tbuckley/cabot-search huggingface dataset:
Clinical features and prognosis of Turkish epithelial ovarian cancer patients with BRCA1 and BRCA2 mutations
Authors: P. Saip, H. Yazici, H. Karagol, E. Bengisu, E. Topuz, N. Dalay
Journal: Journal of Clinical Oncology (2004)

5133 Background: Attempts to define the clinical significance of BRCA mutation status in ovarian cancer have produced conflicting results. The objective of this study was to determine whether hereditary Turkish ovarian cancer patients have distinct clinical features and outcome compared with sporadic cases. Methods: Eighy-seven concecutive epithelial ovarian cancer patients were genotyped for BRCA mutations between 1995–1999 years. Seventeen (19.5%) of these had germline mutations. Clinical and survival data of these patients were recorded. Results: No significant difference was found between the sporadic and mutated group in terms of stage, surgical outcome and histopathology. There were more patients under 50 years among the mutated group 13/17 (76% )than the sporadic group 32/70 (46%) p=0.03. The median overall and progression free survivals were 76 and 30 months in the mutated group and 80 and 33 months in the sporadic group respectively. Conclusions: Although the mutated ovarian cancer patients are much younger, no significant survival difference was observed between the groups. No significant financial relationships to disclose.
Does quality of life improvement precede anemia correction in patients with chemotherapy-induced anemia treated with intravenous iron?
Authors: D. H. Henry, N. V. Dahl
Journal: Journal of Clinical Oncology (2007)

9082 Background: Combining intravenous (IV) iron with erythropoiesis-stimulating (ESA) therapy has been shown to increase Hgb response in treating anemia of cancer and chemotherapy. As part of a trial in anemic cancer patients on chemotherapy being treated with an ESA, we compared the effects of IV iron, oral iron, and no iron, on changes in patient-reported HRQOL. Methods: Prospective, randomized, controlled, multicenter trial. Major inclusions: pt starting chemotherapy cycle, Hb &lt;11g/dL, ferritin &gt;100 ng/mL or transferrin saturation &gt;15%. Major exclusions: recent transfusion, ESA, or IV iron use, infection. All pts received epoetin alfa (40,000 U SQ/Wk for first 4 wks, then dose- adjusted per protocol). Pts were randomized to: No iron, PO FeSO4 325 mg tid, or IV ferric gluconate 125 mg IV weekly, for 8 weeks. Change in HRQOL was measured 4 weeks after start and at end of study (week 10, or last observation carried forward) using Functional Assessment of Cancer Therapy (FACT)-Anemia. Results: There were no significant between-group differences at baseline in mean Hb (10.2g/dL), TSAT (31.3%), or serum ferritin (421ng/mL) for the 129 evaluable patients, (mean age 65.3, 69% female). See Table . Hgb responses were significantly greater by end of study in evaluable pts receiving IV FG than oral iron or no iron. Only pts receiving FG reported a significant improvement in FACT-Fatigue subscale (FACT-F). This difference began at 4 weeks, while Hgb response was still similar between groups. No significant improvement in fatigue was reported by either the no iron (ESA alone) nor oral iron group. Conclusions: Combining IV iron with ESA therapy lead to an early and sustained clinically significant (=3) improvement in fatigue score, which preceded the improvement in Hgb response. [Table: see text] [Table: see text]
Cardiac Recovery During Long-Term LVAD
Authors: Isotta Chimenti, Francesca Pagano, Sebastiano Sciarretta, Antonino G.M. Marullo, Ernesto Greco, Euclide Tonelli, Mariangela Peruzzi, Elena Cavarretta, Giuseppe Biondi-Zoccai, Giacomo Frati
Journal: Journal of the American College of Cardiology (2017)
Acceptance of Surgical Treatment for Adolescent Obesity—Reply
Authors: Matthew J. Klebanoff, Jagpreet Chhatwal, Chin Hur
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
A cost-utility analysis of sentinel lymph node mapping, selective lymphadenectomy, and routing lymphadenectomy in the management of low-risk endometrial cancer.
Authors: Rudy Sam Suidan, Charlotte C. Sun, Scott B. Cantor, Andrea Mariani, Pamela T. Soliman, Shannon Neville Westin, Karen H. Lu, Sharon Hermes Giordano, Larissa Meyer
Journal: Journal of Clinical Oncology (2017)

10 Background: Our objective was to evaluate the cost-utility of 3 lymphadenectomy (LND) strategies in the treatment of low-risk endometrial cancer (EC). Methods: A decision analysis model compared 3 LND strategies in women undergoing minimally invasive surgery (MIS) for EC: 1) routine LND in all pts; 2) selective LND based on intraoperative frozen section, in which 60% of pts undergo LND; and 3) sentinel lymph node mapping (SLN) based on a published algorithm, in which 15% of pts map unilaterally (requiring a contralateral LND) and 5% don’t map (requiring bilateral LND). Costs and outcomes were obtained from published literature and Medicare reimbursement rates. Costs categories consisted of hospital, physician, operating room, pathology, and lymphedema treatment. Effectiveness was defined as 3-year disease-specific survival adjusted for the impact of lymphedema (utility = 0.8) on quality of life. Incremental cost-effectiveness ratios (ICERs) per quality-adjusted life years (QALYs) gained were calculated. QALYs and costs were discounted at an annual 3% rate. Results: For the estimated 40,000 women undergoing surgery for low-risk EC each year in the US, the annual cost of routine LND, selective LND, and SLN is $722 million, $681 million, and $656 million respectively. In the base case scenario, routine LND had a cost of $18,041 and an effectiveness of 2.79 QALYs. Selective LND had a cost of $17,036 and an effectiveness of 2.81 QALYs, while SLN had a cost of $16,401 and an effectiveness of 2.87 QALYs. With a difference of $1,005 and 0.02 QALYs, selective LND was both less costly and more effective than routine LND, dominating it. However, with the lowest cost and highest effectiveness, SLN dominated the other modalities and was the most cost-effective strategy. No ICER could be determined. These findings were robust to multiple one- and two-way sensitivity analyses varying the rates of lymphedema and LND, surgical approach (open or MIS), lymphedema utility, and costs. Conclusions: Compared to routine and selective LND, SLN had the lowest cost and highest quality-adjusted survival, making it the most cost-effective strategy in the management of low-risk EC.
Pertuzumab (P) plus chemotherapy (CT) for platinum-resistant ovarian cancer: Safety run-in results of the PENELOPE trial.
Authors: Antonio Gonzalez-Martin, Patricia Pautier, Sven Mahner, Jörn Rau, Nicoletta Colombo, Petronella Ottevanger, Jose Maria Del Campo, Dominique Berton-Rigaud, Andreas Du Bois, Ulrich Freudensprung, Ru-Amir Walker, Christian Kurzeder
Journal: Journal of Clinical Oncology (2014)

5552 Background: In platinum-resistant ovarian cancer, the monoclonal antibody P, which inhibits HER2 heterodimerization, improved PFS when added to gemcitabine in the subgroup of pts with low tumor HER3 mRNA expression [Makhija, 2010]. The 2-part PENELOPE trial (NCT01684878) is prospectively investigating P added to single-agent CT in this population. Methods: Part 1 (safety run-in) of PENELOPE evaluated P + either topotecan (TOP) or paclitaxel (PAC). Pts with platinum-refractory or -resistant recurrent ovarian, primary peritoneal, or fallopian tube cancer (progression [PD] during or within 6 mo of completing ≥4 platinum cycles) and low HER3 mRNA expression (concentration ratio ≤2.81 by central qRT-PCR testing on cobas z480) received IV P 840→420 mg q3w + investigator’s choice of TOP (1.25 mg/m² d1–5 q3w; cohort 1) or PAC (80 mg/m2 d1, 8, 15 q3w; cohort 2) until PD or unacceptable toxicity. The primary objective was to assess safety and tolerability. After all pts had received ≥3 cycles, the Independent Data Monitoring Committee (IDMC) assessed safety results to recommend which regimen(s) should be included in Part 2. Results: InPart 1, 50 pts were enrolled and treated between Oct 2012 and Jul 2013. At data cut-off (Aug 27, 2013), 8 TOP and 17 PAC pts remained on treatment. Conclusions: Both regimens were tolerable. Based on these results, the IDMC had no objection to the trial proceeding to Part 2 (double-blind randomized comparison of CT [TOP, PAC, or gemcitabine] + P or placebo). Clinical trial information: NCT01684878. P + TOP (N=22) P + PAC (N=28) Median age, y (range) 59 (41–80) 64 (32–79) ECOG PS, N (%) 0 9 (41) 13 (46) 1 11 (50) 9 (32) 2 2 (9) 6 (21) Two prior CT lines, N (%) 14 (64) 20 (71) Prior bevacizumab, N (%) 6 (27) 10 (36) Platinum-free interval <3 mo, N (%) 5 (23) 11 (39) Median No. of cycles (range) P 4 (1–11) 4 (1–8) CT 4 (0–11) 4 (1–8) Primary reason for discontinuing P and CT, N (%) PD 9 (41) 9 (32) Symptomatic deterioration 4 (18) 0 AE 0 1 (4)a,b Consent withdrawn 1 (5) 0 Grade ≥3 AEs, N (%)c 16 (73) 7 (25) Neutropenia 4 (18) 1 (4) Febrile neutropenia 3 (14) 0 Diarrhea 3 (14) 1 (4) Anemia 3 (14) 0 Asthenia 3 (14) 0 Deaths 6 (27) 3 (11) PD 6 (27) 2 (7) AE 0 1 (4)a aInfection. b1 further pt discontinued P (grade 1 hypersensitivity). cMedDRA preferred terms in >10%.
Phase II Trial of Panitumumab in Combination with Oxaliplatin and Capecitabine Chemotherapy as 1st Line Therapy in Patients with Colorectal Cancer and Advanced Liver Metastases: The Metapan Study
Authors: F. Leone, D. Marino, S. Artale, C. Cagnazzo, S. Cascinu, A.A. Martoni, A. Sobrero, M. Tampellini, S. Siena, M. Aglietta
Journal: Annals of Oncology (2012)
Melt electrospinning of daunorubicin hydrochloride-loaded poly (ε-caprolactone) fibrous membrane for tumor therapy
Authors: He Lian, Zhaoxu Meng
Journal: Bioactive Materials (2017)

Daunorubicin hydrochloride is a cell-cycle non-specific antitumor drug with a high therapeutic effect. The present study outlines the fabrication of daunorubicin hydrochloride-loaded poly (ε-caprolactone) (PCL) fibrous membranes by melt electrospinning for potential application in localized tumor therapy. The diameters of the drug-loaded fibers prepared with varying concentrations of daunorubicin hydrochloride (1, 5, and 10 wt%) were 2.48 ± 1.25, 2.51 ± 0.78, and 2.49 ± 1.58 μm, respectively. Fluorescence images indicated that the hydrophobic drug was dispersed in the hydrophilic PCL fibers in their aggregated state. The drug release profiles of the drug-loaded PCL melt electrospun fibrous membranes were approximately linear, with slow release rates and long-term release periods, and no observed burst release. The MTT assay was used to examine the cytotoxic effect of the released daunorubicin hydrochloride on HeLa and glioma cells (U87) in vitro. The inhibition ratios of HeLa and glioma cells following treatment with membranes prepared with 1, 5, and 10 wt% daunorubicin hydrochloride were 62.69%, 76.12%, and 85.07% and 62.50%, 77.27%, and 84.66%, respectively. Therefore, PCL melt electrospun fibrous membranes loaded with daunorubicin hydrochloride may be used in the local administration of oncotherapy.
Talking sensibly about depression
Authors: Vikram Patel
Journal: PLoS Medicine (2017)

Depression is the leading mental health-related cause of the global burden of disease and is the focus of World Health Day 2017.• Despite robust evidence of the effectiveness of interventions ranging from self-care to clinical interventions, the vast majority of people with depressive symptoms do not receive any care.• The majority of persons meeting the binary diagnostic criteria for depression have mild to moderate symptoms that most often do not need clinical interventions.• A staged model, from wellness to distress to disorder, offers a hybrid between binary and dimensional approaches to classifying depressive symptoms, with specific interventions delivered through distinct delivery platforms addressing each stage.• Such a staged approach is likely to be more efficient and acceptable to diverse audiences (from the general population to policy makers and practitioners) and provides the basis for these audiences to talk with one voice about this condition.The past 12 months have been a momentous year for global mental health, the discipline of global health concerned with reducing the burden of mental ill-health and inequalities within and between nations.The World Bank and WHO jointly hosted the "Out of the Shadows" summit in Washington in April 2016 to highlight mental health as a global "development" priority, signifying a notable shift in emphasis from a narrower health focus to development more broadly.Twelve months later, the WHO celebrates its annual World Health Day in April 2017 on the theme of depression.This is a very timely (indeed, greatly overdue) recognition, for not only is depression the leading mental health-related cause of the global burden of disease but also because, despite the reams of evidence on how the suffering associated with this condition can be mitigated, vast proportions of people globally do not benefit from these interventions [1].Even in the relatively better-resourced, middle-income countries such as India and China, up to 90% of patients with depression report not having sought or received any care for their symptoms [2].The slogan for World Health Day is "let's talk," emphasizing the central role of disclosure "as a vital component of recovery" by targeting the stigma surrounding mental illness, which acts as a barrier to people with depression seeking help.Significantly, the WHO campaign recommends that talking can involve a wide range of potential listeners, from family members
Progression-free survival for subsequent relapses in patients with peripheral T-cell lymphoma (PTCL).
Authors: Steven M. Horwitz, Richard Delarue, Matthew Alexander Lunning, Julie Vose, Bertrand Coiffier
Journal: Journal of Clinical Oncology (2012)

8063 Background: In B-cell lymphoma, overall response (ORR) is lower and progression free survival (PFS) is often shorter with each subsequent progression. However, this has not been described for PTCL. Methods: We undertook a retrospective analysis in two U.S. centers (MSKCC and UNMC) and in GELA studies. All data for PTCL were reviewed to collect data for each line of therapy: treatment, response, PFS, date of next treatment, and survival. When date of progression could not be defined we calculated PFS as the time to next treatment. Pts who did not progress, died during first line, or were untreated at progression 1 were excluded. Data were collected for 4 lines of treatment, front line and 3 progressions. Results: 254 pts were identified. 205 were analyzed (49 excluded for missing data): GELA 116, MSKCC 51, and UNMC 37. Diagnoses were PTCL NOS in 34% and 60%, AITL in 49% and 35%, ALCL Alk- in 3% and 5%, and others in 15% and 18% for GELA and US centers respectively. 67% were male, median age was 51 vs 58 y. Advanced stage was more frequent in GELA (79% vs. 56% for US); baseline IPI was ≥2 in 90% vs 71%. Multidrug regimens were given in 99% and 80% for front line, 67% and 66% for 2nd line, 61% and 50% for 3rd line, 53% and 54% for 4th line, for GELA and US. Significantly fewer pts received each subsequent line of therapy with 205 pts receiving 2nd line, 96 pts 3rd line and 38 pts 4th line. No pt ≥65 y received 4th line treatment. Responses and PFS are listed in the table. Conclusions: For pts with PTCL, similar to B-cell lymphomas, ORR and PFS decrease with each line of therapy. When evaluating the activity of therapies in relapsed PTCL, line of therapy is a consideration and this series provides a benchmark for comparison. Based on this dataset, it is possible that better responses will be seen as new agents are moved into earlier treatment paradigms. [Table: see text]
Development of an oncology-specific instrument to measure care coordination.
Authors: Randall F. Holcombe, Marisa Cortese, Isabelle Zinghini, Rupali Mahida, Dinah Draluk, Meng Ru, Gary Winkel
Journal: Journal of Clinical Oncology (2017)

148 Background: Care coordination (CC) has been identified by the IOM as critically important for the delivery of quality medical care. Coordination of care is especially important in oncology due to multiple encounters, many physicians, significant toxicities and several care transition points. Standard patient satisfaction surveys do not accurately measure CC and there are few instruments to measure a patient’s perspective of CC directly. In this project, multiple PDSA cycles were utilized with oncology patients to develop a Care Coordination Instrument (CCI) that was then used to compare the level of CC in two distinct practices. Methods: Survey questions were initially prepared by the research team after review of existing literature, submitted to oncology RNs, NPs and MDs and then modified based on their feedback. A new survey was then administered to 30 patients. This was again modified to eliminate or improve questions that were confusing to patients. A third survey instrument was developed and administered to an additional 30 patients. Statistical analysis identified that several questions were too structured leading to many “not applicable” responses. These were changed to a more conceptual framework. The survey was then administered to 30 patients in the myeloma practice and 30 in the GI oncology practice. Results: The CCI included questions from 4 areas of coordination (patient-physician; between health providers; during inpatient-to-ambulatory care transitions; during transitions across different phases of care) and 3 domains (Communication, Operational, Navigation). The GI oncology practice scored significantly better than the myeloma practice on the communication and navigation domains (p &lt; 0.01). There was no significant difference in the operational domain. Conclusions: Testing to date suggests that the CCI is a useful instrument in measuring an oncology patient’s perception of CC. For two distinct practices, significant differences in the delivery of CC were identified. Further refinement is necessary to modify or eliminate questions with high levels of missing data due to non-responsiveness. Separate sub-scores across domains help identify specific targets for quality improvement interventions.
Free condoms should be targeted at people with high STI risk, says NICE
Authors: Gareth Iacobucci
Journal: BMJ (2017)

Local councils should target free condoms at people most at risk of sexually transmitted infections (STIs), guidance by the National Institute for Health and Care Excellence (NICE) recommends.1

The watchdog’s latest public health guidance says that local authorities and other commissioners should make condoms more freely available through various distribution schemes to cater for the needs of different local populations and help reduce STI rates.

Although free condoms are available in England from places such as sexual health clinics, NICE said that it had issued the guidance to ensure that local schemes were targeted at people most at risk and …
Faster and better: Improving the diagnostic phase of lung cancer at a system level.
Authors: Melissa Kaan, Claire Holloway, Julie Gilbert, Vicky Simanovski, Garth Matheson
Journal: Journal of Clinical Oncology (2017)

115 Background: For many patients going through diagnostic testing for cancer, the time from suspicion to diagnosis or rule-out, can be a confusing and anxious time. In 2007, Cancer Care Ontario began investing in the implementation of diagnostic assessment programs (DAPs) across Ontario, Canada to improve the quality of care during the diagnostic phase of lung cancer. DAPs consist of multidisciplinary healthcare teams that manage and coordinate a patient’s diagnostic care from testing to a definitive diagnosis. The objectives of the DAPs are to: 1) decrease time from suspicion to diagnosis or resolution; 2) optimize the patient’s experience during the diagnostic process; 3) optimize satisfaction and experience among primary care providers and specialists; and 4) provide a sustainable solution by offering good value for money. Today over 35,000 patients have been diagnosed in one of the 18 lung DAPs that exist across the province. Methods: The implementation of DAPs featured the introduction of a patient navigator to act as the primary point of contact for patients, improve the patient experience and ensure their patients were progressing through any required diagnostic imaging and consultations in a timely manner. Cancer Care Ontario also engaged with primary care providers to refer patients with findings suspicious for lung cancer to DAPs as early as possible to ensure they benefited from organized assessment. Cancer Care Ontario has collected patient level data to measure wait times and implemented a patient survey to assess patient experience. Results: In the past five years, the median wait time from referral to a lung DAP to diagnosis or rule out has decreased by 19% to 24 days and the 90th %tile has decreased by 28% to 51 days. The large majority of patients have had a positive experience with their DAPs, with 95% of patients scoring their experience in the diagnostic process as “good” or “excellent”. Conclusions: The implementation of DAPs across the province is seen as a valuable component of quality of care by improving the diagnostic phase of cancer. The sustainability of the DAP model is demonstrated by the continued improvements in access and maintained patient experience in spite of growing volumes (91% increase in the past five years).
Resident Duty Hours and Medical Education Policy — Raising the Evidence Bar
Authors: David A. Asch, Karl Y. Bilimoria, Sanjay V. Desai
Journal: New England Journal of Medicine (2017)

Interview with Dr. David Asch on resident work hours and using evidence to inform medical education policy. (08:41)Download New rules for residents that go into effect in July extend permissible work shifts for first-year residents from 16 hours to 24. The policy seems to reverse the direction we have been moving in, on the basis of a new approach to developing and using evidence to inform education policy.