tbuckley/cabot-search huggingface dataset:
Outcomes of patients with renal monoclonal immunoglobulin deposition disease
Authors: Taxiarchis V. Kourelis, Samih H. Nasr, Angela Dispenzieri, Shaji K. Kumar, Morie A. Gertz, Fernando C. Fervenza, Francis K. Buadi, Martha Q. Lacy, Stephen B. Erickson, Fernando G. Cosio, Prashant Kapoor, John A. Lust, Suzanne R. Hayman, Vincent Rajkumar, Steven R. Zeldenrust, Stephen J. Russell, David Dingli, Yi Lin, Wilson Gonsalves, Elizabeth C. Lorenz, Ladan Zand, Robert A. Kyle, Nelson Leung
Journal: American Journal of Hematology (2016)

Recent reports suggest that deep hematologic responses to chemotherapy are associated with improved renal outcomes in monoclonal immunoglobulin deposition disease (MIDD). Here we describe the long term outcomes and identify prognostic factors after first line treatment of the largest reported series of patients with MIDD. Between March 1992 and December 2014, 88 patients with MIDD were seen at Mayo Clinic, MN. Renal responses were defined using criteria used for light chain amyloidosis (AL) or those used by the IMWG. Sixty‐one (69%) patients had a GFR &lt; 30 mL/min/1.73 m 2 and 16 (18%) were on renal replacement therapy at diagnosis. The interval between albuminuria or elevation in creatinine and MIDD diagnosis was 12 months suggesting a delay in diagnosis. Thirty‐seven patients (42%) had at least a hematologic CR/VGPR. Fifty‐three (60%) received an autologous stem cell transplant (ASCT) or proteasome inhibitor (PI)‐based treatments. Patients receiving ASCT or PI‐based therapies were more likely to achieve at least a hematologic CR/VGPR compared to those receiving other therapies: 66% vs 2%, p &lt; 0.0001. Patients that achieved a hematologic CR were more likely to achieve a renal response (53% vs 24%, p = 0.001). Five year overall and renal survival for the entire cohort was 67% and 57%, respectively. In multivariate analyses, a baseline GFR &lt; 20 mL/min/1.73 m 2 and a renal response (using AL or IMWG criteria) were independently predictive of progression to dialysis. This study confirms that deep hematologic responses, best achieved with ASCT or PI‐based therapies, are a prerequisite to achieving renal responses. Am. J. Hematol. 91:1123–1128, 2016. © 2016 Wiley Periodicals, Inc.
Variable Outcome of Allogeneic Stem Cell Transplant According to the Different Levels of Pre-Transplant Minimal Residual Disease, in Adult Patients with Acute Myeloid Leukemia
Authors: Francesco Buccisano, Luca Maurillo, Alfonso Piciocchi, Maria Ilaria Del Principe, Gottardo De Angelis, Ambra Di Veroli, Raffaella Cerretti, Mariagiovanna Cefalo, Concetta Ditto, Alessandra Picardi, Laura Cudillo, Benedetta Mariotti, Francesco Lo Coco, William Arcese, Sergio Amadori, Adriano Venditti
Journal: Blood (2015)
HHS Moves to Accelerate Zika Vaccine Development
Authors: Jennifer Abbasi
Journal: JAMA (2016)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
A Unified Code of Ethics for Health Professionals
Authors: Matthew K. Wynia, Sandeep P. Kishore, Cynthia D. Belar
Journal: JAMA (2014)

A social contract is an agreement among members of a society to cooperate for social benefits. The most prominent example, around which Rousseau first described the social contract in 1762,1 is democratic governance, in which free citizens exchange some individual freedom for shared state protections. In democracies, a number of different structures and documents, such as laws and regulations, make the social contract tangible—and keep it open to debate and evolution.
Economic impact and outcome benefits of integrating quantitative proteomics analysis to guide treatment strategies for metastatic breast cancer patients.
Authors: Darron Segall, Jason Xenakis, Deanna Hertz, Shankar Sellappan, Adele Blackler, Jedd Levine, Shahrooz Rabizadeh, Todd A. Hembrough
Journal: Journal of Clinical Oncology (2016)

e18242 Background: Tumor molecular profiling is increasingly being used to develop personalized treatment strategies for cancer patients (pts). The OncoPlex Dx (OPDx) test (NantOmics) uses a quantitative, multiplexed, mass spectrometry assay to measure protein expression in tumors. Here we provide a model to evaluate the cost implications and clinical outcomes of including the OPDx Test to guide treatment strategies for metastatic breast cancer (mBC) pts from a US payer (CMS) perspective.Methods: A decision analysis model was developed in Excel 2010; time frame, 1 treatment course. The budget impact of using the OPDx Test was determined from diagnostic, therapeutic, and hospitalization costs and was compared to standard testing/care (empiric care). Pts with mBC planning 1st- or 2nd-line therapy enter the model and receive the OPDx Test (27-protein panel) or standard test (HER2, ER, PR). The model assumes 2 scenarios: 1) 100% of oncologists adopt the test results; 2) 25% of oncologists adopt the test results, 75% use empiric care. Published data informed PFS, serious adverse events, and clinical pathways. Sensitivity analyses assessed the impact of parameter uncertainty on model results. Results: 1st-line pts: PFS (OPDx Test vs empiric care) was 18.7 vs 17.1 months (mo) (scenario 1) and 17.3 vs 17.1 mo (scenario 2) resulting in an incremental cost of $93 and $157 per mo of PFS; for scenario 1 and 2, respectively, inclusion of the OPDx Test increased overall treatment costs by $8,599 and $1,477 per pt or $0.03 and $0.02 per member per month (PMPM). 2nd-line pts: PFS (OPDx Test vs empiric care) was 7.1 vs 6.6 mo (scenario 1) and 6.6 vs 6.6 mo (scenario 2) resulting in an incremental cost of $478 and $828 per mo of PFS; for scenario 1 and 2, respectively, inclusion of the OPDx Test increased overall treatment costs by $8,599 and $1,378 per pt or $0.08 and $0.07 PMPM. Sensitivity analysis yielded an average cost of (1st-line/2nd-line) $4,409/$3,193 per pt and a mean improvement in PFS of 0.75/0.16 mo.Conclusions: Integration of the OPDx Test to personalize treatment strategies based on pt tumor biology has the potential to improve outcomes while incurring minimal extra cost.
Adverse Drug Events in Hospitalized Patients-Reply
Authors: John P. Burke
Journal: JAMA (1997)

<h3>In Reply.</h3> —Active surveillance for ADEs can prevent the unfortunate adversarial relationships between physicians and pharmacists that concern Dr Davis. Surveillance, rather than mandatory reporting, must be the core of the "concerted multidisciplinary effort" called for by Dr Rybacki. Using exactly this approach, we have published evidence that early notification of physicians can alert them to ongoing ADEs so that mild and moderate reactions don't progress to more serious conditions,<sup>1</sup>focused surveillance can reduce the incidence of certain types of ADEs,<sup>2</sup>and antibiotic management programs, including but not limited to computerized ordering, can reduce the incidence of ADEs to antibiotics by 75%.<sup>3,4</sup>Indeed, we are the only center to have developed and implemented broad-based programs that prevent ADEs. The major reason for our success has been our focus on improving drug use at the bedside rather than on elucidating and cataloging all sources of inconsequential drug errors. Dr Davis
PET-CT compared to invasive mediastinal staging in non-small cell lung cancer (NSCLC)
Authors: G. Darling, D. Maziak, R. Inculet, K. Gulenchyn, A. Driedger, Y. Ung, J. Miller, C. Gu, W. Evans, M. Levine
Journal: Journal of Clinical Oncology (2009)

7575 Background: In patients with NSCLC, preoperative staging tests including mediastinoscopy (M) are important in defining which patients are surgical candidates. 18 FDG PET-CT is useful in identifying patients with mediastinal disease not evident by CT. Alternatively, M may not be required if PET-CT is negative. We have previously reported reduced rates of unnecessary thoracotomy (T) in the PET-CT arm of a trial which compared staging with PET-CT versus conventional imaging (bone scan and CT liver and adrenals) in patients with clinical stage I, II, or IIIA NSCLC being considered for surgery (J Clin Oncol 26 May 20 suppl: abstr 7502). Methods: In this analysis, we determined the accuracy of PET-CT in mediastinal staging compared to invasive surgical staging either by M alone or by M and T. Patients in the PET-CT arm had invasive mediastinal staging either by M or mediastinal nodal sampling at T. PET-CT was considered positive if N2 or N3 nodes exhibited increased 18 FDG uptake. Results: M was performed in 81 of 143 patients in the PET-CT arm; the remainder had mediastinal nodal staging at T. Combining M with T, the sensitivity and specificity of PET-CT were 0.70 [95% CI: 0.48–0.85] and 0.94 [95%CI: 0.89–0.97], respectively. Of 21 patients with a positive PET-CT, 7 did not have tumor. The positive predictive value (PPV) and negative predictive value (NPV) were 0.67 [95% CI: 0.45–0.83] and 0.95 [95% CI: 0.90–0.98], respectively. The results for PET-CT versus M alone were: sensitivity, 1.0 [95% CI: 0.76–1.0]; specificity, 0.88 [95%CI: 0.79–0.94]; PPV, 0.60 [95%CI: 0.39–0.78]; NPV, 1.0 [95% CI: 0.94–1.0]. Based on PET-CT alone, 7 patients would have been denied T if PET-CT abnormalities had not been evaluated with invasive mediastinal staging. Conclusions: Mediastinal abnormalities on PET-CT should be confirmed by invasive mediastinal staging because of the risk of a false positive test. Patients should not be denied potentially curative therapy based on PET-CT alone. If PET-CT is negative in the mediastinum, the likelihood of occult metastatic disease in the mediastinum is very low and invasive staging may not be required depending on the clinical context. No significant financial relationships to disclose.
Membrane Proteins Are Dramatically Less Conserved than Water-Soluble Proteins across the Tree of Life
Authors: Victor Sojo, Christophe Dessimoz, Andrew Pomiankowski, Nick Lane
Journal: Molecular Biology and Evolution (2016)

Membrane proteins are crucial in transport, signaling, bioenergetics, catalysis, and as drug targets. Here, we show that membrane proteins have dramatically fewer detectable orthologs than water-soluble proteins, less than half in most species analyzed. This sparse distribution could reflect rapid divergence or gene loss. We find that both mechanisms operate. First, membrane proteins evolve faster than water-soluble proteins, particularly in their exterior-facing portions. Second, we demonstrate that predicted ancestral membrane proteins are preferentially lost compared with water-soluble proteins in closely related species of archaea and bacteria. These patterns are consistent across the whole tree of life, and in each of the three domains of archaea, bacteria, and eukaryotes. Our findings point to a fundamental evolutionary principle: membrane proteins evolve faster due to stronger adaptive selection in changing environments, whereas cytosolic proteins are under more stringent purifying selection in the homeostatic interior of the cell. This effect should be strongest in prokaryotes, weaker in unicellular eukaryotes (with intracellular membranes), and weakest in multicellular eukaryotes (with extracellular homeostasis). We demonstrate that this is indeed the case. Similarly, we show that extracellular water-soluble proteins exhibit an even stronger pattern of low homology than membrane proteins. These striking differences in conservation of membrane proteins versus water-soluble proteins have important implications for evolution and medicine.
Experimental investigation of the susceptibility of Italian Culex pipiens mosquitoes to Zika virus infection
Authors: Daniela Boccolini, Luciano Toma, Marco Di Luca, Francesco Severini, R Romi, Maria Elena Remoli, Michela Sabbatucci, Giulietta Venturi, Giovanni Rezza, Claudia Fortuna
Journal: Eurosurveillance (2016)

We investigated the susceptibility of an Italian population of Culex pipiens mosquitoes to Zika virus (ZIKV) infection, tested in parallel with Aedes aegypti, as a positive control. We analysed mosquitoes at 0, 3, 7, 10, 14, 20 and 24 days after an infectious blood meal. Viral RNA was detected in the body of Cx. pipiens up to three days post-infection, but not at later time points. Our results indicate that Cx. pipiens is not susceptible to ZIKV infection.
Concurrent chemoradiation using weekly versus tri-weekly cisplatin in locally advanced squamous cell carcinoma of the head and neck (SCCHN): A comparative analysis.
Authors: AMR MOHAMED, Kelly Schrapp, Taofeek Kunle Owonikoko, Conor Ernst Steuer, Zhengjia Chen, Suchita Pakkala, Rathi Narayana Pillai, J. Trad Wadsworth, Kristin Ann Higgins, Suresh S. Ramalingam, Jonathan Jay Beitler, Dong Moon Shin, Fadlo Raja Khuri, Madhusmita Behera, Nabil F. Saba
Journal: Journal of Clinical Oncology (2015)

6055 Background: Cisplatin based chemoradiation (CRT) is the standard of care for most patients with locally advanced SCCHN. We conducted a systemic review to compare the efficacy and safety profile of weekly versus tri-weekly cisplatin administration in patients with locally advanced SCCHN Methods: All prospective studies between 1970- 2013 were independently identified by three authors for inclusion. Studies were excluded if induction therapy was part of the treatment regimen, 5-FU or other targeted therapy was used, cisplatin has been used intra-arterially, orally or in the post-operative setting or if the total dose of cisplatin was less than 180mg/m2, or radiation dose of less than 60 GY. Clinical outcomes were extracted and analyzed using weighted estimates. Two-tailed T-test was used for all comparisons with a significance level of 0.05 Results: Out of 120 studies, 23 with a total of 2,303 patients qualified for inclusion. The number of patients treated with weekly cisplatin was 915 (84% males) and tri-weekly was 1388 (84% males). Both groups received median dose of radiation of 70 Gy. Overall response rate for weekly cisplatin was 88% (CI 0.73-0.95) and 63.5% (CI 0.47-0.76) for tri-weekly cisplatin (P = 0.06). The 2-y, 5-y survival rate (SR) and weighted median overall survival (OS) for weekly vs. tri-weekly cisplatin were 89% vs. 75% (P = 0.28), 81% vs 63% (P = 0.18), and 28 vs 27 mos. (P = 0.33), respectively. The 2-y PFS rate was 81% vs 62%, P = 0.26 for weekly and tri-weekly cisplatin, respectively while locoregional failure free rate was 39% (CI 0.16- 0.67) vs. 44% (CI 0.24-0.65); P = 0.8. Grade 3-5 toxicity was 46% in weekly vs 56.5% in tri-weekly cisplatin (P = 0.23) Conclusions: Weekly cisplatin combined with radiation in locally advanced SCCHN is comparable in efficacy and safety to tri-weekly based regimens. Our analysis provides supportive evidence for the use of either weekly or triweekly regimens. Based on our results, tolerability ought to be a key factor in determining the choice of cisplatin schedule in locally advanced SCCHN
REL-Protocol PhilosoPhi34: An Open Label, Single Arm, Phase II Study of Nilotinib 300 Mg BID in Newly Diagnosed Chronic Phase Chronic Myeloid Leukaemia Patients, to Study the Disappearance of CD34+/Lin-Ph+ Cells from Bone Marrow during Treatment. Preliminary Data
Authors: Ester Pungolino, Giuseppe Rossi, Maria Angela Mura, Alessandra Perego, Ester Maria Orlandi, Mauro Turrini, Lorenza Borin, Maria Adele Capucci, Alessandra Iurlo, Alessandra Trojani, Mariella D'Adda, Francesco Spina, Gabriella De Canal, Maria Luisa Pioltelli, Maria Luisa Latargia, Sergio Pauli, Chiara Elena, Stefania Brusorio, Francesco Lanza, Simona Malato, Michela Anghilieri, Maria C Carraro, Enrica Morra, Roberto Cairoli
Journal: Blood (2015)
A Screen for Mll-AF9 Cooperating Mutations in Leukemogenesis Using MLV-Based Mutagenesis.
Authors: Rachel J.S. Bergerson, Lara S. Collier, Tony Cox, Wendy A. Hudson, Raha Allaei, Linda Wolff, John H. Kersey, David J. Adams, David A. Largaespada
Journal: Blood (2006)
Comparative Analysis Of Cytogenetic Evolution Patterns During Relapse In The Hematopoietic Stem Cell Transplantation and Chemotherapy Settings Of Patients With Acute Leukemia
Authors: Young-Uk Cho, Hyun-Sook Chi, Sang Hyuk Park, Young Jin Kim, Seongsoo Jang, Eul-Ju Seo, Chan-Jeoung Park
Journal: Blood (2013)
Serial 18F-FDG PET/CT Findings in a Patient With IgLON5 Encephalopathy
Authors: Wei Zhang, Na Niu, Ruixue Cui
Journal: Clinical Nuclear Medicine (2016)

We presented the serial FDG PET/CT brain scans of a 64-year-old woman with IgLON5 encephalopathy, which is a novel syndrome in association with antibodies to a neuronal cell adhesion protein named IgLON5, and FDG PET findings have not been characterized previously. For our case, the relatively hypermetabolism in primary sensorimotor cortices, basal ganglia, and cerebrum comparing to other cortical regions on the pretreatment FDG PET/CT was partially recovered on the follow-up FDG PET/CT scan after immunotherapy, corresponding with the alleviation of clinical syndromes. The metabolic change pattern was not similar as other types of autoimmune encephalitis.
A three-gene expression-based risk score can refine the European LeukemiaNet AML classification
Authors: Stefan Wilop, Wen-Chien Chou, Edgar Jost, Martina Crysandt, Jens Panse, Ming-Kai Chuang, Tim H. Brümmendorf, Wolfgang Wagner, Hwei-Fang Tien, Behzad Kharabi Masouleh
Journal: Journal of Hematology & Oncology (2016)

Risk stratification based on cytogenetics of acute myeloid leukemia (AML) remains imprecise. The introduction of novel genetic and epigenetic markers has helped to close this gap and increased the specificity of risk stratification, although most studies have been conducted in specific AML subpopulations. In order to overcome this limitation, we used a genome-wide approach in multiple AML populations to develop a robust prediction model for AML survival. We conducted a genome-wide expression analysis of two data sets from AML patients enrolled into the AMLCG-1999 trial and from the Tumor Cancer Genome Atlas (TCGA) to develop a prognostic score to refine current risk classification and performed a validation on two data sets of the National Taiwan University Hospital (NTUH) and an independent AMLCG cohort. In our training set, using a stringent multi-step approach, we identified a small three-gene prognostic scoring system, named Tri-AML score (TriAS) which highly correlated with overall survival (OS). Multivariate analysis revealed TriAS to be an independent prognostic factor in all tested training and additional validation sets, even including age, current cytogenetic-based risk stratification, and three other recently developed expression-based scoring models for AML. The Tri-AML score allows robust and clinically practical risk stratification for the outcome of AML patients. TriAS substantially refined current ELN risk stratification assigning 44.5 % of the patients into a different risk category.
Comparison of Dabigatran and Warfarin in Patients With Atrial Fibrillation and Valvular Heart Disease
Authors: Michael D. Ezekowitz, Rangadham Nagarakanti, Herbert Noack, Martina Brueckmann, Claire Litherland, Mark Jacobs, Andreas Clemens, Paul A. Reilly, Stuart J. Connolly, Salim Yusuf, Lars Wallentin
Journal: Circulation (2016)

The RE-LY trial (Randomized Evaluation of Long-Term Anticoagulant Therapy) compared dabigatran 150 and 110 mg twice daily with warfarin in 18 113 patients with atrial fibrillation. Those with prosthetic heart valves, significant mitral stenosis, and valvular heart disease (VHD) requiring intervention were excluded. Others with VHD were included.This is a post hoc analysis of the RE-LY trial.There were 3950 patients with any VHD: 3101 had mitral regurgitation, 1179 with tricuspid regurgitation, 817 had aortic regurgitation, 471 with aortic stenosis, and 193 with mild mitral stenosis. At baseline, patients with any VHD had more heart failure, coronary disease, renal impairment, and persistent atrial fibrillation. Patients with any VHD had higher rates of major bleeds (hazard ratio [HR], 1.32; 95% confidence interval [CI], 1.16-1.5) but similar stroke or systemic embolism event rates (HR, 1.09; 95% CI, 0.88-1.33). For patients receiving dabigatran 110 mg, major bleed rates were lower than for patients taking warfarin (HR, 0.73; 95% CI, 0.56-0.95 with VHD; HR, 0.84; 95% CI, 0.71-0.99 without VHD), and major bleed rates for dabigatran 150 mg were similar to those for warfarin in patients with VHD (HR, 0.82; 95% CI, 0.64-1.06) or without VHD (HR, 0.98; 95% CI, 0.83-1.15). For dabigatran 150 mg, stroke/systemic embolic event rates were lower compared with warfarin in those with VHD (HR, 0.59; 95% CI, 0.37-0.93) and those without VHD (HR, 0.67; 95% CI, 0.52-0.86), and stroke/systemic embolic event rates were similar for warfarin and dabigatran 110 mg regardless of the presence of VHD (HR, 0.97; 95% CI, 0.65-1.45; and HR, 0.88; 95% CI, 0.70-1.10). Intracranial bleeds and death rates for dabigatran 150 and 110 mg were lower compared with warfarin independently of the presence of VHD.The presence of any VHD did not influence the comparison of dabigatran with warfarin.URL: http://www.clinicaltrials.gov. Unique identifier: NCT00262600.