tbuckley/cabot-search huggingface dataset:
Prevalence of vitamin D deficiency in a large heterogeneous sample of cancer patients.
Authors: P. G. Vashi, C. A. Lammersfeld, K. Trukova, D. P. Braun, D. Gupta
Journal: Journal of Clinical Oncology (2010)

e12022 Background: Vitamin D deficiency constitutes a largely unrecognized epidemic in many populations worldwide, including those with cancer. We investigated the prevalence of vitamin D deficiency (as defined by low serum 25-hydroxyvitamin D [25(OH)D], the major circulating form of vitamin D) in a large heterogeneous sample of cancer patients. Methods: 1,082 cancer patients seen at our cancer center located in Northern Illinois between Jan 08 and Dec 08. Serum 25(OH)D was measured at presentation prior to undergoing any treatment at our facility. Though appropriate thresholds to define 25(OH)D deficiency are debated, the most widely accepted cutoff is 32 ng/mL. Although we defined hypovitaminosis D as serum 25(OH)D levels of < 32 ng/mL, various cutoff points of 25(OH)D including 20 ng/mL and 8 ng/mL were also used. Results: 422 were males and 660 females. 489 patients were analytic (newly diagnosed and treated at our hospital) while 593 were nonanalytic (diagnosed and treated elsewhere). The mean age at diagnosis was 53.4 years. The most common cancer types were breast (239, 22.1%), lung (177, 16.4%), pancreas (124, 11.5%), colorectal (105, 9.7%), prostate (73, 6.7%) and ovarian (63, 5.8%). The mean serum 25(OH)D level was 23.8 ng/mL. 848 (78.4%) patients had serum 25(OH)D levels below 32 ng/mL, 476 (44.0%) below 20 ng/mL and 105 patients (9.7%) below 8 ng/ml. The mean serum 25(OH)D levels in ng/mL were 24.8, 20.6, 22.9, 22.4, 23.7 and 25.9 for breast, colorectal, lung, prostate, pancreas and ovarian cancers respectively. The difference in the mean values for males (23.7 ng/mL) and females (23.8 ng/mL as well as for analytic (23.8 ng/ml) and nonanalytic patients (23.7 ng/mL) was statistically nonsignificant. There was no correlation between age and vitamin D levels for both analytic (r = 0.04, p = 0.4) and nonanalytic (r = -0.03, p = 0.53) patients. Conclusions: Suboptimal vitamin D status is a very common problem in people with cancer. Those with an inadequate status should be supplemented with vitamin D as appropriate. Future studies should investigate the effect vitamin D supplementation on serum vitamin D levels in oncology. No significant financial relationships to disclose.
Colorectal Cancer on the Decline — Why Screening Can’t Explain It All
Authors: H Gilbert Welch, Douglas J Robertson
Journal: New England Journal of Medicine (2016)

U.S. colorectal-cancer incidence has dropped by more than 45% since its peak in the mid-1980s, and related mortality has fallen by more than half. But though screening is often credited for these trends, it cannot explain such large decreases.
Case 30-1997
Authors: Jay M. Wilson, Eugene J. Mark
Journal: New England Journal of Medicine (1997)

Presentation of CaseAn 18-day-old girl was admitted to the hospital because of a left pneumothorax and cystic changes in the left lung.The infant was a triplet, born by cesarean section to a 36-year-old mother after a 32-week gestation. The Apgar score was 9 at one and five minutes, and the birth weight was 1535 g (40th percentile for gestational age). The patient had mild respiratory distress and required nasal continuous positive airway pressure for two days. The findings on a radiograph of the chest were compatible with mild respiratory distress syndrome. Theophylline was given for periodic apnea and . . .
A Retrospective Study of Alemtuzumab Level, T Cell Chimerism and Graft Versus Host Disease Using Intermediate Dose Alemtuzumab for Matched Related and Matched Unrelated Reduced Intensity Transplantation.
Authors: Andrew Charlton, Laura Spence, Venetia Bigley, Natasha Groves, Geoff Hale, Sarah Pagan, Brie E Turner, Gail Jones, Graham H Jackson, Anne M Dickinson, Matthew Collin
Journal: Blood (2009)
Case 30-1981
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, Betty U. McNeely, Leslie W. Ottinger, Austin L. Vickery
Journal: New England Journal of Medicine (1981)

Presentation of CaseA 45-year-old man was admitted to the hospital because of recurrent gastrointestinal bleeding.At the age of 15 years massive upper gastrointestinal bleeding occurred, without previous gastrointestinal symptoms. The patient was admitted to another hospital, where an emergency removal of two thirds of the stomach with a Billroth II anastomosis was performed for a presumed duodenal ulcer. At the age of 29 years hematemesis and syncope occurred after several weeks of vague abdominal distress. A marginal ulcer was suspected, and an emergency vagotomy was performed, with revision of the previous anastomosis; the gastic mucosa appeared inflamed and . . .
Recurrent abnormalities can be used for risk group stratification in pediatric AMKL: a retrospective intergroup study
Authors: Jasmijn D. E. de Rooij, Riccardo Masetti, Marry M. van den Heuvel-Eibrink, Jean-Michel Cayuela, Jan Trka, Dirk Reinhardt, Mareike Rasche, Edwin Sonneveld, Todd A. Alonzo, Maarten Fornerod, Martin Zimmermann, Martina Pigazzi, Rob Pieters, Soheil Meshinchi, C. Michel Zwaan, Franco Locatelli
Journal: Blood (2016)
TCTAP A-010 Combined Contrast-Induced Acute Kidney Injury and Hypoxic Liver Injury Is Associated with Worse Outcome in Patients with ST Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: Results from INTERSTELLAR Registry
Authors: Sung Woo Kwon, Jeonggeun Moon, Tae-Hoon Kim, Hojun Jang, Jon Suh, Hyun Woo Park, Pyung Chun Oh, Sang-Don Park, Woong Chol Kang
Journal: Journal of the American College of Cardiology (2016)
What is the diagnosis?
Authors: Mathew Tate, Simon Dubrey
Journal: BMJ (2016)

A 55 year old man had chest and abdominal discomfort after a long haul flight. The chest discomfort resembled his usually stable angina pectoris. On admission his heart rate was 90 beats/min and his blood pressure was 95/52 mm Hg. Electrocardiography showed T wave inversion in the inferolateral leads, compatible with ischaemia, although serum troponin and D-dimer tests were negative. His arterial blood gases, pH, and lactate were normal. What does the supine abdominal radiograph show and what sign suggests the diagnosis (fig 1⇓)?



Fig 1  Supine abdominal radiograph



The radiograph shows numerous round …
Abstract P1-14-02: Disease-free (DFS) and overall survival (OS) data from ACOSOG Z1041 (Alliance) a randomized neoadjuvant trial comparing FEC followed by paclitaxel plus trastuzumab (FEC → P+T) with paclitaxel plus trastuzumab followed by FEC plus trastuzumab (P+T → FEC+T) in HER2-positive operable breast cancer
Authors: AU Buzdar, VJ Suman, F Meric-Bernstam, AM Leitch, MJ Ellis, JC Boughey, GW Unzeitig, ME Royce, MS Ewer, KK Hunt
Journal: Cancer Research (2016)

Abstract Background ACOSOG Z1041 (Alliance) found pathological complete response rates in women with operable HER2-positive breast cancer were similar with FEC → P+T (Arm 1) and P+T → FEC+T (Arm 2) where treatment was administered as 5-FU 500 mg/m2, epirubicin 75 mg/m2 and cyclophosphamide 500 mg/m2 day 1 of a 21-day cycle x 4; paclitaxel 80 mg/m2 weekly x 12 and trastuzumab 4 mg/kg once then 2 mg/kg weekly x 11. We now report DFS and OS results with a median follow up of 4.4 years (range: 26 days to 6.2 years). Methods All patients who began study treatment were included in the analyses. Stratified log rank tests and stratified proportional hazard models were used to assess differences in DFS and OS from randomization between treatment arms. Results From September 15, 2007 to December 15, 2011, 282 women with HER2-positive breast cancer were enrolled. Two patients randomized to arm 1 withdrew consent prior to treatment and are excluded from these analyses. Patient and disease characteristics of the remaining 280 women (arm 1, n=138; arm 2, n=142) were similar between treatment arms. Recurrences and deaths are shown in the table. DFS were not found to differ with respect to treatment arm (stratified logrank p=0.6870; HR stratified (Arm2/Arm1)=0.88; 95%CI: 0.48-1.61). Also, OS was not found to differ with respect to treatment arm (stratified logrank p=0.8790; HR stratified (Arm2/Arm1)=1.07; 95%CI: 0.43-2.69). Conclusions Concurrent administration of trastuzumab with anthracyclines offers no additional benefit in terms of achieving pathologic complete response or improving survival and is not needed. FEC → P+TP+T → FEC+T Arm 1Arm 2n138142Recurrences2022Deaths811 Grant Support: U10 CA76001 The study is registered with ClinicalTrials.gov, number NCT00513292. Citation Format: Buzdar AU, Suman VJ, Meric-Bernstam F, Leitch AM, Ellis MJ, Boughey JC, Unzeitig GW, Royce ME, Ewer MS, Hunt KK. Disease-free (DFS) and overall survival (OS) data from ACOSOG Z1041 (Alliance) a randomized neoadjuvant trial comparing FEC followed by paclitaxel plus trastuzumab (FEC → P+T) with paclitaxel plus trastuzumab followed by FEC plus trastuzumab (P+T → FEC+T) in HER2-positive operable breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-14-02.
<italic>Brief Communication:</italic> BCG Therapy Given as an Adjuvant to Surgery: Prevention of Death From Metastases From Mammary Adenocarcinoma in Rats<xref ref-type="fn" rid="fn2"><sup>2</sup></xref>
Authors: F C Sparks, T X O'Connell, Y T Lee, J H Breeding
Journal: JNCI Journal of the National Cancer Institute (1974)

In a tumor system in which surgical excision alone resulted in 100% mortality from spontaneous metastases by day 111, preoperative injection of BCG into the tumor or postoperative therapy with BCG alone or BCG plus a tumor-cell vaccine resulted in significant survival rates to day 334 in rats. No residual tumor could be identified in the survivors, which suggested that they were “cured.”
Gastric Outlet Obstruction
Authors: Vincent E. de Meijer, Casper H. J. van Eijck, Bas Groot Koerkamp
Journal: JAMA Surgery (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 Surgery 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 Surgery journal
Circulating Biomarkers of Dairy Fat and Risk of Incident Diabetes Mellitus Among Men and Women in the United States in Two Large Prospective Cohorts
Authors: Mohammad Y. Yakoob, Peilin Shi, Walter C. Willett, Kathryn M. Rexrode, Hannia Campos, E. John Orav, Frank B. Hu, Dariush Mozaffarian
Journal: Circulation (2016)

Background— In prospective studies, the relationship of self-reported consumption of dairy foods with risk of diabetes mellitus is inconsistent. Few studies have assessed dairy fat, using circulating biomarkers, and incident diabetes mellitus. We tested the hypothesis that circulating fatty acid biomarkers of dairy fat, 15:0, 17:0, and t-16:1n-7, are associated with lower incident diabetes mellitus. Methods and Results— Among 3333 adults aged 30 to 75 years and free of prevalent diabetes mellitus at baseline, total plasma and erythrocyte fatty acids were measured in blood collected in 1989 to 1990 (Nurses’ Health Study) and 1993 to 1994 (Health Professionals Follow-Up Study). Incident diabetes mellitus through 2010 was confirmed by a validated supplementary questionnaire based on symptoms, diagnostic tests, and medications. Risk was assessed by using Cox proportional hazards, with cohort findings combined by meta-analysis. During mean±standard deviation follow-up of 15.2±5.6 years, 277 new cases of diabetes mellitus were diagnosed. In pooled multivariate analyses adjusting for demographics, metabolic risk factors, lifestyle, diet, and other circulating fatty acids, individuals with higher plasma 15:0 had a 44% lower risk of diabetes mellitus (quartiles 4 versus 1, hazard ratio, 0.56; 95% confidence interval, 0.37–0.86; P -trend=0.01); higher plasma 17:0, 43% lower risk (hazard ratio, 0.57; 95% confidence interval, 0.39–0.83; P -trend=0.01); and higher t-16:1n-7, 52% lower risk (hazard ratio, 0.48; 95% confidence interval, 0.33–0.70; P -trend &lt;0.001). Findings were similar for erythrocyte 15:0, 17:0, and t-16:1n-7, although with broader confidence intervals that only achieved statistical significance for 17:0. Conclusions— In 2 prospective cohorts, higher plasma dairy fatty acid concentrations were associated with lower incident diabetes mellitus. Results were similar for erythrocyte 17:0. Our findings highlight the need to better understand the potential health effects of dairy fat, and the dietary and metabolic determinants of these fatty acids.
Case 31-1991
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, E.L. Logigian, E.T. Hedley-Whyte
Journal: New England Journal of Medicine (1991)

Presentation of CaseA 62-year-old man was admitted to the hospital because of two contrast-enhancing cerebral lesions and a right hemiparesis.There was a history of hypertension and of insulin-dependent diabetes mellitus. The patient was in a stable state of health in other respects until three months earlier, when repeated bouts of angina pectoris developed. Two days later he was admitted to another hospital, where evidence of an acute myocardial infarct was found. The patient's hospital course was complicated by second-degree and third-degree atrioventricular block and by episodes of nonsustained ventricular tachycardia; a temporary transvenous pacemaker and a central-venous-pressure catheter . . .
PAX5 Fusion Genes Activate The STAT5 Signaling Pathway Through Lck Over-Expression
Authors: Valeria Cazzaniga, Marco Giordan, Cristina Bugarin, Chiara Palmi, Angela Savino, Geertruy te Kronnie, Giuseppe Gaipa, Andrea Biondi, Grazia Fazio, Giovanni Cazzaniga
Journal: Blood (2013)
BMET-26PHASE 2 STUDY OF VB-111, AN ANTI-CANCER GENE THERAPY, AS MONOTHERAPY FOLLOWED BY COMBINATION OF VB-111 WITH BEVACIZUMAB, IN PATIENTS WITH RECURRENT GLIOBLASTOMA
Authors: Andrew Brenner, Yael Cohen, James Vredenburgh, Katherine Peters, Lakshmi Nayak, Deborah Blumenthal, Felix Bokstein, Eyal Breitbart, Livnat Bangio, Naamit Sher, Dror Harats, Patrick Wen
Journal: Neuro-Oncology (2015)

BACKGROUND: VB-111 is an anti-angiogenic agent consisting of a non-replicating adenovirus vector (Ad-5) with a modified murine pre-proendothelin promoter leading to apoptosis of tumor-vasculature by expressing a fas-chimera transgene in angiogenic-endothelial cells. Safety and efficacy of VB-111 alone and in combination with bevacizumab (BEV) were evaluated in recurrent-Glioblastoma (rGBM) patients in this Phase 1-2 dose-escalation study. METHODS: VB-111 was administered at 3x1012 or 1x1013 bimonthly until progression, followed by BEV standard-of-care (SOC). The protocol was amended to add-on BEV 10mg/Kg biweekly combined with VB-111 bimonthly, until further progression. Assessments included safety, pharmacokinetics, overall survival (OS) (Kaplan Meyer) and tumor response (RANO). RESULTS: 46 patients at 4 sites (US and Israel) received up to 13 doses of VB-111. Upon further progression, 24 received VB-111 with BEV, 22 were treated with BEV SOC. VB-111 was safe and well-tolerated alone and in combination with BEV. There were 30 grade ≥3 AEs, of which 6 were considered possibly related to VB-111: thrombocytopenia, pyrexia, brain edema, depressed consciousness, general weakness, pulmonary embolism. Median OS was 16 months for patients receiving combination therapy versus 8 months for those receiving SOC (p= 0.05). OS of combination therapy was superior to the historical control BELOB BEV arm, 16 versus 8 months (p = 0.003). Of 46 patients who received VB-111, 25 patients spiked a fever post-VB-111 dosing at least once, while 21 didn't. Feverish patients demonstrated a median OS of 16 months, compared to non-feverish patients, with a median OS of 8.5 months (p = 0.03). CONCLUSIONS: VB-111 was safe and well-tolerated alone and in combination with BEV in rGBM patients. OS of patients who received VB-111 followed by combination therapy almost doubled compared to historical BEV data, and compared to patients who received VB-111 monotherapy. Toxicities were as expected in this population. A phase 3 randomized controlled trial is currently underway.
Comparison of the 2010 AJCC TNM staging system with a modified lymph node ratio staging system in 7,233 gastric cancer patients.
Authors: J. Wang, P. Dang, P. K. Pandalai, C. P. Raut, U. N. Maduekwe, S. S. Yoon
Journal: Journal of Clinical Oncology (2010)

4023 Background: The 2010 AJCC staging system for gastric cancer modifies T and N definitions, but continues to base N stage on the absolute number of positive nodes (PN) regardless of the number of examined nodes (EN). With decreases in EN, the lymph node ratio (NR, ratio of PN to EN) may better stage patients. Methods: 7,233 gastric cancer patients who underwent gastrectomy between 1998 and 2006 were identified from the SEER database. Patients were classified into 5 NR groups according to a modified NR algorithm. TNRM staging system was constructed using the log-rank test. Overall survivals based on 2010 AJCC and TNRM staging systems were compared. Results: The median number of EN was 10 and 69% of patients had <16 EN. Both 2010 AJCC and TNRM staging systems were statistically significant prognostic factors (p<0.001). 5-year survivals (5YS) based on these systems are shown in the Table. When stratified by TNRM stage, 6 out of the 9 TNM stages (IA, IIA-B, IIIA-C) represented patients with statistically heterogeneous prognosis with the largest range of 5YS being 36% (stage IIB). In contrast, when stratified by AJCC stage, 3 of 8 TNRM stages (3, 7, 8) represented patients with statistically heterogeneous prognosis with the largest range being only 18% (stage 3). Using ±5% of estimated 5YS as a threshold for misclassification, 49% of patients were inaccurately staged by the AJCC system while this rate dropped to 7% with the TNRM system. Conclusions: The 2010 AJCC staging system does not optimally stratify survival in SEER gastric cancer patients given the majority of patients have <16 EN. A modified TNRM system is a more accurate means of staging these patients. TNRM 1 2 3 4 5 6 7 8 p value* AJCC TNM 5 YrS (#PTs) 81%(217) 67%(1,211) 52%(213) 40%(715) 28%(1212) 17%(1344) 6%(777) 2%(1,544) <0.001 0 76% (186) 82% 74% 0.12 IA 71% (647) 81% 68% <0.001 IB 60% (454) 66% 42% 50% 0.07 IIA 46% (915) 68% 60% 35% 36% <0.001 IIB 31% (892) 53% 46% 29% 17% <0.001 IIIA 19% (882) 28% 15% 8% <0.001 IIIB 14% (1387) 24% 18% 5% 5% <0.001 IIIC 8.0% (934) 29% 20% 10% 4% <0.001 IV 2.0% (936) 2% - p value* <0.001 0.97 0.25 <0.001 0.14 0.07 0.46 0.03 <0.001 * p value of testing the heterogeneity within each TNM or TNR M stage. No significant financial relationships to disclose.
A rare intravascular tumour diagnosed by endobronchial ultrasound
Authors: William T Owen, Elena Karampini, Ronan A Breen, Mufaddal Moonim, Arjun Nair, Sally F Barrington, George Santis
Journal: Thorax (2016)

A 24-year-old man was referred to the haematologists for investigation of unexplained anaemia on the background of a 6-month history of exertional breathlessness, mild cough and night sweats. Investigations revealed iron-deficiency anaemia (haemoglobin 94 g/L), thrombocytosis and markedly elevated inflammatory markers (C-reactive protein (CRP) 235 mg/L). A CT scan of his chest identified a large expansile filling defect within the left main pulmonary artery, almost entirely occluding the left-sided pulmonary circulation, which had high-grade 18F-fluorodeoxyglucose (FDG) uptake on a subsequent positron emission tomography (PET) CT (figure 1).



Figure 1 
CT pulmonary angiogram and positron emission tomography CT merged image showing high-grade 18F-fluorodeoxyglucose (FDG) uptake in a 35 mm lesion within the left main pulmonary artery.



The lesion …
Initial Results of a Phase 1/2a, Dose Escalation Study of PVX-410 Multi-Peptide Cancer Vaccine in Patients with Smoldering Multiple Myeloma (SMM)
Authors: Michael (Luhua) Wang, Ajay K. Nooka, Andrew J. Yee, Sheeba K. Thomas, Elizabeth O'Donnell, Jatin Shah, Donna M. Weber, Jonathan L. Kaufman, Sagar Lonial, David Avigan, Noopur Raje
Journal: Blood (2014)
Efficacy and safety of fondaparinux versus enoxaparin in patients undergoing percutaneous coronary intervention treated with the glycoprotein IIb/IIIa inhibitor tirofiban
Authors: Xin Zhao, Xiao-Xu Yang, Su-Zhen Ji, Xiao-Zeng Wang, Li Wang, Chong-Huai Gu, Li-Li Ren, Ya-Ling Han
Journal: Military Medical Research (2016)

In worldwide, the mortality rate of acute myocardial infarction (AMI) raises year by year. Although the applications of percutaneous coronary intervention (PCI) and anticoagulants effectively reduce the mortality of patients with acute coronary syndrome (ACS), but also increase the incidence of bleeding. Therefore, drugs with stable anticoagulant effects are urgently required.We enrolled 894 patients with acute coronary syndrome who underwent percutaneous coronary intervention in Shenyang Northern Hospital from February 2010 to May 2012; 430 patients were included in the fondaparinux group (2.5 mg/d), and 464 were included in the enoxaparin group (1 mg/kg twice daily). Fondaparinux and enoxaparin were applied for 3-7 days. All patients were treated with tirofiban (10 μg/kg for 3 min initially and 0.15 μg/(kg · min) for 1 to 3 days thereafter). The primary efficacy endpoint was the incidence of a major adverse cerebrovascular or cardiovascular event. The primary safety endpoint was bleeding within 30 days and 1 year after percutaneous coronary intervention.One-year data were available for 422 patients in the fondaparinux group and for 453 in the enoxaparin group. The incidence of a major adverse cerebrovascular or cardiovascular event (10.9 % vs 12.6 %, P = 0.433) and cardiac mortality (0.5 % vs 1.5 %, P = 0.116) were generally lower in the fondaparinux group than in the enoxaparin group, although the differences were not significant. Compared with the enoxaparin group, the fondaparinux group had a significantly decreased rate of bleeding at 30 days (0.9 % vs 2.8 %) and 1 year (2.4 % vs 5.4 %). In addition, the rate of major bleeding events was lower in the fondaparinux group, but this difference was not significant (0.2 % vs 0.9 %, 0.2 % vs 1.1 %).In tirofiban-treated patients with acute coronary syndrome undergoing percutaneous coronary intervention, fondaparinux presented similar efficacy for ischemia events as enoxaparin. However, fondaparinux significantly decreased the incidence of bleeding, thus providing safer anticoagulation therapy.