tbuckley/cabot-search huggingface dataset:
Exposure on September 11, 2001, and Cancer Risk
Authors: Kiumarss Nasseri
Journal: JAMA (2013)

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
Scanning and monitoring of osteoporosis in early breast cancer survivors: The use of Arm-DXA as a tool to decrease the gap between the guidelines and real practice.
Authors: Yousuf Al-Farhat, Auth Peter
Journal: Journal of Clinical Oncology (2016)

e12007 Background: Breast cancer survivors who are on adjunct therapy with Aromatase Inhibitors (AIs) or premature menopause due to chemotherapy are known to have an increased risk of osteoporosis. Being at high risk for osteoporosis, these patients should be screened using with dual energy X-ray absorptiometry (DXA) to measure bone mineral density (BMD) according to national guidelines. This study screened the population of patients with early Breast cancer utilizing the Arm-DXA as a user friendly and efficient method. Methods: All Breast cancer patients at the Tolna County Cancer Center, Szekszárd who are with diagnosis of early invasive breast cancer were scanned using Arm-DXA during their regular visit to the center. Patients who have metastatic disease or known to have osteoporosis were excluded from the study. Results: During the first six month of the study an arm-DXA scan for BMD was done on 262 patients. Of these 20.6% (n = 54) were postmenopausal and had osteoporosis, in about 34.7% (n = 91) had osteopenia and of those with osteopenia a 79.1% (n: 72) were postmenopausal. Patients who had osteoporosis (with -2.5 T Score or less) were sent to Rheumatology centers. Patients who had osteopenia with T score between -1.5 and -2.5 (n: 54) were sent to all body DXA. The study finds that 26% (n: 69) patients are under adjunct AIs therapy and have clinically significant bone loss. About 43.4% (n: 30) had more than 2 years treatment and were switched to tamoxifen. Conclusions: This study highlights the fact that osteoporosis is an under-detected in early breast cancer survivors who are on or after hormone and chemotherapy. About 55% of early breast cancer survivors found to have osteoporosis or osteopenia in our study. The Arm-DXA as a tool for screening and monitoring can be used in daily practice as user friendly and efficient tool to decrease the gap between the guidelines and real practice on prevention and treatment of osteoporosis in this population.
Mononucleosis-induced pseudo neutropenia
Authors: Michael Loudin, Thomas Deloughery, Joseph Shatzel
Journal: American Journal of Hematology (2016)

A 28-year-old previously healthy woman presented with a 6-day history of fevers, headaches, and malaise. On physical examination the patient was febrile, with tender left-sided cervical lymphadenopathy. Laboratory workup was significant for mild transaminitis, a white blood cell count of 8.82 K/mL with a differential significant for 89% lymphocytes, and an absolute neutrophil count of zero. Upon manual review of the patient's blood smear frequent atypical lymphocytes (red arrow) as well as burst neutrophils (black arrow) were observed (Image 1). Repeat processing of the original CBC with an albumin infused slide resulted in an absolute neutrophil count of 2,000. Monospot test was positive. She was discharged from the emergency department, and her symptoms resolved without treatment over the subsequent 2 weeks. Image 1. Peripheral blood smear demonstrating atypical lymphocyte (red arrow) and burst neutrophil (black arrow). Neutrophil fragility can occur in viral syndromes such as infectious mononucleosis and may result in pseudo-neutropenia due to destruction of neutrophils during automated processing. The pathophysiology of this phenomenon is not understood, and while we have encountered this phenomenon previously in our clinical experience, there are no published reports in the literature to our knowledge. Neutrophil lysis and the resulting pseudo-neutropenia can be corrected for with the use of albumin infused slide preparation, which prevents the lysis. This syndrome has no pathophysiologic consequence to our knowledge, and should be suspected in patients presenting with an infectious syndrome and unexplained severe neutropenia. If unidentified it may lead to unnecessary diagnostic testing and treatment, such as antibiotic therapy, hospitalization, and bone marrow sampling.
Mutational Markers and Risk Stratification in Thyroid Cancer—The Art of War Refined
Authors: E. Shannon Story, Edward S. Kim
Journal: JAMA Oncology (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 Oncology 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 Oncology journal
Microbiota: relevant player in thiopurine metabolisation?
Authors: Imke Atreya, Markus F Neurath
Journal: Gut (2016)

In this issue, Oancea et al 1 demonstrate for the first time that gut microbiota is able to convert the thiopurine drug thioguanine into therapeutically active thiopurine nucleotides (TGN). They thereby open new perspectives for an optimised use of thiopurines in the treatment of patients with IBD and inspire the vision of topical thiopurine delivery to the inflamed gut.

During the last years, our understanding of the molecular mechanisms, which underlie the well-known efficacy of thiopurines in IBD therapy, has been improved significantly. In order to allow potent therapeutic effects, classic thiopurine drugs including azathiopurine, mercaptopurine and thioguanine have to undergo metabolisation towards TGN. In particular, 6-thioguanine triphosphate (6-thio-GTP) could be identified as a crucial mediator of azathioprine-induced immunosuppressive effects in activated T cells and also in innate immune cells.2–4 Through its capacity to compete with endogenous GTP for the binding to the small GTPase Rac1 and subsequent inhibition of Rac1/Vav1 interaction, 6-thioGTP is able to efficiently block Rac1 signalling and thereby impact on immune cell function.2 ,3 Thiopurine-driven Rac1 blockade was shown to trigger apoptosis of stimulated T cells and to impair the capacity of T cells to form complexes with antigen-presenting cells (T cell/APC synapse formation).2 ,3 Regarding innate immune cells, thiopurine exposure of macrophages and subsequent inhibition of Rac1 signalling result in a significantly decreased inducible nitric oxide synthase (iNOS) expression and thus affect macrophage functions.5 Collectively, these findings highlight the concept that azathioprine-derived metabolites directly affect functions of …
C-Reactive Protein and Risk of Colon Cancer
Authors: Vincenzo Pasceri, Giovanni Cammarota
Journal: JAMA (2004)

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
Phase 2 HERALD study of patritumab (P) with erlotinib (E) in advanced NSCLC subjects (SBJs).
Authors: Joachim Von Pawel, Jennifer Tseng, Mircea Dediu, Christian Schumann, Berta Moritz, Jeanne Mendell-Harary, Xiaoping Jin, Wenqin Feng, Catherine Copigneaux, Robert A. Beckman
Journal: Journal of Clinical Oncology (2014)

8045 Background: P is a fully human anti-HER3 antibody that inhibits HER3 binding with its ligand heregulin (HRG). Preclinically, P enhances anti-tumor activity with EGFR inhibitors, prevents HER3 reactivation after anti-EGFR treatment, and inhibits HRG-dependent activation. Phase Ib showed that P, with E (150mg/day PO), was tolerated at 18mg/kg IV q3w. Methods: This Ph2 randomized, placebo-controlled double-blind study assessed safety and efficacy of P+E vs. placebo (Pbo)+E in E-naïve sbjs with advanced NSCLC (2nd or later line). 215 sbjs were randomized to: 1) High Dose [HD]: P 18 mg/kg IV q3w; 2) Low Dose [LD]: P: 18 mg/kg IV X 1, 9 mg/kg IV q3w maintenance; or 3) Pbo q3wk. All subjects received E 150 mg/day PO. Endpoints included PFS (primary), and OS and safety (secondary). HRG, measured as mRNA, was prospectively hypothesized to be the primary predictive biomarker before database lock. High/Low HRG cutoff was set at the median of the blinded data. Results: 212 sbjs comprised the ITT. Median (m) PFS for ITT for HD, LD, and Pbo arms was 1.4 mos (HR 0.98), 2.5 mos (HR 0.77), and 1.6 mos, respectively (p=NS). 101 sbjs (51 HRG high) had adequate tissue for HRG testing. PFS was significantly improved in the HRG high subgroup (Table). HRG low subgroup showed no improvement in PFS (HR 0.92) and OS (HR 1.05) vs. Pbo. Grade >3 AE’s (HD, LD, Pbo) included: diarrhea (11.4%, 8.5%, 4.2%) and rash (5.7%, 7.0%, 2.8%). Conclusions: P showed improved PFS in the HRG high, but not in the ITT population. P safety was similar to Pbo with the exception of manageable rash and gastrointestinal effects. HRG appears to be a predictive biomarker for P, confirming preclinical findings (Schneider et al, Yonesaka et al, ASCO 2014). HERALD is the first randomized Pbo controlled trial in NSCLC to report a predictive biomarker for HER3. Based on these results, a 2-part (A, confirmation of HRG predictive value; B, pivotal HRG high only) Phase 3 study was initiated. Clinical trial information: NCT01211483. High dose P + E Low dose P + E Pooled doses P + E E alone (Pbo) mPFS (mos) 3.4 3.0 3.0 1.4 PFS HR (95% CI) 0.37 (0.16, 0.85)* 0.29 (0.13, 0.66)† 0.32 (0.16, 0.67)† mOS (mos) 6.1 10.7 9.7 5.0 OS HR (95% CI) 1.15 (0.50, 2.61) 0.60 (0.25, 1.41) 0.81 (0.39, 1.67) Log-rank p value: *<0.03, †<0.003).
Cancer chemotherapeutic error in hospitalized patients: Attributable damages and extra costs.
Authors: F. Ranchon, G. A. Salles, V. Schwiertz, N. Vantard, S. Parat, C. Moch, P. Girard, P. J. Souquet, G. Freyer, C. Rioufol
Journal: Journal of Clinical Oncology (2010)

e19529 Background: Medication errors in hospitalized patients are still relatively common with potential dramatic consequences, specialy with antineoplastic drugs because of their high toxicity, their small therapeutic index and health's status of cancer patients. The aim of this study was to assess antineoplastic medication errors (those which have affected patient and those captured before they occur) in terms of frequency, patients harm and cost. Methods: A 1-year prospective study was conducted in a French 1200-bed university hospital detecting medication errors at every step of the anticancer chemotherapy use process. Severity of medication errors and potential consequences of avoided errors were estimated independently by two physicians. A costs analysis was performed by simulation of potential hospital stays and valued at the complete hospital cost of the corresponding diagnosis related groups. Results: Of 6,607 antineoplastic prescriptions charts, 341 presented at least one error (5.16%) corresponding to 449 medication errors of which 436 were captured before administration to patient. Prescription errors represented 91% of errors followed by pharmaceutical errors (8%) and administration errors (1%). In total, 13.4% of avoided errors would have caused a temporary injury, 2.6% a permanent damage and 2.6% would have compromised the vital prognosis of the patient (including 4 to 8 potential deaths). If not avoided, 216 additional hospital days would have been necessary. Thirteen medication errors reached the patient without damages except 2 patients, needing reinforced monitoring. Avoided medication errors would have caused an estimated annual opportunity cost of 92,907€ with 74% attributed to hospital stays and 26% to drugs. Conclusions: This study demonstrates that major medication errors take place in hospital but that a dedicated control quality system allowed capturing most of them before they reach the patient. Potential consequences for patients and cost of medication errors justify the development of preventive actions. No significant financial relationships to disclose.
Retrospective cost analysis of breast cancer patients treated in a Brazilian outpatient cancer center (OCC).
Authors: N. Teich, C. Pepe, F. M. Vieira, V. Teich, M. Cintra, F. Leibel, A. Boukai, R. C. Helal, A. O. Victorino, J. G. Musacchio
Journal: Journal of Clinical Oncology (2010)

e11026 Background: Public health data indicate that the global burden of breast cancer in women, measured by incidence and mortality, is substantial. The associated treatment costs increase steadly above economic growth, leading to substantial financial, equity and access problems. However, the economic impact of management costs in Brazilian clinical practice has not been documented yet. Information about patients' quality of life associated with the introduction of new drugs and procedures is also lacking. Methods: This is a retrospective study of women with breast cancer treated at a private practice OCC in Rio de Janeiro, Brazil. All the patients were covered by Amil, a Brazilian HMO. Direct costs (DC) of 199 patients diagnosed since 2002 and followed to the end of 2009 were analyzed and correlated to clinical stage. Results: 48% of women were diagnosed in stage I, 34% patients in stage II, and only 2.5% were diagnosed in stage IV, similar numbers to those seen in developed countries. The average DC of their medical care per patient was US$21,658.94 (mean 2.48 yrs ± SD 1.66) for stage I compared to US$48,295.29 (mean 2.76 yrs ± SD 1.67) for stage II, and were US$63,662.06 (mean 2.34 yrs ± SD 1.56) for stage III and US$63,697.33 (mean 1.77 yrs ± SD 0.80) for stage IV. We also observed that DC per patient-year increased according to clinical stage. In the first year, average cost was US$15,183.85 for stage I, while it was US$ 44,160.74 for stage IV. Those DC decreased along the years in all stages. For example, in the seventh year of follow-up, the average DC was only US$ 467.27 for stage I (2005 purchasing power parity index 1 USD = 1.4 BRL). Conclusions: Breast cancer accounts for a significant part of the health insurance budget. Later stage at diagnosis is associated with higher DC per patient-year of treatment, and known lower probability of 5-year survival. No significant financial relationships to disclose.
Prognostic impact of malignant pleural effusion in patients with stage M1b non-small cell lung cancer.
Authors: D. Morgensztern, S. N. Waqar, D. I. Kuperman, B. W. Goodgame, K. Trinkaus, R. Govindan
Journal: Journal of Clinical Oncology (2010)

7636 Background: The presence of malignant pleural effusion (MPE) is associated with worse outcomes in patients with non-metastatic non-small cell lung cancer (NSCLC). As a result, the AJCC 7th edition reclassified these tumors from stage IIIB to stage IV (M1a). The effect of MPE in patients with distant metastases (stage M1b) however, remains unknown. We evaluated the prevalence, risk factors, and prognostic impact of MPE at presentation in patients with NSCLC. Methods: The Surveillance Epidemiology and End Results (SEER) registry was queried for patients with NSCLC, aged 21 or older, and diagnosed between 2004 and 2005. Demographic variables included age, gender, race, histology, and N stage. Odds ratio estimates were calculated using logistic regression, the Kaplan-Meier method was used to estimate the overall survival (OS), and the Cox proportional hazard model to evaluate whether MPE (CS extension code 72) was an independent risk for outcome. Results: A total of 57,685 patients with NSCLC were identified, with MPE present in 9,170 patients (15.9%). There were 3,944 cases of MPE among the 31,506 patients without distant metastases (12.5%) and 5,226 cases among the 26,179 with distant metastases (20%). Independent risk factors for MPE were age over 60 years (p < 0.0001), male gender (p = 0.0002), non-white race, (p < 0.0001), mediastinal lymph node involvement (p < 0.0001), and adenocarcinoma (p < 0.0001), large cell (p < 0.0001) or carcinoma NOS (p < 0.0001) histologies. In patients with NSCLC and distant metastases, the median survival was 5 months without MPE and 3 months with MPE. In these patients with stage M1b, the 1-year and 2-year survival rates were 24.8% and 11.3% respectively for patients without MPE and 13.5% and 5.4% respectively in those with MPE (HR 1.49; 95% CI 1.44-1.54; p < 0.001). MPE was also an independent factor for worse outcomes when adjusted for demographic variables (HR 1.38; 95% CI 1.33-1.44; p < 0.001). Conclusions: MPE at presentation is commonly observed in NSCLC and its presence represents an independent risk factor for worse survival in patients with distant metastases. No significant financial relationships to disclose.
Extrusion–spheronization a promising pelletization technique: In-depth review
Authors: Sagar Muley, Tanaji Nandgude, Sushilkumar Poddar
Journal: Asian Journal of Pharmaceutical Sciences (2016)

First, different steps such as granulation, extrusion, spheronization and drying of the extrusion–spheronization process are mentioned. Then the parameters that can influence the pellet quality which involves formulation, equipment and process parameters are discussed. Finally, methods available for characterization of the pellets are explained. This review article deals with various aspects of the extrusion–spheronization technique. The first part includes different steps in the production process of pellets such as granulation, extrusion, spheronization, and drying. In the second part, the parameters which can influence the quality of pellets including formulation (moisture content, granulating liquid, excipients, and drugs), equipment (mixer, extruder, friction plate, and extrusion screen) and process (extrusion speed, extrusion temperature, spheronizer load, spheronization time, spheronization speed, and drying method) are discussed. In the final part, methods available for characterization (particle size distribution, surface area, shape and sphericity, porosity, density, hardness and friability, flow properties, disintegration, and dissolution) of the pellets are explained.
Benefits of Long-Term Pulmonary Rehabilitation Maintenance Program in Patients with Severe Chronic Obstructive Pulmonary Disease. Three-Year Follow-up
Authors: Maria-Rosa Güell, Pilar Cejudo, Francisco Ortega, M. Carmen Puy, Gema Rodríguez-Trigo, José Ignacio Pijoan, Lorea Martinez-Indart, Amaia Gorostiza, Khaled Bdeir, Bartolome Celli, Juan B. Galdiz
Journal: American Journal of Respiratory and Critical Care Medicine (2016)

In chronic obstructive pulmonary disease (COPD), the benefits of pulmonary rehabilitation (PR) tend to wane over time. Whether maintenance techniques may help sustain the benefits achieved after completion of the initial PR program remains controversial.To determine whether a long-term (3-yr) maintenance program after PR preserves the short-term effects on outcomes in patients with COPD.This was a multicenter prospective randomized trial including 143 patients with moderate-severe COPD, with 3 years of PR maintenance following an 8-week outpatient PR program. Patients were randomized to maintenance intervention group (IG) and standard monitoring program or control group (CG). The effects on BODE index, 6-minute-walk test distance (6MWD), and health-related quality of life were compared at 12, 24, and 36 months.A total of 138 (96.5%) completed the 8-week program. At this time, all outcomes (BODE, 6MWD, and health-related quality of life) showed clinically and statistically significant improvements (P ≤ 0.001). During the follow-up period, the magnitude of change in 6MWD differed between IG and CG (P = 0.042), with a slight initial increase in the IG during the first year and smaller decline afterward. The BODE index changes differed between baseline and measurements at Month 24 (P = 0.043). At 3 years, the adherence rate of IG patients was 66% and 17% for the CG group (P < 0.001).This study shows a 2-year beneficial effect of a program of rehabilitation maintenance on the BODE index and 6MWD when compared with a standard strategy. This effect vanishes after the second year of follow-up. Clinical trial registered with www.clinicaltrials.gov (NCT 01090999).