tbuckley/cabot-search huggingface dataset:
Safety and tolerability of a novel IL-12 gene therapeutic administered in combination with carboplatin/docetaxel in patients with recurrent ovarian cancer.
Authors: K. Anwar, M. N. Barnes, F. J. Kelly, C. Chu, K. Cutter, J. Fewell, R. D. Alvarez
Journal: Journal of Clinical Oncology (2010)

5045 Background: We have previously demonstrated the safety and tolerability of EGEN-001, an IL-12 expressing plasmid formulated with a novel lipopolymeric gene delivery system, in women with platinum-resistant recurrent ovarian cancer. We now describe the safety and tolerability of EGEN-001 administered in combination with carboplatin/docetaxel in women with recurrent ovarian cancer. Methods: Patients were treated intraperitoneally (IP) with escalating dosages and cycles of EGEN-001 in combination with intravenous (IV) docetaxel and carboplatin. A final evaluation of patients for safety, antitumor activity and various biologic endpoints was performed 6 months after EGEN-001 treatment. Results: 13 patients were enrolled in 4 cohorts. The first three cohorts (n = 3 each) received escalating doses of EGEN-001 (IL-12 DNA: 12 mg/m2, 18 mg/m2 and 24 mg/m2) once every 10-11 days for four treatments. The fourth cohort (n = 4) received up to 8 treatments at the highest tolerated dose (24 mg/m2). Patients also received, IV docetaxel (75 mg/m2) and carboplatin (AUC 5) at 3 week intervals for a planned 6 cycles. All test doses and cycles of EGEN-001 were well tolerated. The most common EGEN-001-related adverse events included abdominal pain, abdominal tenderness, catheter site pain, chills, and pyrexia. A majority of the EGEN-001 related adverse events (32 of 49) were reported by patients in Cohort 4. At the 6-month follow-up assessment, 23% of the patients had complete response, 8% of the patients had partial response, 38% of the patients had stable disease and 31% of the patients had progressive disease. The serum CA-125 levels decreased in all patients after treatment initiation and remained below pretreatment levels in 61% of the patients at final 6-month follow-up. There were significant treatment-related increases in IFN-γ and TNF-α concentrations in peritoneal fluid with only little increases in blood. Conclusions: IP administration of novel IL-12 gene therapeutic EGEN-001 in combination with carboplatin/docetaxel therapy is feasible and demonstrates potential antitumor activity in patients with recurrent ovarian cancer. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Egen Egen Egen, Expression Genetics
HIV Screening in Pregnancy
Authors: Rebecca Voelker
Journal: JAMA (2000)

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
Predictors of increased daytime sleepiness in patients with COPD
Authors: Claudia Enz, Stefanie Zogg, Esther Helen Steveling, Selina Dürr, Sabrina Maier, David Miedinger, Jörg Daniel Leuppi
Journal: European Respiratory Journal (2014)

Background: Previous reports have shown that COPD patients suffer increased daytime sleepiness. The role of underlying sleep-related breathing disorder and nocturnal activity is still unclear.

Objective: The aim of this study was to identify potential predictors of subjective daytime sleepiness.

Methods: Patients with stable COPD were recruited at the University Hospital in Basel, Switzerland, in a cross-sectional manner. COPD risk groups A-D were determined according to the new GOLD guidelines based on spirometry and COPD assessment test (CAT). To assess disturbed respiration and energy expenditure during sleep, ApneaLink and Sensewear Mini Armband were administered during one night. Subjective daytime sleepiness was recorded using Epworth Sleepiness Scale (ESS) (a score >10/24).

Results: Data from 28 females and 34 males were analysed (n=62). Median BMI was 25 (IQR=8) kg/m2 and mean age was 65±9 yrs (range 44-90). Twenty-two patients (36%) were in COPD risk group A, twenty-eight patients (45%) in risk group B and twelve patients (19%) in risk groups C+D. Eleven patients (18%) had a pathological ESS >10/24. ESS correlated positively with CAT score (r=0.386, p 10/24. Multiple linear regression revealed that age (β=-0.243, p<0.05), Apnea Hypopnea Index (β=0.283, p<0.05) and CAT score (β=0.441, p<0.01) were independent predictors of ESS, while nocturnal energy expenditure showed no significant association (p=0.619).

Conclusion: The present findings provide evidence that daytime sleepiness may partly be attributable to respiratory disturbances during sleep in patients with COPD.
Abstract 64: Association Between Blood Pressure Measurements, Vasopressor Use and Outcome in Post--Cardiac Arrest Patients Treated with Therapeutic Hypothermia from 4 Sites (COMICA Study Group)
Authors: Sarah M Perman, Anne V Grossestreuer, Marion Leary, Michael W Donnino, Michael N Cocchi, Mary Ann Peberdy, Joseph P Ornato, John N Clore, Clifton W Callaway, Jon C Rittenberger, Benjamin S Abella, David F Gaieski
Journal: Circulation (2012)

Introduction: Specific hemodynamic optimization strategies have not been clearly described nor defined for post-cardiac arrest syndrome (PCAS) patients undergoing therapeutic hypothermia (TH). Hypothesis: Patients who suffer worse neurologic outcomes will have more significant hemodynamic derangements in the early hours post-arrest than those with good neurologic outcome. Methods: This is a collaborative study amongst 4 centers with aggressive TH protocols (BID, Penn, Pitt, VCU). It is a secondary analysis from prospectively collected data of out-of-hospital cardiac arrest patients who underwent TH. The primary outcome is neurologic status at hospital discharge measured as cerebral performance category (CPC), dichotomized into “good” (1 or 2) or “poor” (3, 4, or 5). Demographic information, initial rhythm and co-morbid conditions were obtained. Study variables were abstracted at baseline, 12, 24, 36 and 48 hrs. Variables recorded were systolic blood pressure (SBP) at baseline; MAP at each time point; worst, highest and lowest mean arterial pressure (MAP) for each 24 hr interval; vasopressor use. Results: A total of 111 patients were enrolled. Patients were 61 ± 16.8 years, 59.5% male, with an initial rhythm of VF/VT in 50.5% of cases. The initial SBP for patients with good vs. poor outcome was 150 ± 37 mmHg vs. 128 ± 32 mmHg respectively (p=0.037). Patients in both groups had comparable MAPs at 12 hrs (91 vs. 87, p= 0.34) and at 36 hrs (86 vs. 81, p=0.113); however, the vasopressor use at these time points differed. At 12 hrs, vasopressors were used in 20% of patients with good outcome, versus 43.4% of patients with poor outcome (p=0.017). At 36 hrs, 31.4% of patients with a good outcome were on vasopressors vs. 50.7% with a poor outcome (p=0.06). In the first 24 hrs, subjects with good and poor outcome had equal distributions of their worst MAPs into the “low” (90 mmHg) categories. Conversely, in the second 24 hrs, patients with a poor outcome had a higher proportion of patients where their worst MAP was “low” versus those who had a good outcome (67% vs. 76%, ns). Conclusions: Patients with poor neurologic outcomes have lower initial SBPs and a higher percentage of vasopressor use during TH versus patients with good neurologic outcomes.
The Elements of the Science of Nutrition.
Journal: JAMA (1910)

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
Management and Long-Term Clinical Outcome of Api2-Malt1 Positive Gastric Malt Lymphoma
Authors: M. Tajika, Y. Niwa, T. Tanaka, M. Ishihara, N. Mizuno, K. Hara, S. Hijioka, H. Imaoka, T. Yogi, H. Tsutsumi, T. Fujiyoshi, T. Sato, T. Yoshida, N. Okuno, N. Hieda, Y. Yatabe, V. Bhatia, K. Yamao
Journal: Annals of Oncology (2014)
Sequential chemoradiotherapy versus concurrent chemoradiotherapy plus consolidation chemotherapy in unresectable stage III non-small cell lung cancer
Authors: H. M. El-Shenshawy, A. Fathy, S. Eteba
Journal: Journal of Clinical Oncology (2008)

18509 Background: To evaluate the efficacy and toxicity of concurrent/consolidation chemoradiotherapy versus sequential chemoradiotherapy in unresectable stage III non-small cell lung cancer (NSCLC). Methods: Thirty-two patients with stage III unresectable NSCLC were randomly assigned to one of the two treatment arms. In the sequential arm, patients received induction chemotherapy with docetaxel (75 mg/m2) repeated every 3 weeks for 3 cycles, followed by thoracic radiotherapy at a dose of 61Gy in 33 fractions over 6.5 weeks. In the concurrent/consolidation arm, the same radiotherapy was started on day 2 with two concurrent cycles of (PE): cisplatin 50 mg/m2 on days 1, 8, 29, and 36; etoposide 50 mg/m2 on days 1 through 5 and 29 through 33. Then these patients received consolidation therapy with docetaxel started 4–6 weeks after concurrent chemoradiotherapy, repeated every 3 weeks for 3 cycles at a dose of 75 mg/m2. Results: The overall response rate was higher in concurrent/ consolidation arm (62.5%) than in sequential arm (43.7%), (P=0.031). The median survival was 19 months in concurrent/consolidation arm and 13.6 months in the sequential arm, (P=0.001). The 2- year survival rate was better in concurrent/consolidation arm (43.7%) than in the sequential arm (25%), (P=0.032). Median progression- free survival was longer in concurrent/consolidation arm (11.9 months) than in sequential arm (8 months), (P=0.071). The major and most frequent toxicity was neutropenia, which was 43.7% in concurrent/consolidation arm versus 56.2% in sequential arm, (P=0.09). However, esophageal toxicity (≥ grade 3) was relatively higher in concurrent/consolidation arm 25% versus 12.5% in sequential arm, (P= 0.05). Brain metastases was the most common site of distant failure in both treatment arms. Locoregional failure was more frequent in sequential arm (37.5%) than in concurrent/ consolidation arm (18.7%), (P=0.039). Conclusions: Consolidation docetaxel after concurrent cisplatin/etoposide with radiotherapy in stage III NSCLC was feasible, tolerable and can be safely administered with relatively low incidence of radiation esophagitis. In addition, treatment outcomes compared favorably with the sequential chemoradiotherapy. No significant financial relationships to disclose.
Molecular profiling of circulating tumor cells (CTC) in patients with castrate metastatic prostate cancer (CMPC) receiving abiraterone acetate (AA) after failure of docetaxel-based chemotherapy.
Authors: D. C. Danila, A. Anand, C. C. Sung, M. Leversha, D. E. Rathkopf, M. J. Morris, S. F. Slovin, A. Molina, M. Fleisher, H. I. Scher
Journal: Journal of Clinical Oncology (2010)

4635 Background: Molecular profiles show consistent reactivation of androgen receptor (AR) in CMPC in part through overexpression of AR and androgen-synthetic enzymes. The relevance of recurrent TMPRSS2:ERG rearrangement in CMPC remains poorly defined. AA inhibits CYP17 to decrease serum androgen to undetectable levels and has anti-tumor activity in heavily pretreated pts. Selecting targeted therapies and assessing outcome in patients (pts) with CMPC remain critical unmet medical needs, where CTC are being tested as efficacy response and predictive biomarkers. Methods: AA (1000 mg QD PO) was studied in pts with metastatic CMPC who had progressed on docetaxel based chemotherapy. The primary endpoint was a ≥50% decline in PSA from baseline. Pre- and post-therapy CTC numbers were studied as efficacy response markers. TMPRSS2:ERG status was studied by multiplex RT-PCR in enriched CTC. Results: 54 pts were screened and 48 treated; 38 pts received prednisone from the start of treatment. The median (IQR) age was 73 years (63-79), PSA 99.9 ng/mL (36.4-343) and CTC were 18 (4-49) per 7.5 ml of blood at baseline. Metastatic sites were bone alone in 10 pts, bone and lymph nodes in 21 pts, 15 with visceral disease, 2 with soft tissue alone. In 35 pts (73%) with ≥ 5 CTC at the start of treatment, 13 pts had CTC decline <5 after 1m of therapy; additionally 11 pts had CTC <5 at all times (group A). CTC remained ≥ 5 in 22 pts and 2 pts had an increase of CTC from <5 to ≥ 5 (group B). Pts in Group A had a median time to PSA progression of 28 weeks, compared to 12 weeks in group B (P <0.005). From 28 pts with FISH in CTC, 5/19 pts with AR amplification or gain had a decrease in PSA with AA; 5/9 pts with no evident AR copy number abnormalities showed a significant decline in PSA. TMPRSS2:ERG was detected in 15/41 pts (37%), of which 7 (47%) pts had >50% PSA decline compared to 10/26 (38%) of pts without TMPRSS2:ERG. Conclusions: The significant relationship between clinical outcomes and changes in CTC numbers as an efficacy response biomarker, as well as the predictive value of molecular profiles in CTC warrant further testing in prospective phase III trials. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Cougar Biotechnology Cougar Biotechnology, Veridex Cougar Biotechnology Cougar Biotechnology, Veridex
Radiotherapy for stage 2 testicular seminoma: the prognostic influence of tumor bulk.
Authors: B R Mason, J H Kearsley
Journal: Journal of Clinical Oncology (1988)

Forty-nine consecutive patients with stage 2 testicular seminoma were treated with primary radiotherapy from 1968 to 1985. Overall diseases-free survival (DFS) for patients with 36 months minimum follow-up was 82% at 3 years. This figure did not decline further with time. Infradiaphragmatic bulk disease was found to be a significant prognostic factor for local and distant relapse as well as for ultimate survival. Patients with either stage 2A or 2B disease (infradiaphragmatic bulk less than or equal to 10 cm size) had a 3-year DFS of 89% compared with a 64% 3-year DFS rate for patients with stage 2C disease (infradiaphragmatic bulk greater than or equal to 10 cm size). The (local plus distant) relapse rate was 4.0% for patients with stage 2A disease, 16.7% for patients with stage 2B disease, and 33.3% for patients with stage 2C disease. The majority of distant relapses were multifocal and prophylactic mediastinal irradiation did not appear to influence either relapse rate nor overall survival. Of seven patients who relapsed, four died of progressive malignancy, two deaths were related to salvage chemotherapy, and only one patient is alive and well following successful chemotherapeutic salvage. On the basis of our experience, we recommend radiotherapy with the use of modern imaging techniques as initial treatment for patients with retroperitoneal masses less than 10 cm size. Aggressive cisplatin-based chemotherapy should be seriously considered for patients with retroperitoneal masses greater than or equal to 10 cm size, or for patients who relapse following radiotherapy.
Phase II trial of irinotecan and capecitabine in patients with advanced colorectal cancer (ACRC)
Authors: J.-B. Ahn, K. H. Jung, Y. S. Park, Y. H. Kim, H. J. Chang, D. K. Sohn, S. B. Lim, H. S. Choi, S.-Y. Jeong, J. G. Park
Journal: Journal of Clinical Oncology (2005)

3714 Background: Irinotecan (I) and capecitabine (C) are active in ACRC. The combination of these 2 agents is synergistic in preclinical and clinical studies. We conducted a phase II study of IC combination for previously untreated patients with measurable ACRC to evaluate the objective response rate and to assess the time to progression in Korea. Methods: The treatment consisted of I 100 mg/m2 i.v. on days 1 and 8 and C 1000 mg/m2 p.o. bid on days 2–15 of each 3-week cycle, given in the outpatient unit. For the patients older than 65 years, the dose of I and C were reduced to 60 mg/m2 and 750 mg/m2, respectively. Maximum 9 cycles of treatment were given. Treatment response was evaluated by CT scan every three cycles and toxicity was monitored every cycle. Results: Between 1/2002 and 8/2004, 37 patients (M/F, 24/13; ECOG PS 0/1, 21/16; median age 55, range 38–75) were enrolled. Six patients were older than 65 years. Main measurable diseases were in the liver, lung, lymph nodes, and peritoneum in 28, 6, 2, 1, respectively. One patient did not receive chemotherapy due to abnormal liver function after the enrollment. The median number of cycles administered was 6 (range 1–9). With intention-to-treat analysis, the objective response rate was 51.4% (19 PR; 95% C.I. 35.3–67.5%). The median time to progression was 7.1 months (95% C.I. 4.6–9.6 months) and median survival was 24.8 months (95% C.I. 10.5–39.1 months). Grade 3/4 neurtopenia occurred in 11/3 patients and there was no neutropenic fever. Significant (grade 2/3) non-hematologic toxicities encountered were 11/4 nausea/vomiting, 7/3 diarrhea, 7/1 hand-foot syndrome, and 5/0 stomatitis. There was no treatment-related death. Conclusions: The IC combination is an active and convenient outpatient regimen for the treatment of ACRC. No significant financial relationships to disclose.
Intravitreal Triamcinolone Acetonide Injection for Treatment of Refractory Diabetic Macular Edema
Authors: Taygan Yilmaz, Christopher D. Weaver, Micheal J. Gallagher, Miguel Cordero-Coma, Rene A. Cervantes-Castaneda, Dino Klisovic, Alejandro J. Lavaque, Robin J. Larson
Journal: Ophthalmology (2009)
A field test of Motto's risk estimator for suicide
Authors: D C Clark, M A Young, W A Scheftner, J Fawcett, L Fogg
Journal: American Journal of Psychiatry (1987)

The authors undertook a field test of Motto and colleagues' Risk Estimator for Suicide by selecting a subset (N = 593) of psychiatric patients with major or chronic affective disorder that corresponded to Motto's sample. They rated each subject on Motto's scale, using standardized data collected at hospital admission. Fourteen patients (2.4%) in their sample and 136 (4.9%) in Motto's sample died by suicide within 2 years. The authors tested the null hypothesis of a uniform suicide risk across all 10 deciles of risk scores by comparing observed and expected frequencies of suicide using the variance test for homogeneity of the binomial distribution. Their findings raise questions about Motto's risk scale but do not definitively invalidate it.
Salvage treatment with biweekly administration of paclitaxel (P) and gemcitabine (G) in patients (pts) with metastatic breast cancer (MBC) heavily pretreated with anthracycline and docetaxel containing regimens
Authors: A. Alexopoulos, M. V. Karamouzis, G. Ioannidis, H. Stavrinides, A. Ardavanis, J. Stavrakakis, C. Georganta, K. Kandilis, G. Rigatos
Journal: Journal of Clinical Oncology (2005)

836 Background: The outcome of MBC pts pretreated with anthracycline- and docetaxel-containing regimens is extremely poor. The docetaxel/gemcitabine (D/G) combination has shown considerable activity as salvage treatment in pts with MBC. Preclinical and clinical data have also suggested an in vivo enhanced activity of the P/G combination. This single institution phase II study evaluated the efficacy and safety of P/G in pts with heavily pretreated MBC. Methods: The regimen consisted of P 130 mg/sm as 3-h infusion followed by G 1500 mg/sm as 30’infusion; both drugs administered on days 1,15 q 4 weeks for 6 cycles. G-CSF was administered on days 7–10 and 20–23 to all pts. Twenty eight pts have enrolled the trial since February 2004 with the following characteristics: median age 55 yrs (40–70), median ECOG PS 1 (0–2), pre/postmenopausal 6/22. All patients were anthracycline pretreated (18/28 as adjuvant) and had received docetaxel-based regimens as palliative (p) chemotherapy (ct); 8 pts had received 1 pct, 12 pts 2pct and 8 pts 3 pct. The number of disease sites was 1 in 12 pts (43%), 2 in 11 pts (40%) and 3 in 5 pts (17%). Response evaluation was performed every second cycle. Results: The overall response rate was 47%, with CR in 2 pts (7%) and PR in 11 pts (40%). Stable disease was observed in 6 patients and 9 patients had progressive disease. 10/13 responders had previous D-objective response, while 3/13 responders had D-resistant disease. The mean response duration was 4.5 months. The mean time to disease progression was 7 months. Hematological toxicity was manageable, with G3–4 neutropenia in 7% of pts, anemia G2 in 32%, G3 in 4% and thrombocytopenia G1–2 in 11% of pts. G1–2 nausea/vomiting was recorded in 50%, G1–2 mucositis in 18%, G1–2 skin toxicity 15% and G1–2 peripheral neurotoxicity in 29%. No cardiotoxicity was observed. Conclusions: Preliminary results of this ongoing trial suggest that the combination of biweekly P/G combination is an effective and well tolerated regimen as salvage treatment for MBC pts. No significant financial relationships to disclose.