tbuckley/cabot-search huggingface dataset:
Prediction of early and late distant recurrence in early-stage breast cancer with Breast Cancer Index.
Authors: Yi Zhang, Catherine A. Schnabel, Brock Schroeder, Piiha-Lotta Jerevall, Rachel Catherine Jankowitz, Olle Stal, Adam Brufsky, Dennis Sgroi, Mark G. Erlander
Journal: Journal of Clinical Oncology (2013)

594 Background: Breast Cancer Index (BCI) is a continuous risk index based on the combination of HOXB13:IL17BR (H:I) and the Molecular Grade Index (MGI) that estimates the individual risk of recurrence in ER+, LN- breast cancer patients. In the current study, a modified BCI model was developed using untreated breast cancer patients in order to evaluate its pure prognostic value, and to better optimize BCI for both early and late risk assessment. Methods: A model was built by linearly combining H:I and MGI weighted by their corresponding Cox regression coefficients using ER+ LN- patients from the untreated arm of the prospective Stockholm trial (N=283). Validation was performed in 2 independent ER+, LN- cohorts: the TAM arm of the Stockholm trial (N=317), and a multisite cohort of TAM-treated patients (N=358). Correlation of BCI with distant metastasis was evaluated by Kaplan-Meier analysis using the log rank test, and multivariate analysis adjusting for standard prognostic factors was performed using Cox proportional hazards. Results: The BCI linear model was significantly associated with risk of cumulative (0-10y), early (&lt;5y) and late (≥5y) distant metastasis. Based on pre-specified cutpoints, BCI classified 64% and 55% patients as low-, 21% and 22% as intermediate-, and 16% and 23% as high-risk, with 10-y rates of distant recurrence (95% CI) of 4.8% (1.7-7.8%) and 6.6% (2.9–10.0%), 11.7% (3.1–19.5%) and 23.3% (12.3-33.0%), 21.1% (18.5–32.0%) and 35.8% (24.5–45.5%), in the Stockholm TAM and multisite cohort, respectively. Conclusions: BCI demonstrated significant prognostic performance beyond clinicopathological factors to predict cumulative, early and late risk of recurrence in early stage breast cancer patients. Use of BCI at diagnosis should enable clinicians to identify patients who are at high risk of late recurrence and may benefit from an additional 5y of hormonal therapy. [Table: see text]
Art: Asia: Body Mind Spirit
Authors: Kristina Fišter
Journal: BMJ (2004)

The most interesting aspects of this exhibition, which uses the Wellcome Library's artefacts to explore Asia's holistic approach to medicine, need to be sought out by the visitor, but they are there. Did you know, for example, that the Chinese first bathe their newborns on the third day of their life? Or that professional ear cleaners still offer their services in public places, cleaning the ear canals of willing passers-by with narrow wooden scoops?​scoops?




Figure 1



Detail of Chila Burman's “ReOrientalisms”




The wealth of messages from the 200 or so items is not quite as immediately obvious as we're used to these days, spoiled as we are by multimedia attention grabbers wherever we look. The only piece of modern equipment at the exhibition is a television set, showing a woman doing an amazing performance of a t'ai chi sequence. Right next to it, though, we're drawn back into the past through a photograph of a mass t'ai chi session at dawn—an unnerving sight to a Westerner, in spite of its probable beneficial effect on the health of the many participants.

You'll find 16th century recipes for treating gonorrhoea that use dragon bones, together with instructions for where to find them. And you'll learn that Japanese methods for treating smallpox included hanging ropes of plaited straw at the entrance of houses and recommendations to read books printed in red ink. You'll see acupuncture needles more than 2000 years old and replicas of ancient Arab obstetrical forceps, dental forceps, and bone saws. Do you also want to see Samye, the first Buddhist monastery in Tibet, which is believed to be the place where the first international medical conference was held, in the 8th century? But you're not going to Tibet any time soon? Just visit the Brunei Gallery during lunchtime.

The most interesting item and the last one in the exhibition—and one of the rare exhibits dealing with the present time—is a piece commissioned from the artist Chila Burman. It is a collage of leaflets, brochures, fliers, and packaging of Chinese, Indian, Korean, Japanese, and Tibetan complementary medicine and bodycare products, all collected on the bank holiday weekend of 30 August 2004 on a London high street. It is an astonishing cross section of our daily visual reality that shows how often and how powerfully we are all asked to join Asia's belief in a balanced relationship of body, mind, and spirit.
A phase 1 dose-escalation study of BBI503, a first-in-class cancer stemness kinase inhibitor in adult patients with advanced solid tumors.
Authors: Scott Andrew Laurie, Derek J. Jonker, William Jeffery Edenfield, Joe Stephenson, Deborah Keller, Matthew Hitron, Wei Li, Youzhi Li, Keyur Gada, Yuan Gao, Chiang Li
Journal: Journal of Clinical Oncology (2014)

2527 Background: Targeting cancer stem cells (CSC) may hold significant therapeutic promise. BBI503 is an orally-administered first-in-class multi-kinase inhibitor with potent activity against CSC. Preclinically, potent anti-CSC and broad-spectrum anti-tumor and anti-metastatic activity was seen in vitro and in vivo. Methods: A first-in-man phase 1 dose escalation studyin patients with advanced cancer was conducted to determine safety, tolerability, RP2D, pharmacokinetics and preliminary anti-tumor activity of BBI503. BBI503 was given orally, continuously, in 28-day cycles until disease progression, unacceptable toxicity, or other discontinuation criteria were met. Results: Escalating doses from 10 mg to 450 mg once daily were administered to 26 patients. MTD was not reached. BBI503 was well tolerated, with mild GI adverse events, including grade 1, 2 diarrhea, abdominal cramping, nausea, anorexia. Grade 3 diarrhea was observed in 2 subjects at 450 mg once daily. BBI503 exhibited favorable pharmacokinetics with dose-dependent increases in plasma concentration up to 300 mg once daily. Inhibition of cancer stem cell markers was observed in biopsied tumor tissues. Of 20 evaluable patients, 11 (55%) had stable disease (SD) with a median time to progression of 16 wks. Of those patients with SD, tumor regression and/or prolonged stable disease (≥ 16 weeks) were observed in 10 (50% of all enrolled patients) (see Table). Clinical trial information: NCT01781455. Diagnosis Number of patients evaluable Number of patients with minor regression or SD ≥ 16 wks. Colorectal cancer 5 3 Head and neck cancer 2 2 Hepatocellular carcinoma 2 1 Renal cell carcinoma 1 1 Gastric/GEJ adenocarcinoma 1 1 Pancreatic neuroendocrine 1 1 Non-small cell lung cancer 1 1
Fractional Flow Reserve and Coronary Computed Tomographic Angiography
Authors: Harvey S. Hecht, Jagat Narula, William F. Fearon
Journal: Circulation Research (2016)

Invasive fractional flow reserve (FFR) is now the gold standard for intervention. Noninvasive functional imaging analyses derived from coronary computed tomographic angiography (CTA) offer alternatives for evaluating lesion-specific ischemia. CT-FFR, CT myocardial perfusion imaging, and transluminal attenuation gradient/corrected contrast opacification have been studied using invasive FFR as the gold standard. CT-FFR has demonstrated significant improvement in specificity and positive predictive value compared with CTA alone for predicting FFR of ≤0.80, as well as decreasing the frequency of nonobstructive invasive coronary angiography. High-risk plaque characteristics have also been strongly implicated in abnormal FFR. Myocardial computed tomographic perfusion is an alternative method with promising results; it involves more radiation and contrast. Transluminal attenuation gradient/corrected contrast opacification is more controversial and may be more related to vessel diameter than stenosis. Important considerations remain: (1) improvement of CTA quality to decrease unevaluable studies, (2) is the diagnostic accuracy of CT-FFR sufficient? (3) can CT-FFR guide intervention without invasive FFR confirmation? (4) what are the long-term outcomes of CT-FFR–guided treatment and how do they compare with other functional imaging-guided paradigms? (5) what degree of stenosis on CTA warrants CT-FFR? (6) how should high-risk plaque be incorporated into treatment decisions? (7) how will CT-FFR influence other functional imaging test utilization, and what will be the effect on the practice of cardiology? (8) will a workstation-based CT-FFR be mandatory? Rapid progress to date suggests that CTA-based lesion-specific ischemia will be the gatekeeper to the cardiac catheterization laboratory and will transform the world of intervention.
P256 Clinical sequelae of tuberculosis in children attending a single UK centre: An 11 year retrospective study: Abstract P256 Table 1
Authors: S Bhowmik, S Nicol, C Bell, C Murray, F Child
Journal: Thorax (2015)

<h3>Introduction</h3> Although public health outcomes in tuberculosis (TB) are widely reported in the literature, there is little information on clinically important sequelae particularly in children. The aim of this study was to collect clinical outcome data on a cohort of children treated for TB in a tertiary children’s hospital in the UK. <h3>Method</h3> We performed a retrospective study of all children attending our centre aged &lt;16 years who started treatment for TB disease between January 2003 and December 2013. Patients with latent TB were excluded. Children were divided into 2 groups: symptoms (suggestive of TB) or screening (new entrants and TB contacts) depending on their clinical presentation. Information about symptoms, comorbidities, diagnostic tests, treatment, side effects and clinical outcomes (end of treatment) was collected from medical records and enhanced TB surveillance reports. <h3>Results</h3> 209 patient episodes in 205 children were identified (4 retreated ≥6 months after initial treatment); 96(47%) male; mean age 8.6 years (range 0.1–15.8); 40% Asian, 32% Black African, 19% White. Following WHO guidelines 49(23.4%) were definite (culture positive), 152(72.7%) probable and 8(3.8%) possible cases. 92(44%) presented with symptoms, 117(56%) through screening (111 contacts, 6 new entrants). Site of disease was pulmonary in 53%, hilar lymphadenopathy in 25%, military in 3%, central nervous system in 5% and other in 14%. Drug resistance was unusual (single 4%; multi 2%). All were HIV negative. The majority received quadruple therapy (84%), 27(13%) triple and 7(3%) other TB-drug regimes. Clinical outcomes were determined for 196 patients (see Table 1). All 14(7%) with adverse outcomes (including 1 death) presented with symptoms (p &lt; 0.001). Samples for culture were obtained in 118 (74(80%) symptomatic; 44(38%) screened). Positive cultures were significantly more common in the symptomatic group (64%) compared with the screened group (4.5%; p &lt; 0.001) and in those with an adverse outcome (86%) compared with good outcome (36%; p = 0.002). <h3>Conclusion</h3> TB is not a benign disease in children. This study shows that clinical outcomes are significantly worse in those who present with symptoms compared with those identified through screening and reminds us of the importance of identifying children at risk of TB infection early.
Resilience—Back to the Future
Authors: Wiley W. Souba
Journal: JAMA Surgery (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 Surgery 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 Surgery journal
Should Restrictions Be Relaxed for Metformin Use in Chronic Kidney Disease? No, We Should Never Again Compromise Safety!
Authors: Kamyar Kalantar-Zadeh, Csaba P. Kovesdy
Journal: Diabetes Care (2016)

Metformin is and has been considered as first-line therapy for type 2 diabetes for over a quarter of a century. Like other biguanides, metformin can cause a lactic acidosis that is exceptionally rare but fatal. The likelihood of metformin-associated lactic acidosis is substantially higher in patients with kidney impairment and also among those with seemingly normal kidney function who are at risk of acute kidney injury (AKI). Hence, regulatory agencies in many industrialized nations have maintained strict renal restrictions surrounding metformin. However, there have been millions of people exposed to metformin for many years, many of them with serum creatinine values at or close to 1.5 mg/dL with estimated glomerular filtration rates (eGFRs) much below 60 mL/min/1.73 m2 who have not developed lactic acidosis. Thus, there clearly remains controversy in this area, and there has been heightened pressure to remove the renal restrictions of metformin. To provide a discussion on the pros and cons of relaxing the renal restrictions for metformin use, we provide a Point-Counterpoint. In the point narrative below, Drs. Kalantar-Zadeh and Kovesdy provide their argument that although there is little evidence of the potential benefits of metformin in kidney disease, just considering the sheer numbers of metformin users and the high fatality rate of its associated lactic acidosis, the most appropriate practice is to avoid metformin use in people with eGFR &amp;lt;45 mL/min/1.73 m2 or in those who are at high risk of AKI irrespective of underlying eGFR. In the following counterpoint narrative, Drs. Bakris and Molitch argue that the data from a very large analysis demonstrate clearly that serum creatinine should be supplanted with eGFR as the criteria for metformin use and that the incidence of lactic acidosis is only elevated in those with a reduced eGFR who become dehydrated for various reasons or in those exposed to some toxin resulting in AKI. Otherwise the data clearly support the use of metformin under normal circumstances down to eGFR &amp;gt;30 mL/min/1.73 m2. —William T. Cefalu Editor in Chief, Diabetes Care
Prevention of Antidrug Antibody Formation to Infliximab in Crohn's Patients With Prior Failure of Thiopurines
Authors: Haggai Bar-Yoseph, Matti Waterman, Ronit Almog, Thomas Billiet, Séverine Vermeire, Bella Ungar, Henit Yanai, Iris Dotan, Shomron Ben-Horin, Yehuda Chowers
Journal: Clinical Gastroenterology and Hepatology (2016)
Prevention of Rh-hemolytic disease.
Authors: C A Clarke
Journal: BMJ (1967)

IN LESS than 30 years our understanding of rhesus hemolytic disease of the newborn has run full cycle from hypothesis to prevention. Recent studies, such as the one by Zipursky and Israels, published in this week’s issue (p. 1245), encourage the belief that the disease can be practically eradicated.
Development Of a Human IgM Secreting Model Of Rpci-WM1 Through Xenografting In SCID Mice For In Vivo Drug Evaluation
Authors: Kasyapa S. Chitta, Aneel Paulus, Sharoon Akhtar, Maja Kuranz, Sikander Ailawadhi, Kena Miller, Candido E. Rivera, Gerardo Colon-Otero, Vivek Roy, Stephen M Ansell, Anne J. Novak, Peter Martin, Morton Coleman, Asher Chanan-Khan
Journal: Blood (2013)
Absolute lymphocyte count recovery after induction chemotherapy predicts superior survival in acute myelogenous leukemia
Authors: D. Behl, L. F. Porrata, S. N. Markovic, M. A. Elliott, C. C. Hook, S. H. Kaufmann, L. Letendre, R. K. Pruthi, A. Tefferi, M. R. Litzow
Journal: Journal of Clinical Oncology (2005)

6553 Background: Absolute lymphocyte count (ALC) recovery post-autologous stem cell transplantation is a powerful independent predictor for survival in acute myelogenous leukemia (AML). The role of ALC recovery after induction chemotherapy (IC) in AML is unknown. We hypothesized that ALC recovery after IC has a direct impact on survival. Methods: 109 consecutive AML patients treated with standard induction and consolidation chemotherapy (CC) from 1998 until 2002 were retrospectively analyzed. The primary end point was to assess the impact of ALC recovery after IC on overall survival (OS) and progression-free survival (PFS). ALC recovery was studied at days 15, 21, and 28 after IC and just prior to first CC. Results: The median age of the cohort was 59 years (range: 14–81 years). The median follow-up was 17 months (range: 1–78 months). The data is as shown in the table. Using a cut-off of ALC recovery at ≥ 2 time points, multivariate analysis demonstrated superior OS and PFS at ALC cut-off values that discriminated clinical outcomes at a high level of significance for blood counts obtained at the time points chosen. According to our data, ALC recovery at ≥ 2 time points is an independent prognostic factor for OS and PFS when compared to age, FAB classification, cytogenetics, LDH, white blood cell count, and secondary AML. Conclusion: This data supports our hypothesis suggesting a critical role of lymphocyte (immune) recovery after IC in AML. No significant financial relationships to disclose.
Ankylosing Spondylitis and Axial Spondyloarthritis
Authors: Joel D. Taurog, Avneesh Chhabra, Robert A. Colbert
Journal: New England Journal of Medicine (2016)

This article summarizes the clinical definition of ankylosing spondylitis and axial spondyloarthritis, discusses the pathogenesis of these conditions, and reviews approaches to management.
Prospective Payment
Authors: C J Schramm, J Gabel
Journal: New England Journal of Medicine (1988)

Faced with rising budget deficits and the expected doubling of Medicare costs within the next five years, Congress directed in 1982 that Medicare develop a prospective payment system for reimbursing hospitals. The establishment of that system, popularly known as DRGs (diagnosis-related groups), marked a dramatic turning point in the payment of hospitals by Medicare. By severing the direct link between the provision of services and payment for them, prospective payment reversed the incentives for hospitals, offering the reward of increased profits rather than reduced revenue for cost-effective care. Proponents of prospective payment argued that the new system would trim an . . .
The JAK Inhibitor Ruxolitinib Substantially Affects NK Cells in MPN Patients
Authors: Kathrin Schönberg, Janna Rudolph, Maria Vonnahme, Isabelle Cornez, Sowmya Parampalli Yajnanarayana, Walter Verbeek, Steffen Koschmieder, Tim H. Brümmendorf, Peter Brossart, Annkristin Heine, Dominik Wolf
Journal: Blood (2014)
Long-Acting Serotonin Antagonist Palonosteron To Prevent Nausea and Vomiting after High-Dose Melphalan and Autograft in Myeloma.
Authors: S. Trifilio, K. Kaniecki, J. Zook, J. Pi, K. Carson, M. Fishman, K. Masino, N. Bainbridge, J. Mehta
Journal: Blood (2006)
P-214 Salvage Chemoradiotherapy for Locally Recurrent Bile Duct Cancer
Authors: J.I. Yu, H.C. Park, D.H. Lim, S.T. Kim, Y.S. Park, J.O. Park, S.H. Choi, D.W. Choi, J.S. Heo
Journal: Annals of Oncology (2016)
알코올간질환 : 지방간의 병리 소견
Authors: 이재혁
Journal: Clinical and Molecular Hepatology (2008)

Steatosis (fatty liver) and steatohepatitis (fatty liver with inflammation) represent two of the most frequent pathologic manifestations of hepatotoxicity. Steatosis and steatohepatitis may be due to alcohol ingestion (alcoholic liver disease, ALD) or may be a manifestation of central obesity, diabetes, or hypertriglyceridemia with insulin resistance. However, drugs must always be considered as a potential cause of steatosis and steatohepatitis as well. In patients who are not alcohol abusers, these two conditions are designated as nonalcoholic fatty liver disease (NAFLD). Although the term NAFLD disease encompasses both steatosis and steatohepatitis, the term nonalcoholic steatohepatitis (NASH) refers specifically to the presence of an inflamed steatotic liver in a nonalcoholic patient. Differentiation of alcohol-induced steatosis/steatohepatitis from NAFLD/NASH depends heavily on the appropriate clinical history. However, it is now known that a minimal intake of alcohol does not necessary exclude a diagnosis of NAFLD. Morphologically, it is not possible to reliably distinguish alcohol-induced steatosis from nonalcoholic steatosis. However, in the case of NASH, parenchymal inflammation and hepatocellular degeneration (Mallory body formation, apoptosis, ballooning) usually coexist with moderate to severe hepatocellular steatosis. This is in contrast to alcoholic hepatitis and to severe drug-induced steatohepatitis, in which fat droplets within hepatocytes usually diminish in the presence of a severe onslaught of inflammation, fibrosis, and hepatocellular destruction.
RM-016 Prognostic factors and assessment of postoperative chemoradiotherapy in gastric cancer
Authors: F. Mghirbi, M. Ayadi, K. El Behi, F. Letaief-ksontini, O. Jmour, K. Meddeb, A. Mokrani, Y. Yahyaoui, H. Rais, N. Chraiet, A. Mezlini
Journal: Annals of Oncology (2016)
Tartrate‐Resistant Acid Phosphatase Deficiency in the Predisposition to Systemic Lupus Erythematosus
Authors: Jie An, Tracy A. Briggs, Audrey Dumax‐Vorzet, Marta E. Alarcón‐Riquelme, Alexandre Belot, Michael Beresford, Ian N. Bruce, Claudia Carvalho, Laurence Chaperot, Johan Frostegård, Joel Plumas, Gillian I. Rice, Timothy J. Vyse, Alice Wiedeman, Yanick J. Crow, Keith B. Elkon
Journal: Arthritis & Rheumatology (2016)

Mutations in the ACP5 gene, which encodes tartrate-resistant acid phosphatase (TRAP), cause the immuno-osseous disorder spondyloenchondrodysplasia, which includes as disease features systemic lupus erythematosus (SLE) and a type I interferon (IFN) signature. Our aims were to identify TRAP substrates, determine the consequences of TRAP deficiency in immune cells, and assess whether ACP5 mutations are enriched in sporadic cases of SLE.Interaction between TRAP and its binding partners was tested by a yeast 2-hybrid screening, confocal microscopy, and immunoprecipitation/Western blotting. TRAP knockdown was performed using small interfering RNA. Phosphorylation of osteopontin (OPN) was analyzed by mass spectrometry. Nucleotide sequence analysis of ACP5 was performed by Sanger sequencing or next-generation sequencing.TRAP and OPN colocalized and interacted in human macrophages and plasmacytoid dendritic cells (PDCs). TRAP dephosphorylated 3 serine residues on specific OPN peptides. TRAP knockdown resulted in increased OPN phosphorylation and increased nuclear translocation of IRF7 and P65, with resultant heightened expression of IFN-stimulated genes and IL6 and TNF following Toll-like receptor 9 stimulation. An excess of heterozygous ACP5 missense variants was observed in SLE compared to controls (P = 0.04), and transfection experiments revealed a significant reduction in TRAP activity in a number of variants.Our findings indicate that TRAP and OPN colocalize and that OPN is a substrate for TRAP in human immune cells. TRAP deficiency in PDCs leads to increased IFNα production, providing at least a partial explanation for how ACP5 mutations cause lupus in the context of spondyloenchondrodysplasia. Detection of ACP5 missense variants in a lupus cohort suggests that impaired TRAP functioning may increase susceptibility to sporadic lupus.