tbuckley/cabot-search huggingface dataset:
Thirty Years After the National Institute of Neurological Disorders and Stroke Recombinant Tissue Plasminogen Activator Trial
Authors: Raphael A. Carandang
Journal: JAMA Neurology (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 Neurology 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 Neurology journal
Abstract 17748: Pulmonary Vein Antral Isolation in Sinus Rhythm Outcomes are Comparable to Ablation in Atrial Fibrillation in Patients with Long Standing AF (Mid-Term Results)
Authors: Mohamed Bassiouny, Walid Saliba, Mariam Diab, John Rickard, Thomas Dresing, Thomas Callahan, Jay Sengupta, Bryan Baranowski, Mohamed Kanj, Patrick Tchou, Bruce Lindsay, Oussama Wazni
Journal: Circulation (2012)

Introduction:  Ablation of long standing persistent atrial fibrillation (AF) remains a challenge. We sought to determine outcomes comparing two strategies in this group of patients: PVI in sinus rhythm (SR) after DC cardioversion (DCC) vs. PVI and ablation targeting complex fractionated atrial electrograms (CFAE) while in AF.   Methods  Between June 2009 and August 2011, 74 patients with long standing persistent AF resistant to anti-arrhythmic medications were prospectively enrolled and randomized to either DCC prior to PVI and ablation in SR (DCC first), or ablation in AF, including PVI and CFAE ablation, then DCC if the patient remains in AF (Ablation first). Duration of procedure, fluoroscopy times, radiation exposure doses, incidence of complications, and AF/AT burden post PVI as measured by weekly transtelephonic monitors, holters and ECG on outpatient follow up 4-6 months after PVI were compared.   Results:  There were no differences in baseline patient characteristics between the two groups. 8 patients withdrew from the study prior to randomization. Overall 42/66 (65%) patients remained in SR at 6 months follow up. There was no significant difference in atrial arrhythmia recurrence between patients randomized to the DCC first vs Ablation first strategy (P=0.200). 9 out of 33 patients (27%) randomized to DCC first had recurrence; 6 developed paroxysmal AF and 2 persistent AF and 1 AT. 15 out of 33 patient (45%) randomized to Ablation first had recurrence; 7 developed paroxysmal AF and 8 persistent AF. One patient in the DCC first and 4 in the Ablation first group developed atrial flutter as well as AF. One patient randomized to DCC first developed moderate stenosis of the left superior pulmonary vein and another had a small hematoma that did not require interventions. Procedure duration and fluoroscopy time were significantly shorter in the DCC first strategy compared to the ablation first (225±65 min vs 276±87 min, P=0.009 and 59±17 min vs 70±25 min, P=0.041 respectively). CFAE mapping was done in 24 patients in Ablation first group vs only 3 in DCC first group (P   Conclusion:  Additional ablation beyond antral PV isolation does not afford better outcomes in patients with long standing persistent AF and may result in more left sided atrial flutter.
Progesterone Therapy of No Benefit for Recurrent Miscarriage
Authors: Anita Slomski
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
Phase II study of irinotecan plus S-1 combination for previously untreated advanced non-small cell lung cancer: Hokkaido Lung Cancer Clinical Study Group 0601
Authors: S. Oizumi, K. Akie, S. Ogura, N. Shinagawa, S. Fukumoto, M. Harada, T. Kojima, I. Kinoshita, H. Dosaka-Akita, H. Isobe, M. Nishimura
Journal: Journal of Clinical Oncology (2009)

e19012 Background: Platinum-containing therapy is a standard first-line treatment for advanced non-small cell lung cancer (NSCLC). Platinum-free regimens can be alternative if they can provide similar efficacy with better tolerability. This study evaluated the efficacy and safety for combination of irinotecan and S-1, a newly developed oral 5-fluorouracil derivative, for chemotherapy-naïve advanced NSCLC. Methods: In this multicenter phase II trial, we initially planned to enroll 40 patients. Chemotherapy consisted of 4-week cycles of irinotecan (100 mg/m 2 IV, day 1 and 15) and S-1 (80 mg/m 2 orally, day 1–14). Primary end point was response rate; secondary endpoints were overall survival (OS), progression-free survival (PFS), and safety. Association of UGT1A1 genotypes (*6 and *28) with frequency of severe toxicity was also examined. Results: A total of 112 cycles was administered into 40 patients (median, 3 cycles: range, 1–6). Median age was 64 years (range, 42–75); 29 patients (73%) had adenocarcinoma, and 8 patients (20%) had squamous cell carcinoma. Majority of the patients (32 cases, 80%) had stage IV disease. Twelve patients exhibited partial response (PR), and 17 patients exhibited stable disease (SD), resulting in response rate of 30% [95% confidence interval (95% CI), 16.6–46.5] and disease control rate of 72.5% (95% CI, 56.1–85.4). Median OS and PFS were 13.8 months (95% CI, 10.7–16.9) and 4.7 months (95% CI, 3.4–6.0), respectively. Hematological toxicities of grade 3 or 4 were neutropenia (32.5%) and anemia (5.0%). The most common non-hematologic toxicities of grade 3 or 4 included diarrhea (15.0%) and anorexia (17.5%). There were no treatment-related deaths. Among the 40 patients, there were 1 homozygous and 8 heterozygous for UGT1A1*6, whereas 7 heterozygous for UGT1A1*28; none of the patients had both genotypes. Patients with homozygous or heterozygous for UGT1A1*6 showed a trend for high incidence of grade 3 diarrhea (p = 0.055). No association of UGT1A1*28 with severe toxicity was observed in this study. Conclusions: Irinotecan and S-1 combination is an alternative treatment with tolerable toxicity for previously untreated advanced NSCLC. No significant financial relationships to disclose.
Long-Term Neurocognitive Functioning and Social Attainment in Adult Survivors of Pediatric CNS Tumors: Results From the St Jude Lifetime Cohort Study
Authors: Tara M. Brinkman, Matthew J. Krasin, Wei Liu, Gregory T. Armstrong, Rohit P. Ojha, Zsila S. Sadighi, Pankaj Gupta, Cara Kimberg, Deokumar Srivastava, Thomas E. Merchant, Amar Gajjar, Leslie L. Robison, Melissa M. Hudson, Kevin R. Krull
Journal: Journal of Clinical Oncology (2016)

To assess the prevalence and severity of neurocognitive impairment in adult survivors of pediatric CNS tumors and to examine associated treatment exposures.Participants included 224 survivors of CNS tumors who were treated at St Jude Children's Research Hospital (current median age [range], 26 years [19 to 53 years]; time from diagnosis, 18 years [11 to 42 years]) and completed neurocognitive testing. Information on cranial radiation therapy (CRT) doses and parameters of delivery were abstracted from medical records. The prevalence of severe impairment (ie, at least two standard deviations below normative mean) was compared across radiation treatment groups (no CRT, focal irradiation, craniospinal irradiation) using the χ(2) test. Log-binomial models were used to estimate risk ratios (RRs) and corresponding 95% CIs for severe impairment.In multivariable models, craniospinal irradiation was associated with a 1.5- to threefold increased risk of severe impairment compared with no CRT (eg, intelligence: RR = 2.70; 95% CI, 1.37 to 5.34; memory: RR = 2.93; 95% CI, 1.69 to 5.08; executive function: RR = 1.74; 95% CI, 1.24 to 2.45). Seizures were associated with impaired academic performance (RR = 1.48; 95% CI, 1.02 to 2.14), attention (RR = 1.54; 95% CI, 1.12 to 2.13), and memory (RR = 1.44; 95% CI, 1.04 to 1.99). Hydrocephalus with shunt placement was associated with impaired intelligence (RR = 1.78; 95% CI, 1.12 to 2.82) and memory (RR = 1.42; 95% CI, 1.03 to 1.95). Differential follow-up time contributed to variability in prevalence estimates between survivors treated with older nonconformal and those treated with more contemporary conformal radiation therapy methods. Neurocognitive impairment was significantly associated with lower educational attainment, unemployment, and nonindependent living.Survivors of pediatric CNS tumors are at risk of severe neurocognitive impairment in adulthood. The prevalence of severe impairment is greater than expected in the general population, even in the absence of CRT, and is associated with disrupted attainment of adult social milestones.
Pegylated liposomal anti-eIF3c shRNA-vinorelbine tartrate formulation (SEVINA-V) inhibits oncogenic protein translational initiation, and oncogene addiction inducing PCD type I, II, and III in NSCLC chemoresistant to taxanes
Authors: J. Giannios, E. Michailakis, N. Alexandropulos, A. Kanellopoulos
Journal: Journal of Clinical Oncology (2008)

19059 Background: eiF3c is required for the initiation of protein translation,and directly interacts with mTOR activating eIF4e,which is overexpressed in NSCLC.mTOR activates the PI3K/AKT signal transduction pathway,which mediates cell proliferation through activation of growth and survival factors.Furthermore,bcl-2 overexpression inhibits apoptosis causing addiction and chemoresistance. Methods: We developed xenograft animal models from taxane chemoresistant NSCLC overexpressing eIF3c,4EBP1,and bcl-2.We formulated pegylated liposomal anti-eIF3c shRNA-vinorelbine tartrate (SEVINA-V).Pegylation circumvented RES elimination.The human NSCLC xenograft animal models were treated with SEVINA-V. Results: Post-treatment,triggering the RNAi pathway through the expression of small hairpin RNA (shRNA) molecules has efficiently silenced the RNA helicase activity of eIF3c disabling cellular cap-dept scanning/initiation.There was subsequent inhibition of PI3K/AKT/mTOR pathway blocking binding of IGFR,PDGFR,EGFR,and HER family receptors in the tumor cell membrane.Inhibition of mTOR prevented downstream activation of mRNA translation,and blocked ribosome biogenesis inhibiting S6K1 and 4E- BP1,which led to inhibition of ribosomal protein,elongation factors,and ODC/cyclinD1,respectively.Thus,4E-BP1-which was induced by taxanes causing chemoresistance-was inhibited.There was upregulation of p53 and cyclin/CDK2-p27 inhibiting CDK1/2 and cyclin D1 activity.Signal transduction initiated by VEGF was inhibited,and translation of c-myc and anti-apoptotic FLIPs was blocked.Vinorelbine tartrate phosphorylated bcl-2,leading to its inactivation,and subsequent circumvention of oncogene addiction.Also,vinorelbine blocked cell cycle at G2/M.TEM exhibited PCD type I,II,and III leading to a bystander killing effect. Conclusions: SEVINA-V has achieved oncogene transcriptional intervention in NSCLC via protein translational inhibition of eIF3c downstream of mTOR dept pathways,which led to PCD circumventing oncogene addiction. No significant financial relationships to disclose.
Searching for truth--from biblical to modern times.
Authors: K H Antman
Journal: Journal of Clinical Oncology (1986)

Article Tools Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1986.4.10.1441 Journal of Clinical Oncology - published online before print September 22, 2016 PMID: 3760918 Searching for truth--from biblical to modern times. K H AntmanxK H AntmanSearch for articles by this author https://doi.org/10.1200/JCO.1986.4.10.1441 PDF "Searching for truth--from biblical to modern times.." Journal of Clinical Oncology, 4(10), pp. 1441–1442© 1986 by American Society of Clinical Oncology
Futile CPR is tantamount to assault
Authors: Richard Venn
Journal: BMJ (2016)

Regardless of the law,1 it is best medical practice to involve patients and relatives in all important medical decisions where “practicable and appropriate.”

However despite the High Court ruling in the case of Carl Winspear, I do not think it is best medical practice or “appropriate” to disturb relatives at 3 am to have a telephone conversation about DNACPR (“Do not attempt cardiopulmonary resuscitation”) …
PWE-362 Detection of neoplasia using dye spray chromoendoscopy in patients with a high risk of familial colorectal cancer: Abstract PWE-362 Table 1
Authors: LA McGowan, LA Hopkins, KJ Monahan
Journal: Gut (2015)

<h3>Introduction</h3> Patients at high risk of familial colorectal cancer require surveillance colonoscopy to identify and remove polyps before malignant transformation can occur. Colonoscopy sensitivity rates vary and its effectiveness depends on user ability, adequate bowel preparation and procedure duration. Furthermore, the majority of polyps occur in the right colon and are characteristically flatter than those found in the left colon, rendering identification difficult. As such, recent guidelines have advocated the use of dye spray chromoendoscopy (DSC) to aid detection rates.<sup>1</sup>Our study assesses the use of chromoendoscopy at a district general hospital and whether polyp detection was higher in those undergoing surveillance colonoscopy when dye spray was used. <h3>Method</h3> High risk patients were selected from our local endoscopy database Scorpio®. High risk was defined by a diagnosis of Lynch Syndrome or High Moderate risk as per BSG guidelines (i.e. a lifetime risk of colorectal cancer of &gt;10%).<sup>2</sup>We retrospectively measured polyp detection rate, procedure duration, adequacy of bowel preparation, withdrawal time, histopathology, and the use of 0.02% indigocarmine dye spray versus white light colonoscopy (WLI). Statistical analysis was performed using chi-square test and 2 tailed T test for binary and continuous variables respectively. <h3>Results</h3> 101 patients were included in this study (62 High Moderate risk and 39 Lynch Syndrome). WLI alone was performed for 77 patients, with DSC performed in 24. Significantly more polyps were detected by the use of dye spray, with an average polyp count of 0.49 for WLI versus 1.79 for DSC (P = 0.00332). There was a predominance of right sided lesions in this cohort. A longer withdrawal time may also be a factor in polyp detection rate. Table 1highlights our main findings. <h3>Conclusion</h3> The use of DSC improves polyp detection in those undergoing surveillance colonoscopy for high risk familial colorectal cancer. Prolonged withdrawal time may account for an increased adenoma detection rate, or may be a function of polypectomy procedures. We recommend a large randomised controlled trial be performed to determine the true efficacy of this chromoendoscopy in high familial risk patients. <h3>Disclosure of interest</h3> None Declared. <h3>References</h3> Kaminski MF. Advanced imaging for detection and differentiation of colorectal neoplasia. ESGE Guideline Cairns SR. Guidelines for colorectal cancer screening and surveillance in moderate and high risk groups. BSG Guideline. Gut 2010
Treatment With a New Synthetic Retinoid, Am80, of Acute Promyelocytic Leukemia Relapsed From Complete Remission Induced by All-trans Retinoic Acid
Authors: Tadasu Tobita, Akihiro Takeshita, Kunio Kitamura, Kazunori Ohnishi, Mitsuaki Yanagi, Akira Hiraoka, Takahiro Karasuno, Makoto Takeuchi, Shuuichi Miyawaki, Ryuzo Ueda, Tomoki Naoe, Ryuzo Ohno
Journal: Blood (1997)
Communicating comfort: How do cancer outpatients and health care providers talk about pain?
Authors: Virginia Townsend LeBaron, Traci M. Blonquist, Autumn Beecy, Donna Lynn Berry
Journal: Journal of Clinical Oncology (2014)

229 Background: Pain remains a significant problem for many cancer patients. Poor communication between healthcare providers and patients can contribute to this problem. This secondary analysis explored patient-provider discussions of current pain in the ambulatory oncology setting. Methods: Audio recordings from 66 adult oncology clinic visits in Boston and Seattle were selected from a pre-existing data set of a larger trial. To ensure a diverse sample, all minority recordings (n=33) were selected with a random sample of non-minority recordings (n = 33) matched on patient characteristics. Recordings were reviewed by two independent investigators and each pain discussion was quantitatively coded using 12 variables based on a review of the literature. A pain discussion was defined as any reference to pain or discomfort initiated by either patient or provider. Results: Preliminary analysis of 33 cases revealed 57 separate discussions of pain (6 involved patients denying any pain). Patients and providers were equally likely to initiate discussions about pain (patient initiated total: 27/57; 47%; provider initiated total: 30/57, 53%). Pain discussions overlapped with general symptom assessment, and pain was commonly attributed to effects of oncologic therapy and discussed as stiffness, soreness, or aching, not necessarily as ‘pain.’ Discussions of pain were typically brief and providers asked more close-ended and leading questions (n= 87) versus open-ended questions (n=18) when assessing pain. Providers rarely (n=3) used a validated pain intensity scale (e.g., 0-10) and explored reports of pain slightly more often than acknowledging only (n=27/51; 53%; n=24/51; 47%, respectively). Conclusions: Discussions of cancer related pain in the ambulatory setting are complex, often with multiple reports of pain of varying etiologies discussed throughout the clinic visit. Providers may limit communication by asking mainly close-ended questions and only exploring patient's pain reports about half the time. This analysis offers insights into areas for improvement in communication patterns related to cancer pain.
HLA-DRB1*07:01 Is Associated With Asparaginase Allergies In Children With Acute Lymphoblastic Leukemia
Authors: Christian A Fernandez, Mary V. Relling, Colton Smith, Wenjian Yang, Eric C. Larsen, W. Paul Bowman, Chengcheng Liu, Laura B. Ramsey, Tamara Chang, Victoria Turner, Mignon L. Loh, Elizabeth A. Raetz, Naomi J. Winick, Stephen P. Hunger, William L. Carroll, Suna Onengut-Gumuscu, Wei-Min Chen, Patrick Concannon, Stephen S Rich, Paul Scheet, Sima Jeha, Ching-Hon Pui, William E. Evans, Meenakshi Devidas
Journal: Blood (2013)
The prognostic value of interim and end-of-treatment PET/CT in patients with newly diagnosed peripheral T-cell lymphoma
Authors: J S Ham, S J Kim, J Y Choi, S H Hyun, S-K Choi, H S Kim, S H Lim, J Y Lee, S-H Jung, Y H Ko, W S Kim
Journal: Blood Cancer Journal (2016)

The treatment outcome of cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP) as first-line chemotherapy in patients with peripheral T-cell lymphoma (PTCL) is still unsatisfactory.1, 2 Because the poor outcome of PTCL is mainly associated with relapse after treatment, an exact assessment of tumor viability after treatment is essential for predicting treatment failure in PTCL.3 For positron emission tomography–computed tomography (PET/CT) analysis, a visual analysis using a five-point scale (5-PS) was adopted as the preferred reporting method at the First International Workshop on Interim PET Scan in Lymphoma, which took place in 2009 in Deauville, France.4 The 5-PS is recommended for reporting PET/CT: scores of 1 and 2 represent complete metabolic response (CMR), but the clinical meaning of a score of 3 remains unclear.5, 6 There are limited data regarding the predictive role of the 5-PS score on interim PET/CT and end-of-treatment (EOT) PET/CT in PTCL.7, 8, 9, 10, 11 Moreover, the cutoff point for the 5-PS score remains unclear. Thus, we examined the treatment outcomes of patients with newly diagnosed PTCL according to their 5-PS scores for interim PET-CT and EOT PET/CT. We analyzed the prognostic value of the 5-PS score for PET/CT and determined the cutoff point that seemed to be the best predictor of outcome.
Capecitabine (X) vs. bolus 5-FU/LV as adjuvant chemotherapy for patients (pts) with Dukes’ C colon cancer: economic evaluation in an Italian hospital setting
Authors: F. Di Costanzo, A. Sobrero, C. Twelves, J. Douillard, G. Giuliani, K. Patel, L. P. Garrison, J. Cassidy
Journal: Journal of Clinical Oncology (2006)

13518 Background: In the X-ACT adjuvant trial, X showed consistent benefits over bolus 5-FU/LV, with at least equivalent disease-free survival (DFS) and an improved safety profile [Twelves et al. 2005]. In addition, X demonstrated superior relapse-free survival (65.5% vs. 61.9% at 3 years follow-up; p=0.0407) and improved covariate-adjusted overall survival (p=0.0208). We used the results from X-ACT to assess the cost-effectiveness of X from the Italian hospital and societal perspective. Methods: Trial-based data were collected on treatment period medical resource use. Unit costs for drug administration, hospitalizations, emergency room visits, and concomitant medications were considered using published sources in Italy. Cost for physician consultation visits, pt time and travel were also considered in the societal perspective. A health-state transition model was used to estimate incremental cost impact and the effectiveness in terms of gains in quality-adjusted life months (QALMs). Costs and effectiveness were discounted at 3.5%. Results: Mean duration of treatment was similar with X and 5-FU/LV; pts received 92% and 93% of planned treatments, respectively. Administration of X required fewer clinic visits per pt (7.4 vs. 28.0 with 5-FU/LV). Acquisition costs of X were higher than 5-FU/LV, approximately 2533 vs. 231€, but this difference was more than fully offset by the difference in administration cost of 5-FU/LV (4338 vs. 152€ for X). Total hospital days for treatment-related adverse events (AEs) and medication costs for treating AEs were higher for 5-FU/LV than X. The cost of emergency room visits for treating AEs and physician consultation did not differ. Compared with 5-FU/LV, X is projected to increase QALMs by 6.5 months, with overall treatment period cost savings of 2234€ for the hospital. From a societal perspective, the cost savings increase to 3976€. These findings show that X is a dominant (cost-saving and more effective) treatment in this setting. Conclusions: X as adjuvant treatment for pts with colon cancer is clinically effective with an improved safety profile vs. 5-FU/LV and is also a dominant choice from an economic perspective. [Table: see text]