tbuckley/cabot-search huggingface dataset:
Menopausal Hormone Therapy Influence on Breast Cancer Outcomes in the Women's Health Initiative
Authors: Rowan T Chlebowski, Aaron K Aragaki, Garnet L Anderson
Journal: Journal of the National Comprehensive Cancer Network (2015)

The Woman's Health Initiative has conducted 2 full-scale, placebo-controlled clinical trials to determine the influence of menopausal therapy on breast cancer incidence and outcome. Estrogen plus progestin use in postmenopausal women with a uterus increases breast cancer incidence and deaths from breast cancer. Despite a short-term reduction in risk after stopping estrogen plus progestin use, an increase in breast cancer risk persists postintervention. Estrogen-alone use in postmenopausal women with prior hysterectomy reduces breast cancer incidence and reduces deaths from breast cancer. The reduced breast cancer risk persists for several years after stopping estrogen-alone use but is lost in late postintervention. These findings suggest recalibration of breast cancer risk and benefit consideration for both regimens, with estrogen plus progestin use associated with greater risk and estrogen-alone use associated with greater benefit. Use of either regimen in clinical practice requires careful consideration of all clinical risks and benefits.
European regulation of continuing professional development won’t improve quality of care
Authors: Janet Grant, Thomas Zilling
Journal: BMJ (2015)

This is the first reported case of a Chiari 1 malformation in association with tuberculous (TB) meningitis. We present a case of a 23-year-old woman with a 2-week history nocturnal fever, vertigo, headache and projectile vomiting. She had nystagmus, scanning speech, bilateral papilloedema and ataxia. Cranial imaging showed a 10 mm tonsillar herniation. Posterior fossa decompression was done. Because the patient’s gamut of symptoms was highly suspicious for a central nervous system infection, a lumbar tap was done which revealed TB meningitis. Four years later, after anti-TB medications and rehabilitation, all her symptoms except gait instability resolved.
How To Do It: Use facilitated case discussions for significant event auditing
Authors: L A Robinson, R Stacy, J A Spencer, R S Bhopal
Journal: BMJ (1995)

An important type of review undertaken routinely in health care teams is analysis of individual cases. This informal process can be turned into a structured and effective form of audit by using an adaptation of the "critical incident" technique in facilitated case discussions. Participants are asked to recall personal situations that they feel represent either effective or ineffective practice. From such review of individual cases arise general standards to improve the quality of care. On the basis of a study of audit of deaths in general practice, we describe how to implement such a system, including forming and maintaining the discussion group, methodology, and guidelines for facilitators. Problems that may arise during the case discussions are outlined and their management discussed, including problems within the team and with the process of the discussions.
Abstract 14016: The Development of De Novo Anti-hla Antibodies after Heart Transplant is Related to the Development of Rejection Depending of Their Complement Fixing Capability
Authors: Marta Farrero Torres, Marcelo J Pando Rigal, Hannah Valantine, Spenser B Smith, Kiran Khush
Journal: Circulation (2012)

Purpose: The development of anti-HLA donor specific antibodies (DSAs) after cardiac transplantation has been linked to rejection with mixed results. Our aim is to define whether de novo DSAs are as...
Mechanisms of Very Late Drug-Eluting Stent Thrombosis Assessed by Optical Coherence Tomography
Authors: Masanori Taniwaki, Maria D. Radu, Serge Zaugg, Nicolas Amabile, Hector M. Garcia-Garcia, Kyohei Yamaji, Erik Jørgensen, Henning Kelbæk, Thomas Pilgrim, Christophe Caussin, Thomas Zanchin, Aurelie Veugeois, Ulrik Abildgaard, Peter Jüni, Stephane Cook, Konstantinos C. Koskinas, Stephan Windecker, Lorenz Räber
Journal: Circulation (2016)

Background— The pathomechanisms underlying very late stent thrombosis (VLST) after implantation of drug-eluting stents (DES) are incompletely understood. Using optical coherence tomography, we investigated potential causes of this adverse event. Methods and Results— Between August 2010 and December 2014, 64 patients were investigated at the time point of VLST as part of an international optical coherence tomography registry. Optical coherence tomography pullbacks were performed after restoration of flow and analyzed at 0.4 mm. A total of 38 early- and 20 newer-generation drug-eluting stents were suitable for analysis. VLST occurred at a median of 4.7 years (interquartile range, 3.1–7.5 years). An underlying putative cause by optical coherence tomography was identified in 98% of cases. The most frequent findings were strut malapposition (34.5%), neoatherosclerosis (27.6%), uncovered struts (12.1%), and stent underexpansion (6.9%). Uncovered and malapposed struts were more frequent in thrombosed compared with nonthrombosed regions (ratio of percentages, 8.26; 95% confidence interval, 6.82–10.04; P &lt;0.001 and 13.03; 95% confidence interval, 10.13–16.93; P &lt;0.001, respectively). The maximal length of malapposed or uncovered struts (3.40 mm; 95% confidence interval, 2.55–4.25; versus 1.29 mm; 95% confidence interval, 0.81–1.77; P &lt;0.001), but not the maximal or average axial malapposition distance, was greater in thrombosed compared with nonthrombosed segments. The associations of both uncovered and malapposed struts with thrombus were consistent among early- and newer-generation drug-eluting stents. Conclusions— The leading associated findings in VLST patients in descending order were malapposition, neoatherosclerosis, uncovered struts, and stent underexpansion without differences between patients treated with early- and new-generation drug-eluting stents. The longitudinal extension of malapposed and uncovered stent was the most important correlate of thrombus formation in VLST.
Survival after mesenchymal stromal cell therapy in steroid-refractory acute graft-versus-host disease: systematic review and meta-analysis
Authors: Shahrukh Hashmi, Mohammad Ahmed, M Hassan Murad, Mark R Litzow, Roberta H Adams, Lynne M Ball, Vinod K Prasad, Partow Kebriaei, Olle Ringden
Journal: The Lancet Haematology (2015)
Abstract 11409: Comparison of National Cardiovascular Data Registry to an Administrative Database
Authors: Sri Ram Pentakota, Joel N Swerdel, William J Kostis, Javier Cabrera, Nora M Cosgrove, Abel E Moreyra, John B Kostis
Journal: Circulation (2014)

Introduction: Public reporting of cardiovascular outcomes from registries has been useful in monitoring and improving quality of care. However, participation in registries such as National Cardiovascular Data Registry (NCDR) is voluntary and information could be biased due to self-selection of the participating hospitals thus limiting the external validity. Administrative databases usually do not include detailed information, but include all patients. Hypothesis: To compare in-hospital mortality following admission for acute myocardial infarction (AMI) between NCDR and a statewide database of all admissions to nonfederal hospitals in New Jersey (Myocardial Infarction Data Acquisition System, MIDAS) for the year 2011. Methods: We compared the proportion of in-hospital deaths for patients admitted for AMI between NCDR (published data) and MIDAS (unadjusted and adjusted for age, gender and cardiac catheterization (CATH) or percutaneous coronary intervention (PCI). MIDAS data were derived by direct standardization using the 2011 National Inpatient Sample (NIS) as the standard population. Results: The in-hospital mortality rates were lower in NCDR than MIDAS (4.56% vs. 6.37% crude, 5.92 adjusted). NCDR patients were younger and received more CATH (84.97% vs. 62.07%) PCI (64.17% vs. 41.67%). Adjustment for demographics and PCI explained 33% (1.36 vs. 1.81) of the mortality difference between NCDR and MIDAS. Similar findings were obtained when mortality was adjusted for demographics and CATH (40%, 1.81 vs. 1.29, of the mortality difference explained). Conclusions: Prospective registries and administrative databases provide complementary information. The significant differences in patient profiles, frequency of procedures and in-hospital mortality rates between NCDR and MIDAS imply that the care in NCDR hospitals is better. The magnitude of the differences warrants caution in generalizing the NCDR data to the entire nation.
A phase II trial of 5-fluorouracil and high-dose intravenous leucovorin in gastric carcinoma.
Authors: S G Arbuck, H O Douglass, F Trave, S Milliron, M Baroni, H Nava, L J Emrich, Y M Rustum
Journal: Journal of Clinical Oncology (1987)

Twenty-eight patients with advanced measurable gastric carcinoma were treated with leucovorin (dl-CF; folinic acid; dl-5-formyltetrahydrofolic acid) 500 mg/m2 administered as a two-hour infusion and 5-fluorouracil (5-FU) 600 mg/m2 intravenous (IV) push midinfusion. Treatment was administered weekly for 6 weeks followed by a 2-week rest. Twenty-five patients were evaluable for response. Twelve of them had received previous combination chemotherapy that included 5-FU. Median age was 59 years, and median Eastern Cooperative Oncology Group (ECOG) performance status was 2. Three patients had partial responses and two of them had been treated previously with 5-FU. Twelve patients had stable disease. Five of these patients had subjective improvement with improved performance status and/or decreased dysphagia. The 95% confidence interval for response is 3% to 32%. Median survival time for all 28 patients enrolled in the study was 22 weeks. Toxicity was moderate and consisted primarily of diarrhea. Myelosuppression, skin rash, and increased lacrimation also occurred. Plasma concentrations of the active reduced folates, I-CF and 5-methyltetrahydrofolic acid (5-CH3FH4), were greater than the 10 mumol/L levels that potentiate 5-FU activity in in vitro models, for more than four hours in all five patients in whom pharmacokinetics were studied. 5-FU and high-dose dl-CF has activity in patients with gastric carcinoma including patients who had previously progressed on 5-FU-containing combinations. Further study in a larger patient population is necessary to determine the usefulness of this regimen in gastric carcinoma.
Long-term safety and efficacy of etanercept in children and adolescents with plaque psoriasis
Authors: Amy S. Paller, Elaine C. Siegfried, David M. Pariser, Kara Creamer Rice, Mona Trivedi, Jan Iles, David H. Collier, Greg Kricorian, Richard G. Langley
Journal: Journal of the American Academy of Dermatology (2016)

There are no systemic therapies approved in the United States to treat pediatric psoriasis.We sought to evaluate long-term safety and efficacy of etanercept in children and adolescents with moderate to severe plaque psoriasis.This 5-year, open-label extension study enrolled patients aged 4 to 17 years who had participated in a 48-week parent study. End points included occurrence of adverse events (AEs) and serious AEs including infections, and rates of 75% and 90% improvement in Psoriasis Area and Severity Index score and clear/almost clear on static physician global assessment.Of 182 patients enrolled, 181 received etanercept and 69 completed 264 weeks. Through week 264, 161 (89.0%) patients reported an AE, most commonly upper respiratory tract infection (37.6%), nasopharyngitis (26.0%), and headache (21.5%). Seven patients reported 8 serious AEs; only 1 (cellulitis) was considered treatment-related. No cases of opportunistic infections or malignancy were reported. Rates of 75% improvement in Psoriasis Area and Severity Index score (∼ 60%-70%) and 90% improvement in Psoriasis Area and Severity Index score (∼ 30%-40%) and static physician global assessment status clear/almost clear (∼ 40%-50%) were maintained through week 264.The number of patients remaining on study at week 264 was small.Etanercept in pediatric patients was generally well tolerated and efficacy was maintained in those who remained in the study for up to 264 weeks.
The Future of Surgical Oncology
Authors: Sunil Singhal
Journal: JAMA Surgery (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 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
Effects of skeletal myoblast transplantation, bFGF administration, and the combination on tissue blood flow and left ventricular remodeling in rat infarcted hearts: Comparison using pinhole SPECT
Authors: K Tambara, M Ohba, R Hosokawa, GU Premaratne, N Kanemitsu, X Lin, H Nakajima, M Yamamoto, Y Tabata, M Fujita, T Ikeda
Journal: Circulation (2004)
Mantle Cell Lymphoma
Authors: Chan Yoon Cheah, John F. Seymour, Michael L. Wang
Journal: Journal of Clinical Oncology (2016)

Mantle cell lymphoma (MCL) is an uncommon subtype of non-Hodgkin lymphoma previously considered to have a poor prognosis. Large gains were made in the first decade of the new century when clinical trials established the importance of high-dose therapy and autologous stem-cell rescue and high-dose cytarabine in younger patients and the benefits of maintenance rituximab and bendamustine in older patients. In particular, greater depth of understanding of the molecular pathophysiology of MCL has resulted in an explosion of specifically targeted new efficacious agents. In particular, agents recently approved by the Food and Drug Administration include the proteasome inhibitor bortezomib, immunomodulator lenalidomide, and Bruton’s tyrosine kinase inhibitor ibrutinib. We review recent advances in the understanding of MCL biology and outline our recommended approach to therapy, including choice of chemoimmunotherapy, the role of stem-cell transplantation, and mechanism-based targeted therapies, on the basis of a synthesis of the data from published clinical trials.
Melanoma, Version 2.2013
Authors: Daniel G. Coit, Robert Andtbacka, Christopher J. Anker, Christopher K. Bichakjian, William E. Carson, Adil Daud, Dominick DiMaio, Martin D. Fleming, Valerie Guild, Allan C. Halpern, F. Stephen Hodi, Mark C. Kelley, Nikhil I. Khushalani, Ragini R. Kudchadkar, Julie R. Lange, Anne Lind, Mary C. Martini, Anthony J. Olszanski, Scott K. Pruitt, Merrick I. Ross, Susan M. Swetter, Kenneth K. Tanabe, John A. Thompson, Vijay Trisal, Marshall M. Urist, Nicole McMillian, Maria Ho
Journal: Journal of the National Comprehensive Cancer Network (2013)

The NCCN Guidelines for Melanoma provide multidisciplinary recommendations on the clinical management of patients with melanoma. This NCCN Guidelines Insights report highlights notable recent updates. Foremost of these is the exciting addition of the novel agents ipilimumab and vemurafenib for treatment of advanced melanoma. The NCCN panel also included imatinib as a treatment for KIT-mutated tumors and pegylated interferon alfa-2b as an option for adjuvant therapy. Also important are revisions to the initial stratification of early-stage lesions based on the risk of sentinel lymph node metastases, and revised recommendations on the use of sentinel lymph node biopsy for low-risk groups. Finally, the NCCN panel reached clinical consensus on clarifying the role of imaging in the workup of patients with melanoma.
Correlation of tumor response and survival in advanced NSCLC patients treated with paclitaxel plus carboplatin (PC) versus paclitaxel plus carboplatin plus gemcitabine (PCG)
Authors: A. Paccagnella, F. Oniga, A. Bearz, A. Favaretto, F. Barbieri, A. Chella, G. Ceresoli, R. Biason, P. D'Amanzo, M. G. Ghi
Journal: Journal of Clinical Oncology (2007)

7650 Background: We showed that PCG significantly increases both response rate (RR) (43.6% vs 20%) and median survival (10.8 mo vs 8.3 mo) over PC and that at Cox analysis, the only independent prognostic factors were PS and treatment (Paccagnella et al, J Clin Oncol 2006;24: 681–687). According to the Prentice criteria (Stat Med 1989;8: 431–440), to directly relate response and survival it is necessarily that responding patients (and non responding) of both arms have a similar survival and that the survival difference between the two arms disappear when the response factor is included in the multivariate analysis. Methods: Out of 324 pts included in the original analysis, 26 pts were not evaluable for response (early death, toxicity, refusal) before the planned response evaluation at two months and were excluded (15 pts from PC arm and 11 pts from PCG arm). The analysis however was also performed considering the non evaluable patients as non responders. Results: Overall, Responder patients had a median Survival that nearly doubled that of no responders: 14.73 mo vs 7.67 mo (HR: 0.49; CI: 0.31–0.54; P=0.000). No responder pts from PC and PCG arms had a similar survival (median 7.53 mo and 8.07 mo respectively; P= 0.96) as well as responder (CR + PR) patients (median 14.13 mo and 15.40 mo respectively; P=0.38). The principal difference between the two arms was that more than the double of patients in PCG arm responded (43.6% vs 20%) and consequently had a survival advantage of clinical relevance in comparison to patients in PC arm. When tumor response was introduced in the Cox model (as a four level variable), the difference in Overall Survival between PCG and PC changed from a significant level (HR=1.28; CI 1.00–1.63; P=0.049) to a not significant level (HR=0.99; CI: 0.76 - 1.28; P=0.97). Conclusions: To our knowledge this is the first report showing a significant direct correlation between response and survival in advanced NSCLC according to Prentice criteria. No significant financial relationships to disclose.
Outcome of initially unresectable advanced and metastatic colorectal cancer patients treated with first-line mFOLFOX6 followed by surgical tumor removal of metastases: Preliminary results of a phase II trial
Authors: J. Hasegawa, Y. Yoshida, T. Mizushima, M. Fujii, H. Mizuno, K. Tamagawa, R. Nezu
Journal: Journal of Clinical Oncology (2009)

e15122 Objective: The aim of this study was to evaluate the efficacy and tolerability of treatment with mFOLFOX6 followed by surgical tumor removal in patients (pts) with initially unresectable liver metastases and/or extrahepatic disease from colorectal cancer (CRC). Methods: This study was a multicenter, open-label clinical trial. Eligibility criteria defined pts with advanced and metastatic CRC deemed not optimally resectable. mFOLFOX6 (oxaliplatin 85 mg/m 2 , l-leucovorin 200 mg/m 2 , and fluorouracil [400 mg/m 2 bolus followed by 2,400mg /m 2 as a continuous 46-hour infusion]) was administered every 2 weeks for a maximum of 10 cycles. Resectability was the primary end point. Results: 26 pts (15M/11F; PS 0/1 19/7; median age: 60 years, rage 37–73) received 181cycles (median 7, range, 3–10) of mFOLFOX6. Main unresectable lesions were liver metastases in 10 pts and extrahepatic disease in 16 pts. Eleven pts (42%) had at least one grade 3 or greater adverse events. Sixteen pts (61%) achieved an objective response to mFOLFOX6 and 8 pts (31%) had a best overall response of stable disease. In 16 of these 24 pts who achieved the disease control, surgical tumor removal was performed (resectability 61%). The main reasons for initial unresectability in these 16 pts were the presence of liver metastases (6 pts), para-aortic lymph-node metastases (4 pts), carcinomatous peritonitis (4 pts), direct invasion to neighboring organ (2 pts). Four complications (25%) which were anastomotic leak, wound infection, chylous ascites, and cholangitis, were observed. At a median follow-up of 13 months (range 5 -21), 5 pts had relapsed after surgical tumor removal. The median time to progression (TTP) of the pts who underwent operation is not reached to date and those who did not undergo surgical removal is 8.6 months (log-rank p&lt;0.05). Conclusions: Our data suggest that mFOLFOX6 has a significant antitumor activity in pts with not only liver metastases but also extrahepatic disease from CRC, allowing for successful resection of disease in a portion of pts initially not judged to be optimally resectable. No significant financial relationships to disclose.
Doctor manipulated hospital system for four years to abuse boys, investigation finds
Authors: Clare Dyer
Journal: BMJ (2015)

A paediatric consultant haematologist at a leading UK teaching hospital manipulated the appointments system and hospital policies to abuse boys in his care unnoticed over a four year period, an independent investigation has found.1

Colleagues missed clues that could have led to the discovery that Myles Bradbury was abusing young patients at Addenbrooke’s Hospital in Cambridge from 2009 to 2013, concluded a report by the public service consultancy Verita.

Bradbury is serving 16 years in prison after admitting 25 offences of sexually assaulting 18 victims, as well as voyeurism and possessing more than 16 000 indecent images.2 He used a “spy pen” to capture images of his adolescent victims while carrying out unnecessary genital examinations.

Staff at the paediatric day unit …
Relationship of Coronary Calcium on Standard Chest CT Scans With Mortality
Authors: Jan M. Hughes-Austin, Arturo Dominguez, Matthew A. Allison, Christina L. Wassel, Dena E. Rifkin, Cindy G. Morgan, Michael R. Daniels, Umaira Ikram, Jessica B. Knox, C. Michael Wright, Michael H. Criqui, Joachim H. Ix
Journal: JACC. Cardiovascular imaging (2016)