tbuckley/cabot-search huggingface dataset:
Integrative Therapies During and After Breast Cancer Treatment: ASCO Endorsement of the SIO Clinical Practice Guideline
Authors: Gary H. Lyman, Heather Greenlee, Kari Bohlke, Ting Bao, Angela M. DeMichele, Gary E. Deng, Judith M. Fouladbakhsh, Brigitte Gil, Dawn L. Hershman, Sami Mansfield, Dawn M. Mussallem, Karen M. Mustian, Erin Price, Susan Rafte, Lorenzo Cohen
Journal: Journal of Clinical Oncology (2018)

Purpose The Society for Integrative Oncology (SIO) produced an evidence-based guideline on use of integrative therapies during and after breast cancer treatment that was determined to be relevant to the American Society of Clinical Oncology (ASCO) membership. ASCO considered the guideline for endorsement. Methods The SIO guideline addressed the use of integrative therapies for the management of symptoms and adverse effects, such as anxiety and stress, mood disorders, fatigue, quality of life, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Interventions of interest included mind and body practices, natural products, and lifestyle modifications. SIO systematic reviews focused on randomized controlled trials that were published from 1990 through 2015. The SIO guideline was reviewed by ASCO content experts for clinical accuracy and by ASCO methodologists for developmental rigor. On favorable review, an ASCO Expert Panel was convened to review the guideline contents and recommendations. Results The ASCO Expert Panel determined that the recommendations in the SIO guideline-published in 2017-are clear, thorough, and based on the most relevant scientific evidence. ASCO endorsed the guideline with a few added discussion points. Recommendations Key recommendations include the following: Music therapy, meditation, stress management, and yoga are recommended for anxiety/stress reduction. Meditation, relaxation, yoga, massage, and music therapy are recommended for depression/mood disorders. Meditation and yoga are recommended to improve quality of life. Acupressure and acupuncture are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-l-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy because of a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related adverse effects. Additional information is available at: www.asco.org/supportive-care-guidelines .
PTH-050 Radiofrequency ablation and argon plasma coagulation endoscopic treatment for symptomatic radiation proctitis to improve anaemia
Authors: Harris Penman, Elaine Henry
Journal: Endoscopy (2018)

<h3>Introduction</h3> Radiation proctitis is a late effect of pelvic radiotherapy – which is commonly used to treat prostate cancer and female pelvic malignancy – and causes rectal bleeding, anaemia, diarrhoea and incontinence. Rectal bleeding post radiotherapy causes worry about bowel cancer and symptoms can force patients to become house bound with increased anxiety. Topical therapy with formaldehyde and argon plasma coagulation (APC) is time consuming and formaldehyde can damage healthy tissue (Andreyev HJN et al 2015). Radiofrequency ablation (RFA) can be used to treat large areas of neovascularisation (Zhou et. al. 2009). We treated a large cohort with symptomatic rectal bleeding to evaluate if ablative endotherapy is effective in treating anaemia in radiation induced proctitis. <h3>Methods</h3> A retrospective review of 37 consecutive male patients treated for rectal bleeding from radiation proctitis were identified; their haemoglobin before and after therapy was used. Those who were anaemic (Hb &lt;130 g/dl) were further analysed to see if haemoglobin improved after endotherapy. Endoscopic therapy was delivered with either APC (ERBE) or RFA (HALO, Medtronic). Large areas were treated with RFA and smaller areas with APC. RFA probes are much more expensive than APC probes. Endoscopic therapy was repeated on an outpatient basis at 3–4 monthly intervals until all vessels were ablated or the patient was asymptomatic. <h3>Results</h3> Small areas were treated with APC, RFA was used for APC treatment failure, heavy bleeding requiring transfusion iron therapy, or intolerable bleeding. 37 patient's results showed an average increase in haemoglobin by 20.9 g/dL, a rise of 17.58%. Sub-group analysis looked 23 who were anaemic before the start of therapy and after treatment (Hb &lt;130 g/dL), mean follow up was 8.97±1.5 months (range 1–38). No side effects were noted. No clinically significant stricturing was experienced. <h3>Discussion</h3> Endoscopic ablative therapy increases haemoglobin in patients with radiotherapy induced neovascularisation. Improvement is most marked in those who are anaemic with a 30% increase in haemoglobin. Reversing anaemia removes the need for ongoing iron therapy or blood transfusions, as well as increasing patient's wellbeing. Reducing or stopping bleeding as evidenced with a sustained reversal of anaemia, will increase quality of life. We have used a pragmatic approach of combining RFA and APC to maximise treatment area and limiting therapy costs. There were no long term complications, although patients may experience a slight increase in bleeding in the initial 24–48 hours post-therapy. Treatment seems to be enduring with the reversal of anaemia being maintained for a mean of 8.97 months and up to 38 months.
Counseling patients with higher-risk MDS regarding survival with azacitidine therapy: are we using realistic estimates?
Authors: Amer M. Zeidan, Maximilian Stahl, Michelle DeVeaux, Smith Giri, Scott Huntington, Nikolai Podoltsev, Rong Wang, Xiaomei Ma, Amy J. Davidoff, Steven D. Gore
Journal: Blood Cancer Journal (2018)

Azacitidine is the only drug proven to prolong overall survival (OS) in patients with higher-risk myelodysplastic syndromes (HR-MDS) in the large randomized trial AZA-001 with a median OS of 24.5 months among azacitidinetreated patients vs. 15.0 months in the conventional care regimens (CCR) arm, with a hazard ratio of 0.58; p = 0.0001 1 .Two-year OS probability was 51% in azacitidine arm compared with 26% in the CCR arm (p < 0.0001).These numbers are often quoted to counsel HR-MDS patients regarding expected benefits with azacitidine therapy.However, several real-life data and registry studies suggest that the median OS benefit with azacitidine is much lower (a median of 13-16 months) than what is suggested by AZA-001 trial [2][3][4][5][6][7][8] .Additionally, in a recent large Surveillance, Epidemiology, and End Results (SEER)-Medicare-linked database study of 532 patients with refractory anemia and excessive blasts (RAEB), the median OS was found to be only 11 months [95% confidence interval (CI), 10-14 months] for azacitidine treated patients in the United States (US) 9 .Furthermore, comparing OS for all patients with MDS before the approval of azacitidine and decitabine (2001-2003) and after their approval (2007-2010) using SEER Medicare data shows that the OS for MDS patients has not improved substantially after the approval of the two hypomethylating agents azacitidine and decitabine in 2004 and 2006, respectively, in the US 10 .When analysis was restricted to patients with RAEB, a proxy for HR-MDS, an improvement in OS of only
Modulation of Rb phosphorylation and antiproliferative response to palbociclib: the preoperative-palbociclib (POP) randomized clinical trial
Authors: M. Arnedos, M.A. Bayar, B. Cheaib, V. Scott, I. Bouakka, A. Valent, J. Adam, V. Leroux-Kozal, V. Marty, A. Rapinat, C. Mazouni, B. Sarfati, I. Bieche, C. Balleyguier, D. Gentien, S. Delaloge, M. Lacroix-Triki, S. Michiels, F. Andre
Journal: Annals of Oncology (2018)

BackgroundThe cyclin-dependent kinase 4 (CDK4)/6 inhibitor Palbociclib is a new standard treatment in hormone-receptor positive breast cancer patients. No predictive biomarkers have been identified and no pharmacodynamics has properly been described so far.Patients and methodsPatients with early-breast cancer were randomized 3 : 1 to oral palbociclib 125 mg daily for 14 days until the day before the surgery versus no treatment. Primary objective was antiproliferative response defined as a natural logarithm of Ki67 expression at day 15 below 1. Secondary end points were subgroups analyses and safety. Exploratory analyses included search for predictive biomarkers. Immunostainings (Ki67, RB, pRB, p16, pAKT, pER, pCDK2, CyclinD1), FISH (CCND1) and gene expression (GE) arrays were carried out at baseline and at surgery. In addition, activating PIK3CA and AKT1 mutations were assessed at baseline.Results74 patients were allocated to palbociclib and 26 to control. Most patients (93%) were hormone-receptor (HR)-positive, whereas 8% were HER2-positive. Palbociclib led to significantly more antiproliferative responses when compared with control (58% versus 12%, P< 0.001), and to a significantly higher Ki67 decrease (P < 0.001). In the HR-positive/HER2-negative subgroup, this antiproliferative effect was even more marked in the palbociclib arm when compared with control (70% versus 9%, P< 0.001). Palbociclib treatment led also to a significantly higher decrease from baseline in phospho-Rb when compared with control (P< 0.001). Among treated patients, changes in Ki67 correlated with changes in phospho-Rb (Spearman rank r = 0.41, P< 0.0001). GE analyses confirmed a major effect on proliferation and cell cycle genes. Among treated patients, CCNE2 expression was significantly more decreased in antiproliferative responders versus nonresponders (P= 0.006).ConclusionShort-term preoperative palbociclib decreases Ki67 in early-breast cancer patients. Early decrease of Rb phosphorylation correlates with drug's effect on cell proliferation and could potentially identify patients with primary resistance.Clinical trial registrationNCT02008734.
Prenatal Ultrasonography and Autism Spectrum Disorder
Authors: David Alan Somerset, Robert Douglas Wilson
Journal: JAMA Pediatrics (2018)

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 Pediatrics 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 Pediatrics journal
AB0082 Clinically relevant discrepancies between different rheumatoid factor assays
Authors: W. Falkenburg, H. von Richthofen, J. Koers, C. Weykamp, M. Schreurs, L. Bakker-Jonges, I.-A. Haagen, W. Lems, D. Hamann, D. van Schaardenburg, T. Rispens
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Accurate measurements of rheumatoid factors (RFs), autoantibodies binding IgG, are important for diagnosing rheumatoid arthritis (RA) and for predicting disease course. Worldwide, various RF assays are being used that differ in technique and target antigens. <h3>Objectives</h3> To study whether assay choice leads to clinically important discrepancies in RF status and level. <h3>Methods</h3> RF measurements using 4 commercial RF assays were compared in 32 RF<sup>+</sup> samples. Using ELISAs, the influence of the target antigen source—human IgG (hIgG) versus rabbit IgG (rIgG)—on measured RF levels was investigated in arthralgia patients and RA patients. <h3>Results</h3> Substantial discrepancies were found between RF levels measured in the four commercial assays. 6 samples (19%) with RF levels below or slightly above the cut-off in an rIgG-based assay were RF<sup>+</sup> in three assays using hIgG as the target antigen, some with very high levels. Direct ELISA comparisons of RF reactivity against hIgG and rIgG estimated that among 173 ACPA<sup>+</sup> arthralgia patients, originally RF negative in rIgG-based assays, up to 10% were single positive against hIgG. Monoclonal RFs binding to hIgG and rIgG or hIgG only supported these findings. In a cohort of 69 early RA patients, virtually all RF responses reacted with both targets, although levels were still variable. <h3>Conclusions</h3> The use of RF assays that differ in technique and target antigen, together with the different specificities of RF responses, leads to discrepancies in RF status and levels. This has important consequences for patient care if RA diagnosis and disease progression assessments are based on RF test results. <h3>Disclosure of Interest</h3> None declared
Diagnosis of Primary Ciliary Dyskinesia. An Official American Thoracic Society Clinical Practice Guideline
Authors: Adam J. Shapiro, Stephanie D. Davis, Deepika Polineni, Michele Manion, Margaret Rosenfeld, Sharon D. Dell, Mark A. Chilvers, Thomas W. Ferkol, Maimoona A. Zariwala, Scott D. Sagel, Maureen Josephson, Lucy Morgan, Ozge Yilmaz, Kenneth N. Olivier, Carlos Milla, Jessica E. Pittman, M. Leigh Anne Daniels, Marcus Herbert Jones, Ibrahim A. Janahi, Stephanie M. Ware, Sam J. Daniel, Matthew L. Cooper, Lawrence M. Nogee, Billy Anton, Tori Eastvold, Lynn Ehrne, Elena Guadagno, Michael R. Knowles, Margaret W. Leigh, Valery Lavergne
Journal: American Journal of Respiratory and Critical Care Medicine (2018)

Section:ChooseTop of pageAbstract <<ContentsGoals of This GuidelineIntroductionMethodsRecommendations for Speci...Conclusions: Proposed Dia...ReferencesCITING ARTICLES
Dietary Patterns Over Time and Microalbuminuria in Youth and Young Adults With Type 1 Diabetes: The SEARCH Nutrition Ancillary Study
Authors: Tina Costacou, Jamie Crandell, Anna R. Kahkoska, Angela D. Liese, Dana Dabelea, Jean M. Lawrence, David J. Pettitt, Kristi Reynolds, Elizabeth J. Mayer-Davis, Amy K. Mottl
Journal: Diabetes Care (2018)

OBJECTIVE We assessed the association between diet quality and microalbuminuria in youth-onset type 1 diabetes using three indices: a modified Mediterranean diet score for children and adolescents (mKIDMED), the Dietary Approaches to Stop Hypertension (DASH), and the Healthy Eating Index-2010 (HEI). RESEARCH DESIGN AND METHODS Youth and young adults from the SEARCH (SEARCH for Diabetes in Youth) Nutrition Ancillary Study (SNAS) diagnosed with type 1 diabetes in 2002–2008, who had repeated dietary assessments at baseline and follow-up visits and urine albumin-to-creatinine ratio (UACR) measured at the outcome visit (2012–2015) (n = 461), were selected for study. Regression models estimated the association between each longitudinally assessed diet score and UACR and microalbuminuria (UACR ≥30 μg/mg). RESULTS The cohort was 43% female, and at follow-up, mean age was 20 years, disease duration was 108 months, and 7% had microalbuminuria. Adherence to a higher-quality diet was low for the mKIDMED (mean 3.7 of a possible range of −3 to 12) and the DASH (mean 42 of 80) and better, for the HEI (mean 56.3 of 100). A borderline inverse association was observed between the HEI score and microalbuminuria after adjustment for caloric and protein intake and demographic and disease factors (odds ratio [OR]HEI 0.83, P = 0.07), which lost significance with further adjustment for HbA1c and systolic blood pressure (ORHEI 0.86, P = 0.19). Results were similar for continuous UACR. No significant associations were observed for diet quality characterized by the mKIDMED or DASH indices. CONCLUSIONS Greater adherence to the HEI may be beneficial for kidney health in youth and young adults with type 1 diabetes. Low adherence to the mKIDMED and DASH diets may explain the lack of association with microalbuminuria.
Increased risk for autochthonous vector-borne infections transmitted by Aedes albopictus in continental Europe
Authors: Céline M Gossner, Els Ducheyne, Francis Schaffner
Journal: Eurosurveillance (2018)

Autochthonous outbreaks of chikungunya and dengue during the past decade showed that continental Europe is vulnerable to Aedes albopictus –borne infections. Ae. albopictus has spread geographically, resulting in more people exposed to risk. Timely application of adequate mosquito suppression measures may delay, or even prevent, the vector population from crossing the potential epidemic abundance threshold should a pathogen be introduced. Health authorities should be on alert to detect early cases to prevent autochthonous outbreaks.
SAT0530 Clinical features association with hla-b allelic types (B27, B51) in korean patients of behcet’s disease
Authors: J.H. Kim, J.H. Jung, S.J. Choi, Y.H. Lee, J.D. Ji, G.G. Song
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The recurrent oral ulcer frequently occur as a first clinical manifestation of Behcet's disease (BD), but BD is characterised by considerable phenotypic variation, comprising a myriad of manifestations, e.g. recurrent genital ulcers and skin, joint, eye, vascular and/or CNS involvement. BD is well known to be associated with HLA-B51 antigen. HLA B27 antigen is famous for association with spondyloarthropathy. But BD is also observed in HLA B27 positive patients. <h3>Objectives</h3> The aim of this study was to clarify the clinical features association with HLA-B antigens (B27, B51) in Korean patients of Behcet's disease. <h3>Methods</h3> We genotyped HLA-B alleles in 433 patients who showed recurrent oral ulcer. The diagnosis of BD was determined according to revised international study group criteria. Among them, 126 patients of BD were included. The genotyping was performed using 66 sets of sequence specific DNA probe (PCR-SSP). The clinical feature was assessed according to HLA B allele in the patients diagnosed with BD. <h3>Results</h3> HLA-B51 allele frequency was more frequent in both 126 BD patients and 433 total patients and the frequency was 40 (31.7%) and 110 (25,4%) respectively. Among the HLA B51 +BD patients (n=40), similar gender ratio was observed (Male 52.5%, Female 47.5%) and clinical features of diagnostic criteria were dominant. Among the HLA B27 +BD patients (n=17), genital ulcer and skin lesions were dominant. HLA B27 +B51+BD patient was one and clinical features were genital ulcer, skin lesion and arthritis. <h3>Conclusions</h3> The specific clinical features of BD were observed in HLA-B51 +BD patients. In HLA B27 +BD patients, genital ulcer and skin lesions were more observed. The study about clinical features associated with HLA-B allele (B27, B51) in spondyloarthropathy patients is also needed. <h3>References</h3> [1] Hamzaoui A, Houman MH, Massouadia M, et al. Contribution of Hla-B51 in the susceptibility and specific clinical features of Behcet's disease in Tunisian patients. Eur J Intern Med2012;23(4):347–9. [2] Sakly N, Boumiza R, Zrour-Hassen S, et al. HLA-B27 and HLA-B51 determination in Tunisian healthy subjects and patients with suspectedankylosing spondylitis and Behçet's disease. Ann N Y Acad Sci2009;1173:564–9. [3] Montes-Cano MA, Conde-Jaldón M, García-Lozano JR, et al. HLA and non-HLA genes in Behçet's disease: a multicentric study in the Spanish population. Arthritis Res Ther2013;15(5):R145. [4] Maldini C, Lavalley MP, Cheminant M, et al. Relationships of HLA-B51 or B5 genotype with Behcet's disease clinical characteristics: systematic review and meta-analyses of observational studies. Rheumatology (Oxford)2012;51(5):887–900. <h3>Disclosure of Interest</h3> None declared
Merkel Cell Carcinoma, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology
Authors: Christopher K. Bichakjian, Thomas Olencki, Sumaira Z. Aasi, Murad Alam, James S. Andersen, Rachel Blitzblau, Glen M. Bowen, Carlo M. Contreras, Gregory A. Daniels, Roy Decker, Jeffrey M. Farma, Kris Fisher, Brian Gastman, Karthik Ghosh, Roy C. Grekin, Kenneth Grossman, Alan L. Ho, Karl D. Lewis, Manisha Loss, Daniel D. Lydiatt, Jane Messina, Kishwer S. Nehal, Paul Nghiem, Igor Puzanov, Chrysalyne D. Schmults, Ashok R. Shaha, Valencia Thomas, Yaohui G. Xu, John A. Zic, Karin G. Hoffmann, Anita M. Engh
Journal: Journal of the National Comprehensive Cancer Network (2018)

This selection from the NCCN Guidelines for Merkel Cell Carcinoma (MCC) focuses on areas impacted by recently emerging data, including sections describing MCC risk factors, diagnosis, workup, follow-up, and management of advanced disease with radiation and systemic therapy. Included in these sections are discussion of the new recommendations for use of Merkel cell polyomavirus as a biomarker and new recommendations for use of checkpoint immunotherapies to treat metastatic or unresectable disease. The next update of the complete version of the NCCN Guidelines for MCC will include more detailed information about elements of pathology and addresses additional aspects of management of MCC, including surgical management of the primary tumor and draining nodal basin, radiation therapy as primary treatment, and management of recurrence.
Melanocortin 4 receptors switch reward to aversion
Authors: Alexandra G. DiFeliceantonio, Paul J. Kenny
Journal: Journal of Clinical Investigation (2018)

The ability to recognize and avoid noxious stimuli is essential for survival. The factors that determine whether a given stimulus is considered positive or negative are complex and not fully understood. In this issue of the JCI, Klawonn and colleagues demonstrate that melanocortin 4 receptor (MC4R) signaling is critical for proper responses to negative stimuli. Mice lacking MC4R were shown to have a surprising preference for aversive stimuli compared with WT animals. Moreover, the authors provide evidence that avoidance behaviors are mediated by hypothalamic POMC neurons signaling to striatal dopamine D1 receptor-expressing medium spiny neurons. Together, these results provide important insight into the regulation of responses to aversive stimuli.