tbuckley/cabot-search huggingface dataset:
Emergency Department–Initiated Palliative Care in Advanced Cancer
Authors: Corita R. Grudzen, Lynne D. Richardson, Pauline N. Johnson, Ming Hu, Binhuan Wang, Joanna M. Ortiz, Emmett A. Kistler, Angela Chen, R. Sean Morrison
Journal: JAMA Oncology (2016)

The delivery of palliative care is not standard of care within most emergency departments (EDs).To compare quality of life, depression, health care utilization, and survival in ED patients with advanced cancer randomized to ED-initiated palliative care consultation vs care as usual.A single-blind, randomized clinical trial of ED-initiated palliative care consultation for patients with advanced cancer vs usual care took place from June 2011 to April 2014 at an urban, academic ED at a quaternary care referral center. Adult patients with advanced cancer who were able to pass a cognitive screen, had never been seen by palliative care, spoke English or Spanish, and presented to the ED met eligibility criteria; 136 of 298 eligible patients were approached and enrolled in the ED and randomized via balanced block randomization.Intervention participants received a comprehensive palliative care consultation by the inpatient team, including an assessment of symptoms, spiritual and/or social needs, and goals of care.The primary outcome was quality of life as measured by the change in Functional Assessment of Cancer Therapy-General Measure (FACT-G) score at 12 weeks. Secondary outcomes included major depressive disorder as measured by the Patient Health Questionnaire-9, health care utilization at 180 days, and survival at 1 year.A total of 136 participants were enrolled, and 69 allocated to palliative care (mean [SD], 55.1 [13.1] years) and 67 were randomized to usual care (mean [SD], 57.8 [14.7] years). Quality of life, as measured by a change in FACT-G score from enrollment to 12 weeks, was significantly higher in patients randomized to the intervention group, who demonstrated a mean (SD) increase of 5.91 (16.65) points compared with 1.08 (16.00) in controls (P = .03 using the nonparametric Wilcoxon test). Median estimates of survival were longer in the intervention group than the control group: 289 (95% CI, 128-453) days vs 132 (95% CI, 80-302) days, although this did not reach statistical significance (P = .20). There were no statistically significant differences in depression, admission to the intensive care unit, and discharge to hospice.Emergency department-initiated palliative care consultation in advanced cancer improves quality of life in patients with advanced cancer and does not seem to shorten survival; the impact on health care utilization and depression is less clear and warrants further study.clinicaltrials.gov Identifier: NCT01358110.
Chemotherapy of soft tissue sarcomas.
Authors: G A Omura
Journal: Journal of Clinical Oncology (1988)

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.1988.6.1.182 Journal of Clinical Oncology - published online before print September 22, 2016 PMID: 3335891 Chemotherapy of soft tissue sarcomas. G A OmuraxG A OmuraSearch for articles by this author https://doi.org/10.1200/JCO.1988.6.1.182 First Page PDF © 1988 by American Society of Clinical Oncology
Elements of Clinical Bacteriology for Physicians and Students.
Journal: JAMA (1900)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Intranasal delivery of bFGF with nanoliposomes enhances in vivo neuroprotection and neural injury recovery in a rodent stroke model
Authors: Ying-Zheng Zhao, Min Lin, Qian Lin, Wei Yang, Xi-Chong Yu, Fu-Rong Tian, Kai-Li Mao, Jing-Jing Yang, Cui-Tao Lu, Ho Lun Wong
Journal: Journal of Controlled Release (2016)
Casualties of war
Authors: Fiona Godlee
Journal: BMJ (2016)

The strike by England's junior doctors-the first in 40 years-is both historic and deeply sad.Doctors have taken this action reluctantly, in protest against proposed changes to their contract that they believe threaten morale, recruitment, and the safety of patients.Although reluctant to strike, junior doctors were nearly unanimous in deciding to do so.They have wide support among senior colleagues, other health professionals, and, as reported earlier this week, the public (doi:10.
Clinical and Immune Responses in Advanced Melanoma Patients Immunized With an Anti-Idiotype Antibody Mimicking Disialoganglioside GD2
Authors: Kenneth A. Foon, Jose Lutzky, Rathindra N. Baral, John R. Yannelli, Laura Hutchins, April Teitelbaum, Oscar L. Kashala, Ruma Das, Juanita Garrison, Ralph A. Reisfeld, Malaya Bhattacharya-Chatterjee
Journal: Journal of Clinical Oncology (2000)

PURPOSE: To determine immune responses and toxicity to the anti-idiotype vaccine, as well as clinical responses and survival, we initiated a clinical trial for patients with advanced melanoma treated with an anti-idiotype antibody (TriGem) that mimics the disialoganglioside GD2. PATIENTS AND METHODS: Forty-seven patients with advanced melanoma received either 1-, 2-, 4-, or 8-mg doses of TriGem (Titan Pharmaceuticals Inc, South San Francisco, CA) mixed with QS-21 adjuvant (Aquila Biopharmaceuticals, Inc, Worcester, MA) 100 μg subcutaneously weekly for 4 weeks and then monthly until disease progression. Median age was 57 years, there were 32 men and 15 women, 43% of patients had undergone prior therapy for metastatic disease, 55% had disease confined to soft tissue, and 45% had visceral metastasis. RESULTS: Hyperimmune sera from 40 of 47 patients showed an anti–anti-idiotype (Ab3) response. Patient Ab3 was truly Ab1′ because it specifically bound purified disialoganglioside GD2. The isotypic specificity of the Ab3 antibody consisted of predominantly immunoglobulin (Ig)G, and all IgG subclasses were represented. One patient had a complete response that persisted at 24 months, and 12 patients were stable from 14+ to 37+ months (median, 18+ months). Disease progression occurred in 32 patients on study from 1 to 17 months (median, 5.5 months), and 21 have died at 1 to 16 months (median, 6 months). The Kaplan-Meier–derived overall median survival has not been reached. Median survival has not been reached for the 26 patients with soft tissue disease only and was 13 months for 21 patients with visceral metastasis. Toxicity consisted of local reaction at the site of injection and mild fever and chills. CONCLUSION: TriGem has minimal toxicity and generates robust and specific IgG immune responses against GD2. Objective responses were minimal, but there may be a favorable impact on disease progression and survival that will require prospective randomized trials.
Canadian Urologic Oncology Group (CUOG) phase II multi-center study using docetaxel/prednisone in the second line setting for metastatic hormone-refractory prostate cancer in patients progressing after first line mitoxantrone/prednisone
Authors: F. Saad, D. Ruether, S. Ernst, S. North, E. Winquist
Journal: Journal of Clinical Oncology (2005)

4612 Background: Until recently the standard approved regimen for symptomatic HRPC has been mitoxantrone/prednisone (MP). The regimen has proven efficacy in pain reduction and improvement in quality of life but has not shown survival benefit. No standard chemotherapy has been approved in the second line setting. Prior to the reporting of the phase 3 results of Tax 327 and SWOG 9916, phase II data showing efficacy with docetaxel/prednisone (DP) led to considering DP in patients progressing after prior MP and was the rational for this study. Objectives: Determine the tolerabilty and response to docetaxel 75mg per square meter every 3 weeks and prednisone 5mg BID in the second line setting in patients with metastatic HRPC having progressed after first line MP. Methods: Thirty patients (30) from 4 centers have been entered in the study. All patients had had prior MP for symptomatic, metastatic HRPC. Baseline PSA, pain scores, analgesic scores, bone scan and CT of the abdomen and chest were obtained. Patients all had castrate levels of testosterone and were maintained on LHRH therapy. Results: The study and analysis of results are still ongoing. Mean PSA at study entry was 272 and 80% of patients reported pain. At last analysis of evaluable cases PSA reductions of greater than 50% was observed in 85% (17/20) of patients. Pain response was observed in over 60% of patients. To date there have been 2 cases of febrile neutropenia and 3 deaths. The study has not yet reached median survival after 10 months giving a median survival of over 20 months since beginning first line MP. Conclusion: Tolerability of taxotere in the second line setting in patients having received mitoxantrone appears to be comparable to that observed in patients receiving docetaxel as first line chemotherapy. Response as measured by PSA and pain also appears to be comparable to docetaxel in the first line setting. Symptom improvement was significant. In selected patients, Docetaxel in the second line setting appears relatively safe and is a therapeutic option that should be considered. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Aventis Aventis Aventis
Abstract 18286: Left Atrial Spontaneous Echocardiographic Contrast is a Predictor of Cardiovascular Events (Death, Stroke, Heart Failure) Beyond the CHA2DS2VASc Score at Long-term Follow-up in a Single-Center Cohort of Patients with Non Valvular Atrial Fibrillation
Authors: Louise Boyer-Chatenet, Sylvie Lang, Stéphane Ederhy, Guillaune Fleury, Nabila Haddour, Catherine Meuleman, Saroumadi Adavane, Emanuele Di Angelantonio, Franck Boccara, Ariel Cohen
Journal: Circulation (2012)

Background: The CHA 2 DS 2 VASc score has been proposed as an additional tool in thromboembolic (TE) risk stratification, beyond the CHADS 2 score, in patients with non-valvular atrial fibrillation (NVAF). The role of additional TE risk markers, i.e. derived from echocardiography, has not been yet fully evaluated. We aimed to evaluate in a multivariate model the role of clinical versus TEE parameters in predicting cardiovascular (CV) events at long-term follow-up. Methods: In 763 consecutive patients hospitalized for NVAF, TEE was systematically performed within 24h after admission. All patients were followed-up (mean 5.8 ± 4.1 years) and cardiovascular (CV) events (stroke, death, or heart failure) defining a composite endpoint were recorded. Results: Two hundred and five patients (26.9%) had a CHADS 2 =0, 228 (29.9%) a CHADS 2 =1, and 330 (43.3%) a CHADS 2 ≥2. The corresponding figures for the CHA 2 DS 2 VASc score were 92 (12.1%), 115 (15.1) and 556 (72.9%), respectively. Left atrial spontaneous contrast (LASEC) was present in 358 (46.9%), described as mild in 212 (27.8%), moderate in 111 (14.6%) and severe in 35 (4.6%). LA thrombus was found in 17 patients (2.2%) and protruding aortic atheroma ≥4 mm in 116 (15.2%). Six hundred thirty three patients (83%) were prescribed warfarin and 158 (27%) aspirin at discharge. At follow-up, death occurred in 253 patients (33.2%), stroke in 29 (3.8%) and heart failure in 100 (13.1%). The Kaplan-Meier curves showed that a CHA 2 DS 2 VASc score &gt;3 was associated with a higher risk of CV events. In the multivariate analysis, non paroxysmal AF (HR 1.54, 95%CI 1.17-2.01), CHA 2 DS 2 VASc score (HR 1.47, 95%CI 1.38-1.57) and LASEC (presence/absence, HR 1.42 95%CI 1.11-1.82) were predictors of CV events. Warfarin treatment at discharge was protective (HR 0.65, 95%CI 0.48-0.87). Conclusions: TEE-detected LA spontaneous echocardiographic contrast in NVAF patients is associated with a higher risk of CV events, beyond the CHA 2 DS 2 VASc score and the type of AF.
Abstract #247: HIF-1\#945; mediates hypoxia modulation of EWS-FLI1 expression in Ewing\#8217;s sarcoma family tumors
Authors: Dave Aryee, Stephan Niedan, Karin Muehlbacher, Max Kauer, Jozef Ban, Idriss Bennani-Baiti, Heinrich Kovar
Journal: Cancer Research (2009)

AACR Annual Meeting-- Apr 18-22, 2009; Denver, CO

Hypoxia is an important phenomenon in the tumor cell microenvironment. Tumor hypoxia is associated with a more aggressive phenotype due to the induction of a number of genes, the majority of which are regulated by hypoxia-inducible factor-1 (HIF-1). The Ewing\#8217;s sarcoma family tumors (ESFT) are highly malignant bone-associated pediatric cancers that are defined by virtually a single oncogenic aberration, the EWS-FLI1 gene fusion. Considering the important role low oxygen plays in the microenvironment of solid tumors, we investigated the role of hypoxia in ESFT cells in vitro. We found that EWS-FLI1 protein and mRNA expression are up-regulated by hypoxia in a HIF-1\#945;-dependent manner. Microarray analysis pointed to a subset of genes being dependent on EWS-FLI1 for hypoxic modulation. Knocking down HIF-1\#945; with a specific short hairpin RNA under hypoxia resulted in suppression of EWS-FLI1 protein and mRNA expression. Conversely, expressing a non-degradable HIF-1\#945; mutant construct under normoxia resulted in EWS-FLI1 expression enhancement. By treating cells under hypoxia with several different kinase inhibitors, we also show that NF\#954;B and PI3K pathways may play a role in HIF-1\#945;-mediated EWS-FLI1 expression enhancement under hypoxia. Our data identify HIF-1\#945; and hypoxia as important factors in the regulation of the pathognomonic Ewing´s sarcoma oncogene EWS-FLI1, and this may have far-reaching consequences for the course of the disease.

Citation Information: In: Proc Am Assoc Cancer Res; 2009 Apr 18-22; Denver, CO. Philadelphia (PA): AACR; 2009. Abstract nr 247.
Thymoma Versus Thymic Carcinoma: Differences in Biology Impacting Treatment
Authors: Ronan J. Kelly
Journal: Journal of the National Comprehensive Cancer Network (2013)

A better understanding of the biology of both thymomas and thymic carcinomas has occurred in recent years thanks to advanced technologies such as comparative genomic hybridization, expression array analysis, and next-generation sequencing. Gene expression profiling and genomic clustering studies have shown that thymic tumors as classified by the 2004 WHO system do have different molecular features. Because of the rarity of these tumors, there is a paucity of high-quality clinical research data, and treatment decisions are often guided by the small amount of prospective trial data, retrospective series, and individual case reports. The literature does report on several advanced thymic tumors that have responded to new targeted agents, indicating that across the spectrum of thymic malignancies there may be clinically relevant molecular subsets. Genomic profiling distinguishes type B3 thymoma and thymic carcinoma from type A and B2 thymomas. Furthermore, type B2 thymomas can be separated from other subgroups in that it has a more distinctly lymphocytic component than the other groups in which epithelial cells predominate. The presence of KIT mutations in thymic carcinomas rather than in thymomas further adds to a growing body of evidence showing that underlying tumor biology may in the future lead to molecular classifications, which may enhance therapies for these rare tumors.
Abstract 4493: Ironing out breast cancer: investigation of a novel iron chelator
Authors: Anna Greenshields, David Hoskin, Melanie Coombs, Taryn Grant
Journal: Cancer Research (2015)

Abstract Introduction: Breast cancer is the second leading cause of cancer-related death in women. Current breast cancer therapy is hindered by dose-limiting toxicities, demonstrating the need for less toxic alternatives. As cancer cells have an increased requirement for iron, we hypothesized that iron withdrawal using a highly selective iron chelator (DIBI) developed by Chelation Partners Incorporated (CPI) would enhance breast cancer cell killing by chemotherapeutic drugs and ionizing radiation. Results: DIBI inhibited the growth of a panel of breast cancer cell lines while similar doses had limited effects on the growth of normal fibroblasts. In breast cancer cells, DIBI-mediated iron chelation increased transferrin receptor 1 mRNA expression and decreased the expression of ferroportin1 mRNA, which is indicative of decreased intracellular iron stores. Iron citrate reversed the inhibitory effect of DIBI, confirming the iron-specific activity of the compound. On the basis of iron-binding capacity, a comparison between DIBI and two conventional iron chelators demonstrated that DIBI was more effective at inhibiting breast cancer cell proliferation. DIBI-treated breast cancer cells showed a dose-dependent reduction in rounds of cell division, as well as arrest in the S-phase of the cell cycle. Higher doses of DIBI also induced apoptosis in breast cancer cells. In addition, DIBI treatment of breast cancer cells induced double-stranded DNA breaks, which are likely important for its anticancer activity. Pretreatment of breast cancer cells with DIBI enhanced the grow-inhibitory effects of ionizing radiation and conventional chemotherapeutic agents, suggesting that DIBI may increase the effectiveness of current breast cancer therapies. Combination treatment with cisplatin and DIBI demonstrated that DIBI enhanced both the cytotoxic and cytostatic anticancer effects of cisplatin. Conclusion: These findings suggest that selective sequestration of iron from the tumor microenvironment may prevent or diminish tumor progression. In the future, treating patients with this novel iron chelator in combination with conventional therapies may increase the effectiveness of current breast cancer treatments. Citation Format: Anna Greenshields, David Hoskin, Melanie Coombs, Taryn Grant. Ironing out breast cancer: investigation of a novel iron chelator. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 4493. doi:10.1158/1538-7445.AM2015-4493
Monoclonal antibodies and radioimmunoconjugates: keeping feasibility at center stage.
Authors: R C Knapp, C C Lau
Journal: Journal of Clinical Oncology (1990)

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.1990.8.12.1938 Journal of Clinical Oncology - published online before print September 22, 2016 PMID: 2230886 Monoclonal antibodies and radioimmunoconjugates: keeping feasibility at center stage. R C KnappxR C KnappSearch for articles by this author , C C LauxC C LauSearch for articles by this author https://doi.org/10.1200/JCO.1990.8.12.1938 First Page PDF © 1990 by American Society of Clinical Oncology
A phase II evaluation of the combination of paclitaxel protein-bound and carboplatin in the first-line treatment of advanced non-small cell lung cancer (NSCLC)
Authors: J. P. Allerton, C. T. Hagenstad, R. T. Webb, G. B. Smith, R. Birch, T. F. Goggins, S. B. Katakkar, W. Khan, N. D. Mehta, F. A. Greco
Journal: Journal of Clinical Oncology (2006)

7127 Background: Abraxane (A) is a cremophor free, albumin-bound nanoparticle of paclitaxel (P) approved for the treatment of metastatic breast cancer. Belani et al. (JCO 21: 2933–2939, 2003) reported that P 100 mg/m 2 days 1, 8 and 15 q 28 days with C AUC 6 on day 1 led to a 32% response rate in 132 patients (pts) with NSCLC. The median time to progression (TTP) was 35 weeks (wks) for stage IIIB and 29 wks for stage IV. Methods: This study was designed to determine if substituting A for P at an identical dose would lead to an improved response rate, TTP or decreased toxicity. Results: Fifty-six pts with stage IIIB/IV NSCLC previously untreated with chemotherapy were enrolled. The median age was 66 (range 37 - 83); 37 were male and median ECOG performance status was 1 (range 0–2). Thirteen pts were stage IIIB. Metastases included bone (17), liver (7), brain (2) and lymph nodes (16). Currently a total of 239 cycles of therapy have been administered with a median of 4 (range 1–8) cycles per pt. In 194 (81%) full dose A was administered on days 1, 8 and 15. The table below shows toxicities compared to P: Seven pts (13%) experienced grade (G) 1 neuropathy and 3 pts (5%) experienced G 2 neuropathy. Five pts were inevaluable for response due to removal from study after &lt;2 cycles of treatment (2 died from progressive disease, 2 because of toxicity - thrombocytopenia and neutropenia - and 1 refused). Of 51 evaluable pts 1 (2%) had a complete response and 23 patients (45%) achieved a partial response. Four of 10 evaluable stage IIIB pts obtained a PR. Twenty-one pts were stable for at least 12 weeks of whom twenty remain stable at 12–29 weeks and one progressed at 23 weeks. A total of 13 pts have progressed and 3 pts have died. The Kaplan-Meier estimate of median TTP is 23 wks and maximum follow up is 34 wks. Conclusions: We conclude that combining A and C is tolerable and active in the treatment of newly-diagnosed NSCLC and antitumor activity compares favorably to that of P/C. Further studies are warranted in this population. [Table: see text] [Table: see text]
Exposure to environmental tobacco smoke in childhood is associated to lung function in smoking adults
Authors: Øyvind Omland, Tine Malling, Vivi Schlünssen, Torben Sigsgaard, Lars Skadhauge, David Sherson, Jesper Bælum, Gert Tomsen
Journal: European Respiratory Journal (2011)

Objective: To analyse for associations between exposure to environmental tobacco smoke (ETS) in childhood and lung function in young adults.

Methods: In a Danish cross-sectional study of asthma in subjects aged 20-44 years (ERCHS protocol) 690 randomly selected subjects were eligible for analysis. Information of the participant exposure to ETS in childhood, cumulative smoking history and current exposure to ETS was based on questionnaire. FEV1 and FVC were measured according to ERS and ATS recommendation.

Results: No ETS exposure in childhood was reported by 130 subjects, while 245 and 315 subjects reported one or two parents smoking at home, respectively. Mean FEV1/FVC ratio (95% CI) was 80.2 (79.5-80.5). ETS in childhood had negative effect on the FEV1/FVC ratio (p=0.025 and p=0.001 by one or two parents, respectively). Stratifying for smoking habits the results were only significant among the 194 current smokers. Figure 1 shows relative difference in FEV1/FVC ratio in smoking adults by number of parents smoking at home in childhood stratified by age group, adjusted for gender, pack year, current exposure to ETS, study centre, and height2.

![Figure][1] 



Conclusion: Young adults have more obstructive pattern in lung function when exposed to ETS as a child, especially in young current smokers.

 [1]: pending:yes
The prevalence and management of diabetes mellitus in Thai adults – the International Collaborative Study of Cardiovascular Disease in Asia (InterASIA) (Journal Article)
Authors: W. Aekplakorn, R. P. Stolk, B Neal, P. Suriyawongpaisal, V. Chongsuvivatwong, S. Cheepudomvit, Mark Woodward
Journal: Diabetes Care (2003)