tbuckley/cabot-search huggingface dataset:
Clinical outcome in diffuse large B-cell lymphoma is dependent on the relationship between different cell-cycle regulator proteins.
Authors: E Sanchez, I Chacon, M M Plaza, E Muñoz, M A Cruz, B Martinez, L Lopez, J C Martinez-Montero, J L Orradre, A I Saez, J F Garcia, M A Piris
Journal: Journal of Clinical Oncology (1998)

PURPOSE The goal of this work was to perform a comprehensive exploration of the relationship between the clinical outcome of diffuse large B-cell lymphoma (DLBCL) and the expression of a panel of tumor suppressor and oncogenic proteins, which includes some cell-cycle regulator proteins involved in the p53 pathway. PATIENTS AND METHODS To this end, we collected the clinical data of 141 patients with DLBCL and immunohistochemically analyzed diagnostic tumoral tissue from each patient for the presence of Ki67 (MIB1, Immuno-tech, Marseille, France), bcl2, p53, p21/WAF1, MDM2, and retinoblastoma (Rb) proteins. RESULTS The results show that several proteins are associated with some of the clinical traits analyzed. Multivariate analysis showed that an extended overall survival (OS) time was associated with low growth fraction, high Rb protein, and low MDM2 expression, as well as with known clinical parameters. The probability of inducing a complete remission (CR) was only associated with clinical parameters, although univariate study showed that a low growth fraction was associated with a higher probability of inducing a CR. Univariate study of disease-free survival (DFS) showed that tumors with high bcl2 expression and nodal origin have a shorter DFS time, although multivariate study only confirmed the adverse effect of bcl2 expression. CONCLUSION Taking all these results into consideration, it seems that although the overall outcome for patients with DLBCL is decided by a combination of different clinical and biologic variables, the expression of some of these cell-cycle regulator proteins appears to be specifically associated with the different clinical features of tumors.
Antibiotic Overuse and Paronychia
Authors: Nathan Handley, Alon Unger
Journal: JAMA Internal Medicine (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 Internal Medicine 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 Internal Medicine journal
Infection and Cancer: The Case of Hepatitis B
Authors: Stephen L. Chan, Vincent W.S. Wong, Shukui Qin, Henry L.Y. Chan
Journal: Journal of Clinical Oncology (2015)

Infection is a well-described cause of cancer in humans. Being one of the most common infections worldwide, hepatitis B virus (HBV) is the leading cause of hepatocellular carcinoma (HCC), particularly in Asian countries. The etiological link between HBV and HCC provides an important opportunity for health care policy makers and clinicians to intervene with HBV infection to prevent cancer development and improve the outcomes of cancer. This review aims to use HBV as an example to illustrate the potential of tackling infection-related conditions to help improve cancer outcomes. This article is divided into four parts: In the first part, an overview is given on the epidemiologic data and risk factors of HCC development in patients with chronic hepatitis B. In the second part, recent progress on the anti-HBV strategies for preventing HCC is updated. In the third part, approaches to improve the outcomes of established HBV-related HCC are covered. These methods include surveillance strategies to identify asymptomatic HCC among patients with chronic HBV infection, and use of antiviral treatment to avoid HBV reactivation during treatment for HCC and reduce the recurrence of HCC after curative treatment. Finally, the status of the development of targeted drugs specifically for HBV-related HCC is discussed in the section on future development.
Identify sepsis in patients by using early warning scores, doctors are urged
Authors: Zosia Kmietowicz
Journal: BMJ (2015)

General practitioners and hospital doctors should all use an early warning score system when they suspect that a patient may have sepsis to help improve the recognition of cases, a report recommends.1

Nearly half (45%) of patients with sepsis admitted to hospital with no other obvious problem either died or were left with a disability, an audit of cases in England, Wales, and Northern Ireland has found.

A third (34%; 184) of the 544 hospitals reviewed had no formal sepsis protocol to identify and manage patients with sepsis, and this needs to be rectified, said a report into sepsis …
the quiet room
Authors: D.A. Frater
Journal: Annals of Internal Medicine (2015)

Ad Libitum17 November 2015the quiet roomD.A. Frater, MDD.A. Frater, MDFrom Dallas, Texas.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-0591 Audio Reading - “the quiet room” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "the quiet room," by D.A. Frater. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In the quietquiet roomwhere she diedI looked forclues shemight haveleft beforesucceedingat whatonce beforeshe hadonly triedI found stillrestingin her bedan imprinther questionmark bodycurledat the kneesthe hips bentthe elbow thepoint of hershoulder ahint incloth ofher faceto onesideI sat atthe edge ofthat finalempty momenteyes closedto see hercurled insomethingelsebesidesthe endand laidmy handto herphantom hipwantingto softenso thehard sadconfusionand gentlyrub toolate Iknowa softtouchupon herheartand yetstilltriedto fathomthe depthof herspiritsinkingprayingthat shetouchedbottomfinallyupon ahoped forcalmandwas notalone inher restingplacethat theeaseupon herface wastherefair andsincereand despitemy hidingfears didnot hersecretdreadbelie(For PMF) Author, Article, and Disclosure InformationAffiliations: From Dallas, Texas.Current Author Address: D.A. Frater, MD; e-mail, [email protected]md. PreviousarticleNextarticle Advertisement Audio Reading - “the quiet room” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "the quiet room," by D.A. Frater. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 17 November 2015Volume 163, Issue 10Page: 808KeywordsElbowFearHeartHipKneesShouldersTouch ePublished: 17 November 2015 Issue Published: 17 November 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Policy Recommendations to Guide the Use of Telemedicine in Primary Care Settings: An American College of Physicians Position Paper
Authors: Hilary Daniel, Lois Snyder Sulmasy
Journal: Annals of Internal Medicine (2015)

Telemedicine-the use of technology to deliver care at a distance-is rapidly growing and can potentially expand access for patients, enhance patient-physician collaboration, improve health outcomes, and reduce medical costs. However, the potential benefits of telemedicine must be measured against the risks and challenges associated with its use, including the absence of the physical examination, variation in state practice and licensing regulations, and issues surrounding the establishment of the patient-physician relationship. This paper offers policy recommendations for the practice and use of telemedicine in primary care and reimbursement policies associated with telemedicine use. The positions put forward by the American College of Physicians highlight a meaningful approach to telemedicine policies and regulations that will have lasting positive effects for patients and physicians.
The pineapple genome and the evolution of CAM photosynthesis
Authors: Ray Ming, Robert VanBuren, Ching Man Wai, Haibao Tang, Michael C Schatz, John E Bowers, Eric Lyons, Ming-Li Wang, Jung Chen, Eric Biggers, Jisen Zhang, Lixian Huang, Lingmao Zhang, Wenjing Miao, Jian Zhang, Zhangyao Ye, Chenyong Miao, Zhicong Lin, Hao Wang, Hongye Zhou, Won C Yim, Henry D Priest, Chunfang Zheng, Margaret Woodhouse, Patrick P Edger, Romain Guyot, Hao-Bo Guo, Hong Guo, Guangyong Zheng, Ratnesh Singh, Anupma Sharma, Xiangjia Min, Yun Zheng, Hayan Lee, James Gurtowski, Fritz J Sedlazeck, Alex Harkess, Michael R McKain, Zhenyang Liao, Jingping Fang, Juan Liu, Xiaodan Zhang, Qing Zhang, Weichang Hu, Yuan Qin, Kai Wang, Li-Yu Chen, Neil Shirley, Yann-Rong Lin, Li-Yu Liu, Alvaro G Hernandez, Chris L Wright, Vincent Bulone, Gerald A Tuskan, Katy Heath, Francis Zee, Paul H Moore, Ramanjulu Sunkar, James H Leebens-Mack, Todd Mockler, Jeffrey L Bennetzen, Michael Freeling, David Sankoff, Andrew H Paterson, Xinguang Zhu, Xiaohan Yang, J Andrew C Smith, John C Cushman, Robert E Paull, Qingyi Yu
Journal: Nature Genetics (2015)

Ray Ming, Robert Paull, Qingyi Yu and colleagues report the genome sequences of two cultivated pineapple varieties and one wild pineapple relative. Their analysis supports the use of the pineapple as a reference genome for monocot comparative genomics and provides insight into the evolution of crassulacean acid metabolism photosynthesis. Pineapple (Ananas comosus (L.) Merr.) is the most economically valuable crop possessing crassulacean acid metabolism (CAM), a photosynthetic carbon assimilation pathway with high water-use efficiency, and the second most important tropical fruit. We sequenced the genomes of pineapple varieties F153 and MD2 and a wild pineapple relative, Ananas bracteatus accession CB5. The pineapple genome has one fewer ancient whole-genome duplication event than sequenced grass genomes and a conserved karyotype with seven chromosomes from before the ρ duplication event. The pineapple lineage has transitioned from C3 photosynthesis to CAM, with CAM-related genes exhibiting a diel expression pattern in photosynthetic tissues. CAM pathway genes were enriched with cis-regulatory elements associated with the regulation of circadian clock genes, providing the first cis-regulatory link between CAM and circadian clock regulation. Pineapple CAM photosynthesis evolved by the reconfiguration of pathways in C3 plants, through the regulatory neofunctionalization of preexisting genes and not through the acquisition of neofunctionalized genes via whole-genome or tandem gene duplication.
Dengue virus NS1 triggers endothelial permeability and vascular leak that is prevented by NS1 vaccination
Authors: P. Robert Beatty, Henry Puerta-Guardo, Sarah S. Killingbeck, Dustin R. Glasner, Kaycie Hopkins, Eva Harris
Journal: Science Translational Medicine (2015)

The four dengue virus serotypes (DENV1 to DENV4) are mosquito-borne flaviviruses that cause up to ~100 million cases of dengue annually worldwide. Severe disease is thought to result from immunopathogenic processes involving serotype cross-reactive antibodies and T cells that together induce vasoactive cytokines, causing vascular leakage that leads to shock. However, no viral proteins have been directly implicated in triggering endothelial permeability, which results in vascular leakage. DENV nonstructural protein 1 (NS1) is secreted and circulates in patients' blood during acute infection; high levels of NS1 are associated with severe disease. We show that inoculation of mice with DENV NS1 alone induces both vascular leakage and production of key inflammatory cytokines. Furthermore, simultaneous administration of NS1 with a sublethal dose of DENV2 results in a lethal vascular leak syndrome. We also demonstrate that NS1 from DENV1, DENV2, DENV3, and DENV4 triggers endothelial barrier dysfunction, causing increased permeability of human endothelial cell monolayers in vitro. These pathogenic effects of physiologically relevant amounts of NS1 in vivo and in vitro were blocked by NS1-immune polyclonal mouse serum or monoclonal antibodies to NS1, and immunization of mice with NS1 from DENV1 to DENV4 protected against lethal DENV2 challenge. These findings add an important and previously overlooked component to the causes of dengue vascular leak, identify a new potential target for dengue therapeutics, and support inclusion of NS1 in dengue vaccines.
Chronic Hyponatremia Causes Neurologic and Psychologic Impairments
Authors: Haruki Fujisawa, Yoshihisa Sugimura, Hiroshi Takagi, Hiroyuki Mizoguchi, Hideyuki Takeuchi, Hisakazu Izumida, Kohtaro Nakashima, Hiroshi Ochiai, Seiji Takeuchi, Atsushi Kiyota, Kazuya Fukumoto, Shintaro Iwama, Yoshiko Takagishi, Yoshitaka Hayashi, Hiroshi Arima, Yukio Komatsu, Yoshiharu Murata, Yutaka Oiso
Journal: Journal of the American Society of Nephrology (2015)

Hyponatremia is the most common clinical electrolyte disorder. Once thought to be asymptomatic in response to adaptation by the brain, recent evidence suggests that chronic hyponatremia may be linked to attention deficits, gait disturbances, risk of falls, and cognitive impairments. Such neurologic defects are associated with a reduction in quality of life and may be a significant cause of mortality. However, because underlying diseases such as adrenal insufficiency, heart failure, liver cirrhosis, and cancer may also affect brain function, the contribution of hyponatremia alone to neurologic manifestations and the underlying mechanisms remain unclear. Using a syndrome of inappropriate secretion of antidiuretic hormone rat model, we show here that sustained reduction of serum sodium ion concentration induced gait disturbances; facilitated the extinction of a contextual fear memory; caused cognitive impairment in a novel object recognition test; and impaired long-term potentiation at hippocampal CA3-CA1 synapses. In vivo microdialysis revealed an elevated extracellular glutamate concentration in the hippocampus of chronically hyponatremic rats. A sustained low extracellular sodium ion concentration also decreased glutamate uptake by primary astrocyte cultures, suggesting an underlying mechanism of impaired long-term potentiation. Furthermore, gait and memory performances of corrected hyponatremic rats were equivalent to those of control rats. Thus, these results suggest chronic hyponatremia in humans may cause gait disturbance and cognitive impairment, but these abnormalities are reversible and careful correction of this condition may improve quality of life and reduce mortality.
Quality of Life Analysis of a Radiation Dose–Escalation Study of Patients With Non–Small-Cell Lung Cancer
Authors: Benjamin Movsas, Chen Hu, Jeffrey Sloan, Jeffrey Bradley, Ritsuko Komaki, Gregory Masters, Vivek Kavadi, Samir Narayan, Jeff Michalski, Douglas W. Johnson, Christopher Koprowski, Walter J. Curran, Yolanda I. Garces, Rakesh Gaur, Raymond B. Wynn, John Schallenkamp, Daphna Y. Gelblum, Robert M. MacRae, Rebecca Paulus, Hak Choy
Journal: JAMA Oncology (2015)

A recent randomized radiation dose-escalation trial in unresectable stage III non-small-cell lung cancer (NSCLC) (Radiation Therapy Oncology Group [RTOG] 0617) showed a lower survival rate in the high-dose radiation therapy (RT) arm (74 Gy) than in the low-dose arm (60 Gy) with concurrent chemotherapy.The primary QOL hypothesis predicted a clinically meaningful decline in quality of life (QOL) via the Functional Assessment of Cancer Therapy (FACT)-Lung Cancer Subscale (LCS) in the high-dose RT arm at 3 months.The RTOG 0617 trial was a randomized phase 3 study (conducted from November 2007 to November 2011) in stage III NSCLC using a 2 × 2 factorial design and stratified by histology, positron emission tomography staging, performance status, and irradiation technique (3-dimensional conformal RT [3D-CRT] vs intensity-modulated RT [IMRT]). A total of 185 institutions in the United States and Canada took part. Of 424 eligible patients with stage III NSCLC randomized, 360 (85%) consented to QOL evaluation, of whom 313 (88%) completed baseline QOL assessments.Treatment with 74-Gy vs 60-Gy RT with concurrent and consolidation carboplatin/paclitaxel with or without cetuximab.The QOL data were collected prospectively via FACT Trial Outcome Index (FACT-TOI), calculated as the sum of the following measures: Physical Well Being (PWB), Functional Well Being (FWB), and the LCS. Data are presented at baseline and 3 and 12 months via minimal clinically meaningful changes of 2 points or more for PWB, FWB, and LCS or 5 points or more for TOI.Of the 313 patients who completed baseline QOL assessments, 219 patients (70%) completed the 3-month QOL assessments, and 137 of the living patients (57%) completed the 12-month assessment. Patient demographics and baseline QOL scores were comparable between the 74-Gy and 60-Gy arms. Significantly more patients in the 74-Gy arm than in the 60-Gy arm had clinically meaningful decline in FACT-LCS at 3 months (45% vs 30%; P = .02). At 12 months, fewer patients who received IMRT (vs 3D-CRT) had clinically meaningful decline in FACT-LCS (21% vs 46%; P = .003). Baseline FACT-TOI was associated with overall survival in multivariate analysis.Despite few differences in clinician-reported toxic effects between treatment arms, QOL analysis demonstrated a clinically meaningful decline in QOL in the 74-Gy arm at 3 months, confirming the primary QOL hypothesis. Baseline QOL was an independent prognostic factor for survival.clinicaltrials.gov Identifier: NCT00533949.
Association Between the Affordable Care Act Dependent Coverage Expansion and Cervical Cancer Stage and Treatment in Young Women
Authors: Anthony S. Robbins, Xuesong Han, Elizabeth M. Ward, Edgar P. Simard, Zhiyuan Zheng, Ahmedin Jemal
Journal: JAMA (2015)

This observational study uses the National Cancer Data Base to compare the number and stage of cervical cancer cases diagnosed in young women before and after expansion of Affordable Care Act Dependent Coverage.
Intravenous Immune Globulin for Statin-Triggered Autoimmune Myopathy
Authors: Andrew L Mammen, Eleni Tiniakou
Journal: New England Journal of Medicine (2015)

Although most statin-related myopathy is self-limited, in rare cases statins trigger autoimmune myopathy, which requires control with immunosuppressive therapy. Three patients with this disorder were treated with intravenous immunoglobulin as initial therapy, with some benefit.
Anxiety disorders and depression: contradictions between family study data and DSM-III conventions
Authors: J F Leckman, K R Merikangas, D L Pauls, B A Prusoff, M M Weissman
Journal: American Journal of Psychiatry (1983)

The authors report data from a case-control family study of lifetime psychiatric diagnoses among the relatives of individuals with major depression. Specifically, they address the relationship between anxiety disorders and major depression. The findings indicate that relatives of individuals with major depression plus an anxiety disorder are at greater risk for major depression, as well as anxiety disorders; than are the relatives of individuals with major depression without an anxiety disorder. This increased risk appears to be present whether or not the anxiety disorder occurs solely in association with episodes of major depression or is temporally separate. The nosological implications of these findings are discussed.
Prolongation of survival for high-grade malignant gliomas with adjuvant high-dose BCNU and autologous bone marrow transplantation.
Authors: D B Johnson, J M Thompson, J A Corwin, K R Mosley, M T Smith, R A de los Reyes, M B Daly, A M Petty, D Lamaster, W P Pierson
Journal: Journal of Clinical Oncology (1987)

Employment of postoperative brain irradiation in the initial management of high-grade malignant glial tumors has now become standard. The addition of conventional chemotherapy to irradiation has not significantly improved median survival beyond 1 year. We treated 25 consecutive patients (13 pilot patients and 12 protocol patients) with histologically confirmed unresectable grade 3 or 4 malignant gliomas with high-dose BCNU (carmustine) followed by autologous bone marrow transplantation and whole brain irradiation. Within 3 weeks of initial surgery, each patient had autologous bone marrow stored (median 2 X 10(8) nucleated cells/kg), and then received BCNU 1,050 mg/m2 intravenously (IV). Peripheral granulocytes recovered (greater than 500/microL) at a median of 19 days (range, 10 to 37 days), and platelets recovered (greater than 20,000/microL) at a median of 18 days (range, 13 to 40 days), following bone marrow infusion. Patients received 60 Gy whole brain irradiation when granulocytes were greater than 1,500/microL. Toxicity was well tolerated. Nausea occurred in 19 patients (76%); however, only eight patients (32%) experienced vomiting (mild in three, moderate in five). Eleven patients (44%) did not require empiric antibiotics, six of whom never developed an absolute granulocyte count less than 500/microL. Three patients with a poor performance status died early (one seizure with vomiting and asphyxiation; one, klebsiella urinary tract infection (UTI) with bacteremia; one, candidal pneumonia), and one additional patient who was performing well died of pulmonary hemorrhage. The 13 pilot patients have now been followed for a median of 23 months, with a significant survival advantage compared with the 52 consecutive historical control patients who received similar surgery and radiotherapy without high-dose BCNU (P = .037). The overall study group of 25 patients also has a significant survival advantage when compared with the same historical control group, with a projected median survival of 26 months (P = .007). This new approach using early postoperative intensive therapy consisting of high-dose BCNU, autologous bone marrow transplantation, and whole brain irradiation appears to significantly improve survival.
Progress Toward Poliomyelitis Eradication — Afghanistan, January 2016–June 2017
Authors: Maureen Martinez, Hemant Shukla, Joanna Nikulin, Mufti Zubair Wadood, Stephen Hadler, Chukwuma Mbaeyi, Rudolph Tangermann, Jaume Jorba, Derek Ehrhardt
Journal: MMWR Morbidity and Mortality Weekly Report (2017)

Afghanistan, Pakistan, and Nigeria remain the only countries where the transmission of endemic wild poliovirus type 1 (WPV1) continues (1). This report describes polio eradication activities, progress, and challenges in Afghanistan during January 2016-June 2017 and updates previous reports (2,3). Thirteen WPV1 cases were confirmed in Afghanistan in 2016, a decrease of seven from the 20 cases reported in 2015. From January to June 2017, five WPV1 cases were reported, compared with six during the same period in 2016. The number of affected districts declined from 23 (including WPV1-positive acute flaccid paralysis [AFP] cases and positive environmental sewage samples) in 2015 to six in 2016. To achieve WPV1 eradication, it is important that Afghanistan's polio program continue to collaborate with that of neighboring Pakistan to track and vaccinate groups of high-risk mobile populations and strengthen efforts to reach children in security-compromised areas.