tbuckley/cabot-search huggingface dataset:
Magnetic Resonance Imaging Exposure During Pregnancy—Reply
Authors: Joel G. Ray, Aditya Bharatha, Walter J. Montanera
Journal: JAMA (2016)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors 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
Dosimetric comparison of radiotherapy plans for left-sided breast cancer patients in rolled versus supine body position.
Authors: M. L. Tao, N. Mikolajczyk, B. Martyn, L. E. Botnick
Journal: Journal of Clinical Oncology (2011)

124 Background: Left-sided breast cancer patients receiving whole breast radiation therapy (WBRT) are potentially at increased risk for cardiac morbidity. We evaluated heart sparing of left-sided breast cancer patients when placed in the rolled vs. the standard supine body position for WBRT. Methods: Ten patients with left-sided breast cancer underwent planning CT scans in 2 different positions: supine and rolled to the right to allow for the heart to drop away from the chest wall. Patients were immobilized using vacuum cradles. The left lung, opposite breast, stomach, heart, left ventricle (LV), and left anterior descending coronary artery (LAD) were defined as organs at risk (OARs). Comparison 3D conformal tangential field plans were generated for each patient. Dose-volume histograms (DVHs) of the planning target volume (PTV) and OARs were examined. Results: All plans met PTV dose coverage and homogeneity criteria of V 95 &gt; 95% and maximal dose &lt; 108. Median V 105 for PTV was 12.75% (range, 2.5-16%). None of these parameters differed either statistically or clinically between plans done with the patient supine or rolled. The maximal doses to the opposite breast and stomach were also not significantly different between the 2 positions. The right lung V 20 was similar for the 2 positions, 11.1% and 12%. Although there were no significant differences in the mean and max doses to the heart or LV, the mean heart dose decreased by 18-70% in 6 patients in the rolled vs. supine position and increased by 2.7-31.5% in 4 patients. The mean dose to the LAD and the LAD V 10 and V 15 were significantly decreased when the patient was rolled: 17.1 vs. 29.5 Gy, 41.1% vs. 62.6% and 40% vs. 66.7% (p &lt; .05), respectively. Six patients had superior plans when in the rolled position with substantial differences in the mean and/or max doses and/or DVHs for the heart, LV and LAD. The remaining 4 patients had no overall improvement or worsening of the plan when the patient was rolled vs. supine. Conclusions: For patients with left-sided breast cancer receiving WBRT, the rolled position potentially reduces dose to the heart and its substructures without compromising the coverage and homogeneity of the PTV, hence limiting the need for IMRT.
Long‐term safety of icatibant treatment of patients with angioedema in real‐world clinical practice
Authors: A. Zanichelli, M. Maurer, W. Aberer, T. Caballero, H. J. Longhurst, L. Bouillet, V. Fabien, I. Andresen
Journal: Allergy (2016)

The Icatibant Outcome Survey (IOS) is an observational study monitoring safety and effectiveness of icatibant in the real-world setting. We analyzed safety data from 3025 icatibant-treated attacks in 557 patients (enrolled between July 2009 and February 2015). Icatibant was generally well tolerated. Excluding off-label use and pregnancy, 438 patients (78.6%) did not report adverse events (AEs). The remaining 119 (21.4%) patients reported 341 AEs, primarily gastrointestinal disorders (19.6%). Of these, 43 AEs in 17 patients (3.1%) were related to icatibant. Serious AEs (SAEs) occurred infrequently. A total of 143 SAEs occurred in 59 (10.6%) patients; only three events (drug inefficacy, gastritis, and reflux esophagitis) in two patients were considered related to icatibant. Notably, no SAEs related to icatibant occurred in patients with cardiovascular disease, nor in those using icatibant at a frequency above label guidelines. Additionally, no major differences were noted in AEs occurring in on-label vs off-label icatibant users.
Identification of a potent small molecule capable of regulating polyploidization, megakaryocyte maturation, and platelet production
Authors: Nick Huang, Mabel Lou, Hua Liu, Cecilia Avila, Yupo Ma
Journal: Journal of Hematology & Oncology (2016)

Megakaryocytic cell maturation involves polyploidization, and megakaryocyte (MK) ploidy correlates with their maturation and platelet production. Retardation of MK maturation is closely associated with poor MK engraftment after cord blood transplantation and neonatal thrombocytopenia. Despite the high prevalence of thrombocytopenia in a range of setting that affect infants to adults, there are still very limited modalities of treatment. Human CD34+ cells were isolated from cord blood or bone marrow samples acquired from consenting patients. Cells were cultured and induced using 616452 and compared to current drugs on the market such as rominplostim or TPO. Ploidy analysis was completed using propidium iodide staining and flow cytometry analysis. Animal studies consisted of transplanting human CD34+ cells into NOD.Cg-PrkdcscidIl2rgtm1Wjl/SzJ mice followed by daily injections of 15 mg/kg of 616452. Within one week of culture, the chemical was able to induce polyploidization, the process required for megakaryocyte maturation with the accumulation of DNA content, to 64 N or greater to achieve a relative adult size. We observed fold increases as high as 200-fold in cells of 16 N or greater compared to un-induced cells with a dose-dependent manner. In addition, MK differentiated in the presence of 616452 demonstrated a more robust capacity of MK differentiation than that of MKs cultured with rominplostim used for adult idiopathic thrombocytopenic purpura (ITP) patients. In mice transplanted with human cord blood, 616452 strikingly enhanced MK reconstitution in the marrow and human peripheral platelet production. The molecular therapeutic actions for this chemical may be through TPO-independent pathways. Our studies may have an important impact on our fundamental understanding of fetal MK biology, the clinical management of thrombocytopenic neonates and leukemic differentiation therapy.
State Medicaid Expansion Tobacco Cessation Coverage and Number of Adult Smokers Enrolled in Expansion Coverage — United States, 2016
Authors: Anne DiGiulio, Meredith Haddix, Zach Jump, Stephen Babb, Anna Schecter, Kisha-Ann S. Williams, Kat Asman, Brian S. Armour
Journal: MMWR Morbidity and Mortality Weekly Report (2016)

In 2015, 27.8% of adult Medicaid enrollees were current cigarette smokers, compared with 11.1% of adults with private health insurance, placing Medicaid enrollees at increased risk for smoking-related disease and death (1). In addition, smoking-related diseases are a major contributor to Medicaid costs, accounting for about 15% (>$39 billion) of annual Medicaid spending during 2006-2010 (2). Individual, group, and telephone counseling and seven Food and Drug Administration (FDA)-approved medications are effective treatments for helping tobacco users quit (3). Insurance coverage for tobacco cessation treatments is associated with increased quit attempts, use of cessation treatments, and successful smoking cessation (3); this coverage has the potential to reduce Medicaid costs (4). However, barriers such as requiring copayments and prior authorization for treatment can impede access to cessation treatments (3,5). As of July 1, 2016, 32 states (including the District of Columbia) have expanded Medicaid eligibility through the Patient Protection and Affordable Care Act (ACA),*,† which has increased access to health care services, including cessation treatments (5). CDC used data from the Centers for Medicare and Medicaid Services (CMS) Medicaid Budget and Expenditure System (MBES) and the Behavioral Risk Factor Surveillance System (BRFSS) to estimate the number of adult smokers enrolled in Medicaid expansion coverage. To assess cessation coverage among Medicaid expansion enrollees, the American Lung Association collected data on coverage of, and barriers to accessing, evidence-based cessation treatments. As of December 2015, approximately 2.3 million adult smokers were newly enrolled in Medicaid because of Medicaid expansion. As of July 1, 2016, all 32 states that have expanded Medicaid eligibility under ACA covered some cessation treatments for all Medicaid expansion enrollees, with nine states covering all nine cessation treatments for all Medicaid expansion enrollees. All 32 states imposed one or more barriers on at least one cessation treatment for at least some enrollees. Providing barrier-free access to cessation treatments and promoting their use can increase use of these treatments and reduce smoking and smoking-related disease, death, and health care costs among Medicaid enrollees (4,6-8).
Identification of gene copy number and whole-genome methylation changes associated with lethal metastatic castration-resistant prostate cancer (CRPC).
Authors: T. W. Friedlander, R. Roy, S. A. Tomlins, Y. Kobayashi, M. A. Rubin, K. J. Pienta, A. Chinnaiyan, E. J. Small, C. J. Ryan, P. Paris
Journal: Journal of Clinical Oncology (2011)

6 Background: Metastatic CRPC undergoes significant genomic evolution compared to primary, localized disease. Multiple genetic mechanisms contribute to this evolution including changes in gene copy number as well as and changes in CpG island methylation. In this study, copy number and methylation status of metastatic CRPC tissue obtained at autopsy were assessed by high-resolution array comparative genomic hybridization (aCGH) and whole genome methylation microarray profiling. Methods: Array CGH was performed on DNA isolated from metastatic CRPC samples obtained from the University of Michigan Rapid Autopsy Program, using the Agilent Human Genome 244K CGH Microarray. A total of 15 samples comprising 7 metastatic liver implants and 8 soft tissue metastases were analyzed with DNA Analytics 4.0 software. Expression of genes identified as commonly amplified or deleted was assessed in a confirmatory fashion using existing Agilent 4×44 Expression Array data. The Illumina Infinium HumanMethylation27 BeadChip was used to determine whole genome methylation status. Results: A total of 79 amplified and 419 deleted genes common to &gt;66% of samples were identified. There was significant correlation (p&lt;0.05) of gene copy number to the mRNA level for 9 of the amplified and 76 of the deleted genes, including amplification/overexpression of AR and deletion/underexpression of the tumor suppressors PTEN and RB. While copy number was normal for the androgen synthesis genes CYP17A1, HSD17B3, HSD17B4, and HSD3B2, methylation analysis indicates their upregulation in the majority of samples, suggesting an alternative mechanism of intratumoral hormone production. There was promoter hypermethylation and gene deletion of RB1 in &gt;85% of samples, suggesting that inactivation of this tumor suppressor through multiple pathways is critical to tumor cell survival. Conclusions: This is the first known study examining both gene copy number and whole genome CpG island methylation status in metastatic CRPC. Integration of this data allows for identification of specific genes or pathways that confer a selective growth advantage to prostate cancer cells harboring those changes. No significant financial relationships to disclose.
Matched Unrelated Allogeneic Stem Cell Transplantation for Patients with Congenital Amegakaryocytic Thrombocytopenia: Texas Children`s Hospital Experience
Authors: Saleh Bhar, Khaled Yassine, Caridad Martinez, Ghadir S. Sasa, Swati Naik, Donald Mahoney, Alison A Bertuch, Carl Allen, Nabil Ahmed, Meenakshi G. Hegde, Helen E. Heslop, Malcolm K. Brenner, Stephen Gottschalk, Robert A. Krance, Kathryn S. Leung
Journal: Blood (2015)
Abstract 196: The Characteristics of Patients with Kawasaki disease Presented with Fever and Cervical Lymphadenopathy at Admission
Authors: yeo hyang kim, Chae Ok Shin, Myung Chul Hyun, Dong Seok Lee
Journal: Circulation (2015)

Purpose: Of the principal diagnostic criteria of Kawasaki disease (KD), cervical lymphadenopathy is the least common. However, it may be misdiagnosed as bacterial cervical lymphadenitis. We evaluated the characteristics of patients with KD presenting with only fever and cervical lymphadenopathy at admission. Methods: This study enrolled patients diagnosed KD from January 2013 to May 2014. All of patients were divided to three groups: group 1 had only fever and cervical lymphadenopathy at admission; group 2 had typical manifestations with cervical lymphadenopathy; group 3 had typical manifestations without cervical lymphadenopathy. Results: Ninety eight patients (group 1 in 13, group 2 in 31, group 3 in 54) were examined. The median age of group 1 was significantly older than group 2 and 3 ( P =0.001). The duration of fever before admission at our hospital was more prolonged in group 1 than in group 2 and 3 ( P =0.001). In comparison between groups, the laboratory results at the admission day were not significantly different. However, group 1 showed significantly elevated white blood cell counts, elevated neutrophil counts, and decreased lymphocyte counts after first intravenous immunoglobulin administration ( P =0.001, P =0.001, and P =0.003). The frequency of additional intravenous immunoglobulin treatment did not have significant difference. Group 1 had significantly increased duration of hospitalization, and frequency of second line treatment such as systemic steroid or infliximab than group 2 and 3 ( P =0.000, P =0.024, and P =0.007). The development of a coronary artery dilatation (z score &gt;2.5) was higher in group 1 than in group 3 ( P =0.008). Conclusions: KD with cervical lymphadenopathy as main presentation indicates a severe form of KD associated with increased risks of second line treatment such as systemic steroid or infliximab and coronary artery dilatation. KD should be suspected in the older children with antibiotics non-responsive, prolonged fever and cervical lymphadenopathy. For differentiation between responder and non-responder for first line treatment, white blood cell counts and their subset after first intravenous immunoglobulin administration may be beneficial.
RIG-I-Induced Type I IFNs Promote Regeneration of the Intestinal Stem Cell Compartment during Acute Tissue Damage
Authors: Julius C Fischer, Michael Bscheider, Gabriel Eisenkolb, Alexander Wintges, Caroline A Lindemans, Simon Heidegger, Sebastien Monette, Marco Calafiore, Kori A. Porosnicu Rodriguez, Sophie Lieberman, Chen Liu, Christian Peschel, Melissa Docampo, Enrico Velardi, Robert R. Jenq, Alan M Hanash, Jarrod A Dudakov, Tobias Haas, Marcel van den Brink, Hendrik Poeck
Journal: Blood (2015)
Unique Role of mTOR Inhibitor, Everolimus in Inducible Regulatory T Cells
Authors: Tokiko Nagamura-Inoue, Yuki Yamamoto, Seiichiro Kobayashi, Kazuo Ogami, Kiyoko Izawa, Miki Yuzawa, Hajime Tsunoda, Arinobu Tojo
Journal: Blood (2012)
Overnight urinary isoprostanes as a marker of oxidative stress in obstructive sleep apnoea
Authors: Chris D. Turnbull, Ioannis Akoumianakis, Charalambos Antoniades, John R. Stradling
Journal: European Respiratory Journal (2016)

Oxidative stress is thought to be of importance in the development of cardiovascular disease in obstructive sleep apnoea (OSA). However, our recent study [1] using data from two centres showed that markers of oxidative stress were not increased by the return of OSA caused by continuous positive airways pressure (CPAP) withdrawal for 2 weeks. Unexpectedly, we found decreased levels of urinary isoprostanes in early morning urine specimens and this, combined with increased levels of blood superoxide dismutase, raised the possibility that oxidative stress might be decreased by OSA. Urinary isoprostanes, a key biomarker of oxidative stress, are not increased by OSA during CPAP withdrawal <http://ow.ly/grU8305ZX1s>
The Prognostic Role of CD68 and FoxP3 Expression in Primary Central Nervous System Lymphoma
Authors: Soo-Jeong Kim, Hyunsung Park, Hyunsoo Cho, Yu Ri Kim, Jung Yeon Lee, Ji Eun Jang, Kim Yundeok, June-Won Cheong, Yoo Hong Min, Jin Seok Kim
Journal: Blood (2015)
To determine the predictive value of preoperative breast MRI in selecting patients appropriate for nipple-sparing mastectomy.
Authors: J. M. Barry, P. de Alcantara Filho, C. D'Arcy, M. Stempel, V. Sacchini
Journal: Journal of Clinical Oncology (2011)

e11579 Background: The presence of the nipple areolar complex (NAC) is fundamental to the identity and esthetic of the breast. The objective of the nipple-sparing mastectomy is to preserve this in the appropriate setting. However, accurate patient selection is critical prior to performing a nipple-sparing mastectomy (NSM). Currently, there is a paucity of evidence to assist surgeons in developing an oncologically safe selection criteria. The aim of this study is to determine the utility of preoperative breast MRI to more accurately select patients for this procedure. Methods: All patients undergoing mastectomy with a preoperative MRI (within 3 months) were reviewed over a two-year period at a single institution. Preoperative breast MRI results were compared with the final pathological mastectomy specimen report. Patients were excluded if they had a lumpectomy prior to MRI. Patients were also excluded if Paget’s disease of the nipple-areolar complex was present and if inflammatory breast cancer was suspected. Patients receiving neo-adjuvant chemotherapy or who had a nipple-sparing mastectomy were also excluded. Results: 128 patients (187 mastectomies specimens) were identified who had a preoperative MRI prior to mastectomy. Indications for mastectomy were 67 invasive ductal cancers, 62 prophylactic/benign mastectomies, 41 had DCIS and 17 with invasive lobular cancers. The overall sensitivity of the preoperative MRI was 57% and specificity was 89.75%. The positive and negative predictive values were 41.4% and 94.3% respectively. Further analysis revealed that 66.6% of the false negatives were patients with DCIS identified in the lactiferous ducts of the NAC. On excluding these patients, the sensitivity and specificity was 75% and 91% respectively and the positive and negative predictive values were 42.9% and 97.6% respectively. Conclusions: Preoperative MRI is beneficial in selecting patients suitable for NSM with invasive cancer or in the prophylactic setting. Interestingly, in the presence of DCIS, the preoperative MRI may be misleading if used to select patients. Therefore, intra-operative retro-areolar frozen section is recommended in this subset.
Cost-effectiveness of treating patients with advanced progressive pancreatic neuroendocrine tumors with everolimus versus sunitinib in the United States.
Authors: Maruit Chulikavit, Roman Casciano, Allison Perrin, Zhimei Liu, Xufang Wang, Joseph Babigumira, Kris Grzegorzewski, Louis P Garrison
Journal: Journal of Clinical Oncology (2012)

e14525 Background: Everolimus and sunitinib were recently approved to treat patients with advanced, progressive pancreatic neuroendocrine tumors (pNETs). This analysis examined the projected cost-effectiveness of everolimus versus sunitinib in this disease setting from a US payer perspective. Methods: A lifetime (20-year) Markov model was developed to simulate a cohort of advanced, progressive pNET patients and to estimate the cost per life-year (LY) gained and quality-adjusted life-year (QALY) gained when treating with everolimus as compared to sunitinib. Absent head-to-head trials, efficacy data were based on a weight-adjusted indirect comparison of the two agents using the respective phase 3 trial data. Disease or health states considered in the model included: stable disease with no adverse events, stable disease with adverse events, disease progression, and death. Costs of anti-tumor therapies, symptomatic care drugs, and post-progression therapy were based on wholesale acquisition cost. Other costs including physician visits, tests, infusions, hospitalizations, adverse event costs, and end-of-life care costs were obtained from literature and/or standard sources such as the Healthcare Cost &amp; Utilization Project and Medicare reimbursement rates. Utility inputs were based on a time trade-off study conducted in the United Kingdom. Sensitivity analyses were conducted to test the model’s robustness. Results: In the base case analysis, the estimated gain of everolimus over sunitinib was 0.448 LYs (0.304 QALYs) at an incremental cost of $12,673, resulting in an incremental cost-effectiveness ratio (ICER) of $28,281/LY ($41,702/QALY gained), which fell within the cost per QALY range for many other widely used oncology drugs. The ICER was most sensitive to the uncertainty of the sunitinib trial outcomes: however, a probabilistic sensitivity analysis found consistent results across simulations. Conclusions: While the analysis is limited by its reliance on an indirect comparison of two phase 3 studies rather than a single head-to-head trial, everolimus is projected to be cost-effective relative to sunitinib in advanced pNET.
Final Results of a Phase II Trial with Plitidepsin (Aplidin) Alone and in Combination with Dexamethasone in Patients with Relapsed/Refractory Multiple Myeloma
Authors: Maria-Victoria Mateos, Mª Teresa Cibeira, Paul Richardson, Joan Blade, Felipe Prosper, Albert Oriol, Javier de la Rubia, Adrian Alegre, Juan José Lahuerta, Ramón García-Sanz, Constantine S. Mitsiades, Jose Espinoza, Kenneth C. Anderson, J.F. San Miguel
Journal: Blood (2008)