tbuckley/cabot-search huggingface dataset:
Obesity and disease-free survival in patients with nodal-positive early-stage breast cancer: The ADEBAR trial.
Authors: P. G. Hepp, B. K. Rack, K. Annecke, A. Wischnik, W. Simon, N. Harbeck, H. L. Sommer, K. Friese, M. Kiechle, W. Janni
Journal: Journal of Clinical Oncology (2010)

541 Background: The prevalence of obesity increases throughout all evolved civilizations. On the other hand several epidemiological studies have shown not only an increase in breast cancer among obese women but also an adverse impact of obesity on survival of breast cancer patients. This analysis focuses on the impact of obesity on patients (pts) treated within the ADEBAR study protocol. Methods: The ADEBAR Trial compared 4 cycles of EC followed by 4 cycles of Docetaxel vs. 8 cycles of FEC (120) in pts with primary breast cancer (> = 4LN). 1500 pts have been accrued from sep/01 through may/05. For this analysis data of 1,361 pts has been analyzed about the impact of obesity on disease free survival. Therefore pts have been grouped to either “underweight” (BMI < 18.5 kg/m2), ”normal weight” (BMI 18.5-25 kg/m2), ”overweight” (25 kg/m2<bmi<30kg m2)=“ “obese”=“ or=“ (bmi=“>30). Results: 13 pts (1.0%) were “underweight”, 557 pts (40.9%) were normal weight, 491 pts (36.1%) were overweight, 300 pts (22.0%) were obese at the time of study enrollment. After a follow up period of 60 months 87.5% of the underweight group, 70.4% of the normal weight group, 70.7% of the overweight group and 58.6% of the obese group were alive with no signs of recurrent disease. This difference was significant (Chi- square = 9.355; p < 0.0249). Conclusions: This analysis strongly implicates an impact of obesity on disease free survival in patients with early stage node positive breast cancer in the prospectively randomized ADEBAR multicenter trial. It is therefore in line with earlier findings in epidemiological research and raises the question whether a weight reduction might be an additional approach on breast cancer therapy. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration sanofi-aventis sanofi-aventis Amgen, Johnson & Johnson, Novartis, sanofi-aventis Amgen, sanofi-aventis
The role of clinical characteristics and molecular biomarkers in low grade gliomas (LGG): A GICNO study.
Authors: Alba Ariela Brandes, Alexandro Paccapelo, Dario De Biase, Michele Reni, Antonella Mura, Stefania Bartolini, Carmelo Sturiale, Lorenzo Volpin, Gianluca Marucci, Raffaele Agati, Annalisa Pession, Claudio Ghimenton, Elena Zunarelli, Benedetta Urbini, Roberta Depenni, Alicia Tosoni, Girolamo Crisi, Stefano Pizzolitto, Daniela Danieli, Enrico Franceschi
Journal: Journal of Clinical Oncology (2016)

2032 Background: Molecular characterization of low grade gliomas (LGG) has improved in recent years and is essential for diagnosis and treatment of these diseases. Moreover, clinical factors, such as age and the extent of surgery retain a prognostic role in LGG that were assessed for IDH1/2, 1p/19q codeletion, and MGMT methylation status. Methods: we retrospectively evaluated all adult LGG patients (pts) from our data warehouse who received surgery and had sufficient tissue to assess biomarkers characterization. IDH1/2 assessment was performed on formalin-fixed paraffin-embedded samples by PCR, MGMT by methylation specific PCR, 1p/19 codeletion by FISH. Results: 198 consecutive LGG were included. The median age was 38 (range:18–72). Median follow up was 74.0 months, 109 pts (55.1%) were < 40 years of age; 26 pts (13.1%) underwent biopsy, 119 pts (60.1%) partial resection, 53 pts (26.8%) complete resection. Twenty-eight pts (14.1%) were considered low risk (< 40 years with complete resection). IDH1/2 mutation was found in 79.8% of pts. 1p/19q codeletion was found in 41.4% of pts, MGMT methylation in 57.1% of pts. Median survival in low risk patients was 211.0 months (95%CI: 190.4–231.6) and was 145.3 months (95%CI: 108.5–182.2) in high risk patients (P = 0.006). Median survival for patients with IDH1/2 mutation was 159 months (95%CI: 103.3–214.7) and was 87.9 months in patients IDH1/2 wild type (95%CI: 61.1–114.6, P < 0.001). The impact of molecular biomarkers on survival is in the table. Multivariate analysis showed that clinical risk (P = 0.006), IDH1/2 mutation (P < 0.001) and 1p/19q codeletion (P = 0.03) were significantly correlated with overall survival. MGMT methylation was not significant. Conclusions: Molecular characteristic of LGG define the prognosis of these tumors. Moreover, clinical risk assessment retains a role even in the era of molecular characterization. Median OS (months) 95%CI 5-year OS 10-year OS 1p19q codel 186.2 128.2 244.2 94.7 73.8 1p19q non codel 138.5 91.0 186.0 84.9 51.5 IDH1 mut, 1p19q codel, MGMT met NR / 100.0 95.7 IDH1 mut, 1p19q codel, MGMT unmet 189.4 / 92.9 61.9 IDH1 mut, 1p19q not codel, MGMT met 202.7 / 95.8 72.9 IDH1 mut, 1p19q not codel, MGMT unmet 109.1 105.3 112.8 90.7 44.1
Rosacea and gastrointestinal disorders: a population‐based cohort study
Authors: A. Egeberg, L.B. Weinstock, E.P. Thyssen, G.H. Gislason, J.P. Thyssen
Journal: British Journal of Dermatology (2016)

Rosacea is a common inflammatory facial skin condition. Recent genetic and epidemiological studies have suggested pathogenic links between rosacea and gastrointestinal disorders, but data are limited. The objective was to investigate the association between rosacea and coeliac disease (CeD), Crohn disease (CD), ulcerative colitis (UC), Helicobacter pylori infection (HPI), small intestinal bacterial overgrowth (SIBO) and irritable bowel syndrome (IBS), respectively. We performed a nationwide cohort study. A total of 49 475 patients with rosacea and 4 312 213 general population controls were identified using nationwide administrative registers. We established the prevalence of the aforementioned disorders, and used Cox regression analysis to obtain hazard ratios (HRs) of the risk of new‐onset CeD, CD, UC, HPI, SIBO and IBS, respectively, in patients with rosacea. The prevalence of CeD, CD, UC, HPI, SIBO and IBS, respectively, was higher among patients with rosacea when compared with the control subjects. Adjusted HRs revealed significant associations between rosacea and CeD (HR 1·46, 1·11–1·93), CD (HR 1·45, 1·19–1·77), UC (HR 1·19, 1·02–1·39), and IBS (HR 1·34, 1·19–1·50), respectively, but not HPI (HR 1·04, 0·96–1·13) or SIBO (HR 0·71, 0·18–1·86). Rosacea is associated with certain gastrointestinal diseases, but the possible pathogenic link is unknown. Gastrointestinal complaints in patients with rosacea should warrant clinical suspicion of disease.
Platelet-Rich Plasma for Treatment of Achilles Tendinopathy—Reply
Authors: Robert J. de Vos
Journal: JAMA (2010)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Prescribing Opioids for Chronic Pain
Authors: Leana S. Wen, M. Cooper Lloyd
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 Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Evidence of shared epitopic reactivity among independent B-cell clones in chronic lymphocytic leukemia patients
Authors: S Mimmi, E Vecchio, E Iaccino, M Rossi, A Lupia, F Albano, F Chiurazzi, G Fiume, A Pisano, S Ceglia, M Pontoriero, G Golino, P Tassone, I Quinto, G Scala, C Palmieri
Journal: Leukemia (2016)

Chronic lymphocytic leukemia (CLL) is a neoplastic disease of mature B cells that express a functional immunoglobulin (Ig) B-cell receptor (Ig-BCR) on the cell surface. 1 The Ig-BCR includes the binding site (idiotype) for the epitope of cognate antigen, which results from the stochastic and productive Ig variable genes rearrangement and possible somatic hypermutation.Individual B-cell clones differ from one another because of the diverse amino acid sequences within the idiotype of the expressed Ig-BCR, 2 so that the epitopic specificity is shared in a given clonal B-cell population.Several studies have recently highlighted two peculiar characteristics that distinguish CLL among other mature B-cell malignancies.First, the Ig-BCR repertoire of CLL is biased, as it is restricted toward the preferential usage of certain Ig heavy-(IgV H ) and light (IgVκ/λ) -chain variable genes, 3,4 and unusually similar, stereotyped heavy-chain complementarity determining region 3 (V H CDR3) amino acid sequences. 5The skewed Ig-BCR could be owing to an Ig-BCR-driven selection mechanism initiated by specific antigens that promote the expansion and possibly the maintenance of the cognate CLL clone. 6Consistent with this hypothesis, several studies have demonstrated the reactivity of CLL Ig-BCR against foreign antigens, self-antigens, peptides and intrinsic IgV H motif. 7 Second, CLL is not always a monoclonal disorder, as two or multiple CLL clones have been found in 2-5%
Arginine Deprivation With Pegylated Arginine Deiminase in Patients With Argininosuccinate Synthetase 1–Deficient Malignant Pleural Mesothelioma
Authors: Peter W. Szlosarek, Jeremy P. Steele, Luke Nolan, David Gilligan, Paul Taylor, James Spicer, Michael Lind, Sankhasuvra Mitra, Jonathan Shamash, Melissa M. Phillips, Phuong Luong, Sarah Payne, Paul Hillman, Stephen Ellis, Teresa Szyszko, Gairin Dancey, Lee Butcher, Stephan Beck, Norbert E. Avril, Jim Thomson, Amanda Johnston, Marianne Tomsa, Cheryl Lawrence, Peter Schmid, Timothy Crook, Bor-Wen Wu, John S. Bomalaski, Nicholas Lemoine, Michael T. Sheaff, Robin M. Rudd, Dean Fennell, Allan Hackshaw
Journal: JAMA Oncology (2016)

Preclinical studies show that arginine deprivation is synthetically lethal in argininosuccinate synthetase 1 (ASS1)-negative cancers, including mesothelioma. The role of the arginine-lowering agent pegylated arginine deiminase (ADI-PEG20) has not been evaluated in a randomized and biomarker-driven study among patients with cancer.
Smoking Cessation and Risk of Stroke in Women
Authors: Peter M. Gocze
Journal: JAMA (1993)

<h3>To the Editor.</h3> —We were extremely interested to read the important article by Kawachi et al,<sup>1</sup>in which they demonstrated that after smoking cessation the risk of stroke was decreased among female nurses. We think it is important to emphasize that nursing is a more stressful job than most other female professions. The possibility exists that a stress-induced, acute increase in blood pressure may also be an important factor in predisposition to hemorrhagic stroke (rather than the smoking-induced rise in blood pressure). As Kawachi et al note, "too few cases of stroke (n=2) occurred among current users of oral contraceptives to permit meaningful analysis." Because the age range of the nurses in this study was 30 to 55 years and because use of contraceptive pills is contraindicated in smokers older than 30 years of age and in nonsmokers older than 35 years of age, one would expect that currently
Bone Morphogenetic Protein‐2 Promotes Human Mesenchymal Stem Cell Survival and Resultant Bone Formation When Entrapped in Photocrosslinked Alginate Hydrogels
Authors: Steve S. Ho, Nina L. Vollmer, Motasem I. Refaat, Oju Jeon, Eben Alsberg, Mark A. Lee, J. Kent Leach
Journal: Advanced Healthcare Materials (2016)

There is a substantial need to prolong cell persistence and enhance functionality in situ to enhance cell‐based tissue repair. Bone morphogenetic protein‐2 (BMP‐2) is often used at high concentrations for osteogenic differentiation of mesenchymal stem cells (MSCs) but can induce apoptosis. Biomaterials facilitate the delivery of lower doses of BMP‐2, reducing side effects and localizing materials at target sites. Photocrosslinked alginate hydrogels (PAHs) can deliver osteogenic materials to irregular‐sized bone defects, providing improved control over material degradation compared to ionically cross‐linked hydrogels. It is hypothesized that the delivery of MSCs and BMP‐2 from a PAH increases cell persistence by reducing apoptosis, while promoting osteogenic differentiation and enhancing bone formation compared to MSCs in PAHs without BMP‐2. BMP‐2 significantly decreases apoptosis and enhances survival of photoencapsulated MSCs, while simultaneously promoting osteogenic differentiation in vitro. Bioluminescence imaging reveals increased MSC survival when implanted in BMP‐2 PAHs. Bone defects treated with MSCs in BMP‐2 PAHs demonstrate 100% union as early as 8 weeks and significantly higher bone volumes at 12 weeks, while defects with MSC‐entrapped PAHs alone do not fully bridge. This study demonstrates that transplantation of MSCs with BMP‐2 in PAHs achieves robust bone healing, providing a promising platform for bone repair.
Secondary Monoclonal Gammopathy Of Undetermined Significance Is Frequently Associated With High Response Rate and Superior Survival In Patients With Plasma Cell Dyscrasias
Authors: Dehui Zou, Gang An, Guoqing Zhu, Yan Xu, Weiwei Sui, Shuhui Deng, Fenghuang Zhan, Lugui Qiu
Journal: Blood (2013)
Diagnostic yield of a two-hour sedimentation of pleural effusion in patients with suspected malignancy.
Authors: M. J. Hochmair, J. Schalleschak, G. C. Funk, A. Valipour, M. K. Breyer, R. Kohansal, H. Prosch, M. Kaufmann, S. Mashaal, O. C. Burghuber
Journal: Journal of Clinical Oncology (2010)

e18111 Background: The diagnosis of pleuritis carcinomatosa in clinical practice remains difficult. In order to exclude/confirm a malignant pleural effusion, current guidelines recommend two independent samples of pleural fluid aspiration. The aim of the present study was to evaluate the additional utility in excluding/confirming a suspected pleuritis carcinomatosa using a 2 hour sedimentation of pleural effusion. Methods: In total 78 patients underwent pleural fluid aspiration (using ultrasound guided thoracocentesis) between March 2007 and January 2010. Cytological analyses has been performed either directly after samples have been taken (method I), or 2 hours after sedimentation (method II). All analyses have been carried out by the same investigator. Results: 16 patients had to be excluded (no evidence of lung cancer). Of the remaining 62 (male: 62%; age: 66 ± 12, years) 42 were diagnosed with NSCLC (69% adenocarcinoma, 19% squamous cell carcinoma, 12% others), 7 with SCLC, 5 having malignant pleural mesothelioma and 8 having cancer of other lung origin. Using method I, the diagnosis of malignancy was obtained in 25 patients (40.3%). In contrast, when using method II the diagnosis of malignancy was obtained in 30 patients (48.3%). Therefore, the additional diagnostic yield of sedimentation was 8% (95% CI: 4.3–19.8). Conclusions: Two hour sedimentation of pleural effusion may increase the diagnostic yield in routine pleural fluid aspiration in patients suspected for pleuritis carcinomatosa. No significant financial relationships to disclose.
Prospective evaluation of intra-operative quick parathyroid hormone assay as an early predictor of post thyroidectomy hypocalcaemia
Authors: Ashwini C. Reddy, Gyan Chand, M. Sabaretnam, Anjali Mishra, Gaurav Agarwal, Amit Agarwal, A.K. Verma, S.K. Mishra
Journal: International Journal of Surgery (2016)
Effect of Fecal Microbiota Transplantation on Recurrence in Multiply Recurrent <i>Clostridium difficile</i> Infection
Authors: Colleen R. Kelly, Alexander Khoruts, Christopher Staley, Michael J. Sadowsky, Mortadha Abd, Mustafa Alani, Brianna Bakow, Patrizia Curran, Joyce McKenney, Allison Tisch, Steven E. Reinert, Jason T. Machan, Lawrence J. Brandt
Journal: Annals of Internal Medicine (2016)

Background: To date, evidence for the efficacy of fecal microbiota transplantation (FMT) in recurrent Clostridium difficile infection (CDI) has been limited to case series and open-label clinical trials. Objective: To determine the efficacy and safety of FMT for treatment of recurrent CDI. Design: Randomized, controlled, double-blind clinical trial. (ClinicalTrials.gov: NCT01703494) Setting: Two academic medical centers. Patients: 46 patients who had 3 or more recurrences of CDI and received a full course of vancomycin for their most recent acute episode. Intervention: Fecal microbiota transplantation with donor stool (heterologous) or patient's own stool (autologous) administered by colonoscopy. Measurements: The primary end point was resolution of diarrhea without the need for further anti-CDI therapy during the 8-week follow-up. Safety data were compared between treatment groups via review of adverse events (AEs), serious AEs (SAEs), and new medical conditions for 6 months after FMT. Fecal microbiota analyses were performed on patients' stool before and after FMT and also on donors' stool. Results: In the intention-to-treat analysis, 20 of 22 patients (90.9%) in the donor FMT group achieved clinical cure compared with 15 of 24 (62.5%) in the autologous FMT group ( P = 0.042). Resolution after autologous FMT differed by site (9 of 10 vs. 6 of 14 [P = 0.033]). All 9 patients who developed recurrent CDI after autologous FMT were free of further CDI after subsequent donor FMT. There were no SAEs related to FMT. Donor FMT restored gut bacterial community diversity and composition to resemble that of healthy donors. Limitation: The study included only patients who had 3 or more recurrences and excluded those who were immunocompromised and aged 75 years or older. Conclusion: Donor stool administered via colonoscopy seemed safe and was more efficacious than autologous FMT in preventing further CDI episodes. Primary Funding Source: National Institute of Diabetes and Digestive and Kidney Diseases.
HLA-Cw6 homozygosity in plaque psoriasis is associated with streptococcal throat infections and pronounced improvement after tonsillectomy: A prospective case series
Authors: Ragna H. Thorleifsdottir, Sigrun L. Sigurdardottir, Bardur Sigurgeirsson, Jon H. Olafsson, Hannes Petersen, Martin I. Sigurdsson, Johann E. Gudjonsson, Andrew Johnston, Helgi Valdimarsson
Journal: Journal of the American Academy of Dermatology (2016)
Whistle-blowing and duty of candour in the National Health Service: a ‘history and policy’ case study of the 1960s and 2010s
Authors: Claire Hilton
Journal: Journal of the Royal Society of Medicine (2016)

The Mid Staffordshire Public Inquiry (Francis Report) in 20131 identified a catalogue of preventable harm, including deaths, of patients in a NHS general hospital. This paper uses historical sources from the 1960s to help explore two interacting themes raised in the Report, the duty of candour and whistle-blowing, with the aim of informing current debate. Whistle-blowing and duty of candour deserve consideration particularly during periods of austerity, as the NHS is experiencing now, since under-resourced clinical teams struggling to cope are more likely to cut corners compromise care and be defensive if criticised.
Benefit of <i>MGMT</i> methylation in glioblastoma in relation to <i>hTERT</i> promoter mutation.
Authors: HuyTram N Nguyen, Tie Li, Amy Lie, Byram H Ozer, Reshmi Chowdhury, Fei Liu, Bowen Wei, He-jing Wang, Robert M. Elashoff, Linda M. Liau, William H. Yong, Benjamin M. Ellingson, Phioanh Leia Nghiemphu, Timothy Francis Cloughesy, Albert Lai
Journal: Journal of Clinical Oncology (2016)

2006 Background: Human telomerase reverse transcriptase (hTERT) promoter mutation occurs in 70-80% of glioblastoma (GBM) and has been shown to enhance telomerase expression. No consensus has been established on the clinical significance of hTERT mutation in GBM. Methods: We retrospectively identified 303 IDH1 wildtype primary GBM patients treated with standard upfront chemo-radiotherapy and determined hTERT promoter genotype. 190 GBM patients from TCGA that also received standard treatment were used for validation, using hTERT expression as a surrogate for mutation. The primary objective was to assess the effect of hTERT status on overall survival (OS) and progression free survival (PFS) using Kaplan-Meier and Cox regression analyses. Results: hTERT promoter mutation was detected in 228 (75%) cases, in which 177 (78%) were C228T and 51 (22%) were C250T. hTERT mutant patients showed similar OS and PFS to hTERT wildtype patients. However, Cox analysis showed a strong interaction between hTERT promoter mutation and MGMT promoter methylation. Therefore, we sub-stratified patients by both hTERT mutation and MGMT methylation. We observed improved survival from MGMT promoter methylation only in the presence of hTERT promoter mutation: MGMT methylated patients had median OS of 28.3 months vs. 15.9 months in MGMT unmethylated patients (log-rank p < 0.001), and median PFS of 15.4 months vs. 7.86 months (log-rank p < 0.001); OS and PFS hazard ratios were 0.32 (p < 0.001) and 0.36 (p < 0.001). Among the hTERT wildtype group, no significant differences in OS and PFS were observed between MGMT methylated and unmethylated patients. Consistent with our results, the TCGA cohort demonstrated survival benefit from MGMT promoter methylation only in patients with high hTERT gene expression: MGMT methylated patients had median OS of 17.8 months vs. 13.9 months from MGMT unmethylated patients (log-rank p = 0.002); OS hazard ratio was 0.52 (p = 0.028). Conclusions: Although hTERT promoter mutation alone was not prognostic of GBM outcome, it strongly interacted with MGMT promoter methylation, and appeared to enable the survival benefit from MGMT promoter methylation. The mechanism of this interaction warrants further investigation.