tbuckley/cabot-search huggingface dataset:
Adherence to mammogram (MMG) screening guidelines in BRCA1/2 mutation carriers
Authors: D. J. Goldfrank, J. Lee, N. D. Kauff, K. E. Hurley, L. M. Balistreri, J. Hellawell, P. I. Borgen, C. A. Hudis, K. Offit, M. E. Robson
Journal: Journal of Clinical Oncology (2005)

583 Background: MMG is routinely recommended for breast cancer screening in women with BRCA1 or BRCA2 mutations, usually beginning at or before age 25. However, previous studies have described poor screening adherence, especially among young carriers. In these studies, only 39–45% of unaffected carriers under age 40 participated in screening one year after genetic testing. These studies also suggested a decline in screening adherence with continued follow-up. Methods: We conducted a prospective observational study of unaffected BRCA mutation carriers to evaluate adherence to MMG screening recommendations. Women undergoing BRCA1/2 testing between 6/1/1995 and 12/31/2003 were enrolled in IRB-approved prospective follow-up studies. Screening performed prior to testing was determined by questionnaire at the time of enrollment. Patients were followed annually with structured questionnaires and medical records review. Participation in MMG screening and reported frequency of MMG screening at baseline and last follow-up were compared using the Wilcoxon signed-rank and Fisher’s exact tests. Results: 139 unaffected women with breast tissue at risk at the time of genetic testing were followed for a median of 38.3 months. Women who underwent risk-reducing mastectomy (25), developed cancer (13) or did not provide MMG information (5) were excluded. At a median follow-up of 32.0 months, 87 of 96 (90.6%) remaining women reported MMG screening within 12 months of their most recent questionnaire. Of 46 women aged <40 at genetic testing, 84.8% (39) described MMG within 12 months, compared with 96.0% of women 40 or older (P=0.10). Screening uptake after genetic testing in the 86 women providing both baseline and follow-up information increased from 73.3% to 96.5% (p<0.0001). In women under age 40 at testing (40), screening increased from 52.5% to 92.5% (p<0.001). Average annual MMG frequency increased from 0.76 to 1.12 (p<0.0001) in all women and from 0.53 to 1.03 (p<0.0001) in women <40. Conclusions: We found a significant increase in adherence to MMG screening recommendations after risk assessment and counseling which persisted for a median of 32 months. In our experience, adherence was not significantly reduced in younger women. No significant financial relationships to disclose.
PTU-085 Clinical benefits of the use of infliximab (INF) and adalumimab (ADA) therapeutic drug level monitoring in a uk district general hospital
Authors: C Chan, H Padmanabhan, H Steed, B McKaig, A Shah, A Murugananthan, J Folkes, MJ Brookes
Journal: Gut (2015)

<h3>Introduction</h3> Therapeutic failures with biologic drugs in inflammatory bowel disease (IBD) pose a significant challenge for clinicians who manage patients with IBD. There is a paucity of data demonstrating clinically relevant threshold levels of IFN and ADA. Small studies have shown that high IFN trough levels and low antibody levels were associated with successful maintenance of remission. For ADA the role of monitoring drug levels is less clear with considerable overlap trough serum levels between those in remission and in those not achieving remission. <h3>Method</h3> A retrospective review of all therapeutic drug level (INF and ADA) monitoring for 12 months in the 2014. Clinical characteristics included demographics. We also collected data on IBD type, duration, distribution and activity. We monitored INF and ADA trough levels, antibody trough levels, presence of concomitant immunosuppression and outcome of drug monitoring. <h3>Results</h3> In total thirty-eight IBD (95% Crohn’s disease; n = 36) patients had drug level monitoring (74% receiving IFN n = 28; 26% receiving ADA n = 10) for the following indications: (i) 13% primary nonresponse (n = 5); (ii) 58% secondary loss of response (n = 22) and; (iii) 29% other indication (n = 11). Antibodies were detectable in 21% (n = 8) of patients. Drug monitoring led to 34% (n = 13) patients continuing drug without any modification; 45% (n = 17) escalated dose or interval; 8% (n = 3) switched biologic therapy; 10% (n = 4) underwent surgery. None of the ADA patients were receiving concomitant immune suppression, however the use of Azathioprine (AZA) and IFN was associated with a lower incidence of antibody formation (10% vs. 24%; p &lt; 0.05). <h3>Conclusion</h3> The burden of biologic drug and antibody monitoring in a UK DGH IBD unit is small, but is advantageous to enable prompt optimisation of therapy. The results are optimisation of therapy and recapture of response in over half of patients on long-term biologic agents for maintenance of remission of IBD. <h3>Disclosure of interest</h3> None Declared.
Treating achalasia; more than just flipping a coin
Authors: Peter J Kahrilas
Journal: Gut (2016)

Even as the preferred treatment of achalasia migrates towards per-oral endoscopic myotomy (POEM), the relative merits of pneumatic dilation (PD) and laparoscopic Heller myotomy (LHM) continue to be argued. In this issue of Gut , the long-term results of the European achalasia trial comparing 201 patients randomised to PD or LHM are presented,1 reporting similar outcomes between therapies. After a minimum follow-up of 5 years, 82% of patients with PD and 84% of patients with LHM had a sustained good response when analysed by intention to treat (or 91% of patients with PD and 82% of patients with LHM when analysed per protocol). The outcomes being similar, the authors conclude that the decision between therapies should be based on available expertise and patient preference. Certainly, this was an important trial and an important result. Equally certain, the medical-surgical debate will continue. Assessing the adequacy of treatment in achalasia has many facets. There are many ways to look at it and, most assuredly, surgeons and gastroenterologists will not look at these data the same way.

The ideal therapy for achalasia would revert swallow function to normal, render the patient symptom-free and not result in pathological reflux. No current therapy achieves this and none on the horizon is likely to do so. …
Venovenous extracorporeal membrane oxygenation for acute respiratory failure
Authors: Eddy Fan, Luciano Gattinoni, Alain Combes, Matthieu Schmidt, Giles Peek, Dan Brodie, Thomas Muller, Andrea Morelli, V. Marco Ranieri, Antonio Pesenti, Laurent Brochard, Carol Hodgson, Cecile Van Kiersbilck, Antoine Roch, Michael Quintel, Laurent Papazian
Journal: Intensive Care Medicine (2016)
Abstract 3636: Regulation of Cardiac Sarcoplasmic Reticulum Calcium Uptake by PI3K{gamma}
Authors: Maradumane L Mohan, Sandro L Yong, Qing Wang, Sathyamangla V Naga Prasad
Journal: Circulation (2009)

Phosphoinositide 3-kinase γ(PI3Kγ) is a well known anti-apoptotic signaling molecule whose allelic deletion (PI3Kγ−/−) interestingly results in increased basal cAMP levels and enhanced cardiac cont...
Phase II trial of mitomycin C (MMC) in advanced gallbladder and biliary tree carcinoma. An EORTC Gastrointestinal Tract Cancer Cooperative Group Study
Authors: B G Taal, R A Audisio, H Bleiberg, G H Blijham, J P Neijt, C H Veenhof, N Duez, T Sahmoud
Journal: Annals of Oncology (1993)
Nilotinib 800 mg daily as first line treatment of chronic myeloid leukemia in early chronic phase: results of a phase II trial of the GIMEMA CML Working Party
Authors: G. Rosti, F. Castagnetti, F. Palandri, F. Pane, G. Martinelli, G. Saglio, M. Baccarani
Journal: Journal of Clinical Oncology (2008)

7054 Background: Imatinib (IMA) 400 mg is the standard treatment for chronic myeloid leukemia (CML) in early chronic phase (CP): the results of the IRIS trial have shown a 72 mos OS rate of 95%; the EFS and the PFS rates were 83% and 93%, respectively. A complete cytogenetic response (CCgR) and a major molecular response (MMR) were associated with a 100% PFS at 60 mos. Nilotinib, a second generation TKI, has a higher binding affinity and selectivity for Abl with respect to IMA, being 20 to 50 times more active in IMA-sensitive cell lines, and is highly effective in IMA-resistant pts, across every disease phase. Among 320 CP pts resistant or intolerant to IMA, who received nilotinib 400 mg BID for at least 6 mos, the rates of major and complete CgR were 56% and 40%, respectively, with very few progressions. Methods: Giving these impressive results in resistant pts, along with a very good profile of tolerability, the GIMEMA CML WP felt rationale and safe to explore nilotinib (400 mg BID) in naïve adult CML-CP pts in an open-label, single stage, multicentric, phase II study (ClinicalTrials.gov:NCT00481052). The trial was approved by the IRBs of each participating institution and all pts provided written IC. The primary endpoint is the CCgR rate at 1 year; the kinetic of MR is studied by Q-PCR, baseline and after 1, 2, 3, 6, 9 and 12 mos from starting treatment. Results and Conclusions: the study was opened on June 20, 2007 and it will be closed after the enrollment of 70 pts. As of December 12, 2007, 52 pts have been enrolled: 45% males, median age 50 yrs (range 25–83), 49% low sokal risk. 51/52 pts are on treatment to date (median follow-up 78 days; range 8–167); 1 pt permanently interrupted nilotinib after 1 month due to a relapsed breast cancer. 15/15 pts completed 3 mos on treatment: all of them reached a CHR; 3/5 evaluable for the CgR obtained a CCgR and 2/5 a partial CgR; 5/11 evaluable for the MR showed a BCR-ABL/ABL ratio < 0,1%; 3/15 experienced a grade 3 AE (1 liver; 1 amylases increase without pancreatitis, 1 thrombocytopenia); 10/15 are still receiving the scheduled dose, while 5/15 required dose reduction to 400 mg OAD. No SAEs have been reported yet. Responses (particularly regarding the kinetics of the MR) will be presented on site for 50 pts at 3 mos and for 30 pts at 6 mos. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Bristol-Myers Squibb, Novartis, Wyeth Bristol-Myers Squibb, Novartis Bristol-Myers Squibb, Johnson & Johnson, Novartis, Roche, Schering-Plough, Wyeth
PTH-113 Factors affecting survival outcomes in patients with cholangiocarcinoma – a uk regional hepato-biliary centre experience
Authors: NG Ladep, U Aujla, L Dwyer, O Noorullah, S Hood, N Stern, R Sturgess
Journal: Gut (2015)

<h3>Introduction</h3> The incidence and mortality of Intrahepatic bile duct cholangiocarcinoma (CCA) has risen worldwide over the past few decades. Over the last four decades, an exponential rise in the age-standardised mortality rate of CCA has been recorded in England and Wales. We examined the factors affecting survival from CCA at a regional hepato-biliary centre. <h3>Method</h3> We retrospectively reviewed 340 patients with confirmed CCA to evaluate the factors affecting survival over a period of six years (2009–2014). The hospital integrated data base was used for clinical, radiological, histological and endoscopic details. Overall survival by modality of treatment was examined by Kaplan-Meier log rank test. Factors contributing to mortality were assessed by Cox proportional hazards. <h3>Results</h3> There was a female preponderance of CCA (n = 174, 51.2%), histology being the most prevalent mode of diagnosis (n = 154, 45.3%) and palliative biliary stenting most utilised treatment (n = 171, 50.3%). Intrahepatic CCA had the largest tumour diameter versus extrahepatic CCA (median: 6.2 cm vs 3.0 cm, p= &lt;0.0001). Overall median survival was 8 months (range 7–11). The median survival for those treated with chemotherapy, biliary stent and best supportive care were 16 (11–18), 5 (4–6) and 4 (2–7) months, respectively. 5 year survival post resection was 80%. Surgical resection and chemotherapy were associated with improved survival (HR: 0.13; 95% CI: 0.06–0.28, p &lt; 0.0001) and (HR: 0.33; 95% CI: 0.17–0.60, p = 0.0003) respectively, whereas the presence of biliary calculi at diagnosis conferred a negative impact on survival (HR: 1.83; 95% CI: 1.19–2.81, p = 0.006). Presence of biliary calculi was a significant independent predictor of survival in patients with hilar CCA. <h3>Conclusion</h3> Similar to experience elsewhere, we observed that surgical resection and chemotherapy offered survival benefit to CCA patients. The association of increased mortality in presence of biliary calculi prompts further prospective investigation of the possibility that the diagnosis of stone disease delays recognition of coexisting bile duct tumours. <h3>Disclosure of interest</h3> None Declared.
Endogenous Fibrinolysis
Authors: Osita N. Okafor, Diana A. Gorog
Journal: Journal of the American College of Cardiology (2015)

Most acute cardiovascular events are attributable to arterial thrombosis. Plaque rupture or erosion stimulates platelet activation, aggregation, and thrombosis, whilst simultaneously activating enzymatic processes that mediate endogenous fibrinolysis to physiologically maintain vessel patency. Interplay between these pathways determines clinical outcome. If proaggregatory factors predominate, the thrombus may propagate, leading to vessel occlusion. However, if balanced by a healthy fibrinolytic system, thrombosis may not occur or cause lasting occlusion. Despite abundant evidence for the fibrinolytic system regulating thrombosis, it has been overlooked compared with platelet reactivity, partly due to a lack of techniques to measure it. We evaluate evidence for endogenous fibrinolysis in arterial thrombosis and review techniques to assess it, including biomarkers and global assays, such as thromboelastography and the Global Thrombosis Test. Global assays, simultaneously assessing proaggregatory and fibrinolytic pathways, could play a role in risk stratification and in identifying impaired fibrinolysis as a potential target for pharmacological modulation.
Idiopathic cardiomyopathy and panic disorder: clinical association in cardiac transplant candidates
Authors: J P Kahn, R E Drusin, D F Klein
Journal: American Journal of Psychiatry (1987)

Patients under evaluation for cardiac transplant surgery were seen for routine psychiatric diagnosis and treatment. Of 35 patients with idiopathic cardiomyopathy, 83% (N = 29) had definite or probable panic disorder. Of 25 patients with postinfarction cardiac failure, rheumatic heart disease, or congenital heart disease, only 16% (N = 4) had definite or probable panic disorder. The authors suggest that autonomic mechanisms may underlie the association of cardiomyopathy and panic disorder and that increased cardiac sympathetic tone or circulating catecholamines may cause myocarditis and cardiomyopathy.
An epidemiologic study of problems associated with violence among psychiatric inpatients
Authors: T J Craig
Journal: American Journal of Psychiatry (1982)

Approximately 11% of a 1-year sample of psychiatric inpatients from a single catchment area engaged in assaultive behavior before admission to the hospital. Among schizophrenic, alcoholic, and organic brain syndrome patients, assaultiveness was linked to emotional turmoil, as manifested by agitation and anger. In contrast, male patients with other diagnoses showed assaultiveness in the absence of substantial emotional distress, and patients with affective disorders were unlikely to exhibit assaultiveness even when high levels of agitation and anger were reported. The findings suggest that assessment and treatment of violent behavior in psychiatric patients are primarily linked to the nature of the underlying psychopathology.
A Policy-Driven Perspective on Rising Drug Costs in Dermatology
Authors: Harrison P. Nguyen, Howard P. Forman
Journal: JAMA Dermatology (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 Dermatology 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 Dermatology journal
NHS England rolls out world’s first national diabetes prevention programme
Authors: Ingrid Torjesen
Journal: BMJ (2016)

One hundred thousand people in England will be recruited to the world’s first nationwide diabetes prevention programme by 2020, NHS England has announced.

The joint initiative by NHS England, Public Health England, and Diabetes UK will begin this year with 20 000 places being made available in 27 areas, covering 26 million people (about half of the population in England). The programme will cover the whole country by 2020, and then 100 000 places will be available each year.

Patients referred to Healthier You: the NHS Diabetes Prevention Programme …
Development and validation of a histological index for UC
Authors: Mahmoud H Mosli, Brian G Feagan, Guangyong Zou, William J Sandborn, Geert D'Haens, Reena Khanna, Lisa M Shackelton, Christopher W Walker, Sigrid Nelson, Margaret K Vandervoort, Valerie Frisbie, Mark A Samaan, Vipul Jairath, David K Driman, Karel Geboes, Mark A Valasek, Rish K Pai, Gregory Y Lauwers, Robert Riddell, Larry W Stitt, Barrett G Levesque
Journal: Gut (2015)

<h3>Objective</h3> Although the Geboes score (GS) and modified Riley score (MRS) are commonly used to evaluate histological disease activity in UC, their operating properties are unknown. Accordingly, we developed an alternative instrument. <h3>Design</h3> Four pathologists scored 48 UC colon biopsies using the GS, MRS and a visual analogue scale global rating. Intra-rater and inter-rater reliability for each index and individual index items were measured using intraclass correlation coefficients (ICCs). Items with high reliability were used to develop the Robarts histopathology index (RHI). The responsiveness/validity of the RHI and multiple histological, endoscopic and clinical outcome measures were evaluated by analyses of change scores, standardised effect size (SES) and Guyatt9s responsiveness statistic (GRS) using data from a clinical trial of an effective therapy. <h3>Results</h3> Inter-rater ICCs (95% CIs) for the total GS and MRS scores were 0.79 (0.63 to 0.87) and 0.80 (0.69 to 0.87). The correlation estimates between change scores in RHI and change score in GS and MRS were 0.75 (0.67 to 0.82) and 0.84 (0.79 to 0.88), respectively. The SES and GRS estimates for GS, MRS and RHI were: 1.87 (1.54 to 2.20) and 1.23 (0.97 to 1.50), 1.29 (1.02 to 1.56) and 0.88 (0.65 to 1.12), and 1.05 (0.79 to 1.30) and 0.88 (0.64 to 1.12), respectively. <h3>Conclusions</h3> The RHI is a new histopathological index with favourable operating properties.
HPV and cervical cancer
Authors: Neeta Singh
Journal: Cancer Research (2008)

AACR Annual Meeting-- Apr 12-16, 2008; San Diego, CA

4717 

Cervical cancer is a major problem globally, particularly in the Indian subcontinent. The predominant risk factor is persistence infection with a high risk oncogenic type of HPV. Multiple host and viral factors determine the final outcome of HPV infection. Analysis of the interaction of these variables that affect the dynamics of HPV clearance versus persistence, will help in determining the cervical cancer pathogenesis.    The objective of this study was to investigate HPV types and HPV 16 variant distribution, viral load, p53 codon 72 polymorphism and episomal and integrated forms of HPV.    110 untreated, freshly frozen cervical tumors, 28 SILs and 109 controls were analysed for HPV presence by consensus PCR. HPV typing was done using Xcyton DNA chip. Viral loads were measured by Real time PCR, and HPV 16 variants were analyzed by PCR followed by sequencing. P53 codon 72 polymorphism was analyzed by PCR and restriction enzyme digestion.    The presence of HPV was seen in 94% of the tumors,79% of SILs and 10% of controls. HPV types 16 and 18 were the most frequent types, followed by 45,31,73,33 in tumors. Multiple infections were more common in SILs and controls then in tumors. Viral loads progressively increased from controls, to SILs, to tumors. The European variant was the most frequent class detected in tumors, SILs and controls. Novel nucleotide changes were also seen which may affect viral protein activity. The arginine genotype was overexpressed in tumors. Most controls, SILs and tumors contained predominantly episomal DNA which may influence integrant activity.    HPV 16 was the most frequent type detected. HPV types and viral variants may be important for improving cervical cancer screening effectiveness, vaccine development, and for insights into HPV oncogenesis.
MPTH-22INTEGRATING MOLECULAR MARKERS INTO THE WORLD HEALTH ORGANIZATION (WHO) CLASSIFICATION OF GLIOMAS: SURVEY RESULTS FROM THE SNO MEMBERSHIP
Authors: Romina Nejad, Daniel N. Louis, Kenneth Aldape, Gelareh Zadeh
Journal: Neuro-Oncology (2015)

INTRODUCTION: Gliomas are currently classified based on the 2007 WHO Classification of Tumours of the Central Nervous System, which uses histological features to classify and grade these heterogeneous tumors. With recent advances in the development of clinically relevant molecular signatures, there is an interest to incorporate appropriate molecular markers in to the classification. The views of the neuro-oncology community on such changes would be informative for advising this process. METHODS: A survey with 8 questions regarding molecular markers in tumor classification was sent to an email list of SNO members and attendees of prior meetings (n = 5065). There were 403 respondents. Analysis was performed using whole group response and based on self-reported subspecialty. RESULTS: Survey results among all respondents show support for incorporating our molecular knowledge of brain tumors into the WHO classification. Across all seven subspecialty groups, 370% of respondents agreed to this integration. Interestingly, despite support in the majority of questions, neuropathologists were more inclined to disagree that molecular markers should be included in the WHO classification (25% for neuropathologists versus 13% overall). This is in contrast to radiation oncologists who were less inclined (3%) to disagree with this statement. Additionally, neuropathologists were more inclined to state there was no need to change the structure of diagnosis into a “layered” format (17% versus 6% overall) or to agree that pediatric diffuse gliomas should be classified differently from adult tumors despite different molecular features (23% versus 5% overall). CONCLUSION: Based on a survey provided to SNO membership, we report strong support for the integration of molecular markers into the WHO classification of brain tumors, as well as for using an integrated “layered” diagnostic format. While membership from each specialty showed support, there was variation by specialty in enthusiasm regarding proposed changes.
Randomized Phase Ii Study of S-1 Plus Oral Leucovorin (Sl) Versus Sl Plus Oxaliplatin (Sol) Versus S-1 Plus Cisplatin (Sp) in Patients with Advanced Gastric Cancer (Agc):Updated Overall Survival Data
Authors: K. Yamaguchi, S. Hironaka, N. Sugimoto, T. Moriwaki, Y. Komatsu, T. Nishina, A. Tsuji, T.E. Nakajima, M. Gotoh, N. Machida, N. Fuse, T. Esaki, Y. Emi, Y. Takinishi, S. Matsumoto, N. Boku, H. Baba, I. Hyodo
Journal: Annals of Oncology (2014)