tbuckley/cabot-search huggingface dataset:
Colorectal adenocarcinoma: risks, prevention and diagnosis
Authors: Sri G Thrumurthy, Sasha S D Thrumurthy, Catherine E Gilbert, Paul Ross, Amyn Haji
Journal: BMJ (2016)

#### What you need to know Colorectal cancer is the fourth most common cause of cancer related mortality globally, with 1.4 million new cases and 700 000 deaths annually.1 Colorectal cancer refers to tumours of the rectum or large bowel (including the appendix) that arise from the colorectal mucosa (fig 1⇓). Adenocarcinoma is the most common form of colorectal cancer (>95%). Rarer subtypes include carcinoid tumour, sarcoma, and lymphoma; these present differently from adenocarcinoma1 and will not be discussed in this review. Fig 1 Distribution of bowel cancer by anatomical site, UK (2007-09) (adapted from Cancer Research UK, bowel cancer incidence statistics, www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/bowel-cancer/incidence) Colorectal cancer typically develops from adenomatous polyps that undergo dysplastic changes to become cancerous (fig 2⇓).2 Tumours can occur sporadically, but there are some inherited colorectal cancer syndromes (see table 1⇓). Several risk factors are also recognised (see box 1). Fig 2 Progression from colorectal polyp to cancer (adapted from Johns Hopkins Colon Cancer Center. Polyps 101. www.hopkinscoloncancercenter.org/CMS/CMS\_Page.aspx?CurrentUDV=59&CMS\_Page_ID=744568E4-291E-4276-97C4-FA7A4EE02235) View this table: Table 1 Inherited syndromes predisposing to colorectal cancer #### Box 1: Risk factors for colorectal cancer ##### Sociodemographic factors
Impact of sarcopenia on treatment tolerance in United States veterans with diffuse large B‐cell lymphoma treated with CHOP‐based chemotherapy
Authors: Daphne Y. Xiao, Suhong Luo, Katiuscia O'Brian, Arun Ganti, Peter Riedell, Kristen M. Sanfilippo, Ryan C. Lynch, Weijian Liu, Kenneth R. Carson
Journal: American Journal of Hematology (2016)

While sarcopenia has been associated with decreased overall survival in diffuse large B-cell (DLBCL) patients, the impact of sarcopenia on treatment tolerance has not been well-studied. We evaluated the association of sarcopenia with febrile neutropenia hospitalization, treatment-related mortality, and ability to complete standard number of cycles in a retrospective cohort of United States veterans diagnosed with DLBCL between 1998 and 2008 and treated with cyclophosphamide, doxorubicin, vincristine, and prednisone, with or without rituximab. Baseline body composition parameters were evaluated using computed tomography analysis. In total, 522 patients were included in the study, of whom 245 (47%) had baseline sarcopenia. After controlling for other variables, baseline sarcopenia was independently associated with increased risk of febrile neutropenia hospitalization (adjusted Odds Ratio (aOR) 1.64, 95% confidence interval (CI) 1.01-2.65) and inability to complete standard number of treatment cycles (aOR 1.49, 95% CI 1.02-2.16) compared with no baseline sarcopenia. There was a non-statistically significant trend toward higher treatment-related mortality in sarcopenic patients than non-sarcopenic patients (aOR 1.77, 95% CI 0.92-3.41). Sarcopenia is associated with increased risk of treatment intolerance and may be useful in guiding treatment planning and supportive care measures. Am. J. Hematol. 91:1002-1007, 2016. © 2016 Wiley Periodicals, Inc.
Traumatic Hindquarter Amputation
Authors: J H MCPHERSON
Journal: BMJ (1974)

Disposal of Unused Medicines More than 300,000 unused tablets, capsules, and other medicines were returned to chemists in the Metropolitan Borough of Stockport during the town's campaign for the disposal of unwanted medicines and pills.The campaign was launched on 16 October by the Metropolitan Borough of Stockport in conjunction with local pharmacists.More than one in 20 of all home accidents dealt with at Stockport Infirmary concern child poisoning, and 400, of these cases are child- ren who have swallowed medicines pre- scribed for other people.
Is CA125 useful in monitoring patients with platinum-resistant ovarian cancer?
Authors: G J S Rustin, M R Hall
Journal: Annals of Oncology (2016)

Patients with recurrent ovarian cancer are offered chemotherapy (CT) with the aim of improving survival and palliating symptoms. Due to the toxicity of therapy and expense particularly of biological therapy, treatment should only be continued if it is known to be effective. This requires regular monitoring during therapy to determine whether the cancer is responding or progressing. Providing patients are tolerating the therapy, it would normally be continued for a specified number of cycles or until it was shown to be ineffective.
QOL-18DO CAREGIVER (CG) NEEDS CHANGE ACROSS THE DISEASE TRAJECTORY?
Authors: Margaretta Page, Judy Patt Smoker, Idonah Molina, Susan Chang
Journal: Neuro-Oncology (2015)

BACKGROUND: It is well documented that CGs of neuro oncology patients have complex needs that vary across the disease trajectory. It has also been suggested that needs vary by individual and further work to better understand the expectations of support, as well as the timing and nature of support is needed. METHODS: In September 2013 the UCSF Neuro Oncology Division launched a program to specifically provide care to CGs. We focused initial efforts on the needs of CGs of patients with newly diagnosed glioblastoma (NDGBM) who were offered services over the first 4 months of the illness. For high risk (HR) patients characterized either at the time of progression or transition to hospice, CGs were offered services as much as needed after referral. The needs assessment spanned several domains. We report on the first 18 months of providing care to these 2 groups of CGs. RESULTS: Of 65 CGs of NDGBM patients, 21% identified no needs, and of those that did, 52% had more than 1 need. 82% of 144 CGs of HR patients had multiple needs. Both groups had highest needs around emotional support and advocacy, with the HR CGs expressing significant higher need for emotional support at 80%. HR CGs had higher percentage of needs when compared to the NDGBM CGs around obtaining caregiver resources ( 42% vs 28%), family relations (30% vs 11 %), health care navigation and obtaining psychological services (26% vs 6 %), and health information (21% vs 8%). CONCLUSIONS: CGs express the need for increasingly complex support as the illness progresses with a differential demand compared to the time of initial diagnosis. This suggests that developing specific modules of care for high demand needs throughout the trajectory of the illness will improve the QOL of CGs of neuro-oncology patients.
Health-related quality of life and burden of fatigue in patients with primary immune thrombocytopenia by phase of disease
Authors: Fabio Efficace, Franco Mandelli, Paola Fazi, Cristina Santoro, Gianluca Gaidano, Francesco Cottone, Alessandra Borchiellini, Monica Carpenedo, Maria Pina Simula, Valeria Di Giacomo, Micaela Bergamaschi, Iolanda Donatella Vincelli, Francesco Rodeghiero, Marco Ruggeri, Laura Scaramucci, Alessandro Rambaldi, Nicola Cascavilla, Fabio Forghieri, Annamaria Petrungaro, Paolo Ditonno, Giovanni Caocci, Sonia Cirrincione, Maria Gabriella Mazzucconi
Journal: American Journal of Hematology (2016)

The main objective of this study was to compare health-related quality of life (HRQOL) of primary immune thrombocytopenia (pITP) patients with that of general population, overall, and by patient group (i.e., newly diagnosed, persistent, and chronic patients). Fatigue was also investigated as a secondary objective. Overall, 424 adult patients were enrolled in a multicenter observational study and the control group consisted of a representative sample from the general population. Propensity score matching plus further multivariate linear regression adjustment was used to compare HRQOL outcomes between pITP patients and general population. Mean age of patients was 54 years. Of those with HRQOL assessment, 99 patients (23.6%) were newly diagnosed, 53 (12.6%) were persistent, and 268 (63.8%) were chronic pITP patients. Comparison by patient group versus their respective peers in the general population revealed greater impairments in persistent pITP patients. Persistent pITP patients reported clinically meaningful impairments in physical functioning (-15; 95% CI -24.1 to -5.8; P = 0.002), social functioning (-15.3; 95% CI -25.5 to -5.1; P = 0.004), role physical (-28.4; 95% CI -43.1 to -13.7; P < 0.001), role emotional (-23.9; 95% CI -40.1 to -7.7; P = 0.004), and mental health scales (-11.3; 95% CI -21.2 to -1.4; P = 0.026) of the SF-36 questionnaire. Higher fatigue severity was associated with lower physical and mental HRQOL outcomes. Our findings suggest that the burden of the disease and treatment might depend on the disease phase and that persistent pITP patients are the most vulnerable subgroup. Am. J. Hematol. 91:995-1001, 2016. © 2016 Wiley Periodicals, Inc.
Consequences of the Presence of the JAK2V617F Mutation in Endothelial Cells: Towards a Better Understanding of the Increased Angiogenesis in Myeloproliferative Neoplasms
Authors: Badr Kilani, Juliana Vieira Dias, Virginie Gourdou-Latyszenok, Eric Lippert, Raj Sewduth, Cécile Duplaa, Jean-Luc Villeval, Thierry Couffinhal, Chloe James
Journal: Blood (2014)
Adjuvant chemotherapy and radiation therapy (RT) versus RT alone for women with high-risk endometrial cancer: Toxicity and quality-of-life results of the randomized PORTEC-3 trial.
Authors: Carien L. Creutzberg, Stephanie M. de Boer, Hein Putter, Melanie Powell, Linda R. Mileshkin, Dionyssios Katsaros, Paul Bessette, Christine Haie-Meder, Jonathan A. Ledermann, P. B. Ottevanger, Pearly Khaw, Alessandro Colombo, Anthony W. Fyles, Marie-Helene Baron, Hans W. Nijman, Remi A. Nout, Vincent T.H.B.M. Smit, Karen Verhoeven-Adema, Roy F.P.M. Kruitwagen, Henry C. Kitchener
Journal: Journal of Clinical Oncology (2015)

5501 Background: PORTEC-3 is an intergroup trial investigating survival improvement with adjuvant chemotherapy given during and after pelvic RT (CTRT) versus RT alone (RT) for women with high-risk endometrial cancer (HR-EC). Primary endpoints are overall and failure free survival, secondary endpoints toxicity and health-related quality of life (HRQL). Accrual was completed Dec 2013. Toxicity and 2-year HRQL results are presented. Methods: 686 women with HR-EC were allocated to RT (48.6 Gy in 1.8 Gy fractions) or CTRT (2 cycles of cisplatin 50 mg/m2 during RT, followed by 4 cycles of carboplatin AUC5 and paclitaxel 175 mg/m2). Adverse events (AE) were graded using CTCAEv3.0. HRQL was evaluated using EORTC QLQ-C30 and symptom scales from CX 24 and OV28 at baseline, after RT and at 6-12 month follow up (FU) intervals. Results: 674 patients met eligibility criteria, and 572 (85%) were evaluable for HRQL. Median FU was 30 months. Rates of AE were significantly higher for CTRT vs RT. During RT, grade ≥ 2 AE were found in 79 vs 44%, and grade ≥ 3 in 36 vs 13% of patients, both p < 0.001. During FU, any grade ≥ 3 AE were reported in 67% (CTRT) vs 32% (RT), especially hematologic (32 vs 8%), neurologic (10 vs 2%) and GI AE (14 vs 5%, all p < 0.001). AE decreased over time; at 1 yr differences for CTRT vs RT were only significant for grade ≥ 2 neurologic (12 vs 1%, p < 0.001) and musculoskeletal AE (3 vs 0%, p = 0.015). Rates of any grade ≥2 and ≥3 AE were 47 vs 39% (p=0.06) and 12 vs 8% (ns). At 2 years, grade ≥2 neurologic AE persisted (10 vs 2%, p<0.001) without differences in grade ≥ 3 AE. QLQC30 functioning scores were lower and HRQL symptom scores were higher for CTRT vs RT after RT and at 6 months, improving with time. At 1 and 2 years, small (mean 5-6 points) but significant differences in physical, role, emotional and social functioning remained. Most striking differences at 2 years were tingling/numbness (24 vs 7%, p < 0.001) and weakness arm/legs (14 vs 9%, p < 0.001). Conclusions: CTRT for high-risk endometrial cancer causes significantly higher AE and symptom ratings and reduced HRQL during and after treatment as compared with RT, but with recovery over time, without differences in grade ≥ 3 AE at 2 years. Clinical trial information: NCT00411138.
Soundings: Making them squirm
Authors: Trisha Greenhalgh
Journal: BMJ (1999)

A few months ago I received a letter from a pharmaceutical company that presented “evidence” for the cost effectiveness of a popular antibiotic.

I’ll spare the company’s blushes, but let’s just call it drug X and say the stuff is heavily advertised in the freebies, comes in a blister pack as two tone brightly coloured capsules, and if you bought a course of it privately you’d probably need to pay with a credit card. The letter said that tests in volunteers had shown that the absorption of drug X from the empty stomachs of healthy volunteers was well over 90%. Drugs P, Q, and R, on the other hand, were only about 70% absorbed, and since they were more than two thirds the price of drug X, this proved that the last was the most cost effective and should be used as a first line treatment for community acquired infections.

The research department of the company that makes drug X is well aware that this line of reasoning requires a major leap of faith, but chooses not to vet the literature produced by its own marketing department. I decided to see how easy it would be to force the company to look up its own backside. I sent the advertisement to the Prescription Medicines Code of Practice Authority, which was set up by the Association of British Pharmaceutical Industry (ABPI) to set and police advertising standards among its own members.

I heard nothing for six months, then the authority wrote with its verdict. On the strength of my covering letter, senior members of the company had been called before a jury of their peers and asked to justify, one by one, the points raised in my letter. Their written response, which must have taken some time to prepare, was dismissed as insubstantial. The company received a rap over the knuckles and was required to withdraw the advertisement. The cost to me was 45 seconds to dictate the letter and the cost of a second class stamp.

The code of practice authority’s quarterly report, which makes dull but gleeful reading, is half an inch thick and contains numerous other examples of drug companies caught with their fingers in the jam by general practitioners, consultants, junior doctors, and (most commonly) their own competitors. If you would like to read about this sport in more detail, or try your hand at it yourself, the authority’s address is 12 Whitehall, London SW1A 2DY.
Cost-effectiveness of novel predictive tests in the treatment of metastatic colorectal cancer: An analysis from a Swiss perspective.
Authors: P. R. Blank, M. Schwenkglenks, R. Herrmann, H. Moch, T. D. Szucs
Journal: Journal of Clinical Oncology (2010)

e16549 Background: monoclonal antibodies against the epidermal growth factor receptor (EGFR), like cetuximab, have led to significant clinical benefits for metastatic colorectal cancer (mCRC) patients but have also increased treatment costs considerably. Recent evidence associates KRAS and BRAF mutations with resistance to EGFR antibodies. We assessed the cost-effectiveness of testing for KRAS and BRAF mutations, prior to cetuximab treatment of chemorefractory mCRC patients, from a Swiss third party payer perspective. Methods: A life-long Markov cohort simulation model was used to estimate direct medical costs costs (€) and clinical effectiveness (quality adjusted life years, QALYs) of following strategies: KRAS testing, KRAS testing with subsequent BRAF testing of KRAS wildtypes (KRAS/BRAF), cetuximab without testing. Comparison was against a reference strategy of no cetuximab treatment. In the testing strategies, cetuximab treatment was initiated if no mutations were detected. Best supportive care was given to all patients. Survival times and utilities derived from published randomised clinical trials (Karapetis, 2008; Mittmann, 2009). Costs were assessed from perspective of the Swiss health system. Results: mutation analysis for KRAS and BRAF accounted for €394 each. Cetuximab administration cost €,840 and €4,208 per month, in the first and subsequent months of mCRC treatment, respectively. Average remaining lifetime costs ranged from €3'345 (no cetuximab) to € 23,989 (no testing). Cetuximab treatment guided by KRAS/BRAF, guided by KRAS and for all patients led to gains of 0.31, 0.34 and 0.35 QALYs, respectively, compared to no cetuximab treatment. KRAS predictive testing was the most cost-effective approach when compared to the reference strategy (incremental cost-effectiveness ratio, €51,591/QALY). Conclusions: new predictive tests for KRAS and BRAF status are currently introduced in pathology. Despite substantial costs of predictive testing, it is economically favourable to determine KRAS-wildtype results. Analysis of total costs and benefits by long-term cost-effectiveness models can support decision making on use of such testing strategies. No significant financial relationships to disclose.
US states that allow medical marijuana see drop in prescriptions for other drugs, study finds
Authors: Owen Dyer
Journal: BMJ (2016)

American states that allow patients access to medical marijuana are seeing fewer prescriptions per doctor for pharmaceutical drugs in several disease categories where marijuana is a potential treatment, a study in Health Affairs has found.1

Proportionally, the greatest reduction was in medicines for spasticity. The average physician in a state without medical marijuana prescribed 2068 doses, but in states with access to medical marijuana this fell by 20% to 1645 doses. The apparent effect was also marked in seizure medicines. The average physician in a state without medical marijuana prescribed 9368 doses, but in states with medical marijuana access this …
Olanzapine for the Prevention of Chemotherapy-Induced Nausea and Vomiting
Authors: Rudolph M. Navari, Rui Qin, Kathryn J. Ruddy, Heshan Liu, Steven F. Powell, Madhuri Bajaj, Leah Dietrich, David Biggs, Jacqueline M. Lafky, Charles L. Loprinzi
Journal: New England Journal of Medicine (2016)

We examined the efficacy of olanzapine for the prevention of nausea and vomiting in patients receiving highly emetogenic chemotherapy.
The Jury Is Still Out on Working Memory Training—Reply
Authors: Gehan Roberts
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
Case 19-1965
Authors: Lot B. Page, Benjamin Castleman
Journal: New England Journal of Medicine (1965)

Presentation of Case First admission. A sixty-eight-year-old man was admitted to the hospital because of anemia.He had been well until one year previously, when a routine physical examination disclosed anemia. Four months before entry studies performed in another hospital disclosed Bence-Jones protein in the urine and a destructive lesion of the right fifth rib in addition to anemia; iron was prescribed. During the three months before admission his appetite diminished, and he lost 5 pounds in weight. Six weeks before admission pain and swelling developed in both hands. There was a past history of occasional nocturia, without dysuria or . . .
Appropriateness of colonoscopy in Europe (EPAGE II) – Chronic diarrhea and known inflammatory bowel disease
Authors: S. Schusselé Filliettaz, P. Juillerat, B. Burnand, C. Arditi, A. Windsor, C. Beglinger, R. Dubois, I. Peytremann-Bridevaux, V. Pittet, J.-J. Gonvers, F. Froehlich, J.-P. Vader
Journal: Endoscopy (2009)

See also: Commentaire de "Retour vers le futur: EPAGE II" (6 articles), pp. 200Endoscopy 2009; 41(03): 388-390DOI: 10.1055/s-0032-1306673
Evaluation of Tumor Response after first line combined therapy (Bevacizumab plus chemotherapy) in unresectable liver metastases from colorectal cancer: predictive value of RECIST 1.1 and CHOI criteria in short-term follow-up
Authors: M. Tilli, S. Gamanji, I. Carandina, G. Benea, A. Frassoldati
Journal: Annals of Oncology (2015)
It’s TIME for a biomarker-driven approach to cancer immunotherapy
Authors: Leisha A. Emens
Journal: Journal for ImmunoTherapy of Cancer (2016)

Cancer immunotherapy has clearly taken its place in the clinic as one pillar of cancer care. Immune checkpoint blockade, which unleashes the activity of pre-existing T cells at the tumor site, is transforming cancer treatment. The FDA approval of the cytotoxic T lymphocyte antigen-4 (CTLA-4)
The Nucleus Accumbens: Mechanisms of Addiction across Drug Classes Reflect the Importance of Glutamate Homeostasis
Authors: M. D. Scofield, J. A. Heinsbroek, C. D. Gipson, Y. M. Kupchik, S. Spencer, A. C. W. Smith, D. Roberts-Wolfe, P. W. Kalivas
Journal: Pharmacological Reviews (2016)

The nucleus accumbens is a major input structure of the basal ganglia and integrates information from cortical and limbic structures to mediate goal-directed behaviors. Chronic exposure to several classes of drugs of abuse disrupts plasticity in this region, allowing drug-associated cues to engender a pathologic motivation for drug seeking. A number of alterations in glutamatergic transmission occur within the nucleus accumbens after withdrawal from chronic drug exposure. These drug-induced neuroadaptations serve as the molecular basis for relapse vulnerability. In this review, we focus on the role that glutamate signal transduction in the nucleus accumbens plays in addiction-related behaviors. First, we explore the nucleus accumbens, including the cell types and neuronal populations present as well as afferent and efferent connections. Next we discuss rodent models of addiction and assess the viability of these models for testing candidate pharmacotherapies for the prevention of relapse. Then we provide a review of the literature describing how synaptic plasticity in the accumbens is altered after exposure to drugs of abuse and withdrawal and also how pharmacological manipulation of glutamate systems in the accumbens can inhibit drug seeking in the laboratory setting. Finally, we examine results from clinical trials in which pharmacotherapies designed to manipulate glutamate systems have been effective in treating relapse in human patients. Further elucidation of how drugs of abuse alter glutamatergic plasticity within the accumbens will be necessary for the development of new therapeutics for the treatment of addiction across all classes of addictive substances.