tbuckley/cabot-search huggingface dataset:
The power of knowledge: Sharing patient test results electronically to improve quality of care.
Authors: Melissa Kaan, Jason LeMar, Julie Gilbert, Erin Rae, Anna Sampson, Elaine Meertens, Saul Melamed, Lisa Sarsfield, Jon Kimball, Shazmin Hassam, Garth Matheson
Journal: Journal of Clinical Oncology (2012)

305 Background: For many patients going through the cancer diagnosis journey, the time from suspicion to diagnosis or rule-out can be a confusing and anxious time. To better support patients during this time, Cancer Care Ontario (CCO) is supporting Diagnostic Assessment Programs (DAPs) and the web-based tool known as the Diagnostic Assessment Program–Electronic Pathway Solution (DAP-EPS). DAPs consist of multi-disciplinary healthcare teams who provide diagnostic and supportive care services in a patient-focused environment, improving access to care and the patient experience. DAPs help manage and coordinate a patient’s diagnostic care from testing to a definitive diagnosis and part of this support involves providing access to personal health information through the DAP-EPS. This work was undertaken to determine the best approach to sharing test results with patients, including the type of test results that should be released and the most effective method for sharing these results with patients, from both the patient and provider perspective. Methods: The exploratory project involved conducting key informant interviews with individuals who had been involved with implementing similar patient portals, a targeted literature review, and a series of engagement sessions with physicians to measure the clinical response to this new strategy. Results: Initial discussions with patients and nurses yielded a strong endorsement for releasing all results, with no time delay. Key Informant interviews yielded similar results from the majority of the hospital contacts consulted. The environmental scan did not suggest that releasing results was associated with any adverse patient or provider effects. The physician engagement sessions generated both positive and negative feedback but overall, doctors were comfortable releasing all results, provided there was a delay built into the system. Conclusions: The release of diagnostic test results is seen as a valuable component of quality of care from the perspective of informing and empowering the patient. As the DAP-EPS moves forward with this initiative, the DAP program will continue to monitor the impact that the release of results has on both patients and providers.
RARE-62. INTRAVASCULAR LYMPHOMA WITH CNS INVOLVEMENT SUCCESSFULLY TREATED WITH R-CODOX-M/IVAC
Authors: Jessica Schulte, Ahmed Sawas
Journal: Neuro-Oncology (2016)

Intravascular lymphoma (IVL) is a rare subtype of Non-Hodgkin’s Lymphoma, characterized by the proliferation of neoplastic lymphocytes solely within the lumina of small to medium sized arteries and capillaries, without extension into the surrounding parenchyma. The most common immunotype is diffuse large B-cell, but NK cell and T-cell variants have been described (Ponzoni, 2007). IVL can involve a variety of organs, however there are two main presentations, named for the countries in which these variants predominate. The Western variant typically involves central nervous system (CNS) and skin, while the Asian variant has a predilection for hemophagocytic syndrome and bone marrow involvement. Prognosis is poor overall and while CNS involvement is estimated at approximately 30% of IVL cases, it is also particularly predictive of poor prognosis (Fonkem, 2014; Shimada, 2010). The treatment for IVL is often an anthracycline-based chemotherapy regimen, which has been shown to improve median survival to 13 months, compared to 1.5 months without chemotherapy (Murase 2007). The addition of Rituximab to this regimen has been shown to further increase progression-free and overall survival (Shimada, 2008). However, the standard rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) regimens have poor CNS penetrance, and survival may be improved through incorporation of high dose methotrexate and intrathecal cytarabine. Here, we describe three patients with IVL. They presented with focal neurological deficits and radiographic evidence of CNS involvement. All 3 IVL patients were treated with rituximab, cyclophosphamide, vincristine, doxorubicin, high-dose methotrexate/ifosfamide, etoposide, and high-dose cytarabine (CODOX-M/IVAC). This report will describe clinical presentation, response to treatment, complications, and progression and overall survival of these patients. Their presentations highlight the diagnostic and therapeutic challenge in the management of this occult entity.
Nomogram predicting treatment-related bowel dysfunction for men with localized prostate cancer treated by radical prostatectomy (RP), external-beam radiotherapy (EBRT), and brachytherapy (PI).
Authors: Joseph C. Klink, Jeff M. Michalski, Martin G. Sanda, Mark S. Litwin, Montserrat Ferrer, Daniel A. Hamstra, Meredith M. Regan, Christopher Saigal, Lorna Kwan, Tianming Gao, Eric A. Klein, Michael W. Kattan, Andrew J. Stephenson
Journal: Journal of Clinical Oncology (2012)

55 Background: RP, EBRT, and PI for treatment of clinically localized prostate cancer may negatively impact bowel function. Predictions of treatment-related bowel problems from patient-reported, prospective data may be useful in treatment decision-making. Methods: Patient-reported data on treatment-related bowel problems was obtained from 4 prospective, longitudinal, health-related quality-of-life (HRQOL) protocols comprising 2,668 patients treated between 1999 and 2011 by RP (n=1294), EBRT (n=630), and PI (n=744). A single HRQOL instrument was not uniformly used for each study, though all patients were asked if they experienced bother related to bowel problems using a similar 5-point scale. Patient responses were obtained at baseline and at 2 years after treatment. The endpoint of the model was bowel dysfunction, defined as bowel symptoms that were identified as a moderate-to-big problem. Cox proportional hazards regression analysis was used to model the clinical information and follow-up data. Internal validation was performed using bootstrapping. Results: Significant differences in baseline characteristics such as patient age, ethnicity, and disease severity existed between the treatment groups. Overall, 46 patients (2%) with complete data available had bowel dysfunction at baseline, including 11 (1%), 19 (4%), and 16 (3%) patients treated by RP, EBRT, and PI, respectively (p = 0.001). The overall rate of bowel dysfunction at 2 years in those patients with no bowel dysfunction at baseline was 2%, 10%, and 4% for patients treated by RP, EBRT, and PI, respectively (p &lt; 0.001). In multivariable analysis, EBRT (p &lt; 0.001), PI (p &lt; 0.001), baseline bowel symptoms (p &lt; 0.001), and institution (p = 0.04) were associated with bowel dysfunction. A nomogram based on the predictive parameters had a concordance index of 0.73 and predictions were well-calibrated with observed outcome. Conclusions: An externally validated nomogram that predicts 2-year incidence of bowel dysfunction after treatment for localized prostate cancer has been developed and may be useful for patient counseling regarding treatment options.
RTHP-22. INFLAMMATORY RESPONSE AFTER MODIFIED NANOTHERM AND RADIOTHERAPY OF RECURRENT GLIOBLASTOMA
Authors: Oliver Grauer, Mohammed Jaber, Katharina Hess, Matthias Weckesser, Wolfram Schwindt, Stephan Maring, Walter Stummer, Johannes Wölfer
Journal: Neuro-Oncology (2016)

There is increasing interest in local tumor ablative treatment modalities which induce immunogenic cell death and the generation of tumor specific immune responses. We report the case of a 42-years old female with recurrent GBM who was treated with intratumoral thermotherapy using superparamagnetic iron-oxide nanoparticles (NanoTherm, MagForce GmbH, Munich, Germany; Fe 112 mg/ml) combined with external beam radiotherapy. After tumor resection, the wall of the remaining cavity was covered with nanoparticles using hydroxycellulose mesh and fibrin glue to create high local particle concentrations for subsequent heating in an alternating magnetic field. Postoperative FET-PET-CT showed enhanced metabolic activity at the margins of the resection cavity indicating residual tumor. The Patient underwent six 1-hour hyperthermia sessions and received concomitant radiotherapy at a dose of 39.6 Gy (5 x 1.8 Gy/wk). 14 weeks later, she developed new clinical symptoms. A CT scan showed a ring-enhancing lesion with extensive perifocal edema surrounding the resection cavity, suggestive of abscess formation. The patient underwent re-surgery and was treated with dexamethasone and antibiotics. Microbiological testing was negative. Histopathology revealed sustained necrosis and large amounts of iron-oxide nanoparticles without evidence for tumor activity. The cellular components consisted of granulocytes, MPO+ macrophages and siderophages with ingested nanoparticles. In addition, CD3+ T-cells, predominantly CD8+ T-cells were detected. Follow-up FET-PET-CT two months later revealed no signs of tumor progression and decreasing edema. This is the first report demonstrating that the combination of modified NanoTherm therapy with radiotherapy can induce a strong inflammatory reaction at the resection cavity mimicking abscess formation. We assume that large amounts of cellular debris are released in situ, which can serve as a source of tumor antigens to elicit host CD8+T-cell mediated adaptive immune responses against the tumor. Further investigations are necessary to decipher immune-related effects of modified NanoTherm therapy.
Stereotactic body radiotherapy response and local control rates for hepatic oligometastases.
Authors: Ben Goodman, Cynthia S Johnson, Netsanet Gebregziabher, Mary A. Maluccio, Paul R. Helft, E. Gabriela Chiorean, Higinia Rosa Cardenes
Journal: Journal of Clinical Oncology (2013)

3546 Background: Stereotactic body radiation therapy (SBRT) is a non-invasive, effective technique in the treatment of hepatic oligometastases from solid tumors. We present response and local control rates from our single institution experience. Methods: We treated 79 metastatic liver lesions from 64 different patients using stereotactic body radiation therapy. One colorectal cancer patient was treated three times and four patients were treated twice. Among the 79 metastatic liver lesions treated, 85% had prior chemotherapy. The primary cancer site included: Colorectal 66%, Non-colorectal GI 14%, Breast 6%, Ovarian 5%, NSCLC 3%, and other 6%. The mean GTV size was 37.3 (cc). The mean GTV diameter was 3.1 (cm). The median total dose was 54 (Gy) with the minimum and maximum total dose being 30 and 60 (Gy). Results: The overall local control rate was 94.2%, with estimates at 12, 24, 36, and 48 months being 96.1%, 87.9%, 87.9% and 87.9% following SBRT treatment. When comparing colorectal cancer patients vs all other primary cancer sites, the one year local control rate was 93.4% and 100%. The two and three year local control rates for colorectal cancer vs other primary cancer sites were 84.9% vs 90.9%. Best response was examined as a 4 level response (CR,PR,SD,PD) per the RECIST criteria. Overall, 67% of patients had a response, and less than 3% of patients had progression with SBRT treatment. For colorectal cancer patients, 79% had a response to treatment. Only 21% of colorectal cancer patients did not respond, however, the majority of these patients still had stable disease following treatment. Non-colorectal primary site cancers had a response in 50% of the lesions following SBRT treatment. The remaining 50% of non-colorectal primary cancers were stable following SBRT treatment and none progressed. The median dose for CR, PR, or SD was 54 Gy. The median dose for patients with progressive disease was less than 50 Gy. The observed CTC toxicities were limited with mostly grade 1-2 toxicity and only two grade 4 and one grade 5 toxicity. Conclusions: Stereotactic body radiation therapy is an effective treatment option for patients with hepatic oligometastases with a limited toxicity profile.
Association Between Subclinical Cardiac Biomarkers and Clinically Manifest Cardiac Diseases With Cortical Cerebral Microinfarcts
Authors: Saima Hilal, Yuek Ling Chai, Susanne van Veluw, Muhammad Amin Shaik, Mohammad Kamran Ikram, Narayanaswamy Venketasubramanian, Arthur Mark Richards, Geert Jan Biessels, Christopher Chen
Journal: JAMA Neurology (2017)

<h3>Importance</h3> Subclinical and clinical cardiac diseases have been previously linked to magnetic resonance imaging (MRI) manifestations of cerebrovascular disease, such as lacunes and white matter hyperintensities, as well as dementia. Cortical cerebral microinfarcts (CMIs), a novel MRI marker of cerebral vascular disease, have not been studied, to date, in relation to subclinical and clinical cardiac diseases. <h3>Objective</h3> To examine the association of blood biomarkers of subclinical cardiac disease and clinically manifest cardiac diseases with CMIs graded on 3-T MRI in a memory clinic population. <h3>Design, Setting, and Participants</h3> This baseline cross-sectional analysis of a cohort study performed from August 12, 2010, to July 28, 2015, included 464 memory clinic participants. All participants underwent collection of blood samples, neuropsychological assessment, and 3-T MRI. <h3>Exposures</h3> N-terminal pro–brain natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) concentrations were measured by electrochemiluminescence immunoassays. Cardiac disease was defined as a history of atrial fibrillation, ischemic heart diseases, or congestive heart failure. <h3>Main Outcomes and Measures</h3> The CMIs were graded according to a previously validated protocol. <h3>Results</h3> Of 464 participants, 124 had insufficient blood plasma samples and 97 had no CMI grading (none, incomplete, or ungradable MRI), leaving a sample size of 243 for final analysis (mean [SD] age, 72.8 [9.1] years; 116 men [42.9%]). Seventy participants (28.8%) had cortical CMIs (median, 1; range, 0-43). Compared with participants with no CMIs, those with CMIs had a significantly higher prevalence of atrial fibrillation (rate ratio [RR], 1.62; 95% CI, 1.20-21.8), ischemic heart disease (RR, 4.31; 95% CI, 3.38-5.49), and congestive heart failure (RR, 2.05; 95% CI, 1.29-3.25). Significantly higher levels of NT-proBNP (RR, 3.16; 95% CI, 2.33-4.27) and hs-cTnT (RR, 2.17; 95% CI, 1.00-4.74) were found in participants with CMIs. In multivariate models adjusted for demographics and vascular risk factors, higher levels of NT-proBNP (RR, 3.19; 95% CI, 2.62-3.90) and hs-cTnT (RR, 4.86; 95% CI, 3.03-7.08) were associated with CMIs. These associations persisted even after excluding patients with clinically manifest cardiac disease. <h3>Conclusions and Relevance</h3> This study found that biomarkers of subclinical cardiac disease and clinically manifest cardiac diseases were associated with CMIs on 3-T MRI in patients attending a memory clinic, suggesting that cardiac disease may contribute to the development of CMIs. Hence, cardiac dysfunction should be targeted as a potentially modifiable factor to prevent CMI-related brain injury.
Bendamustine Plus Rituximab (BR) in the Treatment of Relapsed/Refractory Mantle Cell Lymphoma of a Phase 2 Study: Multivariate Analysis and Updated Final Results By Subgroup
Authors: Myron S. Czuczman, Andre Goy, Dominick Lamonica, Daniel A. Graf, Mihaela C. Munteanu, Richard H. van der Jagt
Journal: Blood (2014)
First generation of a small chemical molecule ROR1 RTK tyrosine kinase inhibitor
Authors: H. Mellstedt, M. Hojjat-Farsangi, A.H. Daneshmanesh, A. Moshfegh, S. Byström, M. Norin, T. Olin, J. Schultz, J. Vågberg, A. Österborg
Journal: Annals of Oncology (2016)
“No compelling evidence” shows that integrated care in England saves money, says NAO
Authors: Gareth Iacobucci
Journal: BMJ (2017)

The government’s spending watchdog has found “no compelling evidence” that integrating health and social care in England will lead to sustainable financial savings or reduced acute hospital activity.

In a new report,1 the National Audit Office (NAO) concluded that progress towards integration of health and social care in England has been slower and less successful than envisaged and has not delivered all of the expected benefits for patients, the NHS, or local government. As a result, it warned, the government’s plan for integrated health and social care services across England by 2020 is at “significant risk.”

The report said that the government’s Better Care Fund, …
197P Tumor-infiltrating lymphocytes predict the chemotherapeutic outcomes in patients with stage IV colorectal cancer
Authors: M. Shibutani, K. Maeda, H. Nagahara, T. Fukuoka, Y. Iseki, S. Matsutani, T. Tamura, G. Ohira, S. Yamazoe, K. Kimura, T. Toyokawa, R. Amano, H. Tanaka, K. Muguruma, K. Hirakawa, M. Ohira
Journal: Annals of Oncology (2016)
Decrease in the Prevalence of Wheeze and Eczema Among Japanese Children: Findings from a Nation-Wide Survey in 2005, 2008, and 2015
Authors: Emi Kawaguchi Morikawa, Koichi Yoshida, Mari Sasaki, Yuichi Adachi, Hiroshi Odajima, Hirohisa Saito, Akira Akasawa
Journal: Journal of Allergy and Clinical Immunology (2017)
Microbiopsy Biomarker Profiling in a Superficial Melanoma Resembling a Pigmented Basal Cell Carcinoma
Authors: Priyamvada Sobarun, Van L. T. Hoang, Miko Yamada, Duncan Lambie, H. Peter Soyer, Tarl W. Prow
Journal: JAMA Dermatology (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 Dermatology 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 Dermatology journal
Identification of Genes Affected during Myeloid Differentiation Induced by Valproic Acid and Retinoic Acid: The Choice of Array Pre-Processing and Normalization Algorithm Has a Critical Effect on Results.
Authors: Windy D. Berkofsky-Fessler, Melanie-Jane McConnell, Donna S. Neuberg, Jonathan D. Licht
Journal: Blood (2004)
20P Verification of mechanism that CSC markers are implicated in poor prognosis for pancreatic ductal adenocarcinoma
Authors: K. Arima, T. Ishimoto, M. Ohmuraya, H. Okabe, Y. Kitano, K. Yamamura, T. Kaida, S. Nakagawa, K. Imai, D. Hashimoto, A. Chikamoto, Y.-I. Yamashita, H. Baba
Journal: Annals of Oncology (2016)
Serum Ferritin Is an Independent Predictive Marker for Stem Cell Mobilization Efficacy in Patients with Hematologic Malignancy.
Authors: Soo-Jeong Kim, Hye Won Lee, Sul Hee Yoon, In-Hae Park, Yuri Kim, Jin Seok Kim, June-Won Cheong, Yoo-Hong Min
Journal: Blood (2006)
Next Generation Sequencing of B Cell Antigen Receptors Expressed in African Endemic Burkitt Lymphoma
Authors: Katharine Lombardo, Andrea M. H. Towlerton, Alicia Morales, Sarah Gerdts, Innocent Mutyaba, Abrahams Omoding, Jackson Orem, Erica Sessle, Corey Casper, Edus Warren
Journal: Blood (2014)
Comparison of Mutation Profile Among Responders and Non-Responders in a Cohort of Patients with Relapsed/Refractory Myeloid Malignancies Treated with MEK 1/2 Inhibitor Trametinib
Authors: Amber Johnson, Ann Marie Bailey, Kenna Shaw, Jorge E. Cortes, Tapan Kadia, Elias J Jabbour, Farhad Ravandi, Funda Meric-Bernstam, Hagop M. Kantarjian, Gordon Mills, Gautam Borthakur
Journal: Blood (2015)
Pathogenic variant burden in the ExAC database: an empirical approach to evaluating population data for clinical variant interpretation
Authors: Yuya Kobayashi, Shan Yang, Keith Nykamp, John Garcia, Stephen E. Lincoln, Scott E. Topper
Journal: Genome Medicine (2017)

The frequency of a variant in the general population is a key criterion used in the clinical interpretation of sequence variants. With certain exceptions, such as founder mutations, the rarity of a variant is a prerequisite for pathogenicity. However, defining the threshold at which a variant should be considered "too common" is challenging and therefore diagnostic laboratories have typically set conservative allele frequency thresholds.Recent publications of large population sequencing data, such as the Exome Aggregation Consortium (ExAC) database, provide an opportunity to characterize with accuracy and precision the frequency distributions of very rare disease-causing alleles. Allele frequencies of pathogenic variants in ClinVar, as well as variants expected to be pathogenic through the nonsense-mediated decay (NMD) pathway, were analyzed to study the burden of pathogenic variants in 79 genes of clinical importance.Of 1364 BRCA1 and BRCA2 variants that are well characterized as pathogenic or that are expected to lead to NMD, 1350 variants had an allele frequency of less than 0.0025%. The remaining 14 variants were previously published founder mutations. Importantly, we observed no difference in the distributions of pathogenic variants expected to be lead to NMD compared to those that are not. Therefore, we expanded the analysis to examine the distributions of NMD expected variants in 77 additional genes. These 77 genes were selected to represent a broad set of clinical areas, modes of inheritance, and penetrance. Among these variants, most (97.3%) had an allele frequency of less than 0.01%. Furthermore, pathogenic variants with allele frequencies greater than 0.01% were well characterized in publications and included many founder mutations.The observations made in this study suggest that, with certain caveats, a very low allele frequency threshold can be adopted to more accurately interpret sequence variants.