tbuckley/cabot-search huggingface dataset:
Use of a Comprehensive Geriatric Assessment for the Management of Elderly Patients With Advanced Non–Small-Cell Lung Cancer: The Phase III Randomized ESOGIA-GFPC-GECP 08-02 Study
Authors: Romain Corre, Laurent Greillier, Hervé Le Caër, Clarisse Audigier-Valette, Nathalie Baize, Henri Bérard, Lionel Falchero, Isabelle Monnet, Eric Dansin, Alain Vergnenègre, Marie Marcq, Chantal Decroisette, Jean-Bernard Auliac, Suzanna Bota, Régine Lamy, Bartomeu Massuti, Cécile Dujon, Maurice Pérol, Jean-Pierre Daurès, Renaud Descourt, Hervé Léna, Carine Plassot, Christos Chouaïd
Journal: Journal of Clinical Oncology (2016)

Purpose Comprehensive geriatric assessment (CGA) is recommended to assess the vulnerability of elderly patients, but its integration in cancer treatment decision making has never been prospectively evaluated. Here, in elderly patients with advanced non–small-cell lung cancer (NSCLC), we compared a standard strategy of chemotherapy allocation on the basis of performance status (PS) and age with an experimental strategy on the basis of CGA. Patients and Methods In a multicenter, open-label, phase III trial, elderly patients ≥ 70 years old with a PS of 0 to 2 and stage IV NSCLC were randomly assigned between chemotherapy allocation on the basis of PS and age (standard arm: carboplatin-based doublet if PS ≤ 1 and age ≤ 75 years; docetaxel if PS = 2 or age &gt; 75 years) and treatment allocation on the basis of CGA (CGA arm: carboplatin-based doublet for fit patients, docetaxel for vulnerable patients, and best supportive care for frail patients). The primary end point was treatment failure free survival (TFFS). Secondary end points were overall survival (OS), progression-free survival, tolerability, and quality of life. Results Four hundred ninety-four patients were randomly assigned (standard arm, n = 251; CGA arm, n = 243). Median age was 77 years. In the standard and CGA arms, 35.1% and 45.7% of patients received a carboplatin-based doublet, 64.9% and 31.3% received docetaxel, and 0% and 23.0% received best supportive care, respectively. In the standard and CGA arms, median TFFS times were 3.2 and 3.1 months, respectively (hazard ratio, 0.91; 95% CI, 0.76 to 1.1), and median OS times were 6.4 and 6.1 months, respectively (hazard ratio, 0.92; 95% CI, 0.79 to 1.1). Patients in the CGA arm, compared with standard arm patients, experienced significantly less all grade toxicity (85.6% v 93.4%, respectively P = .015) and fewer treatment failures as a result of toxicity (4.8% v 11.8%, respectively; P = .007). Conclusion In elderly patients with advanced NSCLC, treatment allocation on the basis of CGA failed to improve the TFFS or OS but slightly reduced treatment toxicity.
Abstract P177: Associations Between Complement Proteins and Arterial Calcification in Midlife Women: Role of Cardiovascular Fat, The Study of Women’s Health Across the Nation (SWAN)
Authors: Nayana Nagaraj, Karen A Matthews, Kelly J Shields, Emma Barinas-Mitchel, Matthew Budoff, Samar R El Khoudary
Journal: Circulation (2015)

Background: Risk of cardiovascular disease(CVD) in women increases after the fifth decade of life. We have previously shown that compared to premenopausal women, postmenopausal women have significantly higher levels of complement protein C3 and cardiovascular fat. We hypothesize that complement protein levels in women transitioning through menopause are positively associated with early markers of vascular disease, arterial calcification, and that this association will be explained by the higher volumes of cardiovascular fat in women at midlife. Methods: Pilot data from the Study of Women’s Health Across the Nation(SWAN) were used. Complement proteins C3 and C4 were measured using frozen serum specimens by immunoturbidimetric assay. Extent of Aortic(AC) and coronary calcification(CAC) were identified using EBCT scans and Agatston scoring method, and were used as continuous variables. Same CT scans were used to quantify volumes of cardiovascular fat around the heart (total heart adipose tissue: TAT) and the descending aorta(peri-vascular adipose tissue: PVAT). Tobit regression was used for statistical analyses. Results: A total of 100 women (50% late peri/postmenopausal; 73% Caucasian), mean age 50.48±2.63 were included. In univariate analyses, higher levels of C3 were significantly associated with greater CAC [β(SE)=0.87(0.23), P=0.0001] and AC [β(SE)=3.49(1.45), P=0.02], while higher levels of C4 were significantly associated with greater CAC only. Similar results were seen after adjusting for age, race and menopausal status. For CAC models, controlling for TAT did not change the significant associations with both C3 (P=0.008) and C4 (P=0.03). On the other hand, adjusting for PVAT partially explained the association between C3 and CAC (P=0.02), while the association between C4 and CAC disappeared (p=0.09). For AC models, associations of C3 and C4 with AC were more pronounced at greater volumes of TAT (Interactions p&lt;0.001) but not of PVAT. Adjusting for PVAT eliminated the association between AC and C3 (p=0.2) Conclusion: Higher levels of complement proteins were significantly associated with greater CAC and AC in women at midlife. The associations with CAC were independent of TAT but not of PVAT, while the associations with AC largely explained by PVAT and modified by TAT. Our findings extend support for the potential inflammatory influence of small visceral adipose depots in the development of arterial calcification and possibly suggest PVAT as a local source for the complement proteins. Early recognition of the high complement protein levels and volumes of cardiovascular fat in women at midlife could be used in early diagnosis of subclinical CVD. These findings need to be replicated in larger samples.
Abstract 11402: Cardioprotective Effects Of mTOR Against Ex Vivo Ischemia-reperfusion Injury In Diet-induced Obese Mice
Authors: Toshinori Aoyagi, Hiroko Aoyagi, Takashi Matsui
Journal: Circulation (2012)

The risk of heart failure following myocardial infarction is higher in diabetic patients than nondiabetic patients. The mechanistic target of rapamycin (mTOR) is a key molecule of the insulin signa...
Hypocellular acute myeloid leukemia: Better or worse prognosis.
Authors: A. Al-Kali, S. N. Konoplev, E. Lin, T. M. Kadia, S. Faderl, F. Ravandi Kashani, M. Ayoubi, M. Brandt, H. Kantarjian, G. Borthakur
Journal: Journal of Clinical Oncology (2010)

6561 Background: Frequency of h-AML is 5%-7% among adult patients with AML. Most reports are based on small numbers of patients. Aim: To examine clinically relevant outcomes in patients with h-AML and compare with other patients with AML. Methods: Between 2000-2009 all new cases of AML (according to WHO criteria) treated at MD Anderson Cancer Center were reviewed for h- AML(bone marrow cellularity ≤ 20%). Wilcoxon rank sum test and Fisher's exact test were used as appropriate to assess difference in patients' characteristics. Results: Among 1,479 patients (pts), 134 pts (9%) had h-AML. Pts with h-AML were older (p = 0.009) and more likely to have antecedent hematological disorder (AHD) (< 0.001). One-third were classified as RAEB-t under FAB classification. Chromosomal analysis showed -5 and/or -7 in 36/138 (27%) pts. Presenting cytopenias were more frequent with median WBC of 1.8 x106/L (p < 0.001), hemoglobin of 7.7 g/dL (< 0.001). Twenty-eight pts (21%) had treatment related AML, 36/134 (27%) evolved from prior MDS or MPD, while 70 (52%) pts had de novo AML. More pts in the hypocellular group received prior chemotherapy (26%, p < 0.027). Complete remission (CR) was achieved in 69/134 pts (51%), but pts treated with clofarabine based regimens (11/13 [85%]) or with idarubicin, cytarabine and IL-11 (IA –IL11) had better (76% [13/17]) CR rate. Overall median event-free survival (EFS) was short, 8 weeks (range 0-343), with improved EFS in the clofarabine based regimen to 49 weeks (range 5-116 weeks) and IA-IL11 to 65 weeks (range, 3-167). On multivariate analysis overall survival, EFS or relapse free survival were not different in patients with h-AML compared to other patients with AML. Conclusions: Hypocellular AML is infrequent; associated dysplasia, exposure to prior chemotherapy or evolution from hematological malignancies are common. CR rate is acceptable but duration of response is short. Clofarabine based regimens may offer better results and needs to be studied systematically. No significant financial relationships to disclose.
Abstract 14348: Inotrope Use and Outcomes in Hospitalized Heart Failure: Impact of Etiology, Systolic Blood Pressure, and Cardiac Output _ Insights From ESCAPE
Authors: Andreas P Kalogeropoulos, Catherine N Marti, Lambros Papadimitriou, Sadia Nasir, Raghda Al-Anbari, Vasiliki V Georgiopoulou, Javed Butler
Journal: Circulation (2013)

Background: Despite limited evidence and mostly negative signals, inotropes are widely used in hospitalized heart failure (HF). We investigated whether HF etiology, systolic blood pressure (SBP), or cardiac index modify the effect of inotropes on outcomes in patients with hospitalized HF. Methods: Using data from the ESCAPE trial, we examined the association of in-hospital inotrope (dobutamine, milrinone, or dopamine) use with 1) major events by 180 days (death, left ventricular assist device, or cardiac transplantation) and 2) study days alive and out of hospital, in relation to HF etiology, admission SBP, and, in a subset of patients, cardiac index. Results: Overall, 107/215 (49.8%) ischemic and 87/216 (40.3%) nonischemic patients received inotropes. Events were more frequent among patients who received inotropes, both with ischemic (42.1% vs. 20.4%; P<0.001) and nonischemic (33.3% vs. 16.3%; P=0.003) HF. Risk with inotropes declined over time in ischemic (adjusted HR at 30 days: 4.63; 95% CI: 2.01 to 1...
Chronic Heart Failure in Congenital Heart Disease
Authors: Karen K. Stout, Craig S. Broberg, Wendy M. Book, Frank Cecchin, Jonathan M. Chen, Konstantinos Dimopoulos, Melanie D. Everitt, Michael Gatzoulis, Louise Harris, Daphne T. Hsu, Jeffrey T. Kuvin, Yuk Law, Cindy M. Martin, Anne M. Murphy, Heather J. Ross, Gautam Singh, Thomas L. Spray
Journal: Circulation (2016)
Creation of an epidemic: The tobacco industry (TI) and smoking-related adenocarcinoma (AD) of the lung
Authors: G. M. Strauss, A. Jemal, M. B. McKenna, J. A. Strauss, K. M. Cummings
Journal: Journal of Clinical Oncology (2007)

7583 Background: When epidemiologic research first demonstrated an association between cigarette smoking (CS) and lung cancer (LC) in the 1950s, AD comprised about 5% of LCs and was only weakly related to CS. In the 1960s and 1970s, AD increased sharply, and became strongly related to CS. Methods: We conducted an epidemiological and ecological analysis correlating time trends in LC histology with changes in cigarette design and TI actions over the past 30 yrs. We utilized SEER data on 307,797 LCs diagnosed from 1975 to 2003 to analyze time trends of age-standardized incidence rates of each LC subtype: AD, squamous (SQ), small cell, and large cell. Comparisons were drawn based on sex, race, and age. Because SEER contains no data on CS, other sources were utilized to correlate changing histology to time trends in smoking prevalence, the changing cigarette, and TI actions. Results: Among all pts, AD surpassed SQ by 1980–84 to become the most common histology. AD increased 62% from 1975–79 to 1995–99, but fell 8% in 2000–03. SQ peaked in 1980–84 and dropped 35% by 2000–03. AD surpassed SQ in 1985–89 in men, while AD was already most common in women by 1975–79. AD rose 38% in men from 1975–79 to 1995–99, while it doubled in women during this interval. Among whites, AD surpassed SQ by 1980–84, although this did not occur among blacks for another decade. Nonetheless, AD incidence has consistently been higher in black men than in other subgroups. AD was already most common in pts &lt;50 yrs by 1975–79, while AD rapidly increased and surpassed SQ in all other age groups by 1990–94. By 2000–03, AD comprised 47% of all LCs (42% in men; 52% in women; 59% in pts &lt;50 yrs). Currently, AD is the most common histology in both sexes, races, and in all age groups. Trends in AD correlate with the wide-scale adoption by smokers of filtered and low tar cigarettes, and with increasing nitrosamine levels in cigarettes. Conclusions: The rise of AD, particularly in women and younger persons, is consistent with the hypothesis that changes in cigarette design and composition was responsible for this rise. These changes were introduced by the TI in response to mounting evidence that CS caused other forms of LC. While low tar cigarettes do not reduce LC risk, their adoption appears to be responsible for creating an epidemic of smoking-related lung AD. No significant financial relationships to disclose.
TRANSPLANTATION OF ORGANS.
Authors: J D HARDY
Journal: JAMA (1905)

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
The usefulness of ultrasonography in a ductal carcinoma in situ screening program for Japanese woman.
Authors: Taijiro Kosaka
Journal: Journal of Clinical Oncology (2012)

24 Background: Although varying among areas, the mammogram (MMG) screening rate is very low in Japan as compared to the U.S. at approximately 20% versus nearly 80% in the U.S. On the other hand, rates of ductal carcinoma in situ (DCIS) detection among diagnosed breast cancers differ minimally: 20% in the U.S., and 15% in Japan. This is a small difference considering the difference MMG screening rates. Racial differences have been suggested to be attributable to the organization of screening programs in Japan, which also use ultrasonography (US) breast cancer screening, as well as breast size in Japanese women. Methods: We retrospectively evaluated MMG and US images of 91 DCIS cases, all 91 Japanese women who under underwent surgery between May 2010 and February 2012. US (TOSHIBA Aplio, probe 9MHz) was performed with knowledge of MMG findings. The 91 cases were divided into group with tumor detected by MMG and US (M&amp;U), MMG detection only (M), and US detection only (U). The following parameters were analyzed: US shape (Tumor-forming lesion: TFL, Non-tumor-forming lesion: NTFL, Cystic-forming lesion: CFL), Skin-Muscle distance: SMD. We excluded asynchronous bilateral breast cancers and micro-invasive DCIS. Results: Sixty-eight lesions (73.0%) were identified by US, which revealed a NTLF in 52 cases, TLF in 9 cases and CFL in 7 cases. All cases with false-negative findings on US (Group M, n = 23) showed micro-calcifications on MMG (n=22) and with the tumor (n=1). In the U group, SMD was only 23 mm versus 43.4mm in the M group. No difference was observed in body mass index or pathological tumor diameter between the U and M. Conclusions: We found US to reveal DCIS in 73% of our cases upon reevaluation. Although US examination would not likely increase the screening detection rate for DCIS in Japanese women, US may reveal more DCIS in Japanese women, in which the breasts are comparatively small, than in western women. Further comparison of possible racial difference is warranted.
Enhancement of the Cytotoxic Effect of Anti-Carcinoembryonic Antigen Immunotoxins by Adenovirus and Carboxylic lonophores&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: T W Griffin, L R Childs, D J FitzGerald, L V Levin
Journal: JNCI Journal of the National Cancer Institute (1987)

Immunotoxins (monoclonal antibodies-ricin A-chain conjugates) directed against the tumor-associated antigen carcinoembryonic antigen (CEA) are selective in vitro cytotoxins for human adenocarcinoma cells. However, the kinetics of intoxication are relatively slow. The effects of the UV radiation-inactivated human adenovirus and the carboxylic ionophores monensin and nigericin were examined on immunotoxin cytotoxicity to the human colorectal adenocarcinoma cell line LoVo. In a 16-hour cytotoxicity assay, adenovirus reduced 33-fold the median inhibitory concentration from 3×10−8M to 9×10−10M. In timed cytotoxicity assays, 50% of control protein synthesis was reached in immunotoxin-treated cells twentyfold faster in the presence of adenovirus (0.5 hr) than in its absence (10 hr). Adenovirus produced no enhancement of immunotoxin effect on a control cell line or on a control immunotoxin on LoVo cells, demonstrating specificity of adenovirus effect. In addition, specific immunotoxin constructed with a nonreducible thioether bond, alone or with adenovirus, produced no toxicity on LoVo cells. These results suggest that both cell surface binding and presence of a reducible disulfide bond in the conjugate are necessary for adenovirus effect. Similar potentiation of the cytotoxicity of anti-CEA immunotoxins was produced by monensin and nigericin. These studies demonstrate that both adenovirus and carboxylic ionophores are potentiators of immunotoxins directed against the CEA, producing cytotoxicity equivalent to that of ricin but specific for CEA-positive adenocarcinoma cells in culture.
Phase II study comparing the utility of concomitant chemotherapy, teletherapy and brachitherapy of high dose rate in uterine neck escamocelular carcinoma patients
Authors: C. A. Ortiz, D. L. Zea, A. Muñoz, C. J. Castro, M. V. Herrera, J. Rosales, L. M. Montaño, T. Wilde
Journal: Journal of Clinical Oncology (2004)

5131 Background: Cervical carcinoma is a health problem in the No-development countries. An Alert of NCI in February 1999 indicate that the best therapeutic option is chemotherapy and radiotherapy combination Methods: a Phase II study of concomitant administration of: Cisplatino 30 ml /mt2, days 1, 8, 15. With 5 FU 750 ml /m2, days 1 to 5. and Teletherapy up to 3420cGy in 180cGy fractions 5 times a week and it will continue until completing 5400 cGy. A weekly application of high dose rate brachitherapy will be made, until completing a total of 5 inserts. Results: 55 patients have been studied with an age average of 47,4, the predominant histological grade was 43,6%, stage II B and 49% stage III B. They all received the complete treatment plan, without delay for the administration of the chemotherapy, radiotherapy and Brachitherapy. Haematological toxicity was mild and only 1,8% of febrile neutropenia was observed. Non-Haematological toxicity was considered mild in most of the patients, it is important to note that 2 cases of irreversible renal impairment, and 2 cases of deep vein thrombosis. Neuropathy and alopecia were mild. 47 patients had a complete response, 3 patients remained in stable illness and only 5 patients (9%) showed a progression of the illness. 36 months after follow-up 32,7% of the patients relapsed. It was found that most of them presented local and regional relapse. In 77% of the patients that relapsed, 2 relapses were in Bone 1 in Lung and 1 in central Nervous System. Deaths were caused by tumour progression, of which 1 was lung and 7 local-regional relapses. There are 32 illness-free patients alive under follow-up (58,1%) and 7 patients alive in progression. Conclusions: This is a chemotherapy scheme, well tolerated with secondary effects mild, therefore the treatment is considered to be safe and effective. The response rate was high although due to the reduced number of patients the global survival and the illness-free period cannot be determined at this moment. We expect to continue recruiting patients. No significant financial relationships to disclose.
High Glasgow Blatchford Score at admission is associated with recurrent bleeding after discharge for patients hospitalized with upper gastrointestinal bleeding
Authors: Neil Sengupta, Elliot Tapper, Vilas Patwardhan, Gyanprakash Ketwaroo, Adarsh Thaker, Daniel Leffler, Joseph Feuerstein
Journal: Endoscopy (2015)

<b>Background and study aims:</b> Upper gastrointestinal bleeding (UGIB) is associated with significant morbidity. The Glasgow Blatchford Score (GBS) can predict endoscopic intervention and in-hospital death, but the ability to predict post-discharge outcomes is unknown. The aims of the study were to determine whether the admission GBS is associated with post-discharge rebleeding and 30-day readmission following hospitalization for UGIB. <b>Patients and methods:</b> In this prospective, observational, cohort study, consecutive patients who were hospitalized with UGIB were enrolled. Admission GBS scores were calculated, and patients with GBS > 7 were classified as high risk. Patients were contacted 30 days following discharge to determine: 1) rate of hospital readmission due to rebleeding, 2) all-cause readmissions, and 3) mortality. Multivariable Cox regression was used to determine associations between GBS, rebleeding, and readmission. <b>Results:</b> A total of 336 patients with UGIB were identified. Patients with high risk GBS were older (68 vs. 62 years; <i>P</i> = 0.01), and were more likely to receive blood (85 % vs. 39 %; <i>P</i> < 0.01) and require intensive care unit admission (64 % vs. 50 %; <i>P</i> = 0.02). Of the 309 patients who survived to discharge, 61 (20 %) were readmitted within 30 days, 25 (8 %) of whom had rebleeding. On multivariable analysis adjusting for the need for endoscopic intervention, high risk GBS patients had higher rebleeding rates (hazard ratio [HR] 3.32, 95 % confidence interval [CI] 1.26 – 11.4). On multivariable analysis, patients with more co-morbidities (HR 1.06, 95 %CI 1.01 – 1.11) and cirrhosis (HR 2.23, 95 %CI 1.19 – 4.04) had higher 30-day readmission rates. <b>Conclusions:</b> High GBS scores were associated with higher rebleeding rates following discharge. Patients with high GBS scores (> 7) should be monitored following discharge as they have a high risk of rebleeding.
Tracking Official Development Assistance for Reproductive Health in Conflict-Affected Countries
Authors: Preeti Patel, Bayard Roberts, Samantha Guy, Louise Lee-Jones, Lesong Conteh
Journal: PLoS Medicine (2009)

Reproductive health needs are particularly acute in countries affected by armed conflict. Reliable information on aid investment for reproductive health in these countries is essential for improving the efficiency and effectiveness of aid. The purpose of this study was to analyse official development assistance (ODA) for reproductive health activities in conflict-affected countries from 2003 to 2006.