tbuckley/cabot-search huggingface dataset:
Care coordination and emergency department (ED) use at the end of life for patients with cancer: Findings from structured interviews with primary caregivers.
Authors: Cara L. McDermott, Scott David Ramsey, Ruth Engelberg, Cossette Woo, J. Randall Curtis, Helene Starks
Journal: Journal of Clinical Oncology (2018)

161 Background: For cancer patients who want to die at home, care coordination helps ensure that patients’ symptoms are managed at home, avoiding an ED visit and subsequent hospitalization. We conducted a qualitative study with patients’ primary caregivers, assessing the relationship between care coordination and ED visits in the last month of life. Methods: From October-December 2017, we audio-recorded semi-structured phone interviews with 35 adults who were primary caregivers for a patient who died with cancer between July-December 2016. Two analysts independently coded transcripts using qualitative content analysis and summarized results as major themes. Results: Most respondents were white (91%), female (63%) and spouses (89%). Twenty-four patients (69%) enrolled in hospice; of those, 15 (63%) received services for &lt; 14 days, often enrolling after an unanticipated hospitalization or developing higher symptom burden. We identified three major themes related to care coordination and unanticipated ED visits/hospitalizations. First, caregivers reported insufficient at-home medical support especially following changes in patient status due to falls, pain, infection, or diarrhea/dehydration: “We have to go back to the hospital. You are getting worse and you are getting so weak, you are going to fall. And he said: ‘Okay, let's go.’ And he never came back home.” Second, lack of knowledge regarding whom to contact with needs: “We could eventually get people, but…there tended to be some significant delay… there weren’t facilities open... the emergency room…always seemed like a questionable best choice… the time and stress involved to the patient seemed like a big negative.” Third, caregiver burden: “We have got to go back to the hospital. I can't do this. I can't do this.” Conclusions: Caregivers reported significant gaps in care coordination and caregiving burdens that prompted ED visits and subsequent hospitalization. Active facilitation of hospice enrollment by oncologists and improved access to hospice resources are key targets to help patients avoid adverse events such as ED visits/hospitalizations while providing adequate support to caregivers.
Antisense STAT3 inhibitor decreases viability of myelodysplastic and leukemic stem cells
Authors: Aditi Shastri, Gaurav Choudhary, Margarida Teixeira, Shanisha Gordon-Mitchell, Nandini Ramachandra, Lumie Bernard, Sanchari Bhattacharyya, Robert Lopez, Kith Pradhan, Orsolya Giricz, Goutham Ravipati, Li-Fan Wong, Sally Cole, Tushar D. Bhagat, Jonathan Feld, Yosman Dhar, Matthias Bartenstein, Victor J. Thiruthuvanathan, Amittha Wickrema, B. Hilda Ye, David A. Frank, Andrea Pellagatti, Jacqueline Boultwood, Tianyuan Zhou, Youngsoo Kim, A. Robert MacLeod, P.K. Epling-Burnette, Minwei Ye, Patricia McCoon, Richard Woessner, Ulrich Steidl, Britta Will, Amit Verma
Journal: Journal of Clinical Investigation (2018)

Acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) are associated with disease-initiating stem cells that are not eliminated by conventional therapies. Transcriptomic analysis of stem and progenitor populations in MDS and AML demonstrated overexpression of STAT3 that was validated in an independent cohort. STAT3 overexpression was predictive of a shorter survival and worse clinical features in a large MDS cohort. High STAT3 expression signature in MDS CD34+ cells was similar to known preleukemic gene signatures. Functionally, STAT3 inhibition by a clinical, antisense oligonucleotide, AZD9150, led to reduced viability and increased apoptosis in leukemic cell lines. AZD9150 was rapidly incorporated by primary MDS/AML stem and progenitor cells and led to increased hematopoietic differentiation. STAT3 knockdown also impaired leukemic growth in vivo and led to decreased expression of MCL1 and other oncogenic genes in malignant cells. These studies demonstrate that STAT3 is an adverse prognostic factor in MDS/AML and provide a preclinical rationale for studies using AZD9150 in these diseases.
Nagashima‐type palmoplantar keratoderma and malignant melanoma in Japanese patients
Authors: A. Korekawa, E. Akasaka, D. Rokunohe, T. Fukui, T. Kaneko, D. Sawamura, M. Ishikawa, T. Yamamoto, H. Nakano
Journal: British Journal of Dermatology (2018)
Abstract 12468: Efficacy and Safety of Lomitapide in Japanese Patients With Homozygous Familial Hypercholesterolemia on Concurrent Lipid-Lowering Therapy
Authors: Mariko Harada-Shiba, Masayuki Yoshida, Katsunori Ikewaki, Atsushi Nohara, Koji Yanagi, Yoshihiko Otsubo, Pamela Foulds, Mark Sumeray
Journal: Circulation (2015)

Introduction: Lomitapide is a microsomal triglyceride transfer protein inhibitor indicated as an adjunctive therapy for adults with homozygous familial hypercholesterolemia (HoFH). In a previous global Phase 3 study in non-Japanese patients with HoFH, lomitapide in combination with other lipid-lowering therapy resulted in a 50% reduction in LDL-C levels from baseline after 26 weeks of treatment. This open-label, multicenter, phase 3 study evaluated the efficacy and safety of lomitapide in adult Japanese patients with HoFH. Methods: Adult patients with HoFH added lomitapide to their maximally tolerated, stable lipid-lowering therapy. Lomitapide was initiated at 5 mg/day and escalated to each patient’s maximum tolerated dose (≤60mg/day) over 14 weeks. The primary endpoint was the mean % change from baseline in LDL-C at Week 26. Results: Nine patients (5 men, 4 women, mean age 50 [33-74] years) received lomitapide (mean dose 20 mg); 8 patients completed 26 weeks of treatment. Mean LDL-C was reduced from 199.3 mg/dL (95% CI: 148.6-250.0) at baseline to 117.9 mg/dL (95% CI: 70.2-165.6, last observation carried forward) at Week 26. Mean % LDL-C reduction was significant in patients with and without apheresis; significant reductions were also seen in key secondary endpoints (Table). A &gt;50% reduction in LDL from baseline was achieved by 5/9 (56%) patients. Gastrointestinal symptoms were the most common adverse event (diarrhea in 7/9 [78%] patients). Abnormal liver function tests were reported in 3/9 (33%) patients; 1 patient discontinued treatment after 22 weeks due to persistent liver enzyme elevations. There were no serious adverse events. Conclusions: The efficacy and safety of 26 weeks of lomitapide in Japanese patients were consistent with results in the global phase 3 study, including a significant reduction in LDL-C and no new safety signals. Treatment in the safety phase (Weeks 26-56) is ongoing.
Abstract 18229: Heart Transplantation for Genetic Cardiomyopathies is Associated With Favorable Long-Term Survival and Graft Outcomes
Authors: Ziad Taimeh, Kairav Vakil, Cindy Martin, Renuka Jain, Monica Colvin
Journal: Circulation (2014)

Introduction and hypothesis: Genetic cardiomyopathies (GNCM) are a spectrum of myocardial disorders that can lead to heart failure, and frequently portend the need for heart transplantation. Post-transplant outcomes in this subgroup of patients have not been examined in a large, multicenter transplant cohort. Methods: Patients who underwent first-time heart transplantation in the United States between 1987 and 2012 were retrospectively identified from the United Network for Organ Sharing database. Patients with hypertrophic cardiomyopathy (HOCM), arrhythmogenic right ventricular cardiomyopathy (ARVC), and left ventricular non-compaction (LVNC) constituted the GNCM group. Primary outcome was survival. Secondary outcomes included rejection, cardiac allograft vasculopathy (CAV), and graft failure. Results: Of the 49,417 transplant recipients identified, 997 recipients (mean age 36±20 years; 55% males; 79% Caucasian) had GNCM (HOCM n=836; ARVC n=83; LVNC n=78). Patients transplanted for GNCM had significantly higher 1, 5 and 10 year survival rates compared to those without GNCM (86%, 76%, 66% vs. 82%, 69%, 50%, respectively, log-rank p&lt;0.001) (Figure 1A). After adjusting for age, sex, and race in multivariate Cox regression analysis; GNCM was associated with favorable post-transplant survival, with a hazard ratio of 0.70 (95% confidence interval 0.58-0.86; p=0.001). While the incidence of rejection was similar in GNCM compared to non-GNCM (43% vs. 40%, p=0.11), the incidences of CAV and graft failure were significantly lower compared to non-GNCM (24% vs 32%, p&lt;0.001, and 9% vs 15%, p&lt;0.001, respectively). The survival rates for HOCM, ARVC, and LVNC, were all similar to each other but significantly higher compared to non-GNCM (log-rank p&lt;0.001) (Figure 1B). Conclusions: Patients with GNCM seem to have better post-transplant survival and graft outcomes than patients transplanted for other cardiomyopathies.
Reversibility of alexithymia with effective treatment of moderate‐to‐severe psoriasis: longitudinal data from <scp>EPIDEPSO</scp>
Authors: F. Sampogna, L. Puig, P. Spuls, G. Girolomoni, M.A. Radtke, B. Kirby, M. Brunori, P. Bergmans, P. Smirnov, J. Rundle, A. Castiglia, F. Lavie, C. Paul
Journal: British Journal of Dermatology (2018)

Alexithymia refers to difficulty in identifying and expressing emotions. Alexithymia is associated with high burden of disease in patients with psoriasis.To investigate whether alexithymia was reversible in patients with psoriasis following real-life therapeutic intervention.The Epidemiological Study in Patients with Recently Diagnosed Psoriasis (EPIDEPSO; NCT01964443) was a 1-year multicentre observational study investigating the prevalence of alexithymia and other psychosocial comorbidities in patients with psoriasis with ≤ 10 years' disease duration and eligible for systemic treatment. Alexithymia was assessed using the Toronto Alexithymia Scale (TAS-20) at baseline, 6 months and 1 year.There was a statistically significant decrease in the prevalence of alexithymia in the follow-up cohort, from 26·7% at baseline to 21·2% at 6 months and 18·8% at 1 year. More than half of the patients (n = 77, 53·8%) who were alexithymic at baseline experienced reversion of their alexithymia. Reversion of alexithymia was higher in patients who reached a high level of disease control, defined as ≥ 75% or ≥ 90% improvement in Psoriasis Area and Severity Index. Reversion of alexithymia was associated with dramatic improvement in quality of life, anxiety and depression. Moreover, hazardous alcohol use, highly prevalent in patients with alexithymia, was reduced almost threefold at 1 year.Alexithymia and associated high disease burden may be reversible in patients with effective treatment of psoriasis. Proactive recognition of patients who are unable to identify and express their feelings is important.
Thinking in and about time: A dual systems perspective on temporal cognition
Authors: Christoph Hoerl, Teresa McCormack
Journal: Behavioral and Brain Sciences (2018)

We outline a dual systems approach to temporal cognition, which distinguishes between two cognitive systems for dealing with how things unfold over time - a temporal updating system and a temporal reasoning system - of which the former is both phylogenetically and ontogenetically more primitive than the latter, and which are at work alongside each other in adult human cognition. We describe the main features of each of the two systems, the types of behavior the more primitive temporal updating system can support, and the respects in which it is more limited than the temporal reasoning system. We then use the distinction between the two systems to interpret findings in comparative and developmental psychology, arguing that animals operate only with a temporal updating system and that children start out doing so too, before gradually becoming capable of thinking and reasoning about time. After this, we turn to adult human cognition and suggest that our account can also shed light on a specific feature of humans' everyday thinking about time that has been the subject of debate in the philosophy of time, which consists in a tendency to think about the nature of time itself in a way that appears ultimately self-contradictory. We conclude by considering the topic of intertemporal choice, and argue that drawing the distinction between temporal updating and temporal reasoning is also useful in the context of characterizing two distinct mechanisms for delaying gratification.
Progression-Free Survival and Overall Survival Beyond 5 Years of NSCLC Patients With Synchronous Oligometastases Treated in a Prospective Phase II Trial (NCT 01282450)
Authors: Dirk De Ruysscher, Rinus Wanders, Lizza E. Hendriks, Angela van Baardwijk, Bart Reymen, Ruud Houben, Gerben Bootsma, Cordula Pitz, Linda van Eijsden, Anne-Marie C. Dingemans
Journal: Journal of Thoracic Oncology (2018)
Abstract 15360: Circulation Levels of Vasopressin for Patients in Hyper Acute Phase of Acute Coronary Syndromes
Authors: Eizo Tachibana, Yasuyuki Suzuki, Masakazu Komoriya, Yasuo Watanabe, Takayuki Yahagi, Tsukasa Yagi, Wataru Atsumi, Keiichirou Kuronuma, Ken Nagao, Atsushi Hirayama
Journal: Circulation (2013)

Purpose: Although there is evidence for short-term clinical effects of vasopressin receptor antagonists in patients with Acute Heart failure (JAMA. 2007; 297). Few study are available for risk stra...
Oral chemotherapy education sessions at an academic and community cancer center.
Authors: Daniel Aaron Roberts, Jim Doolin, Christina Cibotti, Rebekah A Hartwell, Mary Yenulevich, Kelsey Trillo, Ayad Hamdan, Christopher Rodrigues, Morgan Brittany Smith, Holly Dowling, Noah Xavier Tocci, Scott M Devlin, Meghan Shea, Jessica A. Zerillo
Journal: Journal of Clinical Oncology (2018)

254 Background: Oral chemotherapy is becoming more widely utilized within oncology. Concerns regarding poor adherence and toxicity may be addressed by providing patient education. Methods: We developed and implemented a pharmacist-led initial education session for patients newly prescribed oral chemotherapy in both an academic medical center gastrointestinal oncology clinic and an affiliated community oncology cancer center. We provided an education packet including drug-specific information, clinic contact telephone numbers, and a drug schedule calendar. Standardized teaching and documentation templates were used. Patients completed each education session with the MOATT teaching tool for patients receiving Oral Agents for Cancer V1.2. Assessment of compliance with the ASCO/ONS Chemotherapy Administration Safety Standards on Oral Chemotherapy Education was assessed through use of Quality Oncology Practice Initiative (QOPI) quality measures where applicable and compared to historical QOPI data from the academic medical center from 2015-2017. Results: Thirty-one patients were newly prescribed oral chemotherapy and received the initial education session from November 2017 through May 2018. Based on a monthly report generated of new oral chemotherapy prescriptions, after a seven-month run-in, the rate reached 100% of patients at both sites for the most recent month. When comparing the intervention cohort to the historical QOPI cohort using a one-sided P value of 0.017 with bonferroni correction, there was improvement in safe handling/storage (pre: 19%, post 100%, P = 0.0001), drug-drug and food interactions (pre: 31%, post 100%, P = 0.0001), and plan for missed doses (pre: 37%, post: 97%, P = 0.0001). A trend toward improvement was found for schedule/start date discussion (pre: 87%, post: 100% P = 0.018) and side effect/toxicities (pre: 87%, post: 100% P = 0.018). Conclusions: Implementation of an oral chemotherapy education session in both an academic and community setting was feasible and improved adherence to QOPI measures of oral chemotherapy education and ASCO/ONS standards for oral chemotherapy. Further data regarding time to clinical outcomes is forthcoming.
Wearable Cardioverter–Defibrillator after Myocardial Infarction
Authors: Jeffrey E. Olgin, Mark J. Pletcher, Eric Vittinghoff, Jerzy Wranicz, Rajesh Malik, Daniel P. Morin, Steven Zweibel, Alfred E. Buxton, Claude S. Elayi, Eugene H. Chung, Eric Rashba, Martin Borggrefe, Trisha F. Hue, Carol Maguire, Feng Lin, Joel A. Simon, Stephen Hulley, Byron K. Lee
Journal: New England Journal of Medicine (2018)

Despite the high rate of sudden death after myocardial infarction among patients with a low ejection fraction, implantable cardioverter–defibrillators are contraindicated until 40 to 90 days after myocardial infarction. Whether a wearable cardioverter–defibrillator would reduce the incidence of sudden death during this high-risk period is unclear.
Use of Hierarchical Measures of Psychopathology to Capture the Long (and Wide) Shadow of Early Deprivation in the Bucharest Early Intervention Project Analysis
Authors: Jonathan D. Schaefer
Journal: JAMA Psychiatry (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 Psychiatry 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 Psychiatry journal
Real-world economic outcomes of early progression in newly diagnosed multiple myeloma (NDMM) patients (Pts).
Authors: Zoe Clancy, Shivani Pandya, Sulena Shrestha, Li Wang, Onur Baser, Quanhong Ni
Journal: Journal of Clinical Oncology (2018)

194 Background: Despite improved survival with advanced multiple myeloma (MM) treatments (Tx), 15–20% of pts experience early relapse. We assessed the economic impact of early progression among non-stem-cell transplant NDMM pts. Methods: NDMM pts with ≥ 1 Tx (1 st claim date: index date) from 01Jan2011–31Dec2015 were identified from the 100% Medicare database. Eligible pts had ≥ 1 full cycle of therapy and continuous health plan enrollment from 6 months pre-index or first MM diagnosis date until ≥ 12 month post-index date unless pts died &lt; 12 months post-index date. First line of therapy (LOT1) included all Txs prescribed ≤ 60 days post-index date. Among pts who progressed to LOT2, median time to next Tx (TTNT) was estimated from a Kaplan–Meier curve as duration from LOT1 start until the earliest of an addition/switch/restart of non-maintenance MM Tx, or dose increase from maintenance to relapse therapy. Pts who progressed to LOT2 prior to and after median TTNT were included in the early and delayed progression cohorts, respectively. Annual all-cause and MM-related healthcare costs estimated from a generalized linear model were compared between doublet therapy pts in LOT1 in the early and delayed progression cohorts. Results: Of 3,768 MM pts with LOT1, 36.1% progressed to LOT2 with median TTNT of 302 days; 81.3% pts initiated doublet therapy in LOT1, of which 19.2% (n = 589) and 17.3% (n = 533) were included in the early and delayed progression cohorts, respectively. Pts in the early progression cohort were younger and incurred higher all-cause inpatient ($17,332 vs $10,455), outpatient hospital ($18,183 vs $15,097), emergency department ($462 vs $395), office ($37,728 vs $29,174), and total costs ($130,948 vs $108,003) compared with the delayed progression cohort. Similarly, the early progression cohort had higher MM-related total costs ($87,284 vs $72,150) including inpatient and outpatient costs (all P&lt; 0.001). All-cause and MM-related pharmacy costs were similar between cohorts. Conclusions: Early progression after LOT1 is associated with substantially higher economic burden indicating the need for future studies of therapies that delay progression and potentially result in cost savings.
Abstract 11582: Vascular, Hemodynamic and Hormonal Response to Mental Stress and Risk of Mental Stress Induced Myocardial Ischemia
Authors: Muhammad Hammadah, Ayman Alkhoder, Nino Isakadze, Zakaria Almuwaqqat, Malik Obideen, Naser Abdelhadi, Mouwafak Moureiden, Mohamad Mazen Gafeer, Ibhar Al Mheid, Kobina Wilmot, Ronnie Ramadan, Heval Mohamed Kelli, Kareem Hosny, Amit Shah, Pratik Pimple, Yan Sun, Ernest Garcia, Paolo Raggi, Brad Pearce, Fabio Esteves, David Sheps, J. Douglas Bremner, Viola Vaccarino, Arshed Quyyumi
Journal: Circulation (2016)

Introduction: Mental stress-induced myocardial ischemia (MSIMI) has been linked to adverse cardiovascular outcomes in patients with stable CAD. However, the underlying mechanisms are not well understood. We aimed to study vasomotor, hemodynamic and hormonal responses to mental stress (MS) and their relationships with MSIMI. Methods: 660 patients with stable CAD underwent 99mTc sestamibi myocardial perfusion imaging before, and during a public speaking stressor. Hemodynamic parameters (heart rate, BP, rate-pressure product [RPP]), circulating catecholamines, and peripheral arterial tonometry (PAT, Itamar Inc.) were measured at rest, during, and after MS. MSIMI was defined as myocardial perfusion impairment with MS. Results: Participant age was 63±9; 72% male. Overall, 102 (16.1%) patients developed MSIMI. During MS, there was a significant increase in heart rate, BP, RPP and epinephrine, but not norepinephrine levels. The mean PAT ratio, measured as a ratio of the lowest pulse wave amplitude during the speaking task to the final three minutes of pulse wave amplitude during rest, was 0.7 ± 0.3 indicating vasoconstriction with MS. Patients with MSIMI had a greater hemodynamic response (Figure) and a lower PAT ratio (0.6±0.3 vs 0.7±0.3, p=0.008), in comparison to those with no ischemia. After adjustment for age, CAD risk factors and beta blocker use, both higher hemodynamic response (change in RPP≥median) and more vasoconstriction (PAT ratio&lt;median), but not catecholamine response, were independent predictors of MSIMI [OR(95%CI) of 1.8 (1.1-2.9) and 2 (1.2-3.3), p=0.02 and p=0.01, respectively]. A greater hemodynamic response and a lower PAT ratio had an incremental effect on incidence of MSIMI (Figure). Conclusion: A greater hemodynamic response and peripheral vasoconstriction are associated with MSIMI, indicating that both increased myocardial demand and potentially coronary vasoconstriction contribute to this phenomenon.
Abstract 14325: Smoking and Plaque Composition in Human Peripheral Arterial Disease: Implications for Disease Progression and Thrombogenicity
Authors: K-Raman Purushothaman, Prakash Krishnan, Meerarani Purushothaman, Baber Usman, Arthur Tarricone, Jose Wiley, Annapoorna Kini, Jason Kovacic, Samin K Sharma, Valentin Fuster, Pedro R Moreno
Journal: Circulation (2013)

Background: Smoking may play a role in the progression of atherosclerosis, calcification and thrombogenicity. However, there are scarce data evaluating smoking and plaque composition in symptomatic...