tbuckley/cabot-search huggingface dataset:
When doctors disagree, how do patients decide?
Authors: Chika E Uzoigwe, Jagdeva Mehet
Journal: BMJ (2017)

The narrative on the Charlie Gard case has centred on the dilemma of parents disagreeing with doctors.1 But this case really turns on how parents respond when doctors disagree.

Doctors disagree on a host of matters,2 and patients will invariably affiliate themselves to one side of a medical argument. Charlie’s parents’ stance was predicated on the offer from the American …
AB0997 Ultrasonographic evaluation of anterior knee pain in young adults
Authors: AA Negm, M Khairy, A Hasseb, K Abbas
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Objectives</h3> The Primary outcome of the present work is to detect type and frequency of Ultrasonographic changes in patients with anterior knee pain. Secondary outcome is to determine the role of MSUS in early detection of causes of anterior knee pain (AKP). <h3>Methods</h3> Sixty patients with AKP and 20 sex and age matched healthy control were included in this study obtained from the outpatient of Physical Medicine and Rheumatology Department of El Hussein and Bab El - Sharia university hospitals. Inclusion criteria: age between 20–40. Exclusion criteria: Trauma, Crystal induced arthritis, connective tissue diseases (RA, SLE, SpA), chronic liver or kidney disease and previous surgery. Full medical history and clinical examination as well as WOMAC, knee Conventional Radiography and Musculoskeletal Ultrasonography (MSUS) were done to all patients. Bilateral MSUS examination of the following common sites: Insertion of quadriceps tendon, Ligamentum patellae and Anterior aspect of the knee from medial to lateral. According to EULAR guide lines for musculoskeletal ultrasonography. <h3>Results</h3> The mean duration of knee pain in patients group was 11.42±9.134 months. ESR, CRP and WOMAC were higher in patients group (p&lt;0.01). MSUS showed significantly more frequent Supra-patellar and Infra-patellar bursitis in patients than control group (p=0.000). patients had higher frequency of cartilage clarity loss (p=0.039) as well as lower cartilage thickness than control, 2.28±0.258 vs 2.73±0.261 mm respectively (P=0.000, 95% CI: 0.31 to 0.58) <h3>Conclusions</h3> The degree of Knee pain, measured by WOMAC, is positively correlated with inflammatory biomarkers (ESR and CRP) in patients with Anterior knee pain. MSUS revealed a positive correlation between Femoral Articular Cartilage thickness and the periarticular tendon- thickness, namely Patellar origin, patellar insertion and Quadriceps insertion. Interestingly, our data present an evidence of the negative impact of the duration of knee pain over Femoral Articular Cartilage thickness as well as Patellar origin thickness. (FAC thickness get worse with longer duration of pain) <h3>References</h3> Backhaus, M., et al. Guidelines for musculoskeletal ultrasound in rheumatology. Annals of the rheumatic diseases 60.7 (2001): 641–649. <h3>Disclosure of Interest</h3> None declared
Tissue Engineering: Melt Electrospinning Writing of Poly‐Hydroxymethylglycolide‐<i>co</i>‐ε‐Caprolactone‐Based Scaffolds for Cardiac Tissue Engineering (Adv. Healthcare Mater. 18/2017)
Authors: Miguel Castilho, Dries Feyen, María Flandes‐Iparraguirre, Gernot Hochleitner, Jürgen Groll, Pieter A. F. Doevendans, Tina Vermonden, Keita Ito, Joost P. G. Sluijter, Jos Malda
Journal: Advanced Healthcare Materials (2017)

Current limitations in cardiac tissue engineering revolve around the inability to fully recapitulate the structural organization and mechanical environment of native cardiac tissue. In article number 1700311, Miguel Castilho and co-workers develop organized ultrafine fiber scaffolds of a hydroxyl-functionalized polyester that can guide the growth of cardiac cells and improve their mechanical anisotropy. Illustration by Gil Costa, background photograph by Corina Metz.
AB0329 Do anxious or depressive rheumatoid arthritis patients on biotechnologic therapy have worse disease activity, function and quality of life?
Authors: J Borges, N Madeira, A Cardoso, L Cunha-Miranda, F Barcelos, C Miguel, C Silva, S Fernandes, R Trinca, D Medeiros, R Campanilho-Marques, H Santos, R Leitão, A Faustino
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Depression, anxiety and fatigue are common symptoms in rheumatoid arthritis (RA) patients, and seem to influence disease activity, pain, quality of life (QoL) and treatment response. <h3>Objectives</h3> To assess disease activity, function and QoL in RA patients with symptoms of anxiety/depression. <h3>Methods</h3> Observational, cross-sectional study including RA patients on bDMARD followed at our centre, registered at Reuma.pt with ≥1 evaluation from 2015/11 to 2016/07. Clinical data including DAS28, CDAI, SDAI, TJC, SJC, patients9 and physicians9 pain/global assessments (VAS), ESR, CRP, HAQ, EQ5D, HADS score (anxiety and depression domains, cutoff ≥8) and FACIT-F were collected. Data were analyzed using Mann-Whitney, Qui-Squared and Spearman correlation, p&lt;0.05. <h3>Results</h3> 182 patients enrolled, 84.6% female, mean: age at 1st bDMARD 53.8±11.1; time since diagnosis 16.2±9.3 years; DAS28 3.54±1.3; CDAI 10.2±9.6; SDAI 11.2±10.4; HAQ 0.97±0.6; HADS-Anxiety 7.13±4.5; HADS-Depression 6.62±4.54, FACIT-F 35.1±9.2, EQ-5D 0.36±0.2. 77 (44.5%) patients scored ≥8 in the HADS-Anxiety domain and 71 (41.0%) scored ≥8 in the HADS-Depression domain. Comparison of depressive <i>vs</i> non-depressive and anxious <i>vs</i> non-anxious groups appears on table 1. There was a correlation of <i>HADS-Anxiety</i> with DAS28 (r=0.391, p&lt;0.001), CDAI (r=0.441, p&lt;0.001), SDAI (r=0.426, p&lt;0.001), HAQ (r=0.509, p&lt;0.001), FACIT-F (r=-0.669, p&lt;0.001) and EQ5D (r=-0.592, p&lt;0.001). There was a correlation of <i>HADS-Depression</i> with DAS28 (r=0.389, p&lt;0.001), CDAI (r=0.455, p&lt;0.001), SDAI (r=0.439, p&lt;0.001), HAQ (0.596, p&lt;0.001), FACIT-F (r=-0.679, p&lt;0.001) and EQ5D (r=-0.659, p&lt;0.001). <h3>Conclusions</h3> Anxious or depressive patients showed higher disease activity, especially in measures with some subjectivity (such as TJC and PGA) but not regarding ESR or CRP and worse function and QoL. This fact must be taken into account when evaluating therapeutic efficacy. <h3>Disclosure of Interest</h3> None declared
Genomic Analysis of Tumor Microenvironment Immune Types across 14 Solid Cancer Types: Immunotherapeutic Implications
Authors: Yu-Pei Chen, Yu Zhang, Jia-Wei Lv, Ying-Qin Li, Ya-Qin Wang, Qing-Mei He, Xiao-Jing Yang, Ying Sun, Yan-Ping Mao, Jing-Ping Yun, Na Liu, Jun Ma
Journal: Theranostics (2017)

We performed a comprehensive immuno-genomic analysis of tumor microenvironment immune types (TMITs), which is classified into four groups based on PD-L1+CD8A or PD-L1+cytolytic activity (CYT) expression, across a broad spectrum of solid tumors in order to help identify patients who will benefit from anti-PD-1/PD-L1 therapy.The mRNA sequencing data from The Cancer Genome Atlas (TCGA) of 14 solid cancer types representing 6,685 tumor samples was analyzed.TMIT was classified only for those tumor types that both PD-L1 and CD8A/CYT could prefict mutation and/or neoantigen number.The mutational and neoepitope features of the tumor were compared according to the four TMITs.We found that PD-L1/CD8A/CYT subgroups could not distinguish different mutation and neoantigen numbers in certain tumor types such as glioblastoma multiforme, prostate adenocarcinoma, and head and neck and lung squamous cell carcinoma.For the remaining tumor types, compared with TIMT II (low PD-L1 and CD8A/CYT), TIMT I (high PD-L1 and CD8A/CYT) had a significantly higher number of mutations or neoantigens in bladder urothelial carcinoma, breast and cervical cancer, colorectal, stomach and lung adenocarcinoma, and melanoma.In contrast, TMIT I of kidney clear cell, liver hepatocellular, and thyroid carcinoma were negatively correlated with mutation burden or neoantigen numbers.Our findings show that the TMIT stratification proposed could serve as a favorable approach for tailoring optimal immunotherapeutic strategies in certain tumor types.Going forward, it will be important to test the clinical practicability of TMIT based on quantification of immune infiltrates using mRNA-seq to predict clinical response to these and other immunotherapeutic strategies in more different tumors.
Healthcare resource use and costs of severe, uncontrolled eosinophilic asthma in the UK general population
Authors: Marjan Kerkhof, Trung N Tran, Joan B Soriano, Sarowar Golam, Danny Gibson, Elizabeth V Hillyer, David B Price
Journal: Thorax (2017)

Background Little is known about the prevalence of severe, uncontrolled eosinophilic asthma (SUEA) and associated costs. Aims We sought to determine the prevalence of SUEA and compare asthma-related healthcare resource use (HCRU) and associated costs with overall means for a general asthma population. Methods This cohort study evaluated anonymised medical record data (December 1989 through June 2015) from the Clinical Practice Research Datalink and the Optimum Patient Care Research Database to study UK patients with active asthma (diagnostic code and one or more drug prescriptions in the baseline year), aged 5 years and older, without concomitant COPD, and with recorded eosinophil count. SUEA was defined as two or more asthma attacks during 1 baseline year preceding a high blood eosinophil count (≥0.3×10 9 /L) for patients prescribed long-acting β 2 -agonist (LABA) and high-dosage inhaled corticosteroids (ICS) during baseline plus 1 follow-up year. We compared asthma-related HCRU and associated direct costs (2015 pounds sterling, £) during the follow-up year for SUEA versus the general asthma population. Results Of 363 558 patients with active asthma and recorded eosinophil count, 64% were women, mean (SD) age was 49 (21) years; 43% had high eosinophil counts, 7% had two or more attacks in the baseline year and 10% were prescribed high-dosage ICS/LABA for 2 study years. Overall, 2940 (0.81%; 95% CI 0.78% to 0.84%) patients had SUEA. Total mean per-patient HCRU and associated costs were four times greater for SUEA versus all patients (HCRU and cost ratios 3.9; 95% CI 3.7 to 4.1). Conclusions Less than 1% of patients in a general asthma population had SUEA. These patients accounted for substantially greater asthma-related HCRU and costs than average patients with asthma.
SAT0545 Predictive factors for response to ultrasound-guided intra-articular glucocorticoids in knee osteoarthritis
Authors: S Slimani, A Aissoug, S Aouidane, H Bounecer, MM Makhloufi, A Ladjouze-Rezig
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Objectives</h3> To investigate predictive factors for good outcome of ultrasound intra-articular glucocorticoids in knee osteoarthritis (OA). <h3>Methods</h3> We conducted a prospective monocenter cohort study including 116 patients with knee OA, after failure to standard treatments, with pain &gt;4 (numerical rating scale NRS 0–10). Patients received an ultrasound-guided injection of 40 mg triamcinolone acetonide in their most painful knee. We exhaustively collected demographic and clinical data at inclusion, as well as lab, radiographs and ultrasound parameters of the included knees. WOMAC score was calculated at inclusion and after 4 weeks. Responders were defined as patients with at least 40% improvement of their WOMAC score. Univariate analysis was performed in order to select possible predictive factors, and stepwise multiple logistic regression analyses were conducted to identify predictors of response. <h3>Results</h3> Among the 116 patients, 101 were females. Median age was 64 years (40–85) and mean duration of the disease was 14.1±14,8 years. Mean BMI was 29.9±3.8 Kg/m<sup>2</sup>. Mean NRS of pain was 8.4±1.2 and mean WOMAC was 73.3±11,8 at inclusion. 70.0% of the knees were grade 3 or 4 of Kellgren-Lawrence. 98% of knees expressed ultrasound synovial effusion and/or hypertrophy at inclusion. After 4 weeks, 61.2% of patients were responders. Regression analysis showed that patients with a BMI &lt;30 Kg/m<sup>2</sup> (OR=0.38, 95% CI 0.16–0.89) and an ESR &lt;20 mm (OR=0.27, 95% CI 0.08–0.90) were more likely to respond to ultrasound-guided glucocorticoids injection. Having both predictive factors of good response increases the response rate to 73.5%, whereas having no predictive factor decreases the response rate to 25.0%. <h3>Conclusions</h3> Our study is the largest study evaluating predictive factors of response for intra-articular glucocorticoids injections in knee OA. Also, it is the first study of predictive factors for ultrasound-guided injections. Patients with high BMIs and high ESR seem less likely to respond to intra-articular injections. <h3>Disclosure of Interest</h3> None declared
Optical Coherence Tomography Detects Necrotic Regions and Volumetrically Quantifies Multicellular Tumor Spheroids
Authors: Yongyang Huang, Shunqiang Wang, Qiongyu Guo, Sarah Kessel, Ian Rubinoff, Leo Li-Ying Chan, Peter Li, Yaling Liu, Jean Qiu, Chao Zhou
Journal: Cancer Research (2017)

Abstract Three-dimensional (3D) tumor spheroid models have gained increased recognition as important tools in cancer research and anticancer drug development. However, currently available imaging approaches used in high-throughput screening drug discovery platforms, for example, bright-field, phase contrast, and fluorescence microscopies, are unable to resolve 3D structures deep inside (&amp;gt;50 μm) tumor spheroids. In this study, we established a label-free, noninvasive optical coherence tomography (OCT) imaging platform to characterize 3D morphologic and physiologic information of multicellular tumor spheroids (MCTS) growing from approximately 250 to 600 μm in height over 21 days. In particular, tumor spheroids of two cell lines, glioblastoma (U-87MG) and colorectal carcinoma (HCT116), exhibited distinctive evolutions in their geometric shapes at late growth stages. Volumes of MCTS were accurately quantified using a voxel-based approach without presumptions of their geometries. In contrast, conventional diameter-based volume calculations assuming perfect spherical shape resulted in large quantification errors. Furthermore, we successfully detected necrotic regions within these tumor spheroids based on increased intrinsic optical attenuation, suggesting a promising alternative of label-free viability tests in tumor spheroids. Therefore, OCT can serve as a promising imaging modality to characterize morphologic and physiologic features of MCTS, showing great potential for high-throughput drug screening. Cancer Res; 77(21); 6011–20. ©2017 AACR.
Deception in Schools—When Crisis Preparedness Efforts Go Too Far
Authors: David J. Schonfeld, Eric Rossen, Diann Woodard
Journal: JAMA Pediatrics (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 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
Plasma asparaginase activity and asparagine depletion in patients with acute lymphoblastic leukemia (ALL) treated with pegaspargase (SS-PEG <i>E. coli</i> L-asparaginase): Results from Children’s Oncology Group (COG) study AALL07P4.
Authors: Reuven J. Schore, Meenakshi Devidas, Archie Bleyer, Gregory H. Reaman, Naomi J. Winick, Mignon L. Loh, Elizabeth A. Raetz, William L. Carroll, Stephen Hunger, Anne L. Angiolillo
Journal: Journal of Clinical Oncology (2016)

10508 Background: The effectiveness of asparaginase in the treatment of ALL is dependent on depletion of plasma asparagine, an essential amino acid for leukemic lymphoblasts. Previous reports have concluded that the threshold level of plasma asparaginase activity necessary to achieve plasma asparagine depletion is between 0.1 and 0.4 IU/mL. Methods: COG AALL07P4, a limited-institution, closely-supervised sentinel trial for planned FDA submission, examined the pharmacokinetics (PK) and pharmacodynamics (PD) of pegaspargase during induction and consolidation therapy. A major objective was to determine the optimal level of plasma asparaginase required for asparagine depletion when given as part of an augmented BFM chemotherapy regimen for the treatment of newly-diagnosed, NCI high-risk, B-precursor ALL. Plasma asparaginase activity was determined by a validated enzymatic-coupled assay with a lower limit of detection of 0.013 IU/mL. Plasma asparagine was determined using validated reverse-phase high-performance-liquid chromatography and double mass spectrometry that has a lower limit of quantification of 0.05 µg/mL. This trial was conducted with on-site instruction and monitoring of strict acquisition and processing of blood samples to minimize ex vivohydrolysis of asparagine. Results: Fifty-one patients randomized to receive 2500 IU/m2 pegaspargase, intravenously over 1-2 hours are included in this report. A total of 54 doses of pegaspargase administered during induction or consolidation were evaluable for matched plasma asparaginase/asparagine levels. Regardless of the interval after dose administration, when patients had an asparaginase level >0.02 IU/mL, they had an undetectable asparagine level (Table). Conclusions: Our data suggest that the threshold level of serum asparaginase activity needed for serum asparagine depletion is 0.02 IU/mL rather than 0.1 or 0.4 IU/mL as previously published. Clinical trial information: NCT00671034.Plasma Asparaginase Activity Asparagine undetectable Asparagine detectable 0.013 to <0.02 0 2 0.02 to <0.05 16 0 0.05 to <0.1 36 0
Sunlight and Cancer of the Skin
Authors: Harold F. Blum
Journal: JNCI Journal of the National Cancer Institute (1940)

Sunlight and Cancer of the Skin Get access Harold F. Blum Harold F. Blum research fellow National Cancer Institute, National Institute of Health, United States Public Health Service Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 1, Issue 3, December 1940, Pages 397–421, https://doi.org/10.1093/jnci/1.3.397 Published: 01 December 1940
THU0630 Opioid use in patients with polymyalgia rheumatica
Authors: MD Richter, SJ Achenbach, JA Zamora-Legoff, CS Crowson, EL Matteson
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Polymyalgia rheumatic (PMR) is a systemic rheumatic inflammatory disease characterized primarily by musculoskeletal pain and stiffness. Glucocorticoid treatment is the current standard of care however the need for additional pain management, in particular the need for opioid therapy, has not been studied. <h3>Objectives</h3> To examine the trends of chronic opioid use in patients with PMR over an 11 year period in Olmsted County, Minnesota, USA and compare this to subjects without the disease. <h3>Methods</h3> Retrospective data on opioid prescriptions were collected from 2005 to 2015 in a population-based incidence cohort of patients meeting the 2012 American College of Rheumatology classification criteria for PMR alongside comparison subjects. Poisson regression methods were used to compare opioid use between these groups. <h3>Results</h3> 244 patients with PMR and 211 non-PMR comparator subjects were included in the study. Rates of chronic opioid use were not significantly different between the two groups. 7.5% of patients with PMR were identified as chronic users by the end of the study period compared with 5.2% of non-PMR subjects. Any opioid use was also not significantly higher in PMR, with relative risk of 1.10 (95% CI 0.97, 1.26, p=0.14). There were higher rates of chronic use among patients over 80 years in both groups. <h3>Conclusions</h3> PMR does not appear to be associated with increased rates of opioid use when compared with the general population. <h3>Acknowledgements</h3> This study was made possible by the Rochester Epidemiology Project, which receives support from the National institute on Aging of the NIH. <h3>Disclosure of Interest</h3> None declared
ACR–SPR–STR Practice Parameter for the Performance of Cardiac Positron Emission Tomography - Computed Tomography (PET/CT) Imaging
Authors: Rathan M. Subramaniam, Warren R. Janowitz, Geoffrey B. Johnson, Martin A. Lodge, Marguerite T. Parisi, Mark R. Ferguson, Jeffrey C. Hellinger, Gregory W. Gladish, Narainder K. Gupta
Journal: Clinical Nuclear Medicine (2017)

This clinical practice parameter has been developed collaboratively by the American College of Radiology (ACR), the Society for Pediatric Radiology (SPR), and the Society of Thoracic Radiology (STR). This document is intended to act as a guide for physicians performing and interpreting positron emission tomography-computed tomography (PET/CT) of cardiac diseases in adults and children. The primary value of cardiac PET/CT imaging include evaluation of perfusion, function, viability, inflammation, anatomy, and risk stratification for cardiac-related events such as myocardial infarction and death. Optimum utility of cardiac PET/CT is achieved when images are interpreted in conjunction with clinical information and laboratory data. Measurement of myocardial blood flow, coronary flow reserve and detection of balanced ischemia are significant advantages of cardiac PET perfusion studies. Increasingly cardiac PET/CT is used in diagnosis and treatment response assessment for cardiac sarcoidosis.