tbuckley/cabot-search huggingface dataset:
PTU-280 Establishing eligibility for case discussion in multidisciplinary team care within an inflammatory bowel disease service provision – results from a qualitative two-stage expert based study: Abstract PTU-280 Table 1
Authors: P Morar, N Sevdalis, J Read, S Arora, J Warusavitarne, A Hart, J Green, C Edwards, O Faiz
Journal: Gut (2015)

<h3>Introduction</h3> Multidisciplinary Team (MDT) driven care is arising intuitively within the Inflammatory Bowel Disease (IBD) setting. There are no clear evidence-based definitions of what cases are eligible for discussion in the IBD MDT. Providing a standardised framework, with a clearly defined eligibility criteria, may enhance its capacity to establish effective quality improvement. This study aimed to obtain a definition of IBD patients for discussion in the MDT, through expert-based consensus. <h3>Method</h3> This was a prospective, multi-centre, two-stage qualitative study. Stage 1 used semi-structured interviews across a multi-disciplinary sample of 28 participants. Items identified were incorporated into stage 2. Stage 2 used a Delphi formal consensus-building methodology. An eligibility criterion was established to ensure Delphi panellists had expertise in the field of IBD. Panellists were asked to rank each item with a Likert scale which was categorised from 1 (= not relevant) to 5 (= highly relevant). Successive rounds were carried out, with participants being informed of aggregated responses, until formal consensus was reached. Likert ratings were represented with median scores and interquartile ranges (IQR). Consensus was defined with an IQR ≤ 1. Items with a median score &gt; 3, and IQR ≤ 1, were included into the eligibility criteria. <h3>Results</h3> Stage 1: Thematic saturation was achieved after 28 semi-structured interviews (6 colorectal surgeons, 6 IBD nurse specialists, 7 gastroenterologists, 5 radiologists and 4 histopathologists). Table 1demonstrates items identified. Stage 2: A multidisciplinary sample of 24 experts were recruited. Items [median; IQR] acheiving consensus were <i>complex cases requiring surgery [4; 1]</i>, <i>patients on biological therapy [4; 1]</i>, <i>newly diagnosed IBD cases [4; 1]</i>,<i>and patients with recent surgery [3.5; 1]</i>. <h3>Conclusion</h3> Patients eligible for discussion in the IBD MDT should have complex IBD requiring surgery, be on biologics, be newly diagnosed with IBD, or have undergone recent IBD surgery. This consensus-derived eligibility criteria provides a focus for core members, enhancing the MDT as a tool that delivers a high quality IBD service provision. Further validation of this criteria is required prior to implementation into standards. <h3>Disclosure of interest</h3> None Declared.
Diet-Induced Obesity and Diabetes Can Be Epigenetically Inherited
Authors: Tracy Hampton
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
Case 21-1972
Authors: Richard C. Cabot, Benjamin Castleman, Robert E. Scully, Betty U. McNeely, Robert R. Young, Edward P. Richardson, Robert E. Scully
Journal: New England Journal of Medicine (1972)

Presentation of CaseA 60-year-old man was admitted to the hospital because of dysphasia.He had been well until two years previously, when intermittent claudication developed, followed by impotence. Eight months before admission there was the sudden onset of tinnitus, deafness and vertigo, which cleared after three days. A tentative diagnosis of polycythemia was made, and occasional venesections were performed. Nine days before entry there were two brief episodes of weakness of the right hand. Two days later he began to experience difficulty in expressing himself verbally. He was taken to another hospital, where he was found to have moderate . . .
Terminal Care in Cancer
Authors: Ruth Abrams, Gertrude Jameson, Mary Poehlman, Sylvia Snyder
Journal: New England Journal of Medicine (1945)

MEDICAL social workers who daily attempt to cope with the task of arranging for the terminal care of cancer patients have long been concerned with the fact that the combination of limited facilities for the care of chronic cases, hospital policies and human nature makes this an almost insurmountable problem. Because this situation became increasingly difficult, four medical social workers representing as many tumor clinics in Boston met to discuss the nature of the problem, to review the limitations of resources and to discover how they could derive mutual help. An analysis of the situation relative to the medical and . . .
Correlative tumor molecular profiling and plasma biomarker analysis in a phase II study of XL184 in patients with progressive or recurrent glioblastoma multiforme (GBM)
Authors: S. DePrimo, B. Wu, S. Huang, R. Bautista, B. Cancilla, V. Vysotskaia, J. De Groot, M. Prados, R. Buller, P. Wen
Journal: Journal of Clinical Oncology (2009)

2049 Background: XL184 is an oral inhibitor of MET, RET, KIT, and VEGFR-2 with potent antitumor effects in preclinical models of GBM. Clinically, elevated levels of MET, KIT, VEGFR-2, and VEGF-A are found in GBM, where MET and KIT levels correlate with poor prognosis. XL184–201 is a fully enrolled GBM study (N = 46) which mandated collection of archival tumors and serial plasma samples. The encouraging clinical activity of XL184 in this study is the subject of a separate abstract. Methods: Tumor profiling focused on genomic alterations prevalent in GBM, reflecting dysregulation of key signaling pathways (Nature 2008; 455:1061), or XL184 targets. Plasma samples were analyzed with ELISA assays. Correlation of results with clinical outcomes is a secondary objective of study XL184–201. Results: Tumor genotyping assessments included EGFR and KIT copy number; PTEN, PIK3CA, PIK3R1, and NF1 sequencing, as well as MGMT and PTEN promoter methylation. Results from the first 12 cases indicate sequence variations &amp; frequencies similar to reports in the literature. IHC analysis of MET, RET, and VEGFR-2 protein expression was also performed. In ∼ 80% of samples, tumor cells stained positive for MET with a lower fraction positive for RET and VEGFR-2 in tumor cells (42% and 58%, respectively). RET and VEGFR-2 expression was often seen in tumor-associated blood vessels, while MET signal in blood vessels was more limited (33%). Preliminary biomarker analysis established significant modulation of plasma levels of VEGF-A, sMET, sVEGFR-2, sKIT, and PlGF, consistent with multiple on target effects. Objective response was observed in the presence or absence of tumor EGFR amplification, PTEN mutation, and MGMT promoter methylation. The potential predictive value of these and other biomarkers is under investigation. Conclusions: Plasma biomarkers confirm pharmacodynamic activity of XL184 in advanced GBM where marked clinical activity has been observed. Upon completed analysis of a full set of biological samples and with mature clinical data, predictive markers for clinical activity of XL184 will be evaluated. [Table: see text]
Personalized Clinical Trials in Hepatocellular Carcinoma Based on Biomarker Selection
Authors: Bingnan Zhang, Richard S. Finn
Journal: Liver Cancer (2016)

&lt;b&gt;&lt;i&gt;Background: &lt;/i&gt;&lt;/b&gt;Since the approval of sorafenib there have been numerous failures of new agents in Phase III studies for treatment of advanced hepatocellular carcinoma (HCC). These studies have generally ignored the molecular heterogeneity of HCC and they have not enrolled patients based on predictive markers of response. The development of molecular targeted therapeutics in HCC needs to model the approach that has been taken with great success in other solid tumors, to decrease the likelihood of failure in future studies. &lt;b&gt;&lt;i&gt;Summary: &lt;/i&gt;&lt;/b&gt;Here we review the paradigm taken with novel targeted agents in other solid tumors and highlight ongoing studies in HCC that are incorporating biomarkers in clinical development. &lt;b&gt;&lt;i&gt;Key Messages: &lt;/i&gt;&lt;/b&gt;With the appreciation of the molecular diversity of HCC, clinical development of new agents in HCC will need to be targeted towards those patients who are most likely to benefit. This strategy, based on biomarkers for patient selection, is more likely to yield positive results and mitigate the risk of continued negative Phase III studies.
Transposable elements in the mammalian embryo: pioneers surviving through stealth and service
Authors: Patricia Gerdes, Sandra R. Richardson, Dixie L. Mager, Geoffrey J. Faulkner
Journal: Genome biology (2016)

Transposable elements (TEs) are notable drivers of genetic innovation. Over evolutionary time, TE insertions can supply new promoter, enhancer, and insulator elements to protein-coding genes and establish novel, species-specific gene regulatory networks. Conversely, ongoing TE-driven insertional mutagenesis, nonhomologous recombination, and other potentially deleterious processes can cause sporadic disease by disrupting genome integrity or inducing abrupt gene expression changes. Here, we discuss recent evidence suggesting that TEs may contribute regulatory innovation to mammalian embryonic and pluripotent states as a means to ward off complete repression by their host genome.
Government is in “denial” over NHS funding crisis, says BMA chair
Authors: Gareth Iacobucci
Journal: BMJ (2016)

The UK government is in “denial” over the financial crisis facing the NHS and must act immediately to ease the unprecedented pressure on doctors, the BMA’s chairman of council, Mark Porter, has said.

In a speech to a BMA special representatives meeting in London on Tuesday 3 May, specially convened to discuss the crisis facing the health service, Porter warned the government that its policies on and attitudes to healthcare were driving doctors away from the UK.

Although doctors were unflinching in their commitment to patients, the government’s funding cuts, diminishing morale among doctors, and ever growing demand from patients were placing intolerable pressure on the medical workforce, he said. The NHS now “needs our hope as much as it needs our effort,” he added. “It has never needed our hope more than …
Complications following immediate breast reconstruction and influence on breast cancer recurrence rates.
Authors: Suzanne M Beecher, Donal Peter O'leary, Carmel Malone, Ray McLaughlin, Karl Sweeney, Alan Hussey, Michael J. Kerin
Journal: Journal of Clinical Oncology (2015)

11022 Background: The rate of immediate breast reconstruction has risen over the past number of years. Post-operative infections are more frequent in patients who undergo reconstruction. The inflammatory response to a postoperative infection can increase the risk of tumour recurrence in other forms of cancer through the release of pro-inflammatory mediators. The aim of this study was to assess the relationship between complications and breast cancer recurrence in patients who undergo immediate breast reconstructive surgery. Methods: A review of a prospectively maintained database of allpatients who had immediate breast reconstruction between 2004 & 2009 was conducted. All patients had a minimum 5-year follow up. Univariate & multivariate Cox Regression analysis was performed using SPSS v21. Results: 229 patients who underwent immediate breast reconstruction were identified. The overall 5-year disease-free survival was 86%. 53 (23%) patients had wound complications. 43 (19%) had a wound infection. There was a significantly greater risk of developing systemic recurrence in patients who experienced a post-operative wound complication compared to those without (HR: 4.94; 95% CI: 2.72 - 8.95; P < 0.0001). The five-year disease free survival rate for patients who had a wound complication was 64% compared to 91% in patients without a complication (p < 0.0001). Conclusions: This study demonstrates that wound complications after immediate breast reconstructive surgery may have survival implications for breast cancer patients. Further research is warranted to confirm this relationship. In addition, strategies are required to minimize the risk of post-operative wound complications in breast cancer patients undergoing reconstruction.
Comparison of active surveillance with other treatment options for low-risk prostate cancer.
Authors: Hima Bindu Musunuru, Gerard Morton, Laurence Klotz, Danny Vespirini, Patrick Cheung, Hans T. Chung, Liying Zhang, Alexandre Mamedov, Perakaa Sethukavalan, Vibhuti Jethava, Laura D'Alimonte, Andrea Deabreu, Suneil Jain, Toshihiro Yamamoto, D. Andrew Loblaw
Journal: Journal of Clinical Oncology (2015)

178 Background: To evaluate outcomes and treatment history of low risk (LR) prostate cancer patients(pts) diagnosed between 2006-2008 in a single academic institute. Methods: Treatment and toxicity details were retrieved through retrospective chart review,apart from surgery where toxicity data was not available in detail.Biochemical RFS following primary and salvage treatments and CSS were computed.Pts who underwent salvage treatment for local failure and subsequently remained under biochemical control were censored as disease free for the salvage bRFS. Results: 594 pts were eligible for this study. Treatment options were active surveillance (AS=178 pts), low dose rate brachytherapy (LDR=192 pts, I-125 implant), stereotactic ablative body radiotherapy (SABR =84 pts; 35Gy in 5 weekly fractions), external beam radiation (EBRT=81 pts; 76Gy ) and radical prostatectomy (RP=59 pts). Median follow was &gt; 70 months in all cohorts. 17.9% on AS protocol underwent active treatment. Biochemical failures were detected in 9 (5%), 10 (5.2%), 3 (3.5%), 6 (7.4%) and 9 (15.3%) pts respectively. Out of these, 4 pts in AS cohort, 2 in SABR group, and 7 in RP underwent local/salvage treatment. The 7-year bRFS was 94.4%, 93.6%, 95.8%, 90.1% and 89.5% for primary treatment and 95.7%, 93.6%, 98.7%, 90.1% and 98.3% following salvage treatment. 1 pt in AS, 2 in LDR, 1 pt in SABR and EBRT group developed metastatic disease. The 6 year CSS was 100% in all groups apart from LDR (99.4%) and EBRT (98.8%). Significant dysuria (20.8%) and hematochezia (7.4%) were noticed in EBRT cohort (Table). One grade 4 toxicity was noted in LDR, SABR and EBRT pts. Conclusions: AS has CSS comparable to other treatment options in LR prostate cancer setting with minimal toxicity. In the primary setting all treatment modalities apart from RP and EBRT have 7-year bRFS &gt;93%. Differences in bRFS following salvage treatment might be due to pt and treatment selection. [Table: see text]
Case 13-1988
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, Phillip G. Stubblefield, Debra A. Bell
Journal: New England Journal of Medicine (1988)

Presentation of CaseA 42-year-old woman was admitted to the hospital because of abdominal pain and a pelvic mass.There was a long history of bronchial asthma that required long-term oral administration of adrenocorticosteroid medications. Three years before admission she entered the hospital because of salmonella infection with osteomyelitis of the fifth thoracic vertebra. Cultures of the urine and stool yielded Salmonella typhimurium. Harrington rods were inserted, and the diseased vertebra was treated by debridement and wiring. A lengthy course of ampicillin was administered, and the patient was discharged on ampicillin and her customary dose of prednisone. One year . . .
OC-088 Risk of oesophageal neoplasia in barrett’s oesophagus with indefinite for dysplasia or low grade dysplasia at index biopsy: a 10-year cohort study
Authors: WY Chan, DJ Pournaras, L Sreedharan, SL Brown, L Igali, B Kumar, E Cheong
Journal: Gut (2015)

<h3>Introduction</h3> Barrett’s oesophagus (BO) is the only recognised precursor for oesophageal adenocarcinoma (OAC). Accurate prediction of progression to high grade dysplasia (HGD) or OAC is important. The literature reports progression rates for indefinite for dysplasia (IND) at 1.2% per patient-year and low grade dysplasia (LGD) at 9% per patient-year. Our study aims to determine incidence of HGD or OAC in patients with confirmed histopathological diagnosis of IND or LGD at index biopsy. <h3>Method</h3> Retrospective review of all patients diagnosed with IND or LGD over a 10-year period from January 2003 to September 2014. Two specialist pathologists in Barrett’s oesophagus and neoplasia reviewed all histology. Primary end point was progression to HGD or OAC. Patient demographics and grade of endoscopist were recorded. Patients with HGD or OAC at index biopsy were excluded. <h3>Results</h3> 85 patients (78.8% male, 100% White British) had LGD; 138 (65.9% males, 100% White British) patients had IND. 47% (n = 40) patients with LGD and 10.1% (n = 14) patients with IND progressed to HGD or OAC in the 10-year period. Median age at progression was 71 years (IQR 61.5 to 75.3) and 68 years (IQR 60.25 to 73.5) for LGD and IND, respectively. Median time of progression from first diagnosis to HGD or OAC was 16 months for both IND and LGD. Median BO length was 7 cm (IQR 5 to 9.75) in LGD and 6 cm (IQR 4.25 to 6.75) in IND. 35% (n = 14) patients with LGD who progressed had an expert upper GI endoscopist performing the endoscopy; in these 14 patients, median time for progression was 5.5 months (IQR 3.25 to 12.75). 67.5% (n = 27) patients with LGD were diagnosed with HGD or OAC 12 months after their last biopsy; the median time to biopsy in the LGD group was 5 months (IQR 1.5 to 6). But 16.8% (n = 15) patients were diagnosed with HGD/OAC at the first follow-up biopsy; the median time to this diagnosis was 5 months (IQR 2.5 to 6). Excluding 5 IND patients who developed OAC within 12 months, median time to progression for IND was 46 months (IQR 18 to 66); 7 patients with IND progressed to HGD, 5 patients progressed to intramucosal adenocarcinoma, and 2 died of inoperable adenocarcinoma. <h3>Conclusion</h3> The majority of LGD who progressed occurred in less than 12 months, and median time to diagnosis was 5 months. An expert upper GI endoscopist follow up is warranted for earlier diagnosis and treatment in IND and LGD. Current BSG Guidelines suggest a follow-up surveillance endoscopy should be done at 6 months for confirmed LGD prior to radio-frequency ablation. Our findings suggest these patients should be followed up earlier. LGD should be recognised as a marker of more advanced neoplasia. <h3>Disclosure of interest</h3> None Declared.
Efficacy and Safety of Dose-Optimized Nilotinib (NIL) in Patients (Pts) with Newly Diagnosed Chronic Myeloid Leukemia in Chronic Phase (CML-CP): ENESTxtnd Interim Analysis
Authors: Timothy P. Hughes, Eduardo Ciliao Munhoz, Alaa Elhaddad, Ong Tee Chuan, Kudrat Abdulkadyrov, Jake Shortt, Hang Quach, Carolina Pavlovsky, Vernon J. Louw, Luis Meillon, Lee-Yung Shih, Anna G. Turkina, Jonathan Hwang, Prasanna Kumar Nidamarthy, Darshan Dalal, Jeffrey H. Lipton
Journal: Blood (2014)
Factors Affecting the Preventability of Stroke
Authors: Tomoyuki Kawada
Journal: JAMA Neurology (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 Neurology 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 Neurology journal
T-cell growth factor P40 promotes the proliferation of myeloid cell lines and enhances erythroid burst formation by normal murine bone marrow cells in vitro
Authors: DE Williams, PJ Morrissey, DY Mochizuki, P de Vries, D Anderson, D Cosman, HS Boswell, S Cooper, KH Grabstein, HE Broxmeyer
Journal: Blood (1990)
Isolated hyperthermic chemotherapy perfusion for limb melanoma is a safe procedure
Authors: A. Goyal, W. D. Evans, R. E. Mansel
Journal: Journal of Clinical Oncology (2004)

7538 Background: Isolated limb perfusion(ILP) delivers high dose of chemotherapeutic agent to an extremity with multiple in-transit lesions from cutaneous melanoma. This approach requires accurate monitoring of systemic leakage and of the temperature of the affected limb in order to avoid major systemic and local side effects. In this study, the tumour response, systemic toxicity and overall survival were studied in 56 patients who underwent single ILP using melphalan. Methods: 53 perfusions were performed using melphalan, 1.5–2mg/kg (13 prophylactic, 40 therapeutic) and 3 using melphalan in combination with other chemotherapeutic agents (all therapeutic). 75% of the patients had MD Anderson stage III disease. Leakage from the isolated circuit to the systemic circulation was measured with 125I-labelled human serum albumin and correlated with observed systemic bone marrow toxicity. Results: Response to melphalan was seen in 48 patients (92%): 31 complete responses and 17 partial responses. Bone marrow depression was encountered in 59%(33/56) patients: WHO grade I in 8, grade II in 11, grade III in 8, and grade IV in 6. The white cell count reached its nadir after a median period of 11 days. Bone marrow toxicity in patients had a significant negative correlation with leakage from the isolated circuit measured at 60 minutes (Spearman's correlation coefficient -0.368; p=0.015). Other systemic side effects were: nausea and vomiting in 45 patients (82%), fever in 17 patients (31%) and scalp hair loss in 2 patients (4%). The median hospital stay was 16 days. Overall 5-year survival rate was 49% for therapeutic perfusion and 100% for prophylactic perfusion. Conclusion: Therapeutic ILP is a suitable treatment for in-transit metastases not amenable to surgery and confined to a limb, since amputation provides no advantage in terms of survival. Systemic toxicity after ILP was rarely severe, with nausea and vomiting being the most frequently encountered side effects. Systemic leakage during ILP was associated with leucopenia, although the bone marrow depression was transient in all cases. No significant financial relationships to disclose.