tbuckley/cabot-search huggingface dataset:
Improving service delivery to cancer survivors in primary care settings project.
Authors: Lewis E. Foxhall
Journal: Journal of Clinical Oncology (2018)

52 Background: An estimated 14 million cancer survivors live in the U.S., with up to 18 million expected by 2020. Methods: We established a partnership with three Texas family medicine training programs to provide interactive educational sessions focused on survivors’ needs for primary prevention and lifestyle counseling, surveillance and screening, and prevention of psychosocial and long-term effects. Surveys assessing resident and PCP knowledge, self-efficacy, and practices regarding survivorship care management were administered through REDCap in July 2016 and 2017. Results: Baseline response rates were 64% (60/94) and 59% (55/93) at follow-up. Compared to baseline, providers at follow-up were significantly more likely to report being “very confident” in their knowledge about: appropriate surveillance to detect recurrent breast cancer (5% vs 24%; p = 0.01); long-term physical effects of colon cancer and its treatment (8% vs 18%; p = 0.04); potential adverse psychosocial outcomes of colon cancer treatment (24% vs 44%; p = 0.01); appropriate screening for new primary breast (29% vs 61%; p &lt; 0.001) and colon cancers (27% vs 51%; p = 0.01); and preventive lifestyle/behavioral counseling for breast (39% vs 59%; p = 0.03) and colon cancers (37% vs 59%; p = 0.01). Participants were also more likely to “strongly agree” that they have the skills necessary to: provide follow-up care related to the colon cancer and its treatment (10% vs 28%; p = 0.02); initiate appropriate screening for other new primary cancers for breast (28% vs 56%; p &lt; 0.01) and colon cancer survivors (28% vs 58%; p &lt; 0.01); and conduct lifestyle/behavioral counseling to prevent cancer for breast (33% vs 53%; p = 0.03) and colon cancer survivors (34% vs 55%; p = 0.02). Conclusions: Preliminary results suggest our project has improved provider knowledge, self-efficacy, and practices regarding survivorship care management, with the highest levels in areas pertaining to screening and prevention. We aim to continue this trajectory of improvement in subsequent project years and disseminate the project to other primary care training sites in Texas and beyond.
Update: ACIP Recommendations for the Use of Quadrivalent Live Attenuated Influenza Vaccine (LAIV4) — United States, 2018–19 Influenza Season
Authors: Lisa A. Grohskopf, Leslie Z. Sokolow, Alicia M. Fry, Emmanuel B. Walter, Daniel B. Jernigan
Journal: MMWR Morbidity and Mortality Weekly Report (2018)

Intranasally administered live attenuated influenza vaccine (LAIV) was initially licensed in the United States in 2003 as a trivalent formulation (LAIV3) (FluMist, MedImmune, LLC). Quadrivalent live attenuated influenza vaccine (LAIV4) (FluMist Quadrivalent, MedImmune) has been licensed in the United States since 2012 and was first available during the 2013-14 influenza season, replacing LAIV3. During the 2016-17 and 2017-18 influenza seasons, the Advisory Committee on Immunization Practices (ACIP) recommended that LAIV4 not be used because of concerns about low effectiveness against influenza A(H1N1)pdm09-like viruses circulating in the United States during the 2013-14 and 2015-16 seasons (1,2). On February 21, 2018, ACIP recommended that LAIV4 be an option for influenza vaccination of persons for whom it is appropriate for the 2018-19 season (3). This document provides an overview of the information discussed in the decision-making process leading to this recommendation. A description of methodology and data reviewed will be included in the background materials that will supplement the 2018-19 ACIP Influenza Recommendations, which will replace the 2017-18 ACIP influenza statement (2), and which will also contain guidance for the use of LAIV4.
Proposed Strategies for Reducing User Error in Capillary Blood Glucose Monitoring
Journal: Diabetes Care (1993)

For individuals with diabetes mellitus, CBGM provides a more accurate picture of daily glucose fluctuation than urine glucose testing (1-9). As a result, CBGM is the preferred method to assess short-term glucose control and provide data for management decisions and insulin adjustment (10-16). Moreover, the wide availability of glucose monitoring systems designed for patient use has made SMBG the standard of care in diabetes management for all capable persons with insulin-requiring diabetes and an appropriate management tool for persons with non-insulin-requiring diabetes (13-20). In spite of the relative accuracy of current CBGM systems in measuring blood glucose levels, a recent study by the FDA suggests that user-procedural errors can cause inaccurate results (21). Inaccurate data affect patients efforts to achieve good metabolic control and, if used as the basis for regimen adjustment, may endanger health (21-42). Therefore, until reliable, technique-free systems are available, the accuracy of data with this technology must be improved through reduction of user error. This article presents strategies to accomplish this goal recommended by a national group of experts, the NSCQA in CBGM.
The experience of the usage of intraoperative radiation therapy after neoadjuvant systemic therapy for breast cancer.
Authors: Aleksei Manikhas, Ivan Grinev, Armen Oganesyn, Sergey Chikrizov, Georgy M. Manikhas
Journal: Journal of Clinical Oncology (2018)

e12621 Background: to evaluate the usage of intraoperative radiation therapy with the INTRABEAM device in breast cancer patients after neoadjuvant therapy when conservative surgery is allowed. Methods: 51 patients staged as cT2N0M0 were taken for the investigation. Mastectomy was the preferred surgery for all the patients. Sentinel lymph node biopsy was done for all the patients followed by systemic drug therapy depending on a tumor phenotype and signal lymph node status. When conservative surgery was allowed, lumpectomy with intraoperative radiation therapy (IORT) with the INTRABEAM system was performed for the patients according to the positive tumor response. This approach is considered to provide the additional tumor bed boost. Thereafter the whole breast radiation therapy (WBRT) was performed and the patients received systemic adjuvant treatment. 5 patients had a triple-negative tumor phenotype, 21 - luminal type A and 25 - luminal type B (3 of them were Her2/neu-positive). Results: Chemotherapy was assigned to 32 patients, the remaining 19 patients received Exemestane. Lumpectomy with IORT was done for 49 patients, mastectomy was performed in 2 cases due to the absence of the effect of neoadjuvant therapy. Metastasis in the sentinel lymph nodes were identified in 19 patients among 51 examined ones. Axillary lymph node dissection was done in 12 cases. It was decided to refrain from axillary lymph node dissection in 7 cases (because of micrometastases or 1 macrometastasis in sentinel lymph nodes with a total number of removed nodes 3 and more). The quality of life after breast conserving surgery on the proposed method was significantly higher than after mastectomy according to the questionnaire QLQ-C30, QLQ-BR23. The assessment of late toxicity results of radiosurgery was performed by LENT-SOMA scale modified for breast cancer. The combination of WBRT with IORT was well tolerated. For now, there is no local recurrence at a median follow-up 24 months. Conclusions: The combination of breast-conserving surgery with is IORT followed by WBRT is effective, safe method after neoadjuvant systemic therapy for breast cancer patients.
Psychological Symptoms, Social Outcomes, Socioeconomic Attainment, and Health Behaviors Among Survivors of Childhood Cancer: Current State of the Literature
Authors: Tara M. Brinkman, Christopher J. Recklitis, Gisela Michel, Martha A. Grootenhuis, James L. Klosky
Journal: Journal of Clinical Oncology (2018)

The diagnosis, treatment, and medical late effects of childhood cancer may alter the psychosocial trajectory of survivors across their life course. This review of the literature focuses on mental health symptoms, achievement of social milestones, socioeconomic attainment, and risky health behaviors in survivors of childhood cancer. Results suggest that although most survivors are psychologically well adjusted, survivors are at risk for anxiety and depression compared with siblings. Although the absolute risk of suicide ideation and post-traumatic stress symptoms is low, adult survivors are at increased risk compared with controls. Moreover, young adult survivors are at risk for delayed psychosexual development, lower rates of marriage or cohabitation, and nonindependent living. Survivors’ socioeconomic attainment also is reduced, with fewer survivors graduating college and gaining full-time employment. Despite risk for late health-related complications, survivors of childhood cancer generally engage in risky health behaviors at rates similar to or only slightly lower than siblings and peers. CNS tumors and CNS-directed therapies are salient risk factors for poor psychosocial outcomes. In addition, physical health morbidities resulting from cancer-directed therapies are associated with worse psychosocial functioning. Several studies support the effectiveness of cognitive and behavioral interventions to treat psychological symptoms as well as to modify health behaviors. Additional randomized controlled trials are needed to evaluate the efficacy and long-term outcomes of intervention efforts. Future research should focus on the identification of potential genetic predispositions related to psychosocial outcomes to provide opportunities for preventive interventions among survivors of childhood cancer.
Tailored survivorship care plans for head and neck cancer patients.
Authors: Andrew L. Salner, Shrujal S. Baxi, Elizabeth Fortier, Talya Salz
Journal: Journal of Clinical Oncology (2018)

51 Background: Survivorship care plans SCPs typically include generic advice for cancer surveillance, management of late effects (LEs), wellness recommendations (WRs), and cancer screening. We developed a platform called HN-STAR that uses electronic patient-reported outcomes (ePROs) and evidence-based management guidelines to generate tailored SCPs for head and neck cancer survivors (HNCSs), a population particularly vulnerable to various LEs. We surveyed HNCSs and their primary care providers (PCPs) regarding the SCP to assess its acceptability and usefulness. Methods: HNCSs at 2 cancer hospitals used HN-STAR. Prior to a routine clinic visit, HNCSs used a validated ePRO measure (PRO-CTCAE) to report 22 physical LEs and other measures to assess wellness. Based on the visit discussion, HN-STAR generated an SCP that included a treatment summary, WRs, and LE management plans. HNCSs indicated their perceptions of the SCP and intentions to adhere to WR and LE management recommendations. PCPs reported on the SCP utility and their comfort in managing WRs and LEs. Results: 47 HNCSs completed surveys (mean 5.4 yrs. from treatment completion). Most were white (89%), male (85%), had an oropharynx tumor (58%), and received multimodality therapy (81%). 51% experienced at least 9 of the 22 LEs in the last month (mean 8.2/person). 91% of HNCSs felt the SCP was easy to follow. 98% intended to follow recommendations for LEs management and 98% reported they would refer back to the SCP. 87% said they plan to share the SCP with a PCP. 23 PCPs completed the survey. 95% were satisfied with the SCP and 95% reported they would like to have one for every cancer patient. PCPs expressed varying levels of comfort in managing specific LEs of head and neck cancer (30-80%). Conclusions: Among HNCSs, an automatically generated SCP that was tailored to their WRs and LEs was acceptable, was trusted, and provided recommendations they intended to follow. PCPs found the SCP useful, and SCPs may help improve their comfort with LE management. Patient-centered SCPs that focus on existing LEs hold promise as a means to help survivors and PCPs manage survivorship issues.
Til Neglect Do Us Part
Authors: Evan K. Noch
Journal: JAMA Neurology (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 Neurology 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 Neurology journal
Changes in Ability of Hospitals to Provide Pricing for Total Hip Arthroplasty From 2012 to 2016
Authors: Safiyyah Mahomed, Jaime Rosenthal, John Matelski, Peter Cram
Journal: JAMA Internal Medicine (2018)

Discussion | Our findings suggest that 41.7% of physicians who are mothers who initiate breastfeeding sustain breastfeeding for at least 1 year.Although this finding exceeds the national rate of 27%, 3 fewer than one-third of the respondents reported being able to sustain breastfeeding to their personal goal, and nearly half reported that they would have breastfed longer if their job had been more accommodating.Our findings suggest that modifiable, workrelated factors-in particular, accommodating schedules to allow for pumping, providing longer maternity leave, and establishing a dedicated private space-may improve the ability of physicians who are mothers to continue lactation after they return to work.These factors should be taken into consideration when designing a workplace that is conducive to breastfeeding.
Interplay of grade and stage on survival outcomes in appendiceal adenocarcinoma: Corroboration of the AJCC (8th edition) Cancer Staging Classification.
Authors: Kanwal Pratap Singh Raghav, Keith F. Fournier, Benny Johnson, Melissa W. Taggart, Wai Chin Foo, Aurelio Matamoros, Amir Mehdizadeh, Shahab U. Ahmed, Jennifer L. Guerra, Paul F. Mansfield, Richard Eldon Royal, Cathy Eng, Michael J. Overman
Journal: Journal of Clinical Oncology (2018)

773 Background: Histological grade is a key prognostic factor in appendiceal adenocarcinomas (AAs) and has been incorporated in classification of stage IV AAs (IVA – Grade 1: Well; IVB – Grade 2/3: Moderately/Poorly differentiated) in AJCC Cancer Staging (8th edition). The purpose of the study was to corroborate the prognostic impact of this staging classifier. Methods: We performed a retrospective review of 98 AA patients (pts) at UTMDACC (2013 - 2017). Kaplan-Meier method was used to estimate median overall survival (mOS), compared with log-rank tests with emphasis on stage and grade. Results: The cohort included 18, 8, 14, 47 and 11 cases of stage II, III, IVA, IVB and IVC AAs. Histologically, 75 were mucinous (21 non mucinous) and 19, 35 and 42 were grade 1, 2 and 3 respectively. Median age of cohort was 54 years. Median follow-up was 46 months (m). The mOS of stage II, III, IVA, IVB and IVC was 136, 106, 140, 48, 23 m, respectively (P &lt; 0.0001). The mOS of grade 1, 2 and 3 was 160, 75 and 33 m, respectively (P &lt; 0.0001). In univariate analysis (restricted to stage IV pts), grade, AJCC stage, and cytoreductive surgery (CRS) were found to be associated with OS. In multivariate analyses (restricted to stage IV pts), only AJCC stage (HR 3.9, 95% CI: 1.5 - 10.6, P = 0.005) and CRS (HR 3.4, 95% CI: 1.4 – 8.3, P = 0.009) were found to be independently associated with poor OS. In subgroup of mucinous AAs, mOS of grade 3 (32 m) was significantly shorter than grade 2 (54 m) (P = 0.02). In non-mucinous AAs, mOS of grade 3 and grade 2 pts was 38 and 29 m, respectively (P = 0.97). Conclusions: AJCC staging classification has a strong prognostic value in AAs. Beyond the well differentiated AAs which are regarded as a distinct entity in stage IV disease, moderate and poor differentiation also has strong and dissimilar prognostic impact which appears to be dependent on mucinous or non-mucinous subtype in stage IV AAs. Further efforts are needed to incorporate the complex interplay of all grades and mucinous characteristics within the staging system for better prognostication and management.
The Diverse Genomic Landscape of Clinically Low-risk Prostate Cancer
Authors: Matthew R. Cooperberg, Nicholas Erho, June M. Chan, Felix Y. Feng, Nick Fishbane, Shuang G. Zhao, Jeffry P. Simko, Janet E. Cowan, Jonathan Lehrer, Mohammed Alshalalfa, Tyler Kolisnik, Jijumon Chelliserry, Jennifer Margrave, Maria Aranes, Marguerite du Plessis, Christine Buerki, Imelda Tenggara, Elai Davicioni, Peter R. Carroll
Journal: European Urology (2018)
Discordance of <i>IDH</i> mutational status between lesions in an adult patient with multifocal glioma
Authors: Giuseppe Lombardi, Alessandro Della Puppa, Marina Paola Gardiman, Sabrina Rossi, Cinzia Candiotto, Lucia Zanatta, Roberta Bertorelle, Anita De Rossi, Matteo Fassan, Vittorina Zagonel
Journal: Neuro-Oncology (2018)
Undertreated Medical Conditions vs Trauma as Primary Indications for Amputation at a Referral Hospital in Cameroon
Authors: Joseph D. Forrester, Nikola C. Teslovich, Lemery Nigo, James A. Brown, Sherry M. Wren
Journal: JAMA Surgery (2018)

Undertreated Medical Conditions vs Trauma as Primary Indications for Amputation at a Referral Hospital in CameroonHistorically, amputations in sub-Saharan Africa (SSA) were performed to address pathologic changes due to traumatic injury. 1 However, SSA countries are currently experiencing the epidemiologic double burden of disease; as treatment for and education about infectious diseases improve, these countries are increasingly faced with a transition to noncommunicable chronic diseases (NCDs), including diabetes and peripheral vascular disease. 2 This transition is attributed to longer life expectancy and greater exposure to risk factors that include smoking, poor diet, and sedentary lifestyle. 2We hypothesized that NCDs have overtaken trauma as the primary cause for amputation in SSA, with postoperative mortality driven by untreated or undertreated medical conditions.Methods | We performed a retrospective cohort study of amputations at Mbingo Baptist Hospital, a rural referral hospital in Cameroon, from January 1, 2014, through August 30, 2016.Patients were identified through operative case logs, and perioperative variables were obtained through medical record review.Univariate analysis was performed with in-hospital mortality as the primary outcome.Any variable on univariate analysis with P ≤ .10 was included in logistic regression multivariate analysis.Statistical analysis used Stata software (version 14.1; StataCorp), and P < .05indicated statistical significance.
The association of hospital visits with executive functioning among childhood cancer survivors.
Authors: Hamza Gorsi, Christine Trask
Journal: Journal of Clinical Oncology (2018)

133 Background: Childhood cancer survivors are at increased risk of executive dysfunction related to treatment. In addition to the direct effect of treatment, hospital visits may also impact development. Children with complicated health issues visit Emergency Departments (ED) multiple times and spend a very high number of days in the hospital, which can interfere with normal development. Methods: Information from 77 childhood cancer survivors, ranging in age from 6-18, was examined. Parents completed several surveys, including the Behavior Rating Inventory of Executive Functioning (BRIEF). Additional information was collected from the medical record and administrative data sets, including total number of days in the hospital and number of ED visits. Multiple linear regressions were used to determine the relationship between total hospital days/number of ED visits and BRIEF scores, as well as potential confounders, such as socioeconomic factors and treatment factors. Results: The survivors were 11 years old, on average, at the time of participation and evenly divided between boys (49.4%) and girls (50.6%). In the sample, 26% had been treated with cranial radiation and 55% had been treated with intrathecal chemotherapy. On average, this group had 47.0 inpatient days in the hospital with 6.8 visits to the ED. There was a positive correlation between both number of ED visits and number of inpatient days with executive functioning (GEC; r = .33, p = .004; r = .23, p = .05, respectively). In multiple linear regressions, after controlling for time since diagnosis, a higher number of ED visits was associated with greater reported executive dysfunction ( R 2 = .12; F (2, 74) = 5.2, p = .008). Conclusions: An association was found between ED visits and length of hospitalizations on parent-reported executive functioning. ED visits and hospitalization are often related to medical complications, and may reflect severity of illness, but may also influence children’s ability to participate in school and other aspects of normal development. Follow-up prospective studies with a longer duration are needed to understand the course of this relationship in terms of predicting long-term risk.
Seven in 10 women with early breast cancer do not need chemotherapy, study finds
Authors: Susan Mayor
Journal: BMJ (2018)

Most women with early stage hormone receptor positive breast cancer do not benefit from chemotherapy on top of endocrine therapy after surgery if tests show they have a mid-range risk of recurrence, a large randomised trial has reported.1

“Half of all breast cancers are hormone receptor positive, HER2 negative, and axillary node negative. Our study shows that chemotherapy may be avoided in about 70% of these women when its use is guided by the 21 gene recurrence score, so limiting chemotherapy to the 30% who we …