tbuckley/cabot-search huggingface dataset:
Phase II study of hyper-CVAD followed by nelarabine consolidation in newly diagnosed patients with T cell acute lymphoblastic leukemia/lymphoblastic lymphoma (ALL/LL).
Authors: C. E. Vigil, H. Kantarjian, D. A. Thomas, S. M. O'Brien, F. Ravandi Kashani, C. A. Koller, J. A. Burger, R. S. Garris, M. D. Baccus, S. Faderl
Journal: Journal of Clinical Oncology (2010)

6524 Background: Although current chemotherapy regimens like hyper-CVAD result in a high percentage of complete remissions (CR) in T-ALL/LL, almost 50% of the patients (pts) relapse. Nelarabine, a deoxyguanosine analogue, has demonstrated clinical activity as a single agent in relapsed/refractory T cell lymphoid malignancies. The goal of this study was to determine wether the addition of Nelarabine to hyper-CVAD can improve long-term outcome of pts with newly diagnosed T-ALL/LL. Methods: Nelarabine was given at 650 mg/m2 IV daily for 5 days every 28 days for two courses following the completion of hyper-CVAD (fractionated cyclophosphamide, vincristine, doxorubicin and dexamethasone alternating with methotrexate and high-dose cytarabine for a total of 8 courses) and prior to the POMP maintenance (vincristine, prednisone, 6-mercaptopurine and methotrexate). Two more courses of nelarabine at the same dose were given during courses 6 and 7 of the POMP maintenance. Central nervous system prophylaxis consisted of 8 intrathecal treatments alternating within methotrexate and cytarabine. Results: 12 pts were enrolled. The median age was 32 yrs (range, 21-76). Eight pts (67%) had T-ALL. All pts had a pre-T immunophenotype, 2 pts had nodal based-disease,7 had mediastinal disease and no patients had CNS involvement. Cytogenetic analysis showed complex cytogenetics in one pt. The CR rate is 100%, with 2 yr CR duration of 69%, and 9 pts still in remission. The median disease free-survival was 57 weeks (range, 5-114) and the median overall survival was 75 weeks (range, 8-122).The 2-yr overall survival was 72%. The principal toxicity was grade ≥ 3 infections and peripheral neuropathy, which occurred in 58% and 17% of the pts,respectively.The dose of nelarabine had to be reduced to 650 mg/m2 on alternating days in one pt and held in another due to worsening neurotoxicity from previous exposure to vincristine. Conclusions: These preliminary results suggest an encouraging 2-yr survival rate for pts treated on Hyper-CVAD with nelarabine consolidation and maintenance. Longer follow up and larger pt series are required to confirm this initial impression. No significant financial relationships to disclose.
ATPS-39COMBINATORY EFFECT OF A NEWLY DESIGNED BIGUANIDE (HL156A) AND TEMOZOLOMIDE AGAINST GLIOBLASTOMA TUMORSPHERE
Authors: Junjeong Choi, Ji-Hyun Lee, IlKyoo Koh, Sanghee Yoo, Se Hoon Kim, Eui Hyun Kim, Jong Hee Chang, Sun Ho Kim, Sung-Wuk Kim, Pilnam Kim, Seok-Gu Kang
Journal: Neuro-Oncology (2015)
NGTS-0118F-FDG PET AND PET / CT MONITORING OF PLEXIFORM NEUROFIBROMA IN CHILDREN AND ADOLESCENTS WITH NEUROFIBROMATOSIS TYPE 1
Authors: Amedeo A. Azizi, Benjamin E. Theisen, Michael Weber, Wolfgang Happak, Oskar Aszmann, Thomas Benkö, Azadeh Hojreh, Monika Chocholous, Andreas Peyrl, Wolfgang Wadsak, Irene Slavc, Tatjana Traub-Weidinger
Journal: Neuro-Oncology (2015)

BACKGROUND: Neurofibromatosis Type 1 (NF-1) is a hereditary tumour predisposition syndrome with a frequency of 1:3000. Patients are prone to develop tumours of the central and peripheral nervous system. Around 10% develop malignant peripheral nerve sheath tumours (MPNST) mostly arising from plexiform neurofibroma (PN) with 15% of MPNST arising in children and adolescents. 18F-FDG-PET is a sensitive method in differentiating PN and MPNST. METHODS: This retrospective analysis included 39 NF-1 patients with plexiform neurofibroma that underwent 18F-FDG-PET or PET/CT screening for malignant transformation. Mean age at first PET was 13.5 years (2.6 - 22.7), m:f = 18:21. 91 examinations were performed in these patients. Image data were reanalysed and linked to clinical data. 6 patients (7 lesions) had symptoms suspicious for malignant transformation (rapid growth n = 5, pain n = 1, functional deficit n = 1), whereas 33 patients were asymptomatic. RESULTS: All malignant tumours could be identified by 18F-FDG-PET imaging, in both symptomatic and asymptomatic patients. All lesions judged as benign by 18F-FDG imaging were either histologically benign if removed or remained clinically silent during follow up. All malignant lesions had a SUVmax >3.14. We detected malignant lesions with a sensitivity of 100% and a specificity of 77.6% but with a low positive predictive value ppV of 23%. DISCUSSION: Malignant transformation of PN also occurs in asymptomatic children. Detection of MPNST at early stages could increase the possibility of oncologically curative resections and reduce neurological dysfunction. This may drastically improve survival rates in NF-1 patients at high risk for MPNST formation. The high risk and dismal prognosis of MPNST in patients with NF-1 has to be balanced against the use of a weak radioactive tracer in a tumour predisposition syndrome with a relatively low ppV.
Phase II trial of enzastaurin (Enz) with bevacizumab (BV) in adults with recurrent glioblstoma (GBM).
Authors: A. Moustakas, F. M. Iwamoto, T. N. Kreisl, J. Sul, L. J. Kim, J. A. Butman, P. S. Albert, H. A. Fine
Journal: Journal of Clinical Oncology (2010)

e12511 Background: Enz, a PKC-β inhibitor, was developed as an antiangiogenic based on its role in VEGF receptor signal transduction. We recently showed that ENZ has direct glioma cytotoxic activity by inhibiting glycogen synthase kinase 3. BV, a monoclonal VEGF antibody, received FDA accelerated approval for recurrent GBM as monotherapy in May 2009. The objective of this phase II trial was to evaluate the efficacy and safety of Enz with BV in patients (pts) with recurrent GBM. Methods: Pts recurrent GBM and KPS ≥ 60 were eligible. Therapy consisted of daily Enz and BV 10 mg/kg on days 1 and 15 of each 4-week cycle. All pts received a loading dose of Enz on Day 1 (1,125 mg), followed by either 500 or 875 mg qd orally depending on use of EIAED. Brain MRI and clinical reassessment were done every cycle. Primary endpoint was efficacy as measured by PFS6. Results: 40 GBM pts (57.5% men) with a median age of 50.7 years (range, 25.4 to 72.7) and a median KPS of 90 were accrued. Median number of prior chemotherapy regimens was 2 (range 1-5). Grade 3/4 toxicities included neutropenia (n = 1), thrombocytopenia (n = 2), AST elevation (n = 2), bowel perforation (n = 2), thrombosis (n = 1), hypertension (n = 2), hypophosphatemia (n = 2), anemia (n = 1), bleeding (n = 1) and infection (n = 1); 5 pts discontinued secondary to treatment-related toxicity. Using Levin's criteria, 27/39 evaluable pts (69%) had an ORR while 14/35 evaluable pts (40%) had an ORR by Macdonald criteria. 21 of 39 (54%) had a PR according to Levin criteria on MRI done within 96 hours of starting treatment while only 1 pt had an early response according to Macdonald criteria. Early MRI response according to Levin's criteria was a predictor for longer PFS (median of 3 months vs. 1.8 months, log-rank P-value = 0.001). 90% of pts died and the median follow-up of survivors is 21.5 months. Median PFS was 2 months (95% CI, 1.8 to 2.7 months) and PFS6 was 23% (95% CI, 11% to 37%). The median OS was 7.2 months (95% CI, 4.9 to 10.8 months) and 6-month OS was 60% (95% CI, 43% to 73%). Conclusions: Enz combined with BV was reasonably well tolerated and is active in recurrent GBM. However, the addition of Enz to BV did not seem to improve outcomes compared to prior studies of single-agent BV for recurrent GBM. No significant financial relationships to disclose.
Case 22-2010
Authors: Steven M. Greenberg, Otto Rapalino, Matthew P. Frosch
Journal: New England Journal of Medicine (2010)

An 87-year-old woman with a history of dementia was admitted to this hospital because of a seizure. A diagnosis of possible Alzheimer's disease had been made 4 years earlier; at baseline, she recognized only her husband and children. On examination, she was unresponsive. Magnetic resonance imaging scans of the brain revealed T2-weighted hyperintensities in the white matter involving both cerebral hemispheres, as well as innumerable small foci of susceptibility-weighted artifact at the cortical–subcortical junction. Despite a temporary improvement after treatment, she died of pneumonia a few days later. An autopsy was performed.
Competing Risk of Death in Kaplan-Meier Curves When Analyzing Subsequent Keratinocyte Cancer—Reply
Authors: Mackenzie R. Wehner, Eleni Linos, W. John Boscardin, Mary-Margaret Chren
Journal: JAMA Dermatology (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 Dermatology 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 Dermatology journal
Geographic Variation in the Treatment of Localized Breast Cancer
Authors: Diana C. Farrow, William C. Hunt, Jonathan M. Samet
Journal: New England Journal of Medicine (1992)

Breast-conserving surgery followed by radiation therapy is as effective as modified radical mastectomy in treating women with localized breast cancer, as demonstrated by clinical trials reported during the 1980s. The extent to which breast-conserving surgery has been adopted in various regions of the United States is not known.
Long-Term Evaluation of HIV Antigen and Antibodies to p24 and gp41 in Patients with Hemophilia
Authors: J P Allain, Y Laurian, D A Paul, F Verroust, M Leuther, C Gazengel, D Senn, M J Larrieu, C Bosser
Journal: New England Journal of Medicine (1987)

To investigate the relation between human immunodeficiency virus (HIV) antigenemia and clinical manifestations of HIV infections, we studied 96 patients with hemophilia who were positive for HIV antibody, for a median of 34 months. Every 4 to 10 months a clinical and laboratory examination was performed and serum samples were tested for three HIV markers: HIV antigen, antibody to p24, and antibody to gp41. Twenty-two subjects (23 percent) were found to be positive for HIV antigen: 8 were positive upon entry and remained so (Group 1), and 14 became positive during the study, 4 to 26 months after HIV antibody appeared (seroconversion), 13 of whom remained positive for HIV antigen (Group 2). Most subjects positive for HIV antigen had low or undetectable titers of antibody to p24, whereas the antibody titer to gp41 remained high. In Group 2, patients with low p24 antibody titers had further decreases in their titers before or at the time HIV antigen appeared. Once present, HIV antigen persisted and tended to increase in concentration. In contrast to Group 3 (negative for HIV antigen, low anti-p24 titer) and 4 (negative for HIV antigen, high anti-p24 titer), the groups positive for HIV antigen had significantly higher incidences of acquired immunodeficiency syndrome (P = 0.05), immunodeficiency-related infections (P<0.001), and immune thrombocytopenia (P = 0.001), and had more severe disease as measured by the Walter Reed staging system (P<0.001). In this study, HIV antigen appeared to be a better predictive marker of HIVrelated complications than the absolute T4+ count. These results suggest that HIV antigenemia indicates a poor clinical prognosis. (N Engl J Med 1987; 317:1114–21.)
Evaluation of Digoxin Bioavailability in Single-Dose Studies
Authors: David J. Greenblatt, David W. Duhme, Jan Koch-Weser, Thomas W. Smith
Journal: New England Journal of Medicine (1973)

Methods for testing digoxin bioavailability were compared in single-dose crossover studies using eight healthy male subjects. Digoxin (0.75 mg) was given by intravenous infusion, intramuscular injection, oral elixir and oral tablet. Multiple serum concentrations and six-day cumulative urinary excretion were determined after each mode of administration. Area under the eight-hour serum concentration curve correlated with cumulative urinary excretion (r = 0.795), but showed greater between-subject variability. First-day and six-day urinary excretion were highly correlated (r = 0.972). After intravenous digoxin, six-day urinary recovery averaged 76 per cent of the dose. Intramuscular digoxin and digoxin elixir were significantly more bioavailable (80 to 83 and 65 to 67 per cent of intravenous) than the tablet (45 to 55 per cent of intravenous), but not sufficiently absorbed to serve as bioavailability standards. Bioavailability of digoxin preparations can be reliably tested by administration of a single 0.75-mg dose to five to eight healthy subjects and comparison of their urinary digoxin excretion over one to six days with that found after one-hour intravenous infusion of the same dose. (N Engl J Med 289:651–654, 1973)
Lamivudine in the Treatment of Polyarteritis Nodosa Associated with Acute Hepatitis B
Authors: Samardeep Gupta, Cyrus Piraka, Michele Jaffe
Journal: New England Journal of Medicine (2001)

To the Editor: There is no consensus on the optimal treatment of polyarteritis nodosa associated with hepatitis B virus (HBV) infection. The potential risk of accelerating viral replication complicates the use of corticosteroids and cytotoxic agents. Benefit from the combined use of plasmapheresis, corticosteroids, and antiviral agents has been reported previously.1 We describe a patient with HBV-associated polyarteritis nodosa who was treated with this approach. A 39-year-old woman was transferred to our hospital in December 1999 for the treatment of vasculitis. In September 1999, she had presented with a diffuse pruritic rash, polyarticular symmetric arthritis, abdominal pain, and constitutional symptoms. . . .
Patterns in Zika Virus Testing and Infection, by Report of Symptoms and Pregnancy Status — United States, January 3–March 5, 2016
Authors: Sharoda Dasgupta, Sarah Reagan-Steiner, Dana Goodenough, Kate Russell, Mary Tanner, Lillianne Lewis, Emily E. Petersen, Ann M. Powers, Krista Kniss, Dana Meaney-Delman, Titilope Oduyebo, Dan O’Leary, Sophia Chiu, Pamela Talley, Morgan Hennessey, Susan Hills, Amanda Cohn, Christopher Gregory, Janeen Laven, Olga Kosoy, Amanda Panella, Marc Fischer, Amanda Calvert, Jane Basile, Christin Goodman, Robert Lanciotti, Jeremy Ledermann, Jennifer Lehman, Eric Mossel, Katherine Chu, Charles Futoran, Paul Burns, Sandor Karpathy, Joseph Singleton, Aubree Kelly, Michelle Allerdice, Rachael Priestley, Kelly Fitzpatrick, Sher’i Brooks, Avi Stein, Molly Lauterbach, Ryan Pappert, Adam Replogle, Brook Yockey, Chris Sexton, John Young
Journal: MMWR Morbidity and Mortality Weekly Report (2016)

CDC recommends Zika virus testing for potentially exposed persons with signs or symptoms consistent with Zika virus disease, and recommends that health care providers offer testing to asymptomatic pregnant women within 12 weeks of exposure. During January 3-March 5, 2016, Zika virus testing was performed for 4,534 persons who traveled to or moved from areas with active Zika virus transmission; 3,335 (73.6%) were pregnant women. Among persons who received testing, 1,541 (34.0%) reported at least one Zika virus-associated sign or symptom (e.g., fever, rash, arthralgia, or conjunctivitis), 436 (9.6%) reported at least one other clinical sign or symptom only, and 2,557 (56.4%) reported no signs or symptoms. Among 1,541 persons with one or more Zika virus-associated symptoms who received testing, 182 (11.8%) had confirmed Zika virus infection. Among the 2,557 asymptomatic persons who received testing, 2,425 (94.8%) were pregnant women, seven (0.3%) of whom had confirmed Zika virus infection. Although risk for Zika virus infection might vary based on exposure-related factors (e.g., location and duration of travel), in the current setting in U.S. states, where there is no local transmission, most asymptomatic pregnant women who receive testing do not have Zika virus infection.
Treatment of Waldenström's Macroglobulinemia by Plasmapheresis
Authors: Paul J. Schwab, John L. Fahey
Journal: New England Journal of Medicine (1960)

MACROGLOBULINEMIA of Waldenström is a disease of the reticuloendothelial system characterized by a marked increase in the serum gamma macroglobulin concentration. It occurs most frequently in elderly men, whose principal complaints are usually weakness, dyspnea, weight loss, bleeding tendency and, less commonly, decreased visual acuity. Increased distention and tortuosity of the retinal veins and multiple retinal hemorrhages, as well as lymphadenopathy and hepatosplenomegaly, are typically present. Pertinent laboratory findings include a normochromic normocytic anemia, often an absolute lymphocytosis, an elevated erythrocyte sedimentation rate and increased numbers of small lymphocytes and lymphoid plasma cells in the bone marrow. The euglobulin (Sia) . . .
Late Symptoms Due to Traumatic Hemopericardium
Authors: Bernard H. Pastor, Reeve H. Betts
Journal: New England Journal of Medicine (1961)

MOST physicians believe that death ensues rapidly after penetrating wounds of the heart. In a Philadelphia police station a prisoner was recently found dead in a cell with 3 other men. The medical examiner noted at autopsy that the man had been stabbed with an ice pick, and was quoted as saying that the stabbing could not have occurred more than an hour before death and that the victim probably died within twenty minutes.1 The other 3 men were suspected of the killing until it was discovered that the victim had been stabbed three days before death. He had walked . . .
S70 Experimental Human Pneumococcal Colonisation is an asymptomatic event in healthy adults
Authors: A Trimble, AM Collins, CA Hancock, SB Gordon, DM Ferreira, AD Wright
Journal: Thorax (2015)

<h3>Background</h3> Pneumococcal colonisation is a necessary precursor for pneumococcal diseases. Previous studies have suggested that pneumococcal colonisation in children is symptomatic and that there is a relationship between symptom severity/frequency and colonisation density. The literature refers to colonisation in adults as an asymptomatic event but no studies have used robust methodology. Using the Experimental Human Pneumococcal Colonisation (EHPC) model, we investigated whether pneumococcal colonisation (or co-colonisation with a respiratory virus) is symptomatic in healthy adults. <h3>Methods</h3> Non-smoking healthy adults aged 18–60 years old were recruited and inoculated intranasally with 0.1 ml per naris of pneumococcus (serotype 6B, 23F) or saline (control). Nasal and non-nasal symptoms were monitored pre-inoculation and for 7 days post-inoculation using a modified Likert score. Symptom severity scoring ranged from 1 (none) to 7 (cannot function). Area under the curve (AUC) was calculated for each participant. Mean values were compared using ANOVA between the groups. <h3>Results</h3> Data from 53 participants were analysed. 45 were inoculated with pneumococcus and 8 with saline. In total, 14 became experimentally colonised. Colonised and non-colonised participants reported similar symptom severity scores (Figure 1). Mean severity scores for both nasal and non-nasal symptoms did not significantly differ according to colonisation status (p &gt; 0.05), nor was there any significant association with any particular symptom. In the 14 experimentally colonised participants, density of colonisation did not correlate with symptom severity scores (R<sup>2</sup> = 0.03, p = 0.89). 6 participants were co-colonised (with pneumococcus and a respiratory virus), although they showed a trend towards experiencing more non-nasal symptoms than other groups, their mean symptom severity was still occasional only (p &gt; 0.05). <h3>Conclusion</h3> In healthy adults pneumococcal colonisation is an asymptomatic event, regardless of density or viral co-colonisation.
Cutaneous Manifestations of Acute Pancreatitis, with Special Reference to Livedo Reticularis
Authors: William J. Sigmund, Walter B. Shelley
Journal: New England Journal of Medicine (1954)

ACUTE pancreatitis is one of the surgical diseases that occasionally present cutaneous manifestations.1 Despite the rarity and limited diagnostic value of these dermatologic clues, their presence has always demanded attention and explanation.In 1889 Hansemann2 reported that he had seen 2 cases of acute pancreatitis in which a morbilliform eruption appeared on the body. This color change persisted after death, and skin autopsy specimens in each case showed subcutaneous fat necrosis.Halsted,3 in 1901, commented on a peculiar cyanosis observed in a patient during an attack of acute pancreatitis.Jaundice has been noted for many years. Cattell and Warren4 recently . . .
Clinical response of large cell neuroendocrine carcinoma of the lung to perioperative adjuvant chemotherapy.
Authors: H. Saji, M. Tsuboi, J. Matsubayashi, K. Miyajima, J. Usuda, N. Kajiwara, O. Uchida, T. Ohira, N. Ikeda
Journal: Journal of Clinical Oncology (2010)

e17505 Background: Patients with large cell neuroendocrine carcinoma of the lung (LCNEC) are considered to have poor prognosis. This study was undertaken to evaluate the efficacy of perioperative chemotherapy for patients with completely resected LCNEC in a retrospective uni-institutional setting. Methods: From 1999 through 2007, 45 patients with surgically resected LCNEC or mixed LCNEC containing at least one portion of the neuroendocrine differentiation or morphology in non-small cell lung carcinoma (NSCLC) were enrolled as subjects of this study. Survival rates were calculated by the Kaplan-Meier method. Differences between survival curves were computed with the log-rank test. For multivariate analysis, a Cox's proportional hazards regression model was used to evaluate variables that were significant predictors of survival. Results: Of 1,397 patients undergoing surgical resection for primary lung cancer from 1999 to 2007, 45 (3.2%) were classified as LCNEC. Twenty-three (41%) of 45 patients received perioperative chemotherapy, including seven induction chemotherapies and 16 adjuvant chemotherapies. Survival of patients who underwent perioperative adjuvant chemotherapy was significantly higher than that of those who received surgery alone (p = 0.04). The 5-year survival rate of patients who underwent perioperative adjuvant chemotherapy was 87.5%, whereas that of patients who underwent surgery alone was 58.5%. Even in stage I cases, perioperative adjuvant chemotherapy still favors survival compared with surgery alone. In the Cox proportional hazard multivariate analysis, surgery with or without chemotherapy showed an independent prognostic influence on overall survival (p = 0.0457). Patients who received surgery alone were 9.5 times more likely to die than patients who underwent surgery plus chemotherapy. Conclusions: perioperative chemotherapy will be needed to improve survival in patients with LCNEC. As the population of LCNEC is small, it has been difficult to conduct randomized controlled trials to show the survival benefit of adjuvant chemotherapy. This should be, therefore, evaluated further in prospective multi-institutional phase II trials. No significant financial relationships to disclose.