tbuckley/cabot-search huggingface dataset:
Noninvasive liver fibrosis index changes during chemotherapy: Marker for oxaliplatin-induced hepatic sinusoidal obstruction syndrome.
Authors: Sehhoon Park, Hwi Young Kim, Jin Hyun Park, Ki Hwan Kim, Won Kim, In Sil Choi, Yong Jin Jung, Jin-Soo Kim
Journal: Journal of Clinical Oncology (2014)

9617 Background: Even though oxaliplatin (OXA) could induce hepatic sinusoidal obstruction syndrome (SOS), OXA-based regimes are still standard treatment for patients with colorectal (CRC) and advanced gastric cancer (AGC). The aim of the study was to evaluate the utility of non-invasive liver fibrosis index (NIFI) for monitoring OXA-induced hepatic SOS. Methods: From February 2004 to December 2013 patients with CRC or AGC who received OXA-based chemotherapy (CTx) were identified in the institutional electronic patient database. Liver fibrosis were evaluated before and after the OXA exposure with splenic volume index (SVI) and 4 different NIFIs: age-platelet index (API), AST to platelet ratio index (APRI), platelet to spleen ratio (PSR), Fibrosis-4 score (FIB-4). Adjusted odd ratio (aOR) with 95% confidence intervals (CI) were analyzed to evaluate risk after matching age, body mass index, cancer type, stage, previous chemotherapy cycle. Results: A total of 288 patients (pts) were eligible for evaluation: 211 pts were male and median age was 65; 206pts had CRC; 82pts had AGC; median OXA cumulative dose was 798.80mg/m2and median duration of OXA based chemotherapy was 4.87 months. Increase in SVI were directly correlated with the cumulative OXA dose (p=0.005). Using a cutoff of SVI ≥ 0.3, 120 pts (41.67%) were positive for hepatic SOS. All of the 4 NIFIs were significantly correlated with SVI. aOR for each NIFI were show in the Table. Conclusions: Changes of NIFIs showed good correlation with SVI changes during OXA-based chemotherapy. NIFIs could be useful for non-invasive monitoring of OXA induced hepatic SOS. N=288 (mean ± standard deviation) SVI ≥ 0.3 N=120, (41.67%) SVI<0.3 N=168, (58.33%) NIFIs changes before and after OXA-based chemotherapy API 2.40 ± 1.90 2.73 ± 1.91 2.17 ± 1.86 APRI 0.41 ± 1.59 0.64 ± 2.34 0.25 ± 0.60 PSR 1.10 ± 1.97 0.36 ± 1.72 1.63 ± 1.98 FIB-4 1.76 ± 3.24 2.41 ± 4.45 1.29 ± 1.84 aOR 95% CI P value Adjusted OR for NIFIs API 1.16 1.01-1.32 0.032 APRI 1.98 1.12-3.50 0.018 PSR 0.67 0.58-0.79 <0.001 FIB-4 1.28 1.11-1.49 0.001
Decreasing wait times for endobronchial ultrasound (EBUS).
Authors: Karen L. Mackenney, Saadia Faiz, Andrew J Larson, George A Eapen, Lara Bashoura
Journal: Journal of Clinical Oncology (2017)

192 Background: The department of pulmonary medicine evaluates manifestations of cancer and complications of therapy that affect the lungs. It is a procedurally oriented specialty with many diagnostic and therapeutic interventions. Endobronchial ultrasound with transbronchial fine needle aspiration (EBUS-TBNA) is a minimally invasive procedure that allows real time image guided sampling of tissue in the mediastinum. Current guidelines recommend use of EBUS for the initial test to diagnosis and stage lung cancer. It has a low complication rate, but needs specialized equipment as well as anesthesia support. Alternatives include CT-guided biopsy or surgery. The delay from time of referral to EBUS procedure has the potential to delay diagnosis and treatment, create patient anxiety, frustration and expense of travel for multiple appointments. The staff is under pressure to perform excessive cases on a daily basis resulting in overtime staffing costs. Our objectives were to reduce delays in diagnosis/treatment, improve patient satisfaction, improve referring services satisfaction and optimize the use of resources and improve staff working conditions. Methods: We used a Plan, Do, Study, Act process. Initially the process flow diagram was utilized along with a fishbone diagram to allow us to focus on the issues. The aim was to decrease EBUS wait time 20% by 7/2016. Our process flow sheet was arranged into swimlanes in order to identify focus areas. This allowed us to redesign the workflow to improve capacity and improve existing resources to be more efficient. Results: Working with anesthesia services and the cardiopulmonary center staff, we were able to open a second bronchoscopy suite 2 days a week for additional EBUS cases. We also had monthly meetings with issues and to monitor delays to other services. Conclusions: We were able to reduce our wait time from 7.5 days to 4.27 work days. The added capacity allows for surge in demand for EBUS. Our future studies will concentrate on patient and referring service satisfaction, cost savings with reduction in overtime, quantifying impact on decreasing delays in diagnosis and subsequent treatment.
Preoperative inflammatory biomarkers and neurovegetative symptoms in peritoneal carcinomatosis patients.
Authors: Carissa A. Low, Dana H. Bovbjerg, Frank J. Jenkins, Steven Arthur Ahrendt, Mohammad Haroon Asif Choudry, Matthew Peter Holtzman, Heather L Jones, James F. Pingpank, Lekshmi Ramalingam, Herbert Zeh, Amer H. Zureikat, David L. Bartlett
Journal: Journal of Clinical Oncology (2014)

e20628 Background: Inflammation plays a central role in peritoneal carcinomatosis (PC) etiology and progression, and circulating levels of inflammatory biomarkers prior to surgery predict progression-free and overall survival in PC patients. Inflammatory biomarkers also induce central nervous system changes leading to “sickness behaviors” in animal models (e.g., reduced physical activity) and analogous neurovegetative symptoms in humans (e.g. fatigue, restless sleep). As yet unstudied is the possibility that heightened levels of inflammatory markers in PC patients may contribute to their experience of common neurovegetative symptoms, impairing quality of life (QoL). Methods: Validated self-report measures of fatigue (FACIT), neurovegetative depressive symptoms (CESD), and QoL (FACT) were administered to 65 patients scheduled to undergo aggressive surgical treatment for PC (M = 54 years old; 66% male; 52% appendiceal cancer, 37% colorectal cancer, 6% mesotheolioma). Serum samples were collected the morning of surgery, and ELISAs were conducted to quantify circulating IL-6, CRP, and TNF-α levels. Analyses adjusted for age, sex, and body mass index. Results: Consistent with hypotheses, higher IL-6 levels were associated with more severe fatigue (β =-.38, p < .01) and neurovegetative symptoms on the CESD (β = .30, p < .05). IL-6 was also related to overall QoL (β = -.30, p < .05), largely due to significant correlations with physical and functional subscales of the FACT. IL-6 was not significantly related to emotional symptoms on the CESD or to emotional or social functioning aspects of QoL. CRP showed a similar pattern of relationships with fatigue and QoL, while TNF-α levels were not related to patient-reported measures. Conclusions: Preoperative IL-6 and CRP levels contribute to patients’experiences of fatigue and neurovegetative depressive symptoms, impairing physical and functional QoL prior to surgery. These biological mechanisms warrant consideration in the clinical management of neurovegetative symptoms in PC patients. Prospective longitudinal data are needed to elucidate relationships between inflammation and symptoms after surgery.
Detection of Atherosclerotic Inflammation by 68 Ga-DOTATATE PET Compared to [ 18 F]FDG PET Imaging
Authors: Jason M. Tarkin, Francis R. Joshi, Nicholas R. Evans, Mohammed M. Chowdhury, Nichola L. Figg, Aarti V. Shah, Lakshi T. Starks, Abel Martin-Garrido, Roido Manavaki, Emma Yu, Rhoda E. Kuc, Luigi Grassi, Roman Kreuzhuber, Myrto A. Kostadima, Mattia Frontini, Peter J. Kirkpatrick, Patrick A. Coughlin, Deepa Gopalan, Tim D. Fryer, John R. Buscombe, Ashley M. Groves, Willem H. Ouwehand, Martin R. Bennett, Elizabeth A. Warburton, Anthony P. Davenport, James H.F. Rudd
Journal: Journal of the American College of Cardiology (2017)

Inflammation drives atherosclerotic plaque rupture. Although inflammation can be measured using fluorine-18-labeled fluorodeoxyglucose positron emission tomography ([18F]FDG PET), [18F]FDG lacks cell specificity, and coronary imaging is unreliable because of myocardial spillover. This study tested the efficacy of gallium-68-labeled DOTATATE (68Ga-DOTATATE), a somatostatin receptor subtype-2 (SST2)-binding PET tracer, for imaging atherosclerotic inflammation. We confirmed 68Ga-DOTATATE binding in macrophages and excised carotid plaques. 68Ga-DOTATATE PET imaging was compared to [18F]FDG PET imaging in 42 patients with atherosclerosis. Target SSTR2 gene expression occurred exclusively in “proinflammatory” M1 macrophages, specific 68Ga-DOTATATE ligand binding to SST2 receptors occurred in CD68-positive macrophage-rich carotid plaque regions, and carotid SSTR2 mRNA was highly correlated with in vivo 68Ga-DOTATATE PET signals (r = 0.89; 95% confidence interval [CI]: 0.28 to 0.99; p = 0.02). 68Ga-DOTATATE mean of maximum tissue-to-blood ratios (mTBRmax) correctly identified culprit versus nonculprit arteries in patients with acute coronary syndrome (median difference: 0.69; interquartile range [IQR]: 0.22 to 1.15; p = 0.008) and transient ischemic attack/stroke (median difference: 0.13; IQR: 0.07 to 0.32; p = 0.003). 68Ga-DOTATATE mTBRmax predicted high-risk coronary computed tomography features (receiver operating characteristics area under the curve [ROC AUC]: 0.86; 95% CI: 0.80 to 0.92; p < 0.0001), and correlated with Framingham risk score (r = 0.53; 95% CI: 0.32 to 0.69; p <0.0001) and [18F]FDG uptake (r = 0.73; 95% CI: 0.64 to 0.81; p < 0.0001). [18F]FDG mTBRmax differentiated culprit from nonculprit carotid lesions (median difference: 0.12; IQR: 0.0 to 0.23; p = 0.008) and high-risk from lower-risk coronary arteries (ROC AUC: 0.76; 95% CI: 0.62 to 0.91; p = 0.002); however, myocardial [18F]FDG spillover rendered coronary [18F]FDG scans uninterpretable in 27 patients (64%). Coronary 68Ga-DOTATATE PET scans were readable in all patients. We validated 68Ga-DOTATATE PET as a novel marker of atherosclerotic inflammation and confirmed that 68Ga-DOTATATE offers superior coronary imaging, excellent macrophage specificity, and better power to discriminate high-risk versus low-risk coronary lesions than [18F]FDG. (Vascular Inflammation Imaging Using Somatostatin Receptor Positron Emission Tomography [VISION]; NCT02021188)
Survival outcomes for patients with equivocal <sup>18</sup>FDG-PET CT scan for extrahepatic disease prior to liver resection for metastatic colorectal cancer.
Authors: Rajiv Kumar, Carol Beeke, Shahid Ullah, Timothy Jay Price, Rob Padbury, David Roder, Christos Stelios Karapetis
Journal: Journal of Clinical Oncology (2013)

1581 Background: Patients considered for liver resection (LR) for hepatic metastases from metastatic colorectal cancer (mCRC) have an 18 FDG-PET CT scan (PET) to exclude extrahepatic disease (EHD). The prognostic significance of an equivocal PET on overall survival (OS) for patients who proceed to LR is not entirely clear. The aim of the study is to compare OS for patients with equivocal PET prior to LR to those with a PET negative for EHD. Methods: The South Australian Metastatic Colorectal Cancer Registry collects data for mCRC patients diagnosed after February 1, 2006. Patients were included if they had LR and a PET prior to LR. PETs were coded as no EHD and possible EHD. The Cox proportional hazard model was applied to analyse the outcome of patients with an equivocal PET for EHD on OS, adjusting for possible confounders. Results: Of the 2,480 patients on the registry, 273 had had LR. Of these, 183 (67.0%) had a PET prior to LR, with 137 having no EHD and 46 having possible EHD. The no EHD and possible EHD groups were well balanced for patient, tumour and treatment characteristics – mean age: 66.7 yrs-vs-68.4 yrs, male gender: 61.3%-vs-63.0%, KRAS wildtype: 11.0%-vs-16.3%, stage IV disease at initial diagnosis: 49.6%-vs-54.3%, colonic primary: 74.4%-vs-65.2%, one LR: 82.5%-vs-89.1%, one line of chemotherapy: 52.4%-vs-48.6% and well-moderate tumour differentiation: 85.7%-vs-86.4%. The median follow-up was 32.9 months for no EHD and 33.6 months for possible EHD (P-value = 0.84). The OS for no EHD compared with possible EHD at 1-year was 98.5%-vs-93.5%, at 2-years was 87.6%-vs-88.0%, and at 5-years was 61.5%-vs-59.4%. The unadjusted hazard ratio for OS was 1.22 (95% CI 0.64–2.34, P-value = 0.54) for possible EHD. On adjustment for age, gender, stage at diagnosis, primary site, number of LRs, lines of chemotherapy and tumour differentiation, the hazard ratio remained non-significant; however lower (HR=0.76 (95% CI 0.37–1.59, P-value = 0.47)), for possible EHD. Conclusions: A PET was only performed in 67.0% of patients who had LR for mCRC. There was no difference in OS between patients with no EHD and possible EHD on PET who proceed to LR.
Bertram Gerard Moon
Authors: Graham Moon
Journal: BMJ (2017)

Bertram Gerard Moon (“Mickey”) was born into a large family, many of whom were teachers. He was his parents’ firstborn child, and three sisters followed. His father died when Mickey was just 9 years old, and his teacher aunts schooled him to success in the scholarship exams and ensured he was able to complete his secondary education at the then Wednesbury Boys High School. He excelled at sport and the sciences but, by his own admission, had little idea what he wanted to do for a career. Family and school intervened, and he took up an apprenticeship with Boots …
Inferior Vena Caval Filter Insertion in Trauma Patients
Authors: Mark C. Fitzgerald, Biswadev Mitra
Journal: JAMA Surgery (2017)

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
Isolation and Characterization of Broad and Ultrapotent Human Monoclonal Antibodies with Therapeutic Activity against Chikungunya Virus
Authors: Scott A. Smith, Laurie A. Silva, Julie M. Fox, Andrew I. Flyak, Nurgun Kose, Gopal Sapparapu, Solomiia Khomandiak, Alison W. Ashbrook, Kristen M. Kahle, Rachel H. Fong, Sherri Swayne, Benjamin J. Doranz, Charles E. McGee, Mark T. Heise, Pankaj Pal, James D. Brien, S. Kyle Austin, Michael S. Diamond, Terence S. Dermody, James E. Crowe
Journal: Cell Host & Microbe (2015)
Physician Factors Determining Treatment Decisions in Selecting Second Line Agents for Pediatric ITP
Authors: Michele P. Lambert, Rachael F Grace, Cindy Neunert, Jenny M. Despotovic, Rukhmi Bhat, Yves D. Pastore, George R. Buchanan, Robert J. Klaassen, Carolyn M. Bennett, Jennifer A Rothman, Vicky R. Breakey, James B. Bussel, Melissa J. Rose, Amy Geddis, Kristin Shimano, Kerry Hege, Kristina M. Haley, Adonis Lorenzana, Michael Jeng, Shelley E. Crary, Michelle Neier, Travis Brown, Peter Forbes, Ellis J Neufeld
Journal: Blood (2016)
SURFACE TENSION OF SERUM
Authors: P. Lecomte du Noüy
Journal: The Journal of Experimental Medicine (1924)

An attempt was made to apply the assumption that a monolayer of serum exists at a certain dilution, in order to calculate the thickness of this layer or, that is to say, the mean value of one of the dimensions of the molecules of the serum proteins. The criterion taken for the existence of such a monolayer was the existence at a given concentration (1/11,000 for rabbit serum) of a maximum drop in the surface tension of serum solutions kept in watch-glasses. A series of preliminary experiments showed: 1. That the maximum drop in 2 hours took place, for the material used, at a concentration of 1/11,000, and that it always corresponded to an absolute minimum value of the surface tension of the solution, this minimum being quite sharp and well defined. 2. That adsorption took place on the glass as well as on the free surface of the liquid, and that apparently the same part of the molecule, in both cases, was drawn toward the water. 3. That the specific gravity of the anhydrous proteins of the rabbit serum studied was 1.275, whence it followed, on the basis of 6.51 per cent protein content, that the mean thickness of the protein molecules was 35.4 x 10(-8) cm. The same method applied to crystalline egg albumin, pH 6.8, in water, gave 52.8 x 10(-8) cm. for the probable molecular length.
Bystander Defibrillation for Out-of-Hospital Cardiac Arrest in Public vs Residential Locations
Authors: Steen Møller Hansen, Carolina Malta Hansen, Fredrik Folke, Shahzleen Rajan, Kristian Kragholm, Linda Ejlskov, Gunnar Gislason, Lars Køber, Thomas A. Gerds, Søren Hjortshøj, Freddy Lippert, Christian Torp-Pedersen, Mads Wissenberg
Journal: JAMA Cardiology (2017)

Bystander-delivered defibrillation (hereinafter referred to as bystander defibrillation) of patients with out-of-hospital cardiac arrests (OHCAs) remains limited despite the widespread dissemination of automated external defibrillators (AEDs).To examine calendar changes in bystander defibrillation and subsequent survival according to a public or a residential location of the cardiac arrest after nationwide initiatives in Denmark to facilitate bystander-mediated resuscitative efforts, including bystander defibrillation.This nationwide study identified 18 688 patients in Denmark with first-time OHCA from June 1, 2001, to December 31, 2012, using the Danish Cardiac Arrest Registry. Patients had a presumed cardiac cause of arrest that was not witnessed by emergency medical services personnel. Data were analyzed from April 1, 2015, to December 10, 2016.Nationwide initiatives to facilitate bystander resuscitative efforts, including bystander defibrillation, consisted of resuscitation training of Danish citizens, dissemination of on-site AEDs, foundation of an AED registry linked to emergency medical dispatch centers, and dispatcher-assisted guidance of bystander resuscitation efforts.The proportion of patients who received bystander defibrillation according to the location of the cardiac arrest and their subsequent 30-day survival.Of the 18 688 patients with OHCAs (67.8% men and 32.2% women; median [interquartile range] age, 72 [62-80] years), 4783 (25.6%) had a cardiac arrest in a public location and 13 905 (74.4%) in a residential location. The number of registered AEDs increased from 141 in 2007 to 7800 in 2012. The distribution of AED location was consistently skewed in favor of public locations. Bystander defibrillation increased in public locations from 3 of 245 (1.2%; 95% CI, 0.4%-3.5%) in 2001 to 78 of 510 (15.3%; 95% CI, 12.4%-18.7%) in 2012 (P < .001) but remained unchanged in residential locations from 7 of 542 (1.3%; 95% CI, 0.6%-2.6%) in 2001 to 21 of 1669 (1.3%; 95% CI, 0.8%-1.9%) in 2012 (P = .17). Thirty-day survival after bystander defibrillation increased in public locations from 8.3% (95% CI, 1.5%-35.4%) in 2001/2002 to 57.5% (95% CI, 48.6%-66.0%) in 2011/2012 (P < .001) in residential locations, from 0.0% (95% CI, 0.0%-19.4%) in 2001/2002 to 25.6% (95% CI, 14.6%-41.1%) in 2011/2012 (P < .001).Initiatives to facilitate bystander defibrillation were associated with a marked increase in bystander defibrillation in public locations, whereas bystander defibrillation remained limited in residential locations. Concomitantly, survival increased after bystander defibrillation in residential and public locations.
Reducing invasive fungal infections in patients with acute myeloid leukemia receiving induction and re-induction chemotherapy at the University of Virginia Health System.
Authors: Mohammed Athar Naeem, Amy Morris, Torey Murray, Tanya Thomas, Kathlene Degregory, Heather Cox-Hall, Jessica D Lewis, Anjali Bal, Elizabeth Daniels, Michael Kenneth Keng
Journal: Journal of Clinical Oncology (2017)

120 Background: At the University of Virginia Health System (UVaHS), antifungal prophylaxis was not routinely given to patients undergoing induction and re-induction chemotherapy for acute myeloid leukemia (AML) from 7/2011 to 9/2015. A retrospective chart review of 179 patient encounters identified a 19.7% rate of proven or probable invasive fungal infection (IFI); national averages for IFI are 8-10% in this population. Methods: To target an IFI rate of less than 10%, a multidisciplinary team comprised of oncology and infectious diseases physicians, clinical pharmacists, nurses, and information technology specialists was formed. Through participation in the 2016 ASCO Quality Training Program (QTP), the group developed current and ideal state process maps, a Pareto chart, and a priority matrix to determine an action plan. The group identified the most common problems contributing to IFI: inconsistent definition of IFI, no routine antifungal prophylaxis, and lack of education for the health care team. Results: From 9/2014 to 8/2016, the first PDSA cycle consisted of physicians ordering antifungal prophylaxis on an ad hoc basis, resulting in 11.7% IFI in 77 total patient encounters. During the second PDSA cycle starting in 8/2016, a clinical practice guideline standardized the definition of IFI and appropriate antifungal prophylaxis. Physicians, nurses, and pharmacists were educated on the new standard work. PDSA Cycle #2 is ongoing. As of 11/2016, zero of 8 patient encounters had an IFI. To ensure sustainability of the quality improvement study, monthly electronic medical record reports will capture guideline compliance, specifically the use of antifungal agents, and track future IFI. Future data will be statistically analyzed. Conclusions: Using quality improvement methods learned at ASCO QTP, a multidisciplinary team developed an action plan which to date has shown a clinically significant reduction in IFI; this outcome may lead to decreased hospital length of stay and improved patient quality of life. Further PDSA cycles are scheduled and continuous evaluation of the process is ongoing.