tbuckley/cabot-search huggingface dataset:
Who is ordering breast MRIs in newly diagnosed breast cancer patients?
Authors: Anya Romanoff, Matthew McMurray, Hank Schmidt, Parissa Tabrizian, Christina Weltz, Monica Schwartzman, Kathryn Friedman, Laurie Margolies, Elisa R. Port
Journal: Journal of Clinical Oncology (2014)

24 Background: Utilization of breast MRI has increased dramatically in recent years, and there is ongoing debate regarding the role of MRI in patients with breast cancer. Guidelines for MRI use in newly diagnosed breast cancer patients have not been established; therefore, provider ordering of MRI in this population is variable. We investigated patterns of MRI ordering by healthcare providers in the setting of newly diagnosed breast cancer and analyzed predictors of MRI utilization. Methods: All newly diagnosed breast cancer patients presenting for surgical management at a single tertiary care breast center from January 2011 through December 2013 were reviewed. Cases were evaluated for the use of preoperative MRI, and medical specialty of the ordering provider was determined. Patients who presented to a specialized breast center with MRI already completed were compared to those who had MRIs ordered by their treating breast surgeon. Results: A total of 423 women with newly diagnosed breast cancer underwent MRI during the study period. In this group, 253/423 patients (60%) presented to our institution with an MRI already completed. Of MRIs performed prior to presentation, 73% were ordered by a primary care provider, and 27% were ordered by a breast specialist seen previously. Race was a significant predictor of having an MRI before presentation to a breast center (64% of white patients, 41% of black patients, 25% of Asians, and 65% of Hispanic patients, p &lt; .001). Women with commercial insurance were significantly more likely to have an MRI completed before presentation than those with Medicaid (62% versus 37%, p = .002). Age, family history of breast cancer, genetic testing, breast density, mode of diagnosis, and biopsy pathology were not significant factors in determining whether a patient underwent MRI prior to presentation to a breast surgeon. Conclusions: In our experience, the majority of MRIs performed in newly diagnosed patients with breast cancer were ordered by primary care providers as part of their patient’s initial workup. Patient race and insurance status were significant predictors of having an MRI ordered prior to seeing a breast specialist. Further research is needed to develop guidelines for breast MRI use in newly diagnosed cancer patients.
Relationship between Left Atrial Functions, P-terminal Force and Interatrial Block in Chronic Haemodialysis Patients
Authors: Ziya Şimşek, Muhammet Hakan Taş, Emrah İpek, Yusuf Bilen, Erdem Çankaya, Şule Karakelleoğlu, Hüseyin Şenocak
Journal: Journal of the American College of Cardiology (2013)
Decitabine enhances anti-CD33 monoclonal antibody BI 836858–mediated natural killer ADCC against AML blasts
Authors: Sumithira Vasu, Shun He, Carolyn Cheney, Bhavani Gopalakrishnan, Rajeswaran Mani, Gerard Lozanski, Xiaokui Mo, Veronica Groh, Susan P. Whitman, Renate Konopitzky, Christian Kössl, Donna Bucci, David M. Lucas, Jianhua Yu, Michael A. Caligiuri, William Blum, Paul J. Adam, Eric Borges, Bjoern Rueter, Karl-Heinz Heider, Guido Marcucci, Natarajan Muthusamy
Journal: Blood (2016)

Key Points BI 836858, an Fc-engineered anti-CD33 antibody, mediates autologous and allogeneic NK cell–mediated ADCC. Decitabine increases ligands for activating NK receptors potentiating BI 836858 activity, providing a rationale for combination therapy.
THU0323 The Benefits of 6 Week Home Training Program in Females with Fibromyalgia
Authors: R.M. Traistaru, R. Marcu, A.M. Bumbea, T. Avramescu
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Fibromyalgia (FM) is a syndrome expressed by chronic widespread pain which leads to reduced physical function and frequent use of healthcare services (1). The beneficial effects of a relaxation training and aerobic exercise in the management of fibromyalgia (FM) patients were recognized (2). <h3>Objectives</h3> In our study - a single blind randomized controlled trial – was assessed the effects of a standardized 6 week home training (relaxation training – autotraining Scultz and submaximal aerobic exercise daily) on pain, functional ability, and quality of life in females with FM. <h3>Methods</h3> 36 females diagnosed with FM by ACR criteria were randomized into two groups: group 1 – 18 females (G1) was treated by complex therapy (pharmacotherapy, 6 week home training), and group 2 – 18 females control (G2), receiving only pharmacotherapy. We measured pain (quantified with algometer and visual analogue scale), quality of life (Spitzer scale) and value of Fibromyalgia Impact Questionnaire (FIQ). Instruction in home training techniques was given by physiotherapists. <h3>Results</h3> The improvements were found FIQ (45.5% in G1 and 28.5% in G 2, respectively) (p&lt;0.05) and improvement in G1 was significantly higher than G2 (p&lt;0.01). VAS scores for pain reduced in all females; this reduction was significantly higher in G1. The algometer values measured in tender points decreased significantly, especially in lower limbs. The quality of life (Spitzer Scale) was significant improved in G1 group (51%). <h3>Conclusions</h3> Home training program, based on relaxation training and aerobic exercises, can lead to long-term success for quality of life and clinical status in females with FM. All patients proved compliance to the daily training protocol (autotraining Schultz and submaximal aerobic program) was daily applied in the management of females with FM, especially. Early implementation of self management training in association with controlled medication may be a successful key for improvement of quality of life in females with FM. <h3>References</h3> Busch A.J., Schachter C.L., Overend T.J. et.al., J Rheumatol. 2008; 35(6):1130-44. Persson A.L., Veenhuizen H., Zachrison L., Gard G., Physical Therapy Reviews 2008; Volume 13, Issue 5, pp. 355-365. <h3>Disclosure of Interest</h3> None declared
Investigators Detect Correlation Between Peripheral Lymphocyte, TB Skin Test Reaction
Authors: E M Smithwick, S B Levine, J D Quick
Journal: JAMA (1966)

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
High-dose omeprazole infusion compared with scheduled second-look endoscopy for prevention of peptic ulcer rebleeding: a randomized controlled trial
Authors: Philip Chiu, Henry Joeng, Catherine Choi, Kelvin Tsoi, Kwok Kwong, Siu Lam, Joseph Sung
Journal: Endoscopy (2016)

<b>Background and study aim:</b> Previous studies have shown that both scheduled second-look endoscopy and high-dose continuous omeprazole infusion are effective in preventing peptic ulcer rebleeding. The aim of this noninferiority trial was to compare the efficacy of these two strategies for the prevention of rebleeding following primary endoscopic hemostasis. <b>Patients and methods</b>: Consecutive patients who received endoscopic treatment for bleeding peptic ulcers (actively bleeding, with nonbleeding visible vessels) were randomized to two treatment groups following hemostasis. One group (second-look endoscopy group) received the proton pump inhibitor (PPI) omeprazole as an intravenous bolus every 12 hours for 72 hours and a second endoscopy within 16 – 24 hours with retreatment for persistent stigmata of bleeding. The other group (PPI infusion group) received continuous high-dose omeprazole infusion for 72 hours. Patients who developed rebleeding underwent surgery if repeat endoscopic therapy failed. The primary outcome was the rebleeding rate within 30 days after initial hemostasis. The margin for noninferiority was set at 5 %. <b>Results:</b> A total of 153 patients were randomized to the PPI infusion group and 152 to the second-look endoscopy group. Rebleeding occurred within 30 days in 10 patients (6.5 %) in the PPI infusion group and in 12 patients (7.9 %) in the second-look endoscopy group (<i>P</i> = 0.646). Surgery was required for rebleeding in six patients from the PPI infusion group and three patients in the second-look endoscopy group (<i>P</i> = 0.32). Intensive care unit stay, transfusion requirements, and mortality were not different between the groups. Patients in the second-look endoscopy group were discharged 1 day earlier than those in the PPI infusion group (<i>P</i> < 0.001). <b>Conclusions:</b> After endoscopic hemostasis, high-dose PPI infusion was not inferior to second-look endoscopy with bolus PPI in preventing peptic ulcer rebleeding. Trial registration: ClinicalTrials.gov (NCT: 00164931).
Aligned nanofibrillar collagen scaffolds – Guiding lymphangiogenesis for treatment of acquired lymphedema
Authors: Catarina Hadamitzky, Tatiana S. Zaitseva, Magdalena Bazalova-Carter, Michael V. Paukshto, Luqia Hou, Zachary Strassberg, James Ferguson, Yuka Matsuura, Rajesh Dash, Phillip C. Yang, Shura Kretchetov, Peter M. Vogt, Stanley G. Rockson, John P. Cooke, Ngan F. Huang
Journal: Biomaterials (2016)
Increased rates of intensive care unit admission in patients with Mycoplasma pneumoniae : a retrospective study
Authors: T Khoury, S Sviri, A A Rmeileh, A Nubani, A Abutbul, S Hoss, P V van Heerden, A E Bayya, C Hidalgo-Grass, A E Moses, R Nir-Paz
Journal: Clinical Microbiology and Infection (2016)
Androgen versus erythropoietin for the treatment of anemia in hemodialyzed patients
Authors: J L Teruel, R Marcen, J Navarro-Antolin, A Aguilera, G Fernandez-Juarez, J Ortuño
Journal: Journal of the American Society of Nephrology (1996)

According to this facility's protocol for the treatment of anemia in hemodialyzed patients, androgens were administered to male patients aged over 50 yr and recombinant human erythropoietin was administered to male patients below 50 yr of age and to female patients. In the study presented here, both therapeutic approaches have been prospectively analyzed. Patients were divided into two groups. Group A was composed of 18 patients, aged 62 +/- 12 yr, treated with nandrolone decanoate (200 mg/wk im) for 6 months; Group B was composed of 22 patients (6 men, 16 women) aged 47 +/- 15 yr, treated with subcutaneous recombinant human erythropoietin (initial dose, 6000 IU/wk) for 6 months. The increases of hemoglobin were similar in both groups; Group A, from 7.3 +/- 0.8 to 10.8 +/- 1.7 g/dL (P < 0.001), and Group B, from 7 +/- 0.6 to 10.4 +/- 1 g/dL (P < 0.001). In Group A, increases of triglycerides (159 +/- 71 versus 267 +/- 153 mg/dL, P < 0.001), serum albumin (3.9 +/- 0.3 versus 4.2 +/- 0.3 g/dL, P < 0.05), and dry weight (62.1 +/- 9.8 versus 64.9 +/- 10.1 kg, P < 0.001) were observed, which remained unmodified in Group B. Blood pressure control worsened in one patient (6%) from Group A, and in ten patients (45%) from Group B (P < 0.05). In conclusion, androgens produced an improvement in anemia in selected patients, similar to that achieved by use of recombinant human erythropoietin but at a lower cost. Androgens also have an appreciable anabolic effect and did not increase the blood pressure.
PWE-091 Can screening for poor prognosis improve care for patients with end stage liver disease?: Abstract PWE-091 Table 1
Authors: B Hudson, K Ameneshoa, P Collins, J Portal, F Gordon, J Verne, A McCune
Journal: Gut (2015)

<h3>Introduction</h3> Liver disease is the 3<sup>rd</sup>commonest cause of premature death in the UK. The end of life care strategy (Department of Health, 2008) noted many patients do not die in a place of their choosing, and that difficulties exist amongst physicians in identifying the dying process. Data from the Royal Free demonstrated that only 19% of patients assessed unsuitable for liver transplantation were referred to palliative care services, a median of 4 days before death. Across the United Kingdom between 2007–2011 81% of patients with alcoholic liver disease died in hospital, compared to 48% with cancer (Office of National Statistics). Opportunities for advanced care planning in this population are missed. We aimed to design and validate a tool to identify inpatients with liver disease who stand to benefit from palliative care assessment and advanced care planning, and to create a model of care for such patients. <h3>Method</h3> The department of health document ‘Getting it Right: improving end of life care for people living with liver disease’ and the NHS North East document ‘Framework for supportive care in advanced liver disease’ identify evidence based factors which are predictive of death in liver disease. Five of these factors (Childs Pugh C, &gt;2 admissions within last 6 months, continued use of alcohol, unsuitable for liver transplantation, pre-admission WHO performance status &gt;2) were assimilated into a screening tool. <h3>Results</h3> The tool was retrospectively applied to all patients admitted to the Bristol Royal Infirmary with a diagnosis of cirrhosis over 90 consecutive days from 1<sup>st</sup>July 2013 (n = 47). Based on the ‘Gold Standard Care’ framework question (“would you be surprised if your patient was not alive in one year”) mortality one year post admission was calculated. Sensitivity and specificity for predicting one year mortality when 2, 3 or 4 poor prognostic criteria were positive were analysed (see Table 1). On this basis, an admission score of 3 or more criteria was considered a “positive” poor prognosis screen. <h3>Conclusion</h3> The tool has been successfully trialled and audited locally over the past year. Patients who screen positive are highlighted for discussion at a weekly hepatology MDT. Assuming MDT agreement this triggers a consultant led poor prognosis discussion with the patient, a poor prognosis letter to the GP, and involvement of the palliative medicine team to assist with symptom control and advance care planning. Communication skills training has been delivered to consultants and junior staff by the palliative medicine team. <h3>Disclosure of interest</h3> None Declared.
PWE-368 The association of genetic variation within the wnt signalling pathway with colorectal cancer: a meta-analysis
Authors: SS Malik, KJ Monahan, M McPhail
Journal: Gut (2015)

<h3>Introduction</h3> 35% of colorectal cancer (CRC) risk is attributable to heritable factors, of which a large proportion remains unexplained. Genome wide association studies have conclusively identified several risk variants in the TGF-beta pathway. Both TGF-beta and Wnt pathways are key regulators of colonic crypt homeostasis and colorectal carcinogenesis. The Wnt pathway is deregulated in 93% of CRCs, however the role of Wnt pathway genetic variation in CRC risk is uncertain. A systematic review and meta-analysis to assess the association of polymorphisms within the Wnt signalling pathway and the risk of CRC will be performed. <h3>Method</h3> A systematic literature review of the Pubmed and HuGENet databases was conducted. Studies were included/excluded based on pre-specified criteria. In order to assess the risk attributed to each identified variant, the ‘per allele’ model was utilised to calculate pooled odds ratios. Heterogeneity was investigated by subgroup analyses for ethnicity, gender and tumour location. Publication bias was investigated using funnel plots and Egger’s test. Statistical analysis was conducted using the R program (version 3.1.0). <h3>Results</h3> Forty-three polymorphisms across 18 different genes in the Wnt pathway were identified. Meta-analyses were conducted for 12 of these polymorphisms including between 831 to 31,427 cases per polymorphism. 6 polymorphisms were significantly associated with the risk of CRC. Rs1801155 within <i>APC </i>(OR = 1.79; 95% CI 1.27–2.52) and rs10505477 at the 8q24.21 locus (OR = 1.15; 95% CI 1.12–1.19) were associated with an increased risk of CRC. rs16260 (OR=0.94; 95% CI 0.89–0.99) and rs9929218 (OR = 0.93; 95% CI 0.90–0.95) within <i>CDH1</i>; rs6983267 (OR = 0.85; 95% CI 0.83–0.87) within <i>MYC</i>and rs7014346 (OR = 0.87; 95% CI 0.81–0.94) at the 8q24.21 locus, were associated with a decreased risk of CRC. Subgroup analysis revealed gender, ethnicity and tumour location were not sources of heterogeneity. <h3>Conclusion</h3> Six polymorphisms associated with CRC risk account for a significant proportion of familial risk, although are unlikely to account completely for aberrant activation of the Wnt pathway. These polymorphisms are located within <i>APC, CDH1 and MYC</i>genes and the 8q24.21 locus. Further research into their precise role in colorectal carcinogenesis is warranted. Meta-association studies of all SNPs in the Wnt pathway should be conducted to identify further risk variants. Rare variants, copy number variations and epigenetic alterations may contribute to the remaining heritability and Wnt pathway activation. <h3>Disclosure of interest</h3> None Declared.
Imaging Idiopathic Chylopericardium With 99mTc-SC Lymphoscintigraphy and SPECT/CT
Authors: Chris Atkinson, Kevin Banks
Journal: Clinical Nuclear Medicine (2015)

A 27-year-old asymptomatic active duty military man underwent a screening chest x-ray secondary to a history of tuberculosis exposure. His chest x-ray showed no features of tuberculosis infection but unexpectedly revealed a markedly enlarged cardiac silhouette. Echocardiography demonstrated a large pericardial effusion without tamponade physiology. Pericardiocentesis revealed chylous fluid. The effusion was initially refractory to drainage requiring VATS for therapy. Lymphoscintigraphy was performed using Tc-SC to evaluate lymphatic anatomy and confirm communication with the pericardial space. Novel use was made of SPECT/CT with the hope of better assessing the nature of the abnormal communication and potentially helping guide management.
AB0684 Bone Metabolism in a Large Cohort of Patients with Systemic Sclerosis: Table 1
Authors: C. Caimmi, P. Caramaschi, G. Barausse, G. Orsolini, L. Idolazzi, D. Gatti, O. Viapiana, M. Rossini, S. Adami
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Patients with systemic sclerosis (SSc) may have classical and disease-related risk factors for osteoporosis (OP)(1) but there is no agreement about the association between SSc and OP (2). <h3>Objectives</h3> The aim of this study was to evaluate in a large size cohort of SSc patients bone mineral density (BMD) and to analyze its possible determinants. <h3>Methods</h3> 106 consecutive outpatients affected by SSc were enrolled for the present study. All patients underwent evaluation of BMD and vertebral fractures (VFA) using DXA (GE Lunar iDXA), pulmonary function test, nailfold videocapillaroscopy, blood samples. For the statistical analysis we preferred to use Z-score to BMD or T-score since the population was composed by patients with different ages and of both sexes. <h3>Results</h3> Most patients were female with a limited disease pattern (84,9% and 651,% respectively). Mean age was 58.8±12.6, mean BMI was 25.3±4.4 and disease duration was 10 years ±5.8. 25.7 had interstitial lung disease. Parameters correlated with bone metabolism are shown in table 1. 31.1% and 26.4% respectively were or had been smokers or steroid-treated. 65.1% were taking vitamin D supplementation and 18.9% bisphosphonates. 74.4% of women were in menopause. Mean neck Z-score was significantly lower than 0. No significant differences were found for other sites. Female patients were shown to have a total femur and neck Z-score significantly lower than 0 (p=0.028 and p&lt;0.001, respectively). This data was not confirmed for other sites. Thirteen patients out of 96 with a good quality VFA (13.4%) had at least one morphometric non-clinical vertebral fracture. In univariate analysis total femur Z-score was lower in female (p=0.050) and in smokers (p=0.063) and positively correlates with BMI (p=0.001), neck Z-score positively correlates with age (p=0.016) and whole body Z-score positively correlates with BMI (p&lt;0.001). No correlations were found for lumbar Z-score. The multivariate analysis confirmed the positive correlation between BMI and total femur and whole body Z-score and between age and neck femur Z-score (p=0.01, p&lt;0.001 and p=0.019, respectively). Lung fibrosis was shown to correlate with a lower whole body Z-score in multivariate analysis (p=0.049). All data were confirmed even if corrected for vitamin D serum levels and vitamin D supplementation. <h3>Conclusions</h3> Our study evaluates a large sized and well characterized SSc population by a quite complete multivariate analysis aiming to control the most important confounding factors for OP. We found a modest risk of low BMD in patients with SSc and the important protective role of BMI. <h3>References</h3> Loucks J, Pope JE. Osteoporosis in scleroderma. Semin Arthritis Rheum 2005;34:678-82 Omair MA. Low Bone Density in Systemic Sclerosis. A Systematic Review. J Rheumatol 2013;40:1881-90. <h3>Disclosure of Interest</h3> None declared