tbuckley/cabot-search huggingface dataset:
THU0623 Serum igg4 levels at diagnosis can predict the outcomes of untreated patients with igg4-related disease: a retrospective study
Authors: I. Mizushima, N. Suzuki, M. Yoshida, A. Takeji, T. Matsunaga, T. Zoshima, S. Hara, K. Ito, H. Fujii, K. Yamada, M. Kawano
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> IgG4-related disease (IgG4-RD) is a recently recognised systemic fibro-inflammatory disorder that can affect many organs.<sup>1</sup> In IgG4-RD, spontaneous, or at least temporary, remissions without treatment have been reported, and watchful waiting may be appropriate in certain patients with asymptomatic and inactive disease.<sup>2</sup> However, the outcomes of patients with IgG4-RD who do not undergo treatment are still unclear. <h3>Objectives</h3> This study aimed to clarify the outcomes of untreated patients with IgG4-RD and the factors related to the outcomes. <h3>Methods</h3> We retrospectively reviewed the medical records of 107 patients with IgG4-RD, who were followed up for more than 6 months, at a single centre in Japan. Among them, 27 patients were followed up without treatment after the initial diagnosis. We compared the clinical features of these 27 patients with those of the 80 patients who underwent treatment. The outcomes of untreated patients were investigated, and logistic regression analysis was performed to assess factors related to the outcomes. Deterioration of IgG4-RD was defined as symptomatic, radiological, or functional exacerbation of the organ involved or new organ involvement. <h3>Results</h3> The patients comprised 73 men and 34 women (mean age 65.7 years). The follow-up periods were 7–252 (mean, 64.1) months, and the serum IgG4 levels at diagnosis were 10.7–3610 (mean, 706) mg/dL. The 27 untreated patients had significantly fewer affected organs (1.9±1.2 vs 3.0±1.6, p=0.001), lower IgG4-RD responder index (10.8±5.1 vs 13.8±6.8, p=0.048), and lower frequency of ophthalmic and renal parenchymal lesions (25.9% vs 53.8%, p=0.015, and 3.7% vs 26.3%, p=0.012, respectively) than did the 80 patients who underwent treatment. Of these 27 patients, 8 experienced deterioration of IgG4-RD 3–232 months (mean, 62.8) after the diagnosis. New organ involvement was observed in all 8 patients, 2 of whom concurrently suffered exacerbation of the organs involved. In age- and sex-adjusted logistic regression analysis, serum IgG4 elevation (per 100 mg/dL, odds ratio 1.194, 95% confidence interval 1.017–1.402, p=0.030) was the only significant factor related to deterioration of disease in untreated patients with IgG4-RD. <h3>Conclusions</h3> The present study suggests that serum IgG4 levels may be useful to predict the outcomes of untreated patients with IgG4-RD, who tend to have fewer affected organs and lower IgG4-RD responder index. <h3>References</h3> [1] Stone JH, et al. IgG4-related disease. N Engl J Med2012Feb 9;366(6):539–51. [2] Khosroshahi A, et al. International Consensus Guidance Statement on the Management and Treatment of IgG4-Related Disease.Arthritis Rheumatol2015Jul;67(7):1688–99. <h3>Disclosure of Interest</h3> None declared
The Persian Poet
Authors: Faith T. Fitzgerald
Journal: Annals of Internal Medicine (2018)

On Being a Doctor19 June 2018The Persian PoetFaith T. Fitzgerald, MDFaith T. Fitzgerald, MDUC Davis Medical Center, Sacramento, California (F.T.F.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-0918 Audio Reading - “The Persian Poet” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "The Persian Poet," by F.T. Fitzgerald. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail How often do our patients teach us?It was my month as ward attending on internal medicine. An elderly man had been transferred to us after the surgeons, to whom he had initially been admitted for severe abdominal pain, discovered that he had disseminated pancreatic cancer. Nothing they could do for him, they said, and so he was given to us to treat his pain.As I approached his room, I heard coming from it melodic, rhythmic speech in a language I could not identify, let alone understand. When I came through the door and approached his bedside, he abruptly ... Author, Article, and Disclosure InformationAffiliations: UC Davis Medical Center, Sacramento, California (F.T.F.)Corresponding Author: Faith T. Fitzgerald, MD, UC Davis Medical Center, Division of General Medicine, 4150 V Street, Suite 2400, Sacramento, CA 95817; e-mail, [email protected]edu. PreviousarticleNextarticle Advertisement Audio Reading - “The Persian Poet” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "The Persian Poet," by F.T. Fitzgerald. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 19 June 2018Volume 168, Issue 12Page: 891-892KeywordsAbdominal painChildrenElderlyEmotionsPancreatic cancerSurgeons ePublished: 19 June 2018 Issue Published: 19 June 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Bigger Is Not Always Better: Tumor Size and Prognosis in Advanced Melanoma
Authors: Allison Betof Warner, Michael A. Postow
Journal: Clinical Cancer Research (2018)

Tumor burden is a key consideration for the treatment of solid malignancies. Large baseline tumor size (an assessment of volume of disease in target lesions prior to treatment), elevated lactate dehydrogenase (LDH), and site of disease are prognostic of poor overall survival (OS) for patients with advanced melanoma treated with pembrolizumab. Clin Cancer Res; 24(20); 4915-7. ©2018 AACRSee related article by Joseph et al., p. 4960.
Suppression of IL-17F, but not of IL-17A, provides protection against colitis by inducing Treg cells through modification of the intestinal microbiota
Authors: Ce Tang, Shigeru Kakuta, Kenji Shimizu, Motohiko Kadoki, Tomonori Kamiya, Tomoyuki Shimazu, Sachiko Kubo, Shinobu Saijo, Harumichi Ishigame, Susumu Nakae, Yoichiro Iwakura
Journal: Nature Immunology (2018)
Human chorionic gonadotropin (HCG) as a biomarker in sarcoma: A systematic review.
Authors: Martin W. Schoen, Ahmad Al-Taee, Bassel Jallad
Journal: Journal of Clinical Oncology (2017)

e22503 Background: Human chorionic gonadotropin (HCG) has been reported in soft tissue sarcoma and osteosarcoma. In some patients, the ectopic production of HCG can lead to delays in diagnosis due to concern for pregnancy or germ cell tumors. Methods: We performed a systematic review of the scientific literature in English using PubMed to categorize cases of sarcoma search terms were HCG, sarcoma, human chorionic gonadotropin and osteosarcoma. Cases of sarcoma associated with HCG production were identified and further categorized by type and grade of tumor. Initial HCG, Peak HCG, response to therapy and case outcome were collected when available. We also included a case seen at our institution of osteosarcoma with ectopic HCG production. Results: We identified 21 manuscripts and 23 cases of patients with both sarcoma and elevated serum HCG. 10/23 patients were male (43%).The most frequent type of sarcoma was osteosarcoma with 9/23 (39%) of cases, leiomyosarcoma was identified in 7/23 (30%) and liposarcoma in 3/23 (13%) of cases. When described, all tumors were high grade or poorly differentiated. 20/23 tumors (87%) had HCG expression of the tumor by immunohistochemistry. Mean initial HCG was 3607 with a peak value of 6188. In 19 cases, HCG was used to monitor disease after treatment and 14/19 (74%) responded with a decrease in HCG after treatment. Of responders, 3 patients were considered cured and 2 were put into remission, while none of the patients without response survived. Overall, outcomes were poor with 16/23 (70%) deaths within one year. Conclusions: Sarcomas that secrete HCG tend to be high grade, poorly differentiated and appear to portend a poor prognosis. When expressed, HCG can be used as a marker of disease and response to therapy. Oncologists should consider checking HCG as a potentially low-cost marker of prognosis and response to treatment in patients with sarcoma. [Table: see text]
SP0027 Don`t delay, connect today – implementation of the eular campaign in romania
Authors: R. Ionescu
Journal: Annals of the Rheumatic Diseases (2018)

<h3></h3> <b>Background</b> 22% of the population in Europe currently has, or had experienced "long-term muscle, bone and joint problems".<sup>1</sup> Early referral to a rheumatologist for appropriate diagnosis and treatment prevent structural damage, disability and decrease mortality.<sup>2</sup> <h3>Objectives</h3> To launch a patient oriented campaign in Romania in order to increase awareness of rheumatic musculoskeletal diseases (RMDs) – early recognition of symptoms, ways of breaking down the barriers that delay early diagnosis. Also to educate the general public that rheumatic diseases may occur at any age and severe affect both children and young people. The long term goal of the campaign is to decrease the number of people with disabilities, work loss or early retirement as well as the health care costs. <h3>Methods</h3> The launch event of the campaign will be attended by patients, rheumatologists, GPs, HPs, media and also national and local authorities. A coordinated media plan will consist of pre-launch teasers, appropriate broadcasting of the event and post-event reminders as well as educational flyers/materials with the slogan "Don't delay, Connect today", handed out in shopping centres and other crowded areas. Online posts on the www.reumatism.ro website and the dedicated FB page will stimulate communication and mutual support among patients as well as spread information on RMDs to the general public. <h3>Results</h3> Up to 100 participants are expected to attend the launching event and get direct/live benefit from the information on early diagnosis and early treatment. Over 50% of the Romanian population will audience the campaign messages covered by 50 media articles (in Romanian) and over 10 000 people will receive e-messages (online and Facebook impressions/engagement). This coordinated media plan will stimulate communication and mutual support among people with RMDs. <h3>Conclusions</h3> The implementation of the EULAR campaign in Romania "Don't delay, Connect today" aims an early referral to the rheumatologist for diagnosis and treatment and for a normal quality of life of patients with inflammatory rheumatic diseases.The campaign will have a communication peak around the launching event. Until the end of the year an on-going media and online communication strategy will be implemented. <h3>References</h3> [1] Health in the European Union Eurobarometer Special Report 272, September 2007. [2] Emery P, Breedveld FC, Dougados M, et al, Early referral recommendation for newly diagnosed rheumatoid arthritis: evidence based development of a clinical guide, <i>ARD</i>2002. <h3>Disclosure of Interest</h3> None declared
Chemotherapy in advanced ovarian cancer: An overview of randomised clinical trials
Authors: L. A. Stewart, K. Aabo, P. Adnitt, M. Adams, D. S. Alberts, V. Barley, D. R. Bell, U. Bianchi, J. Blessing, M. Buyse, G. Bolis, H. S. Brodovsky, H. Bruckner, R. Canetta, V. Chylak, C. J. Cohen, N. Colombo, P. F. Conte, D. Crowther
Journal: BMJ (1991)
OP0294-PARE Addressing key challenges of lay involvement in musculoskeletal research: co-applicants and trial steering committees
Authors: A. Higginbottom, S. Blackburn, R. Taylor, C. Rhodes, L. Campbell, K. Dziedzic
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Patient and Public Involvement (PPI) in research is a requirement of funding in the UK. It has shown to improve the relevance and quality of research. For over 10 years, a Research User Group (RUG) of over 100 patients with musculoskeletal and other long term conditions who actively work with a Research Institute.<sup>1</sup> Researcher and anecdotal feedback from RUG members and researchers have highlighted two challenging PPI roles: lay co-applicants on research grants and lay membership of trial study steering committees (TSCs). For some RUG members, this has resulted in a less positive experience and a disinterest in having these important roles in the future <h3>Objectives</h3> To address the challenges of involving RUG members as co-applicants and as members of TSCs, and to describe ways of supporting RUG members in these roles. <h3>Methods</h3> Information to improve understanding of the challenges of these roles were gathered during group meetings and informal conversations with 13 RUG members, and a workshop with 35 researchers. PPI and researcher perspectives were captured on flipcharts, notes and meeting minutes. This information shaped the development of resources and approaches to support RUG members as lay co-applicants and TSC members. <h3>Results</h3> <h3>Conclusions</h3> Providing support to RUG members and researchers can sustain active and long-term lay involvement in these challenging yet important research roles. <h3>Reference</h3> [1] Jinks, et al. <i>Res Involv Engagem</i>2016;2:1. <h3>Acknowledgements</h3> We thank all RUG members for their contribution to our research, and R Taylor, C Ingram, C Walker, S Dent, P Callaghan for their input to training and guidance. We thank the Primary Care Consortium and Arthritis Research UK for supporting the RUG. KD is part-funded by a NIHR Knowledge Mobilisation Research Fellowship (KMRF-2014–03–002). <h3>Disclosure of Interest</h3> None declared
Age Correlates with Response to Anti-PD1, Reflecting Age-Related Differences in Intratumoral Effector and Regulatory T-Cell Populations
Authors: Curtis H. Kugel, Stephen M. Douglass, Marie R. Webster, Amanpreet Kaur, Qin Liu, Xiangfan Yin, Sarah A. Weiss, Farbod Darvishian, Rami N. Al-Rohil, Abibatou Ndoye, Reeti Behera, Gretchen M. Alicea, Brett L. Ecker, Mitchell Fane, Michael J. Allegrezza, Nikolaos Svoronos, Vinit Kumar, Daniel Y. Wang, Rajasekharan Somasundaram, Siwen Hu-Lieskovan, Alpaslan Ozgun, Meenhard Herlyn, Jose R. Conejo-Garcia, Dmitry Gabrilovich, Erica L. Stone, Theodore S. Nowicki, Jeffrey Sosman, Rajat Rai, Matteo S. Carlino, Georgina V. Long, Richard Marais, Antoni Ribas, Zeynep Eroglu, Michael A. Davies, Bastian Schilling, Dirk Schadendorf, Wei Xu, Ravi K. Amaravadi, Alexander M. Menzies, Jennifer L. McQuade, Douglas B. Johnson, Iman Osman, Ashani T. Weeraratna
Journal: Clinical Cancer Research (2018)

Abstract Purpose: We have shown that the aged microenvironment increases melanoma metastasis, and decreases response to targeted therapy, and here we queried response to anti-PD1. Experimental Design: We analyzed the relationship between age, response to anti-PD1, and prior therapy in 538 patients. We used mouse models of melanoma, to analyze the intratumoral immune microenvironment in young versus aged mice and confirmed our findings in human melanoma biopsies. Results: Patients over the age of 60 responded more efficiently to anti-PD-1, and likelihood of response to anti-PD-1 increased with age, even when we controlled for prior MAPKi therapy. Placing genetically identical tumors in aged mice (52 weeks) significantly increased their response to anti-PD1 as compared with the same tumors in young mice (8 weeks). These data suggest that this increased response in aged patients occurs even in the absence of a more complex mutational landscape. Next, we found that young mice had a significantly higher population of regulatory T cells (Tregs), skewing the CD8+:Treg ratio. FOXP3 staining of human melanoma biopsies revealed similar increases in Tregs in young patients. Depletion of Tregs using anti-CD25 increased the response to anti-PD1 in young mice. Conclusions: While there are obvious limitations to our study, including our inability to conduct a meta-analysis due to a lack of available data, and our inability to control for mutational burden, there is a remarkable consistency in these data from over 500 patients across 8 different institutes worldwide. These results stress the importance of considering age as a factor for immunotherapy response. Clin Cancer Res; 24(21); 5347–56. ©2018 AACR. See related commentary by Pawelec, p. 5193
Neurologic Abnormalities After Atrial Fibrillation Ablative Procedure
Authors: Robert J. Stanton, Matthew J. Roesch, Daniel Kanter
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
Prevalence of<i>PDL1</i>Amplification and Preliminary Response to Immune Checkpoint Blockade in Solid Tumors
Authors: Aaron M. Goodman, David Piccioni, Shumei Kato, Amélie Boichard, Huan-You Wang, Garrett Frampton, Scott M. Lippman, Caitlin Connelly, David Fabrizio, Vincent Miller, Jason K. Sicklick, Razelle Kurzrock
Journal: JAMA Oncology (2018)

Copy number alterations in programmed cell death ligand 1 (PDL1 or CD274), programmed cell death 1 ligand 2 (PDCD1LG2 or PDL2), and Janus kinase 2 (JAK2) genes (chromosome 9p24.1) characterize Hodgkin lymphoma, resulting in high response rates to programmed cell death 1 (PD-1)/programmed cell death ligand 1 (PD-L1) blockade. The prevalence and utility of PDL1 amplification as a response biomarker to PD-1/PD-L1 blockade are unknown in other tumors.To examine the prevalence of PDL1 amplification and its utility as a response biomarker to PD-1/PD-L1 blockade in solid tumors.This retrospective study (October 1, 2012, to October 1, 2017) used a deidentified tumor database from a commercial company and annotated clinical records from a subset of patients treated at a university tertiary referral center. The study analyzed 118 187 tumors from the deidentified database, including a clinically annotated subgroup of 2039 malignant tumors.Comprehensive genomic profiling was performed on all samples to determine PDL1 amplification, microsatellite instability, and tumor mutational burden (TMB). A subset of patients was treated with PD-1/PD-L1 blockade.The prevalence of PDL1 amplification was determined among 118 187 patient samples that underwent next-generation sequencing. Solid tumors treated with checkpoint blockade were evaluated for response and progression-free survival (PFS).Of the 118 187 deidentified tumor samples, PDL1 amplifications were identified in 843 (0.7%), including more than 100 types of solid tumors. Most PDL1-amplified tumors (84.8%) had a low to intermediate TMB. PDL1 amplification did not always correlate with high-positive PD-L1 expression by immunohistochemical analysis. Six of 9 patients (66.7%) from 1 center with PDL1-amplified solid tumors had objective responses after checkpoint blockade administration. The median PFS among all treated patients was 15.2 months. Responders included 1 patient with glioblastoma (PFS, ≥5.2 months), 2 patients with head and neck squamous cell cancer (PFS, ≥9 and 15.2 months), 2 patients with metastatic basal cell cancer (PFS, 3.8 and ≥24.1 months), and 1 patient with urothelial cancer (PFS, ≥17.8 months).The results of this study suggest that PDL1 amplification occurs in a small subset of malignant tumors. Additional large-scale, prospective studies of PDL1-amplified cancers are warranted to confirm the responses to checkpoint blockade described herein, even in the absence of microsatellite instability, high PD-L1 expression, and a high TMB.
Dump “acronym spaghetti” in integrated care and allow patients and staff to shape new services, say MPs
Authors: Adrian O’Dowd
Journal: BMJ (2018)

MPs have called for health and care professionals, working with local government, patients’ representatives, and the voluntary sector, to take the lead in reforming the NHS to allow for better integration of care.

In a new report the House of Commons Health and Social Care Committee said that the NHS urgently needed changing but not through the usual top-down reorganisation. It said that the NHS and social care services were now looking after a population that was living longer, with increasingly complex health and care needs, and that services needed to be better organised around patients’ needs.

It said that there were current examples of NHS and care services working together to deliver better care and added, “We support the move away from a competitive landscape of autonomous providers towards more integrated, collaborative and …