and diminished its therapeutical effect on relapse, or lead to drug resistance. Caelyx, a doxorubicin formulation of polyethylene glycol-coated liposomes, has demonstrated activity against solid tumors. For this new form of doxorubicin, a superior pharmacokinetic profile over that of free doxorubicin is postulated. It is also theorized that there is a minimal drug-leakage of these long circulating particles, due to an exceeding of the water solubility of doxorubicin in the liposomes. It was the aim of this study, to analyze the plasma levels as well as the cellular uptake of encapsulated and free doxorubicin. Methods: Caelyx was administered i.v. at doses of 30, 40, 50, and 60 mg/m2 within one hour, once every 28 days, for as long as patients respond to and tolerate treatment. To answer the question of a possible accumulation of Caelyx, plasma and urine samples of 30 patients receiving 51 courses, were analyzed for PK calculations. In addition, cellular uptake of doxorubicin was analyzed in single intra-individual comparisons. Results: There is no evidence for an accumulation of the free doxorubicin in plasma up to a dose of 50 mg/m2 Caelyx every four weeks. The mean terminal half life for Caelyx was calculated as 3 days, MRT about 5 days, the Vss 1.5 l, CL was determined to be less than 1 ml/min. There was no detectable renal excretion of the intact liposomes. The calculated PK parameters for the released doxorubicin gave evidence for an increased AUC and MRT, and a decreased Cmax and CL, in comparison to earlier published PK parameters of conventionally administered free doxorubicin. Cellular uptake of doxorubicin increased after application of Caelyx, compared to the intra-individual uptake of the equivalent conventional dose of doxorubicin. Conclusions: In addition to the indirect tumor targeting using the long circulating pegylated liposomes, the slow release of doxorubicin enables the treatment of potential micro metastases, enables the practical use of the anti-angiogenic potential of doxorubicin and furthermore offers an option in the management of leukemia. No significant financial relationships to disclose.