tbuckley/cabot-search huggingface dataset:
Abstract 17801: Temporal Trends in Emergency Care and Outcomes of Geriatric Patients With Acute Myocardial Infarction in Japan -A Report From the Miyagi AMI Registry Study
Authors: Koichi Sato, Jun Takahashi, Yuanji Cui, Kiyotaka Hao, Satoshi Miyata, Yasuhiko Sakata, Hiroaki Shimokawa
Journal: Circulation (2017)

Background: The Miyagi Acute Myocardial Infarction (AMI) Registry Study is a prospective and observational study where all AMI patients in the Miyagi prefecture (2.35 million populations) of Japan,...
Body Composition and Overall Survival in Patients With Nonmetastatic Breast Cancer
Authors: Zachary R. McCaw, Dacheng Liu, Lee-Jen Wei
Journal: JAMA Oncology (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 Oncology 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 Oncology journal
#3 PIRRIST: A patient and public involvement (PPI) intervention to enhance recruitment and retention in surgical trials (oral presentation)
Authors: J. Crocker, S. Rees, L. Locock, S. Petit-Zeman, A. Chant, S. Treweek, J. Cook, N. Farrar, K. Woolfall, J. Bostock, R. Harmston, A. Ferrey, R. Bulbulia
Journal: International Journal of Surgery (2018)
Goals of care and advanced care planning in phase I trials.
Authors: Betty R. Ferrell, Tami R. Borneman, Anna Cathy Williams, Vincent Chung, Marianna Koczywas, Thomas J. Smith
Journal: Journal of Clinical Oncology (2018)

80 Background: Cancer patients participating in phase 1 clinical trials often represent a population with advanced disease, symptoms and QOL impact from disease and treatment. This analysis was conducted using data from a randomized trial in progress testing a palliative care intervention for solid tumor patients on phase 1 trials to evaluate goals of care and advance care planning. Methods: In this analysis, the investigators evaluated chart audit data from patients at baseline and six months after initiating a phase 1 trial. Results: Patients (N = 284) were at a mean age of 60, 56% were female and 32% were ethnic minorities. Predominant diagnoses were lung cancer (18%), colon (15%), and pancreatic (12%) cancers. Thirty six percent (36%) of these patients died within six months of initiating the phase 1 trial. At six months post trial initiation, forty four percent (44%) had no advanced care plan and 58% remained full code status. Forty four percent of those who died were full code status. Forty five percent had no documented goals of care conversation and 32% had no proxy decision maker. Thirteen percent (13%) of those who died received chemotherapy in the last two weeks of life. Only forty four percent (44%) of those who died received hospice care and only fifty seven percent (57%) had received palliative care referrals. Conclusions: This data supports the need for palliative care for cancer patients on phase 1 cancer trials. There are important opportunities to integrate palliative care with cancer clinical trials for best supportive care of these patients.
Subcutaneous administration at home for symptom management in palliative care.
Authors: Luisa Fernanda Rodriguez, Cesar Antonio Consuegra Pareja, Alirio Bastidas, Marta Ximena Leon, Alejandra Umbacia, Andrea Garcia, Juan Pablo Moreno, Eduardo Bruera
Journal: Journal of Clinical Oncology (2018)

49 Background: Patients who require home-based palliative care have advanced complex illnesses with functional limitations and decline. Subcutaneous administration of drugs and hydration is a possible alternative when oral intake is hampered. This observational study characterized the use of subcutaneous catheters at a home based palliative care program in Bogotá, Colombia. Methods: Consecutive medical records from September 1, 2017 to February 28, 2018 were reviewed for 272 patients at a home based palliative care program who received subcutaneous administration of drugs and/ or hydration. Statistical analysis was performed to describe the characteristics of the population and its relation to the use of subcutaneous catheters using SPSS tool. Results: The mean age was 72 years (SD: 18), 163 (60%) were females, with a mean in Barthel Index 20 (SD:22), Karnofsky Performance Status Scale 36 (SD: 9.6), PPS of 36 (SD: 11), and PPI 6 (SD: 3.4). The mean time for subcutaneous use was of 34 days (SD: 52). The main indication for the subcutaneous route was poor symptom control in 162 (60%), and because of reduced oral intake in 107 (39%). The administration of drugs was done by a family member in 207 (76%), all trained by a nurse (spouse 14%, offspring 52%, others 34%). The mean number of drugs used per catheter was 3,7 (SD: 1,7). The most common opioid was hydromorphone (57%) followed by morphine (35%). Other medications used were haloperidol (59%) and midazolam (23%). The most common site of application was the upper right extremity. The change of the catheter due to dysfunction was made in 98 (36%) subjects, due to infection in 9 (3.3%) of the 272 patients and 1.5% of 594 catheter insertions. An association with catheter dysfunction was found after multivariate analysis of the time of catheter use and the number of medications. 240 patients (88.2%) died with the catheter in place. Conclusions: Subcutaneous administration of hydration and drugs when used with proper education, training, and followed up by home care programs is a useful strategy for delivering care at home for optimal symptom control for patients receiving palliative care.
Unloading of the Left Ventricle During Venoarterial Extracorporeal Membrane Oxygenation Therapy in Cardiogenic Shock
Authors: Benedikt Schrage, Daniel Burkhoff, Nicole Rübsamen, Peter Moritz Becher, Michael Schwarzl, Alexander Bernhardt, Hanno Grahn, Edith Lubos, Gerold Söffker, Peter Clemmensen, Hermann Reichenspurner, Stefan Blankenberg, Dirk Westermann
Journal: JACC Heart Failure (2018)
Italy’s health minister fires country’s top health board
Authors: Owen Dyer
Journal: BMJ (2018)

Italy’s health minister, Giulia Grillo, has fired all 30 independent members of the country’s Superior Health Board, a body set up to advise the government on all aspects of public health, explaining that she wished to send a “signal of discontinuity.”

Although incoming governments have occasionally changed a few staff on the council, such wholesale dismissal is unprecedented. The current board was appointed last year and was supposed to remain in place until 2020. It was unchanged from the previous three year term, which began in 2014.

“I decided to give a signal of discontinuity with respect to the past by renewing the composition of the 30 members,” wrote the health minister, a member of the ruling coalition’s Five Star Movement, on her Facebook page. “We are the #governmentofchange and, as I have already done for other appointments to ministry committees, I have chosen to …
Cognitive and visual diagnostic errors in dermatology
Authors: E.J. Lowenstein, R. Sidlow
Journal: British Journal of Dermatology (2018)

This review (part 1 of 2) from New York in the USA is concerned with the heuristic techniques (‘heuristics’) used to make diagnoses. A heuristic approach to problem-solving is one that relies on a practical method rather than a logical one. Examples include a ‘guesstimate’, ‘unwritten rule’, ‘gut feeling’ or just recognising something. Heuristics often work as shortcuts in the way a diagnosis is made. One way in which doctors make diagnoses is from experience: experienced doctors instantly recognise psoriasis because they have seen lots of it; they don't need to tick off every feature every time. If the diagnosis is not immediately obvious, then they may switch to a more logical approach, such as putting together a set of clinical signs. The first method is simpler and quicker but more prone to errors, especially in the hands of the inexperienced. The inexperienced may, therefore, be obliged to use the second method, sometimes laboriously. Often we use a mixture of the two, but we make mistakes with both: a proportion of the consistent level of incorrect diagnosis in medicine may be due to our own thinking processes. Over forty types of heuristic are listed. If doctors have already reached a diagnosis, for example, they may stop prematurely, ignore more subtle information and fail to consider alternatives (the ‘anchoring heuristic’). For dermatologists, heuristics including colour, site, shape and texture are important, but 12 images illustrate how they can be led astray. Humans do better with purely visual information, which seems good news for radiologists and histopathologists.
Reference genome sequences of two cultivated allotetraploid cottons, Gossypium hirsutum and Gossypium barbadense
Authors: Maojun Wang, Lili Tu, Daojun Yuan, De Zhu, Chao Shen, Jianying Li, Fuyan Liu, Liuling Pei, Pengcheng Wang, Guannan Zhao, Zhengxiu Ye, Hui Huang, Feilin Yan, Yizan Ma, Lin Zhang, Min Liu, Jiaqi You, Yicheng Yang, Zhenping Liu, Fan Huang, Baoqi Li, Ping Qiu, Qinghua Zhang, Longfu Zhu, Shuangxia Jin, Xiyan Yang, Ling Min, Guoliang Li, Ling-Ling Chen, Hongkun Zheng, Keith Lindsey, Zhongxu Lin, Joshua A. Udall, Xianlong Zhang
Journal: Nature Genetics (2018)

Allotetraploid cotton species (Gossypium hirsutum and Gossypium barbadense) have long been cultivated worldwide for natural renewable textile fibers. The draft genome sequences of both species are available but they are highly fragmented and incomplete1-4. Here we report reference-grade genome assemblies and annotations for G. hirsutum accession Texas Marker-1 (TM-1) and G. barbadense accession 3-79 by integrating single-molecule real-time sequencing, BioNano optical mapping and high-throughput chromosome conformation capture techniques. Compared with previous assembled draft genomes1,3, these genome sequences show considerable improvements in contiguity and completeness for regions with high content of repeats such as centromeres. Comparative genomics analyses identify extensive structural variations that probably occurred after polyploidization, highlighted by large paracentric/pericentric inversions in 14 chromosomes. We constructed an introgression line population to introduce favorable chromosome segments from G. barbadense to G. hirsutum, allowing us to identify 13 quantitative trait loci associated with superior fiber quality. These resources will accelerate evolutionary and functional genomic studies in cotton and inform future breeding programs for fiber improvement.
Role of systemic high‐dose methotrexate and combined approaches in the management of vitreoretinal lymphoma: A single center experience 1990‐2018
Authors: Alessia Castellino, Jose S. Pulido, Patrick B. Johnston, Kay M. Ristow, N. Nora Bennani, David J. Inwards, William R. Macon, Ivana N. M. Micallef, Rebecca L. King, Diva R. Salomao, Thomas E. Witzig, Thomas M. Habermann, Grzegorz S. Nowakowski
Journal: American Journal of Hematology (2018)

Abstract Vitreoretinal lymphoma (VRL) management remains a challenge. We present 72 patients with VRL, diagnosed at Mayo Clinic between 1990‐2018. Three nondiffuse large B‐cell lymphoma (DLBCL) histology cases were excluded. Among 69 DLBCL, 33 patients had primary VRL (PVRL), 18 concurrent intraocular and central nervous system (CNS) or systemic disease and 18 secondary VRL. Patients received intraocular chemotherapy (intraocular injections of rituximab or metothrexate or steroids or in combination), radiotherapy, systemic or combined systemic plus intraocular treatment in 9, 10, 35, and 15 cases, respectively. Among primary and concurrent VRL, median failure free survival (FFS), CNS relapse‐free survival (CNS‐RFS) and overall survival (OS) were: 1.8, 4.9, and 4.1 years, respectively; among PVRL, median FFS, CNS‐RFS, and OS were: 2.6 year, Not Reached and 9.3 year, respectively. No CNS relapse occurred beyond 4 years in PVRL. Median OS for patients diagnosed between 1990 and 1999 vs between 2000 and 2018 was 1.5 vs 9.4 years, respectively ( P = .0002). OS was significantly higher in PVRL, as compared with concurrent VRL ( P = .04). Previous immunosuppression and poor performance status were predictive of worse outcome. In PVRL, a combined systemic and intraocular therapy showed higher FFS ( P = .002) and CNS‐RFS ( P = .003), but no differences in OS. Among 18 secondary VRL, at a median follow‐up of 1.1 year after vitreoretinal relapse, median FFS and OS were 0.3 and 1.3 years. An improvement in survival of VRL has been observed over the decades. PVRL should undergo combined systemic and intraocular chemotherapy to prevent CNS progression.
Is It Possible to Get a Flu Shot Too Early?
Authors: Rita Rubin
Journal: JAMA (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 HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Abstract 17246: Risk Factors for Major Bleeding Events in Rivaroxaban Users With Atrial Fibrillation: A Nested Case-control Study
Authors: Sally Tamayo, Jason Simeone, Beth Nordstrom, Manesh Patel, Zhong Yuan, Nicholas Sicignano, W. Frank Peacock
Journal: Circulation (2015)

Introduction: Rivaroxaban is a novel oral anticoagulant indicated to reduce the risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF). Anticoagulation therapies carry a risk of major bleeding (MB), for which patient characteristics may play a role. Methods: Using data obtained from the Department of Defense (DoD), we examined risk factors for MB within a cohort of rivaroxaban-treated patients with NVAF using a nested case-control design. Cases with MB were selected by a validated claims-based algorithm that approximates the definition of MB used in clinical trials. Incidence density sampling was used to identify 5 controls without MB for each case. Controls had the same year of entry into the cohort and were at risk for a MB event at the time of each matched case’s event (index date). Potential risk factors for MB included demographic characteristics and comorbidities from the 12 months prior to the index date. Odds ratios (OR) and 95% confidence intervals (CI) were calculated from multivariable conditional logistic regression models to identify risk factors for bleeding. Results: Among 542 MB cases and 2,710 controls, MB cases were older and had more comorbidities (Table 1). Based on the multivariable modeling, increased age, anemia, prior gastrointestinal bleeding, heart failure, and vascular disease were identified as the strongest risk factors for MB (p&lt;0.0001 for all). Conclusions: Several risk factors for MB were identified, although some findings may be affected by unmeasured confounding effects. These risk factors may assist in the development of clinical management strategies.
Glycemic Control, Cardiac Autoimmunity, and Long-Term Risk of Cardiovascular Disease in Type 1 Diabetes Mellitus
Authors: Giovane R. Sousa, David Pober, Alfonso Galderisi, HuiJuan Lv, Liping Yu, Alexandre C. Pereira, Alessandro Doria, Mikhail Kosiborod, Myra A. Lipes
Journal: Circulation (2019)

Background: Poor glycemic control is associated with increased risk of cardiovascular disease (CVD) in type 1 diabetes mellitus (T1DM); however, little is known about mechanisms specific to T1DM. In T1DM, myocardial injury can induce persistent cardiac autoimmunity. Chronic hyperglycemia causes myocardial injury, raising the possibility that hyperglycemia-induced cardiac autoimmunity could contribute to long-term CVD complications in T1DM. Methods: We measured the prevalence and profiles of cardiac autoantibodies (AAbs) in longitudinal samples from the DCCT (Diabetes Control and Complications Trial) in participants with mean hemoglobin A 1c (HbA 1c ) ≥9.0% (n=83) and ≤7.0% (n=83) during DCCT. We assessed subsequent coronary artery calcification (measured once during years 7–9 in the post-DCCT EDIC [Epidemiology of Diabetes Interventions and Complications] observational study), high-sensitivity C-reactive protein (measured during EDIC years 4–6), and CVD events (defined as nonfatal myocardial infarction, stroke, death resulting from CVD, heart failure, or coronary artery bypass graft) over a 26-year median follow-up. Cardiac AAbs were also measured in matched patients with type 2 diabetes mellitus with HbA 1c ≥9.0% (n=70) and ≤7.0% (n=140) and, as a control for cardiac autoimmunity, patients with Chagas cardiomyopathy (n=51). Results: Apart from HbA 1c levels, the DCCT groups shared similar CVD risk factors at the beginning and end of DCCT. The DCCT HbA 1c ≥9.0% group showed markedly higher cardiac AAb levels than the HbA 1c ≤7.0% group during DCCT, with a progressive increase and decrease in AAb levels over time in the 2 groups, respectively ( P &lt;0.001). In the HbA 1c ≥9.0% group, 46%, 22%, and 11% tested positive for ≥1, ≥2, and ≥3 different cardiac AAb types, respectively, similar to patients with Chagas cardiomyopathy, compared with 2%, 1%, and 0% in the HbA 1c ≤7.0% group. Glycemic control was not associated with AAb prevalence in type 2 diabetes mellitus. Positivity for ≥2 AAbs during DCCT was associated with increased risk of CVD events (4 of 6; hazard ratio, 16.1; 95% CI, 3.0–88.2) and, in multivariable analyses, with detectable coronary artery calcification (13 of 31; odds ratio, 60.1; 95% CI, 8.4–410.0). Patients with ≥2 AAbs subsequently also showed elevated high-sensitivity C-reactive protein levels (6.0 mg/L versus 1.4 mg/L in patients with ≤1 AAbs; P =0.003). Conclusions: Poor glycemic control is associated with cardiac autoimmunity in T1DM. Furthermore, cardiac AAb positivity is associated with an increased risk of CVD decades later, suggesting a role for autoimmune mechanisms in the development of CVD in T1DM, possibly through inflammatory pathways.
Live attenuated varicella-zoster virus vaccine does not induce HIV target cell activation
Authors: Catia T. Perciani, Bashir Farah, Rupert Kaul, Mario A. Ostrowski, Salaheddin M. Mahmud, Omu Anzala, Walter Jaoko, Kelly S. MacDonald
Journal: Journal of Clinical Investigation (2018)

Varicella-zoster virus (VZV) is under consideration as a promising recombinant viral vector to deliver foreign antigens including HIV. However, new vectors have come under increased scrutiny, since trials with adenovirus serotype 5-vectored (Ad5-vectored) HIV vaccine demonstrated increased HIV risk in individuals with pre-immunity to the vector that was thought to be associated with mucosal immune activation (IA). Therefore, given the prospect of developing an HIV/VZV chimeric vaccine, it is particularly important to define the impact of VZV vaccination on IA.Healthy VZV-seropositive Kenyan women (n = 44) were immunized with high-dose live attenuated VZV vaccine, and we assessed the expression on CD4+ T cells isolated from blood, cervix, and rectum of IA markers including CD38 and HLA-DR and of markers of cell migration and tissue retention, as well as the concentration of genital and intestinal cytokines. A delayed-start group (n = 22) was used to control for natural variations in these parameters.Although immunogenic, VZV vaccination did not result in significant difference in the frequency of cervical activated (HLA-DR+CD38+) CD4+ T cells (median 1.61%, IQR 0.93%-2.76%) at 12 weeks after vaccination when compared with baseline (median 1.58%, IQR 0.75%-3.04%), the primary outcome for this study. VZV vaccination also had no measurable effect on any of the IA parameters at 4, 8, and 12 weeks after vaccination.This study provides the first evidence to our knowledge about the effects of VZV vaccination on human mucosal IA status and supports further evaluation of VZV as a potential vector for an HIV vaccine.ClinicalTrials.gov NCT02514018.Primary support from the Canadian Institutes for Health Research (CIHR). For other sources, see Acknowledgments.
Ribosomal Lesions Promote Oncogenic Mutagenesis
Authors: Sergey O. Sulima, Kim R. Kampen, Stijn Vereecke, Daniele Pepe, Laura Fancello, Jelle Verbeeck, Jonathan D. Dinman, Kim De Keersmaecker
Journal: Cancer Research (2018)

Abstract Ribosomopathies are congenital disorders caused by mutations in ribosomal proteins (RP) or assembly factors and are characterized by cellular hypoproliferation at an early stage. Paradoxically, many of these disorders have an elevated risk to progress to hyperproliferative cancer at a later stage. In addition, somatic RP mutations have recently been identified in various cancer types, for example, the recurrent RPL10-R98S mutation in T-cell acute lymphoblastic leukemia (T-ALL) and RPS15 mutations in chronic lymphocytic leukemia (CLL). We previously showed that RPL10-R98S promotes expression of oncogenes, but also induces a proliferative defect due to elevated oxidative stress. In this study, we demonstrate that this proliferation defect is eventually rescued by RPL10-R98S mouse lymphoid cells that acquire 5-fold more secondary mutations than RPL10-WT cells. The presence of RPL10-R98S and other RP mutations also correlated with a higher mutational load in patients with T-ALL, with an enrichment in NOTCH1-activating lesions. RPL10-R98S–associated cellular oxidative stress promoted DNA damage and impaired cell growth. Expression of NOTCH1 eliminated these phenotypes in RPL10-R98S cells, in part via downregulation of PKC-θ, with no effect on RPL10-WT cells. Patients with RP-mutant CLL also demonstrated a higher mutational burden, enriched for mutations that may diminish oxidative stress. We propose that oxidative stress due to ribosome dysfunction causes hypoproliferation and cellular insufficiency in ribosomopathies and RP-mutant cancer. This drives surviving cells, potentiated by genomic instability, to acquire rescuing mutations, which ultimately promote transition to hyperproliferation. Significance: Ribosomal lesions cause oxidative stress and increase mutagenesis, promoting acquisition of rescuing mutations that stimulate proliferation.