tbuckley/cabot-search huggingface dataset:
Outcomes of autologous stem cell transplant (ASCT) in multiple myeloma from a tertiary cancer center in India.
Authors: Bhausaheb Pandurang Bagal, Navin Khattry, Amol Dongre, Sadhana Kanan, Hari Menon, Manju Sengar, Reena Nair
Journal: Journal of Clinical Oncology (2012)

e17003 Background: ASCT is part of standard treatment in multiple myeloma (MM).We report the results of such transplants and evaluate the role of prognostic factors if any in our patients. Methods: Sixty-one patients who underwent ASCT between June 1993 and March 2010 were included. Twenty four patients received VAD like regimen. Nineteen patients received novel agent based therapies. Ten patients underwent cyclophosphamide based mobilisation while only G-CSF based mobilisation done in 51 patients. Stem cells were harvested from peripheral blood in all patients. Melphalan was used at 200 mg/m 2 in 24 patients. Prognostic factors evaluated for overall (OS) and progression-free survival (PFS) were baseline hemoglobin and albumin, ISS stage, disease status at day 100 post transplant, use of maintenance treatment post transplant, response to first line chemotherapy, use of novel agents before transplant and time to transplant from diagnosis. Results: Median age was 46 years. Median baseline haemoglobin (Hb) and albumin were 9.7 g/dl and 3.9 g/dl respectively. At the time of transplant 36% were in complete remission (CR), 5% in very good partial response (VGPR) and 28% in partial remission (PR). Median time to engraftment of neutrophils and platelets was 12 and 17 days respectively. Grade III–IV oral mucositis was seen in 35%. Transplant related mortality was 8.0 %. The 5 year overall survival (OS) and progression free survival (PFS) were 73% and 33% respectively. OS was better for patients with pre-transplant Hb greater than 9.7 g/dl (P= .04) and those who achieved CR at day 100 post transplant (P= .03). Patients who received maintenance therapy showed trend towards better OS (P= .07). PFS was better for patients with baseline albumin greater than 3.9g/dl (P = .043), Hb greater than 9.7 g/dl (P = .027) and early stage disease by ISS staging system (P=.001). Conclusions: Our study confirms that ASCT in such patients is safe and effective. Baseline albumin and Hb, ISS stage, day 100 disease response and use of maintenance treatment are important prognostic factors affecting survival.
Common and Rare Egfr Mutations (Egfrm) in the Radiant Trial
Authors: W.E.E. Eberhardt, F.A. Shepherd, N.K. Altorki, M.E.R. O'Brien, J. Wang, J. Wu, S.C. Gill, K.K. Iwata, F.C. Richardson, J.D. Horan, M.A. Foley, K. Kelly
Journal: Annals of Oncology (2014)
Population Pharmacokinetics of Daunorubicin in AML: Influence on Clinical Outcome
Authors: Savitha Varatharajan, Ajay Abraham, John C Panetta, Sreeja Karathedath, Kavitha M Lakshmi, Chepsy C Philip, Fouzia NA, Abhijeet Ganapule, Aby Abraham, Auro Viswabandya, Biju George, Alok Srivastava, Vikram Mathews, Poonkuzhali Balasubramanian
Journal: Blood (2014)
Pain Control and the World Health Organization Analgesic Ladder
Authors: Vittorio Ventafridda
Journal: JAMA (1996)

<h3>To the Editor.</h3> —We would like to congratulate you on the attention devoted by<i>JAMA</i>on the treatment of cancer pain, a much neglected topic. But we cannot fail to be somewhat concerned by the article by Drs Jadad and Browman<sup>1</sup>regarding the WHO analgesic ladder for cancer pain control. We do not need a meta-analysis of randomized controlled studies to know whether aspirin and morphine are effective against pain. Common sense is not always common, obviously. Furthermore, everything measurable is not necessarily relevant. Moreover, in their article, Jadad and Browman do not give enough consideration to the fact that these analgesic guidelines have also been produced to disseminate important therapeutic and caring principles, indispensable for correct treatment of cancer pain, in both developed and developing countries.<sup>2</sup>Thanks to the principles of the WHO analgesic ladder for cancer pain and the development of concordant policies, education of the
Randomized phase II pilot study of loratadine for the prevention of bone pain caused by pegfilgrastim.
Authors: Julia Moukharskaya, Deborah Michelle Abrams, Farrah B. Khan, Joanna Schwartz, Steven Ades, Takamaru Ashikaga, Thomas H. Openshaw, Claire F. Verschraegen, Steven M. Grunberg
Journal: Journal of Clinical Oncology (2014)

9628 Background: Bone pain is a common side-effect of pegfilgrastim and can interfere with a patient’s quality of life and treatment adherence. Antihistamine therapy may have analgesic activity in such patients. This study was designed to investigate the impact of antihistamine loratadine prophylaxis on pegfilgrastim-induced bone pain (PIP). Methods: This is a two stage trial design with the first stage identifying eligible patients who developed significant clinical PIP after receiving an initial dose of pegfilgrastim (6 mg SC) in the chemotherapy setting, and the second stage representing a randomized trial of a 7-day course of loratadine 10 mg daily or placebo starting on day 1 of pegfilgrastim administration. Significant PIP, assessed by Worst Pain Scale (0-10) of the Brief Pain Inventory, was defined as worst pain score >5 and a 2 point increase during the 7 days after pegfilgrastim. The primary end-point of the study was reduction of significant PIP with loratadine, defined as 2 point decrease in worst PIP between treatment and observation stages. Rescue use of other analgesics was allowed. Target sample size was based on the following assumptions: 30% incidence of significant pain, 10% benefit with placebo, 50 % benefit with loratadine, 89% power (chi-square test, 2-sided alpha=0.05) , and stratification by taxane use. Results: A total of 227 patients were enrolled in the observation stage, of whom 213 were included in the final analysis. Incidence of significant PIP was 30.5%. 45 patients with breast, lung and GI malignancy entered the randomization stage, male/female 11 /34, median age 56 (range 31-89). Gender, age, malignancy type, taxane use, and additional use of rescue NSAIDS and non-NSAIDS were all comparably distributed in loratadine vs. placebo groups (p=0.58). The rate of improvement in the significant PIP was 59.1% for loratadine arm and 54.5% for placebo arm (p=1.0). Results were unchanged after adjustment for rescue analgesic use or taxane therapy. Conclusions: Administration of prophylactic loratadine does not decrease the incidence of significant PIP. Clinical trial information: NCT01311336.
The subgingival periodontal microbiota of the aging mouth
Authors: Magda Feres, Flavia Teles, Ricardo Teles, Luciene Cristina Figueiredo, Marcelo Faveri
Journal: Periodontology 2000 (2016)

Different mechanisms have been hypothesized to explain the increase in prevalence and severity of periodontitis in older adults, including shifts in the periodontal microbiota. However, the actual impact of aging on the composition of subgingival biofilms remains unclear. In the present article, we provide an overview of the composition of the subgingival biofilm in older adults and the potential effects of age on the oral microbiome. In particular, this review covers the following topics: (i) the oral microbiota of an aging mouth; (ii) the effects of age and time on the human oral microbiome; (iii) the potential impact of inflammaging and immunosenescence in the host-oral microbiota interactions; and (iv) the relationship of the aging oral microbiota and Alzheimer's disease. Finally, we present analyses of data compiled from large clinical studies that evaluated the subgingival microbiota of periodontally healthy subjects and patients with periodontitis from a wide age spectrum (20-83 years of age).
Anti–<i>N</i>-Methyl-<scp>d</scp>-Aspartate Receptor Encephalitis in Adult Patients Requiring Intensive Care
Authors: Etienne de Montmollin, Sophie Demeret, Noëlle Brulé, Marie Conrad, Frédéric Dailler, Nicolas Lerolle, Jean-Christophe Navellou, Carole Schwebel, Mikaël Alves, Martin Cour, Nicolas Engrand, Jean-Marie Tonnelier, Eric Maury, Stéphane Ruckly, Géraldine Picard, Véronique Rogemond, Éric Magalhaes, Tarek Sharshar, Jean-François Timsit, Jérôme Honnorat, Romain Sonneville
Journal: American Journal of Respiratory and Critical Care Medicine (2016)

Encephalitis caused by anti-N-methyl-d-aspartate receptor (NMDAR) antibodies is the leading cause of immune-mediated encephalitis. There are limited data on intensive care unit (ICU) management of these patients.To identify prognostic factors of good neurologic outcome in patients admitted to an ICU with anti-NMDAR encephalitis.This was an observational multicenter study of all consecutive adult patients diagnosed with anti-NMDAR encephalitis at the French National Reference Centre, admitted to an ICU between 2008 and 2014. The primary outcome was a good neurologic outcome at 6 months after ICU admission, defined by a modified Rankin Scale score of 0-2.Seventy-seven patients were included from 52 ICUs. First-line immunotherapy consisted of steroids (n = 61/74; 82%), intravenous immunoglobulins (n = 71/74; 96%), and plasmapheresis (n = 17/74; 23%). Forty-five (61%) patients received second-line immunotherapy (cyclophosphamide, rituximab, or both). At 6 months, 57% of patients had a good neurologic outcome. Independent factors of good neurologic outcome were early (≤8 d after ICU admission) immunotherapy (odds ratio, 16.16; 95% confidence interval, 3.32-78.64; for combined first-line immunotherapy with steroids and intravenous immunoglobulins vs. late immunotherapy), and a low white blood cell count on the first cerebrospinal examination (odds ratio, 9.83 for <5 vs. >50 cells/mm3; 95% confidence interval, 1.07-90.65). Presence of nonneurologic organ failures at ICU admission and occurrence of status epilepticus during ICU stay were not associated with neurologic outcome.The prognosis of adult patients with anti-NMDAR encephalitis requiring intensive care is good, especially when immunotherapy is initiated early, advocating for prompt diagnosis and early aggressive treatment.
Chronic Obstructive Pulmonary Disease and Cardiac Diseases. An Urgent Need for Integrated Care
Authors: Sara Roversi, Leonardo M. Fabbri, Don D. Sin, Nathaniel M. Hawkins, Alvar Agustí
Journal: American Journal of Respiratory and Critical Care Medicine (2016)

Chronic obstructive pulmonary disease (COPD) is a global health issue with high social and economic costs. Concomitant chronic cardiac disorders are frequent in patients with COPD, likely owing to shared risk factors (e.g., aging, cigarette smoke, inactivity, persistent low-grade pulmonary and systemic inflammation) and add to the overall morbidity and mortality of patients with COPD. The prevalence and incidence of cardiac comorbidities are higher in patients with COPD than in matched control subjects, although estimates of prevalence vary widely. Furthermore, cardiac diseases contribute to disease severity in patients with COPD, being a common cause of hospitalization and a frequent cause of death. The differential diagnosis may be challenging, especially in older and smoking subjects complaining of unspecific symptoms, such as dyspnea and fatigue. The therapeutic management of patients with cardiac and pulmonary comorbidities may be similarly challenging: bronchodilators may have cardiac side effects, and, vice versa, some cardiac medications should be used with caution in patients with lung disease. The aim of this review is to summarize the evidence of the relationship between COPD and the three most frequent and important cardiac comorbidities in patients with COPD: ischemic heart disease, heart failure, and atrial fibrillation. We have chosen a practical approach, first summarizing relevant epidemiological and clinical data, then discussing the diagnostic and screening procedures, and finally evaluating the impact of lung-heart comorbidities on the therapeutic management of patients with COPD and heart diseases.
Prolonged Shedding of Zika Virus Associated with Congenital Infection
Authors: Danielle B L Oliveira, Flávia J Almeida, Edison L Durigon, Érica A Mendes, Carla T Braconi, Ivan Marchetti, Robert Andreata-Santos, Marielton P Cunha, Rúbens P S Alves, Lennon R Pereira, Stella R Melo, Daniel F L Neto, Flávio S Mesquita, Danielle B Araujo, Silvana R Favoretto, Marco A P Sáfadi, Luís C S Ferreira, Paolo M A Zanotto, Viviane F Botosso, Eitan N Berezin
Journal: New England Journal of Medicine (2016)

In this case report, Zika virus was detected in the bloodstream of an infant who was congenitally infected for at least 2 months after birth.
Open Access Platforms for Sharing Clinical Trial Data
Authors: Joseph S. Ross, Harlan M. Krumholz
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
Sensitivity of Pediatric Acute Leukemia Cells to Bortezomib and Epoxyketone-Based Proteasome Inhibitors: Correlations with Proteasome Subunit Expression
Authors: Denise Niewerth, Niels Franke, Gerrit Jansen, Johan van Meerloo, Yehuda Assaraf, Christopher J Kirk, Elena T Chan, Sonja Zweegman, Gertjan J. Kaspers, Jacqueline Cloos
Journal: Blood (2011)
Efficacy and safety of a CXCR2 antagonist, AZD5069, in patients with uncontrolled persistent asthma: a randomised, double-blind, placebo-controlled trial
Authors: Paul M O'Byrne, Hristo Metev, Margareta Puu, Kai Richter, Christina Keen, Mohib Uddin, Bengt Larsson, Marie Cullberg, Parameswaran Nair
Journal: The Lancet Respiratory Medicine (2016)
Proton pump inhibitors as a risk factor for hepatic encephalopathy and spontaneous bacterial peritonitis in patients with cirrhosis with ascites
Authors: Gitte Dam, Hendrik Vilstrup, Hugh Watson, Peter Jepsen
Journal: Hepatology (2016)

Proton pump inhibitors (PPIs) may be a risk factor for hepatic encephalopathy (HE) in patients with cirrhosis, possibly through translocation of gut bacteria, which can also lead to spontaneous bacterial peritonitis (SBP). We examined the associations between PPIs and development of HE or SBP in patients with cirrhosis with ascites. We used data from three 1-year trials of satavaptan for ascites control. We used Cox regression to compare HE and SBP rates between users and nonusers of PPIs. At inclusion, 39% of the 865 patients with cirrhosis with ascites used PPIs, 52% used them at some point during the follow-up, and the proportion of current users was always in the 30%-39% range. There were 189 first-time HE episodes during the follow-up, and the cumulative 1-year risk was 31% for those who used PPIs at baseline versus 25% for those who did not. The confounder-adjusted hazard ratio (HR) of HE for current PPI use versus current nonuse was 1.36 (95% confidence interval [CI], 1.01-1.84). The HR for overt HE was higher (adjusted HR = 1.88; 95% CI, 1.21-1.91). During the follow-up, 86 patients developed SBP. The adjusted HR of SBP for current PPI users versus nonusers was 1.72 (95% CI, 1.10-2.69).PPIs were used by 52% of this international cirrhosis cohort during a 1-year period and was a risk factor for developing HE and SBP. These findings are consistent with the hypothesis that PPIs may increase translocation of gut bacteria. (Hepatology 2016;64:1265-1272).
&lt;emph type="ital"&gt;CYP2C19&lt;/emph&gt; Genotype and Cardiovascular Events
Authors: Mark R. Vesely
Journal: JAMA (2012)

To the Editor: The recent meta-analysis by Dr Holmes and colleagues concluding that CYP2C19 genotype is not a significant predictor of clinical outcomes in patients treated with clopidogrel contrasts with a previous meta-analysis and a large body of pharmacokinetic and pharmacodynamic evidence, including a genome-wide association study. The authors cite small-study bias and inability to evaluate effect modification in treatment-only studies as reasons underlying the discrepant findings. An alternative interpretation is that CYP2C19 genotype is an important predictor of adverse cardiovascular outcomes for patients with coronary stents treated with clopidogrel. CYP2C19 may be less important for patients taking clopidogrel for other indications, particularly those in which the drug has a smaller overall effect on outcomes. This explanation is consistent with the meta-analysis by Mega et al, which analyzed studies predominantly in patients receiving percutaneous coronary intervention (PCI), and with the subanalysis by Holmes et al, in which there was a significant effect of CYP2C19 genotype on stent thrombosis. This effect might have been even more apparent if studies in which stent thrombosis was the primary end point were not excluded. With regard to small-study bias, sample size is not a determinant of effect size, only the variance around the estimate. Moreover, the smaller studies included in the meta-analysis tended to be those including a higher proportion of patients with stents, in whom clopidogrel is more likely to be effective. In addition, according to the null hypothesis, we would expect there to be 20 times more nonsignificant studies than positive studies, with the positive studies equally likely to show significant associations in either direction. This degree of publication bias seems unlikely. In his Editorial, Dr Nissen accused the US Food and Drug Administration (FDA) of “irrational exuberance” in mandating the addition of a boxed warning on clopidogrel pharmacogenetics. The warning pertains specifically to patients who are poor metabolizers (CYP2C19 loss-offunction homozygotes) undergoing PCI. Because all of the analyses except for 1 performed by Holmes et al combined heterozygotes and homozygotes (heterozygotes outnumber homozygotes by at least 5 to 1), the study provided no basis for this accusation by Nissen. Nissen calls for a prospective randomized trial before clinicians adopt CYP2C19 genetics into everyday practice. We contend that until the results of such studies are available, clinicians must evaluate the full body of evidence and use their best clinical judgment to decide which patients may benefit from genetic testing. Other directives may be denying patients access to potentially life-saving individualized alternative therapies.
MLL-Rearrangements Result in Upregulation of Mir-9 and Subsequent Inhibition of the Tumor Suppressor TGFBI
Authors: Colles O. Price, Ping Chen, Zejuan Li, Yuanyuan Li, Anissa Wiley, Chunjiang He, Hao Huang, Xi Jiang, Stephen Arnovitz, Mary Beth Neilly, Janet D. Rowley, Jianjun Chen
Journal: Blood (2011)
Characteristics of Patients Dying With Cancer in Developed Countries—Reply
Authors: Carl Rudolf Blankart, Ezekiel J. Emanuel, Justin E. Bekelman
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 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
Association Between High and Very High Albuminuria and Nighttime Blood Pressure: Influence of Diabetes and Chronic Kidney Disease
Authors: Gema Ruiz-Hurtado, Luis M. Ruilope, Alex de la Sierra, Pantelis Sarafidis, Juan J. de la Cruz, Manuel Gorostidi, Julián Segura, Ernest Vinyoles, José R. Banegas
Journal: Diabetes Care (2016)

Nighttime blood pressure (BP) and albuminuria are two important and independent predictors of cardiovascular morbidity and mortality. Here, we examined the quantitative differences in nighttime systolic BP (SBP) across albuminuria levels in patients with and without diabetes and chronic kidney disease.A total of 16,546 patients from the Spanish Ambulatory Blood Pressure Monitoring Registry cohort (mean age 59.6 years, 54.9% men) were analyzed. Patients were classified according to estimated glomerular filtration rate (eGFR), as ≥60 or <60 mL/min/1.73 m(2) (low eGFR), and urine albumin-to-creatinine ratio, as normoalbuminuria (<30 mg/g), high albuminuria (30-300 mg/g), or very high albuminuria (>300 mg/g). Office and 24-h BP were determined with standardized methods and conditions.High albuminuria was associated with a statistically significant and clinically substantial higher nighttime SBP (6.8 mmHg higher than with normoalbuminuria, P < 0.001). This association was particularly striking at very high albuminuria among patients with diabetes and low eGFR (16.5 mmHg, P < 0.001). Generalized linear models showed that after full adjustment for demographic, lifestyles, and clinical characteristics, nighttime SBP was 4.8 mmHg higher in patients with high albuminuria than in those with normoalbuminuria (P < 0.001), and patients with very high albuminuria had a 6.1 mmHg greater nighttime SBP than those with high albuminuria (P < 0.001). These differences were 3.8 and 3.1 mmHg, respectively, among patients without diabetes, and 6.5 and 8 mmHg among patients with diabetes (P < 0.001).Albuminuria in hypertensive patients is accompanied by quantitatively striking higher nighttime SBP, particularly in those with diabetes with very high albuminuria and low eGFR.