tbuckley/cabot-search huggingface dataset:
THU0461 Illness Perceptions Predict Response to Intra-Articular Steroid Injections in Knee Osteoarthritis: Table 1.
Authors: G. Hirsch, G. Kitas, T. O'Neill, J. Duda, R. Klocke
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Intra-articular corticosteroid injections (IACI) are widely used to treat pain in knee osteoarthritis (OA) but predictors of response to treatment are poorly understood. Since psychosocial factors are known to influence outcomes in osteoarthritis in general, we examined selected factors as potential predictors of treatment outcomes in this context. <h3>Objectives</h3> To examine the role of psychological factors in predicting the outcome to IACI in knee OA. <h3>Methods</h3> 141 subjects with painful knee OA (mean age 63.8, 62% female) underwent baseline assessment prior to routine IACI of the knee joint. As well as physical and disease-related parameters, two groups of psychological characteristics were assessed: firstly illness perceptions, assessed by the revised Illness Perception Questionnaire (IPQR); and secondly pain catastrophizing and depression, assessed by the Pain Catastrophizing Scale (PCS) and depression subscale of the revised Arthritis Impact Assessment Scale (AIMS2), respectively. Symptoms were assessed using the WOMAC pain subscale at baseline, three and nine weeks, and response to treatment defined as 40% reduction in baseline pain. Characteristics of responders and non-responders at each time point were compared. Logistic regression models, adjusted for relevant disease-related factors, were used to estimate effect size of predictors of response with results expressed as odds ratios (OR) and 95% confidence intervals (CI). <h3>Results</h3> Illness perceptions: responders at three weeks had higher scores for the IPQR domain treatment control (p0.031) and lower scores for consequences (p0.005) than non-responders. Only treatment control was an independent predictor of outcome in the regression model (p0.010, OR 1.21). Responders at nine weeks had higher scores for treatment control (p0.002) and lower scores for consequences (p&lt;0.001) and emotional representations (p0.012) than non responders. Consequences and treatment control contributed unique variance to the regression model (p 0.001, OR 0.83 and p0.011, OR 1.24, respectively). Depression and catastrophizing: responders had lower scores for depression and catastrophizing at both three (p0.001 and p0.005 respectively) and nine weeks (p&lt;0.001 and 0.001) than non-responders. Depression was an independent predictor of nine week outcome in logistic regression (p0.0.34, OR 0.86). <h3>Conclusions</h3> We show for the first time that psychological factors predict the outcome of intra-articular corticosteroid injection in knee OA. Illness perceptions, specifically beliefs in less serious consequences of illness and stronger beliefs of treatment effectiveness, predict improved and more prolonged response to treatment better than lower levels of depression. Since illness perceptions are potentially modifiable, this may have implications for clinical practice and patient education. <h3>Disclosure of Interest</h3> None declared
Do It Yourself Newborn Screening
Authors: Pascal Borry, Karine Sénécal, Bartha Maria Knoppers
Journal: JAMA Pediatrics (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 Pediatrics 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 Pediatrics journal
Evolving Treatments for Arterial and Venous Thrombosis
Authors: Noel C. Chan, John W. Eikelboom, Jeffrey I. Weitz
Journal: Circulation Research (2016)

The direct oral anticoagulants (DOACs) represent a major advance in oral anticoagulant therapy and have replaced the vitamin K antagonists as the preferred treatment for many indications. By simplifying long-term anticoagulant therapy and improving its safety, the DOACs have the potential to reduce the global burden of thrombosis. Postmarketing studies suggest that the favorable results achieved with DOACs in the randomized controlled trials can be readily translated into practice, but highlight the need for appropriate patient, drug and dose selection, and careful follow-up. Leveraging on their success to date, ongoing studies are assessing the utility of DOACs for the prevention of thrombosis in patients with embolic stroke of unknown source, heart failure, coronary artery disease, peripheral artery disease, antiphospholipid syndrome, and cancer. The purpose of this article is to (1) review the pharmacology of the DOACs, (2) describe the advantages of the DOACs over vitamin K antagonists, (3) summarize the experience with the DOACs in established indications, (4) highlight current challenges and limitations, (5) highlight potential new indications; and (6) identify future directions for anticoagulant therapy.
Comparing Breast Cancer Multiparameter Tests in the OPTIMA Prelim Trial: No Test Is More Equal Than the Others
Authors: John M. S. Bartlett, Jane Bayani, Andrea Marshall, Janet A. Dunn, Amy Campbell, Carrie Cunningham, Monika S. Sobol, Peter S. Hall, Christopher J. Poole, David A. Cameron, Helena M. Earl, Daniel W. Rea, Iain R. Macpherson, Peter Canney, Adele Francis, Christopher McCabe, Sarah E. Pinder, Luke Hughes-Davies, Andreas Makris, Robert C. Stein
Journal: JNCI Journal of the National Cancer Institute (2016)

Background: Previous reports identifying discordance between multiparameter tests at the individual patient level have been largely attributed to methodological shortcomings of multiple in silico studies. Comparisons between tests, when performed using actual diagnostic assays, have been predicted to demonstrate high degrees of concordance. OPTIMA prelim compared predicted risk stratification and subtype classification of different multiparameter tests performed directly on the same population. Methods: Three hundred thirteen women with early breast cancer were randomized to standard (chemotherapy and endocrine therapy) or test-directed (chemotherapy if Oncotype DX recurrence score >25) treatment. Risk stratification was also determined with Prosigna (PAM50), MammaPrint, MammaTyper, NexCourse Breast (IHC4-AQUA), and conventional IHC4 (IHC4). Subtype classification was provided by Blueprint, MammaTyper, and Prosigna. Results: Oncotype DX predicted a higher proportion of tumors as low risk (82.1%, 95% confidence interval [CI] = 77.8% to 86.4%) than were predicted low/intermediate risk using Prosigna (65.5%, 95% CI = 60.1% to 70.9%), IHC4 (72.0%, 95% CI = 66.5% to 77.5%), MammaPrint (61.4%, 95% CI = 55.9% to 66.9%), or NexCourse Breast (61.6%, 95% CI = 55.8% to 67.4%). Strikingly, the five tests showed only modest agreement when dichotomizing results between high vs low/intermediate risk. Only 119 (39.4%) tumors were classified uniformly as either low/intermediate risk or high risk, and 183 (60.6%) were assigned to different risk categories by different tests, although 94 (31.1%) showed agreement between four of five tests. All three subtype tests assigned 59.5% to 62.4% of tumors to luminal A subtype, but only 121 (40.1%) were classified as luminal A by all three tests and only 58 (19.2%) were uniformly assigned as nonluminal A. Discordant subtyping was observed in 123 (40.7%) tumors. Conclusions: Existing evidence on the comparative prognostic information provided by different tests suggests that current multiparameter tests provide broadly equivalent risk information for the population of women with estrogen receptor (ER)–positive breast cancers. However, for the individual patient, tests may provide differing risk categorization and subtype information.
Dual Antitumoral and Bone Antiresorptive Effect Of The Pan-Pim Kinase Inhibitor, LGH447, In Multiple Myeloma
Authors: Teresa Paíno, Antonio Garcia-Gomez, Lorena González-Méndez, Laura San-Segundo, Montserrat Martín-Sánchez, Susana Hernández-García, Mercedes Garayoa, Enrique M. Ocio, Jesús F. San-Miguel
Journal: Blood (2013)
TCTAP A-165 Calcification Pattern and Plaque Vulnerability: Lessons from In-Vivo and In-Vitro Multimodality Intracoronary Imaging Studies
Authors: Jun Pu, Pei Zhang, Jun Guo, Yunpeng Shang, Xiaofan Wu, Gary S. Mintz, Ben He
Journal: Journal of the American College of Cardiology (2016)
Book: Antimony in Medical History
Authors: Carole Rawcliffe
Journal: BMJ (2000)

R Ian McCallum


Pentland Press, £15, pp 125 




ISBN 1 85821 642 7

———————

Rating: ★★★

Antimony for medical use has a history stretching back to ancient times. But the use of such a potentially toxic purgative has provoked bitter disagreement among practitioners, inspired vitriolic satire, and despatched countless men and women to an early grave. Recently, the presumed connection between antimony and cot deaths has added yet another chapter to the saga. Advanced by some early modern healers as a near miraculous panacea, it was also revered by alchemists because of its uncanny power to purify gold. By 1678, over 106 standard remedies contained antimonials of various sorts; even more could be found in any 19th century medicine chest.

The history of antimony is important not only in its own right but also for the insight it offers into the changing intellectual milieu of medicine and pharmacy. Like theriac, the sovereign remedy with which it might profitably have been compared, antimony exercised a fascination well beyond the pages of the Materia Medica. Professor McCallum has mined a rich seam of evidence from Scotland, the United States, and France, as well as England, and illuminates his text with an apt choice of quotations.

He is generous with hard facts but less forthcoming in the matter of context or explanation. Readers unfamiliar with the tenets of Galenic and Paracelsian medicine, or with the close relation between physic, astrology, alchemy, and religion, may find some passages difficult to understand.

Since the use of antimony became a battlefield over which members of the English medical profession campaigned against empirics and apothecaries, it would have been useful to explore the wider social and economic issues at stake. One of the most interesting of the many excellent illustrations reproduced here depicts a 17th century healer offering an antimony cup containing tartar emetic to her patient. She is repulsed by his guardian angel, who favours a learned physician skilled in the art of medicine.

The use of such overt propaganda against meddlesome women merits further comment, especially as “irregulars” such as Grace, Lady Mildmay, were at this time practising a promiscuous mix of Galenic and Paracelsian medicine heavily reliant on mineral substances. Any preparation that gave credence to the unlettered or unlicensed posed a serious threat to the status quo.

McCallum rightly emphasises the problems facing men and women who had to deal with human suffering in an age before the clinical advances that we now take for granted. If the cure was infinitely worse than the disease, the prospect of a treatment capable of eliminating all corruption from the body was surely irresistible. In the last resort, the triumph of hope over experience may explain why antimony enjoyed such enduring popularity.
The Use of Digitalis in Infants and Children
Authors: Alexander S. Nadas, Abraham M. Rudolph, John D. L. Reinhold
Journal: New England Journal of Medicine (1953)

OVER one hundred and sixty years ago, Withering1 first described the usefulness of digitalis in the treatment of certain types of "dropsy." About fifteen years later, Ferriar2 first attributed the efficacy of digitalis to its effect on the heart.Early in the twentieth century, the principal use of digitalis was found to be in the treatment of auricular fibrillation (Cushny3 and Lewis.)4 Within the past twenty-five years, however, digitalis has become the drug of choice in the treatment of congestive heart failure of adults with or without auricular fibrillation (Christian,5 Luten,6 Wenckebach7 and Levine8). Digitalizing dosages have been successfully . . .
Response to Cetuximab With or Without Irinotecan in Patients With Refractory Metastatic Colorectal Cancer Harboring the <i>KRAS</i> G13D Mutation: Australasian Gastro-Intestinal Trials Group ICECREAM Study
Authors: Eva Segelov, Subotheni Thavaneswaran, Paul M. Waring, Jayesh Desai, Kristy P. Robledo, Val J. Gebski, Elena Elez, Louise M. Nott, Christos S. Karapetis, Sebastian Lunke, Lorraine A. Chantrill, Nick Pavlakis, Mustafa Khasraw, Craig Underhill, Fortunato Ciardiello, Michael Jefford, Harpreet Wasan, Andrew Haydon, Timothy J. Price, Guy van Hazel, Kate Wilson, John Simes, Jeremy D. Shapiro
Journal: Journal of Clinical Oncology (2016)

RAS mutations predict lack of response to epidermal growth factor receptor monoclonal antibody therapy in patients with metastatic colorectal cancer (mCRC), but preclinical studies and retrospective clinical data suggest that patients with tumors harboring the exon 2 KRAS G13D mutation may benefit from cetuximab. We aimed to assess cetuximab monotherapy and cetuximab plus irinotecan in patients with molecularly selected (G13D mutation) chemotherapy-refractory mCRC in a randomized phase II trial of this rare molecular subtype.Patients with chemotherapy-refractory KRAS G13D mutation-positive mCRC who had progressed within 6 months of irinotecan therapy were randomly assigned to cetuximab 400 mg/m(2) loading dose and then 250 mg/m(2) once per week with or without irinotecan 180 mg/m(2) once every 2 weeks. The primary end point was 6-month progression-free survival; secondary end points were response rate, overall survival, quality of life, and toxicity.Fifty-one of 53 patients recruited over 2 years were eligible. The 6-month progression-free survival rate was 10% (95% CI, 2% to 26%) for cetuximab versus 23% (95% CI, 9% to 40%) for cetuximab plus irinotecan with a hazard ratio of 0.74 (95% CI, 0.42 to 1.32). Response and stable disease rates were 0% and 58% for monotherapy versus 9% and 70% for combination treatment, respectively. Overall survival and quality of life were similar; toxicities were higher with combination therapy.In patients with G13D-mutated chemotherapy-refractory mCRC, there was no statistically significant improvement in disease control at 6 months with either cetuximab monotherapy or cetuximab plus irinotecan. No responses were seen with single-agent cetuximab. The responses observed with the combination of cetuximab and irinotecan may reflect true drug synergy or persistent irinotecan sensitivity. The ICECREAM (Irinotecan Cetuximab Evaluation and Cetuximab Response Evaluation Among Patients with a G13D Mutation) study demonstrates the need to prospectively evaluate hypotheses that were previously supported by retrospective analyses and exemplifies the value of international collaboration in trials of rare molecular subtypes.
Correlation of CA15.3 levels with clinical response in advanced breast cancer (ABC) patients receiving fulvestrant
Authors: J. F. Robertson, A. Agrawal, E. Gutteridge, K. Cheung, A. J. Evans
Journal: Journal of Clinical Oncology (2006)

641 Background: A transient initial rise (i.e. spike) in CA15.3 has been reported during treatment with anti-cancer therapies such as tamoxifen and chemotherapy. The spike may result from the partial agonistic and cytotoxic effects of these agents, respectively. Here, we report the clinical relevance of a transient initial rise in CA15.3 in patients treated with fulvestrant, an estrogen receptor (ER) antagonist with no agonist effects. Methods: Serial measurements of CA15.3 were made at regular intervals to monitor response in patients receiving fulvestrant 250 mg/month for the treatment of ABC. Marker profile at baseline, after 1, 3, 6, 9, and 12 months of treatment and at the time of progression was correlated with clinical benefit (CB) (complete response [CR]/partial response [PR]/stable disease ≥6 months) as per UICC criteria. Results: Sixty-seven patients (41 with metastatic breast cancer [MBC]; 26 with locally advanced primary breast cancer [LAPC]) with a median age of 72.9 years were treated with fulvestrant. CB was observed in 64.2% (n=43) with objective response (OR) in 19.4% (n=13). Median duration of clinical benefit (DoCB) was 26.6+ months. CA15.3 data at month 1 were available for 33 patients with CB. Eleven patients with CB (33.3%) had a rise in CA15.3 at month 1. Comparative responses in patients with and without spike phenomenon are shown in the Table . Five MBC patients with a spike in CA15.3 had an OR (CR=1; PR=4) compared with none of the MBC patients without a spike. Conclusions: Spike phenomenon is observed in more patients with MBC than patients with LAPC, which may reflect the overall tumor load in MBC patients. Higher OR rates were observed in MBC patients with spike phenomenon, but shorter DoCB. There was no apparent difference in ER status between patients with or without spike. Fulvestrant should not be stopped during the initial 1–2 months of treatment solely on the basis of a rising tumor marker, as a spike is observed in one-third of ABC patients who achieve CB with fulvestrant. [Table: see text] [Table: see text]
Digital Health and Patient Safety
Authors: Stephen O. Agboola, David W. Bates, Joseph C. Kvedar
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
Efficacy of the MAGE-A3 cancer immunotherapeutic as adjuvant therapy in patients with resected MAGE-A3-positive non-small-cell lung cancer (MAGRIT): a randomised, double-blind, placebo-controlled, phase 3 trial
Authors: Johan F Vansteenkiste, Byoung Chul Cho, Tonu Vanakesa, Tommaso De Pas, Marcin Zielinski, Moon Soo Kim, Jacek Jassem, Masahiro Yoshimura, Jubrail Dahabreh, Haruhiku Nakayama, Libor Havel, Haruhiko Kondo, Tetsuya Mitsudomi, Konstantinos Zarogoulidis, Oleg A Gladkov, Katalin Udud, Hirohito Tada, Hans Hoffman, Anders Bugge, Paul Taylor, Emilio Esteban Gonzalez, Mei Lin Liao, Jianxing He, Jean-Louis Pujol, Jamila Louahed, Muriel Debois, Vincent Brichard, Channa Debruyne, Patrick Therasse, Nasser Altorki
Journal: The Lancet Oncology (2016)
Two FOXP3+CD4+ T cell subpopulations distinctly control the prognosis of colorectal cancers
Authors: Takuro Saito, Hiroyoshi Nishikawa, Hisashi Wada, Yuji Nagano, Daisuke Sugiyama, Koji Atarashi, Yuka Maeda, Masahide Hamaguchi, Naganari Ohkura, Eiichi Sato, Hirotsugu Nagase, Junichi Nishimura, Hirofumi Yamamoto, Shuji Takiguchi, Takeshi Tanoue, Wataru Suda, Hidetoshi Morita, Masahira Hattori, Kenya Honda, Masaki Mori, Yuichiro Doki, Shimon Sakaguchi
Journal: Nature Medicine (2016)
Eltrombopag for the Treatment of Thrombocytopenia of Low and Intermediate-1 IPSS Risk Myelodysplastic Syndromes: Interim Results on Efficacy, Safety and Quality of Life of an International, Multicenter Prospective, Randomized, Trial
Authors: Esther Natalie Oliva, Valeria Santini, Caterina Alati, Antonella Poloni, Alfredo Molteni, Pasquale Niscola, Grazia Sanpaolo, Flavia Salvi, Giuseppe A. Palumbo, Enrico Balleari, Stefana Impera, Agostino Cortelezzi, Anna Marina Liberati, Paolo Avanzini, Paolo Di Bartolomeo, Christian Rose, Odile Beyne-Rauzy, Francesco Buccisano, Monica Bocchia, Fortunato Morabito, Aspasia Stamatoullas, Francesca Ronco, Gina Zini, Maria Grazia D'Errigo, Natale Ranieri, Patrizia Cufari, Irene Santacaterina, Pierre Fenaux, Roberto Latagliata
Journal: Blood (2015)
PWE-117 The role of repeat liver biopsies in autoimmune hepatitis: clinical practice and outcomes
Authors: S Mathew, R Narang, M Pericleous, A Ramu, P Berry, K Cheent, H Lewis, G Kousparos, A Ala
Journal: Gut (2015)

<h3>Introduction</h3> The role of repeat liver biopsies in established Autoimmune hepatitis (AIH) is unclear, with limited data on clinical practice and outcomes, and with variation in biopsy practice between physicians. <h3>Method</h3> We undertook a retrospective review of all patients with AIH who underwent a repeat liver biopsy between 2002–2013 at Frimley Park Hospital (Surrey, England); serving a population 430,000. The indication for repeat biopsy, liver histology and serological markers were recorded, as well as the clinical outcome/management resulting from each procedure. <h3>Results</h3> 17 patients were identified, all who were on treatment for AIH at the time of repeat biopsy. Clinical indications for repeat biopsy included: disease assessment/staging (34%) clinical deterioration (24%), diagnostic uncertainty (24%), medication withdrawal/remission (12%) and insufficient (Bx) sample (6%). Median time between 1<sup>st</sup>and repeat biopsy was 24 months (range 1–108 months). Overall 10/17 (59%) patients had normal LFTs and 12/17 (71%) had normal IgG levels at the time of repeat biopsy. Repeat biopsy led to a change in treatment (dose/regime) in 11/17(65%) patients. Baseline cirrhosis was seen in 3/17 (biopsy/imaging), and developed in a further 2 patients (12%) over 24–48months; both with raised IgG levels at the time of repeat biopsy. 9 patients had a repeat biopsy at ≤ 24months. Within this group 4/9(44%) patients had normal LFTs, and 6/9 (67%) had normal IgG levels. Repeat biopsy led to a change in treatment in 2/4 (50%) patients with normal LFTs and 4/6 (67%) with normal IgG levels. Fibrosis progression was seen in 1/4 (25%) with normal LFTs, and 2/6 (33%) with normal IgG levels. Interface hepatitis/periportal inflammation was present in all repeat biopsies. <h3>Conclusion</h3> BSG and AASLD guidance suggest the use of repeat biopsies at 12–24 months following normalised transaminases to guide treatment withdrawal/maintenance, with IgG levels also thought predictive of histological response. However, the majority of repeat biopsies in our study were requested due to concerns of disease progression, rather than to assess for treatment withdrawal. Despite normalised LFTs/IgG levels, repeat biopsy led to treatment modification in more than half of this group; as well as demonstrating fibrosis progression and on-going histological activity. Our results support the need to individualise repeat liver biopsies to the needs of each patient. <h3>Disclosure of interest</h3> None Declared.