tbuckley/cabot-search huggingface dataset:
Breast cancer surgery during pregnancy.
Authors: Rakesh Surapaneni, Jolanta Jozefara, Karen Hendershott, Krystal Hunter, Elyce Cardonick
Journal: Journal of Clinical Oncology (2012)

1127 Background: There is limited literature on breast surgery during pregnancy. We present prospective registry data on 88 breast cancer patients who underwent breast cancer surgery during pregnancy. Methods: The Cancer and Pregnancy Registry is a voluntary international registry that prospectively collects the clinical course, treatment, and disease outcome of women diagnosed with cancer during pregnancy and the perinatal and neonatal outcomes of their children. Results: We identified 88 patients who were diagnosed with breast cancer and had surgery while pregnant. 59 patients (67%) underwent Mastectomy while29 patients (32%) underwent breast conserving surgery (BCS). Out of 43 patients who underwent BCS as their first surgery 13 patients (30.23%) required subsequent mastectomy during pregnancy. 15 patients (34.88%) from the BCS group and 4 patients (8.69%) from the Mastectomy group had positive margins. There was no significant difference between patients who underwent mastectomy vs BCS based on Age (34.67 vs 34.72 P: 0.97), gestational age at surgery (14.05 vs 16.06 P: 0.23) or ER positivity (47.5% vs 46.4% P: 0.93). 2 patients had neo-adjuvant chemotherapy. 17 patients (19.31%) had sentinel lymph node biopsy. 37 patients (42%) had a pregnancy complication. There was no difference in the rate of complication based on mastectomy vs BCS(45.8% vs 34.5% P: 0.31). There was only 1 patient (from mastectomy group) that delivered within 2 weeks of surgery. Of the 17 patients (19.3%) with spontaneous preterm delivery, there was no difference between Mastectomy and BCS group (22% vs 13.2% P: 0.41). Of the 25 patients (28.4%) with birth complications, there was no significant difference between mastectomy vs BCS (30.5% vs 24.1% P: 0.53). There was also no difference in mean birth weight between the groups (2598 grams vs 2672.3 grams P: 0.57). Conclusions: The data supports the safety of breast cancer surgery during pregnancy. In addition, there were no identified adverse effects in patients who underwent BCS as opposed to mastectomy. Of note, only 19% of patients underwent sentinel node biopsy which is considered the standard of care in early breast cancer patients regardless of pregnancy status.
Reply to: “Allergen‐specific IgG responses preceding allergic sensitization”
Authors: P. M. Matricardi, S. Hofmaier, S. Perna, X. Huang, T. Keil, S. Lau
Journal: Allergy (2018)

The authors declare that they have no conflicts of interest. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
Intralymphatic immunotherapy with 2 concomitant allergens, birch and grass: A randomized, double-blind, placebo-controlled trial
Authors: Laila Hellkvist, Eric Hjalmarsson, Susanna Kumlien Georén, Agneta Karlsson, Karin Lundkvist, Ola Winqvist, Ulla Westin, Lars Olaf Cardell
Journal: Journal of Allergy and Clinical Immunology (2018)
Adherence to geriatric assessment-based recommendations in older patients with cancer: a multicenter prospective cohort study in Belgium
Authors: C. Kenis, L. Decoster, J. Flamaing, P.R. Debruyne, I. De Groof, C. Focan, F. Cornélis, V. Verschaeve, C. Bachmann, D. Bron, S. Luce, G. Debugne, H. Van den Bulck, J.-C. Goeminne, D. Schrijvers, K. Geboers, B. Petit, C. Langenaeken, R. Van Rijswijk, P. Specenier, G. Jerusalem, J.-P. Praet, K. Vandenborre, J.-P. Lobelle, M. Lycke, K. Milisen, H. Wildiers
Journal: Annals of Oncology (2018)

BackgroundIn the general older population, geriatric assessment (GA)-guided treatment plans can improve overall survival, quality of life and functional status (FS). In GA-related research in geriatric oncology, studies mainly focused on geriatric screening and GA but not on geriatric recommendations, interventions and follow-up. The aim of this study was to investigate the adherence to geriatric recommendations and subsequent actions undertaken in older patients with cancer.Patient and methodsA prospective Belgian multicenter (N= 22) cohort study included patients ≥70 years with a malignant tumor upon oncologic treatment decision. Patients with an abnormal result on the geriatric screening (G8 ≤14/17) underwent GA. Geriatric recommendations were formulated based on GA results. At follow-up the adherence to geriatric recommendations was documented including a description of actions undertaken.ResultsFrom November 2012 till February 2015, G8 screening was carried out in 8451 patients, of which 5838 patients had an abnormal result. Geriatric recommendations data were available for 5631 patients. Geriatric recommendations were made for 4459 patients. Geriatric interventions data were available for 4167 patients. A total of 12384 geriatric recommendations were made. At least one different geriatric recommendation was implemented in 2874 patients. A dietician, social worker and geriatrician intervened most frequently for problems detected on the nutritional, social and functional domain. A total of 7569 actions were undertaken for a total of 5725 geriatric interventions, most frequently nutritional support and supplements, extended home care and psychological support.ConclusionsThis large-scale Belgian study focuses on the adherence to geriatric recommendations and subsequent actions undertaken and contributes to the optimal management of older patients with cancer. We identified the domains for which geriatric recommendations are most frequently made and adhered to, and which referrals to other health care workers and facilities are frequently applied in the multidisciplinary approach of older patients with cancer.
Abstract 20208: Nucleolus Mediated Cellular Senescence is Involved in Cardiac Hypertrophy
Authors: Takuya Kumazawa, Kazuho Nishimura, Yoshihiko Saito
Journal: Circulation (2017)

Background: Recently, the contribution of p53 to many undesirable aspects of age-associated diseases, such as cardiovascular disorders, has been recognized. p53 induced-cellular senescence have bee...
"What if I keep my breasts?" Extended follow-up of unaffected <i>BRCA</i> mutation carriers diagnosed with breast cancer (BC) in the Toronto magnetic resonance imaging (MRI) screening study.
Authors: Ellen Warner, Siqi Zhu, Kimberley Hill, Petrina Causer, Roberta A. Jong, Martin Yaffe, Elizabeth Ramsay, Steven Narod, Donald B. Plewes
Journal: Journal of Clinical Oncology (2018)

1523 Background: The addition of MRI to mammography for screening BRCA mutation carriers detects significantly earlier stage BC but, with median follow-up of < 10 years in all reports to date, the long-term prognosis of these cancers is uncertain. Moreover, while the short-term risk of ipsilateral recurrence for carriers who opt for breast conservation (BCT) are reported to be similar to that of non-carriers, the risk of late new breast primaries may be substantially higher. We report the long-term ipsilateral, contralateral, and distant recurrence as well as survival results for the previously unaffected women with BC diagnosed in the Toronto MRI screening study. Methods: From 07/1997 to 06/2009, 380 BRCA mutation carriers with no history of BC or ovarian cancer completed 1 to 9 rounds of annual screening with MRI and mammography; 41 cancers (30 invasive) were detected (38 by MRI, 5 by mammography) in 40 women (20 BRCA1, 20 BRCA2), median age at diagnosis 48 (32 to 68), followed annually for recurrence and survival by mailed questionnaire. 10-year results were calculated using the Kaplan-Meier method. Results: As of 01/2018, median follow up was 13.5 (8 to 19) years with none lost to follow-up. Of the 27/40 (68%) who initially had BCT, 6 (22%) had an ipsilateral recurrence/new primary at 3, 3, 6, 15, 16 and 19 years, with 2 of the latter 3 opting for repeat lumpectomy and re-irradiation. Of the 34 who did not have bilateral mastectomy initially, only 1 developed a metachronous contralateral cancer at 1 year. Of the 40 women, 34 (85%) are alive with no evidence of disease, and 6 have died: 2 (5%) of peritoneal cancer, 1 of ovarian cancer, 1 of suicide, and only 2 (5%) of ER+ BC, with distant recurrences 6 and 7 years after diagnosis. 10-year BC-specific survival was 94.6% for all 40 patients and 92.6% for those with invasive disease. Conclusions: MRI-detected BC in BRCA mutation carriers has a 10-year BC-specific distant recurrence-free survival rate of 95%. Distant recurrences occur relatively early, likely due to the known faster growth rate of these cancers. MRI-based breast screening has proven to be a very reasonable alternative to risk-reducing mastectomy.
Narrowband ultraviolet B treatment for psoriasis is highly economical and causes significant savings in cost for topical treatments
Authors: K. Boswell, H. Cameron, J. West, C. Fleming, S. Ibbotson, R. Dawe, J. Foerster
Journal: British Journal of Dermatology (2018)

Narrowband ultraviolet B (NB-UVB) treatment for psoriasis is considered expensive. However, existing data are based on estimates and do not consider indirect cost savings.To define the actual costs of NB-UVB incurred by the service provider, as well as treatment-associated cost savings.We performed data linkage of (i) comprehensive treatment records and (ii) prescribing data for all NB-UVB treatment episodes spanning 6 years in a population of 420 000. We minimized data fluctuation by compiling data from four independent treatment sites, and using drug prescriptions unrelated to psoriasis as a negative control.National Health Service Tayside spent an average of £257 per NB-UVB treatment course (mean 257 ± 63, range 150-286, across four independent treatment sites), contrasting sharply with the estimate of £1882 used by the U.K. National Institute for Health and Care Excellence. The cost of topical treatments averaged £128 per patient in the 12 months prior to NB-UVB, accounting for 42% of the overall drug costs incurred by these patients. This was reduced by 40% to £53 per patient over the 12-month period following NB-UVB treatment, while psoriasis-unrelated drug prescription remained unchanged, suggesting disease-specific effects of NB-UVB. The data were not due to site-specific factors, as confirmed by highly similar results observed between treatment sites operated by distinct staff. Finally, we detail all staff hours directly and indirectly involved in treatment, allowing direct translation of cost into other healthcare systems.NB-UVB is a low-cost treatment; cost figures currently used in health technology appraisals are an overestimate based on the data presented here. Creating or extending access to NB-UVB is likely to offer additional savings by delaying or avoiding costly third-line treatments for many patients.
Endurance—Frostbite, Then and Now
Authors: Alison Irene Dempsey, Kempland Walley, Joslyn Sciacca Kirby
Journal: JAMA Dermatology (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 Dermatology 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 Dermatology journal
Lost Taussigs — The Consequences of Gender Discrimination in Medicine
Authors: Lisa S. Rotenstein, Anupam B. Jena
Journal: New England Journal of Medicine (2018)

Interview with Dr. Loren Rabinowitz on the hurdles and frustrations that female medical trainees face in a sexist culture. (08:58)Download Aside from the obvious moral issues associated with mistreatment of and job discrimination against women physicians, such behaviors can ultimately result in a loss of talent in biomedical science and worse clinical outcomes for patients.
AB0648 Correlates of fatigue in anca-associated vasculitis
Authors: A. Masiak, K. Nowicka-Sauer, A. Hajduk, B. Grygiel-Górniak, M. Komorniczak, Z. Zdrojewski
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Fatigue is a common symptom among patients with ANCA-associated vasculitis (AAV) identified as the greatest burden of their disease.<sup>1 2</sup> Research revealed associations between fatigue and bio-psychosocial factors but not with clinical factors. <h3>Objectives</h3> To assess fatigue and its correlates among patients with granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). <h3>Methods</h3> 37 patients (44% women; mean age 52.3 years; range 18–85) with GPA (27 patients) and MPA (10 patients) hospitalised in 3 clinical centres completed Multidimensional Fatigue Inventory-20 (MFI-20).<sup>3</sup> Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS). Socio-demographic data including age, sex, education, marital and occupational status were recorded. Disease characteristics included its' duration, severity, activity, organ involvement and laboratory data. <h3>Results</h3> The mean age was 52.3 years (range 18–85 years), and the mean disease duration was 43.1 months (range 1–248). 4 patients had limited type of the disease, 13 – early systemic, 16 – systemic and 4 – severe type of the disease. 75% of patients had active disease as defined by Birmingham Vasculitis Activity Score, BVASv3 (mean BVASv3 in active patients 12.2). 8% of patients were not taking steroids. 40,5% of patients had CRP &gt;5 mg/, 43% had anaemia, 10% – thrombocytosis and 43% had renal insufficiency. Mean score of MFI-20 was 57 points (range 31–100). There were no differences in MFI-20 overall score between groups according to sex, education, marital and occupational status. No significant associations between fatigue and disease-related factors as well as steroid dose were observed. Depression (r=0,79, p&lt;0,00000) and anxiety (r=0,63, p&lt;0,00002) were strongly correlated with MFI-20 overall score. <h3>Conclusions</h3> Since fatigue was not related to clinical characteristics, tiredness declared by the patient should not be interpreted as a symptom of active disease. There were no connexions between fatigue and socio-demographic variables. The strong association between fatigue and depression and anxiety levels indicates the necessity to supplement the standard drug therapy and/or cognitive-behavioural therapy aimed at reducing anxiety and improving mood. <h3>References</h3> [1] Basu N, McClean A, Harper L, et al. Explaining fatigue in ANCA-associated vasculitis. Rheumatology2013;52:1680–1685. [2] Herlyn K, Hellmich B, Seo P, et al. Patient-reported outcome assessment in vasculitis provides important data and a unique perspective. Arthritis Care Res2010;62:1639–45. [3] Buss T, Kruk A, Wiśniewski P, et al. Psychometric Properties of the Polish Version of the Multidimensional Fatigue Inventory-20 in Cancer Patients. J Pain Symptom Manag2014;48:730–737 <h3>Disclosure of Interest</h3> None declared
SAT0559 Systematic literature review (SLR) for the 2018 update of the eular management recommendations for hand osteoarthritis (OA)
Authors: F. Kroon, M. Kloppenburg, J. Schoones, L. Carmona
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> As part of the update of the EULAR management recommendations an SLR of available evidence for hand OA treatment was performed. <h3>Objectives</h3> To inform the task force of an overview of available evidence for the efficacy and safety of all non-pharmacological, pharmacological and surgical interventions for hand OA. <h3>Methods</h3> We searched Medline, EMBASE, Cochrane Central, and 2016–2017 conference abstracts until June 2017 for (randomised) controlled trials or Cochrane reviews. Observational studies with a comparator were included to assess safety, or effects of surgical interventions. Main efficacy outcomes were pain, function, and hand strength. Risk of bias was assessed. Meta-analysis was performed if possible. <h3>Results</h3> Of 7036 records, 127 references were included, of which 50 studies concerned non-pharmacological, 64 concerned pharmacological, and 12 concerned surgical interventions. Most trials were published after 2007. Many studies were at high risk of bias, mainly due to inadequate randomisation or lack of blinding. Overall, effect sizes of effective therapies were small. Beneficial non-pharmacological treatments for pain relief include hand exercise, and prolonged splinting of the thumb base (Table). A single trial showed that assistive devices had no effect on pain, but led to functional improvements (mean difference (MD) −0.3, 95% confidence interval (CI) −0.6;0.01 on AUSCAN function, range 1–5). Topical and oral non-steroidal anti-inflammatory drugs (NSAIDs) proved equally effective for pain relief (Table), while topical NSAIDs led to less adverse events (e.g., risk ratio for withdrawals due to adverse events 0.15, 95% CI 0.03;0.63). Single trials demonstrated beneficial effects for other pharmacological interventions, including chondroitin sulphate, and intra-articular (i.a.) glucocorticoid injections in interphalangeal joints (Table). Compared to placebo, no beneficial effects were demonstrated for i.a. glucocorticoid or hyaluronic acid injections in the thumb base, hydroxychloroquine, or tumour necrosis factor inhibitors (Table). In two trials, structure modification was the primary outcome measure, though no disease-modifying properties were found in these studies. In a Cochrane review no surgical intervention for thumb base OA appeared more effective than another, although in general, more complex procedures led to more complications. <h3>Conclusions</h3> The number of trials in hand OA has steeply increased over the last decade, providing evidence for several therapeutic options for symptom relief, though no disease-modifying drugs have yet been found. High-quality trials investigating often used analgesics like paracetamol are needed. <h3>Disclosure of Interest</h3> None declared
Safety and Efficacy of Budesonide Oral Suspension Maintenance Therapy in Patients With Eosinophilic Esophagitis
Authors: Evan S. Dellon, David A. Katzka, Margaret H. Collins, Sandeep K. Gupta, Lan Lan, James Williams, Ikuo Hirano
Journal: Clinical Gastroenterology and Hepatology (2018)

We aimed to determine the safety and efficacy of budesonide oral suspension (BOS) maintenance therapy in patients with eosinophilic esophagitis (EoE).We performed an open-label extension study of a 12-week, multicenter, randomized, double-blind, placebo-controlled trial. Patients with EoE (11-40 years old) who completed double-blind BOS (n = 45) or placebo therapy (n = 37) received 24 weeks' open-label BOS (2.0 mg once daily for 12 weeks, with optional dose increase [1.5-2.0 mg twice daily] for 12 weeks thereafter). Predefined efficacy outcomes included: proportion of patients with a histologic response (≤6 eosinophils/high-power field [eos/hpf]) and change in mean peak eosinophil counts after 24 weeks. Analyses were stratified by patients who received placebo (placebo/BOS) or BOS (BOS/BOS) during the double-blind trial.BOS was well tolerated and drug-related adverse events were uncommon (placebo/BOS, 19% [7/37]; BOS/BOS, 4% [2/45]). Incidence of oral candidiasis (1 per group) and esophageal candidiasis (placebo/BOS group, n = 4) remained low. Changes in morning serum cortisol levels were not clinically relevant. A histologic response was observed in 49% (16/33) of patients receiving placebo/BOS and 23% (9/39) receiving BOS/BOS. Mean peak eosinophil counts (baseline vs week 24 or early termination) were: placebo/BOS, 118.8 vs 29.1; P < .001 and BOS/BOS, 38.1 vs 72.4; P = .01. Of the patients who responded to double-blind therapy, 42% maintained a histologic response during the open-label extension; 4% of nonresponders gained response.In an open-label extension study of patients with EoE, BOS was well tolerated and drug-related adverse events were uncommon. BOS maintained a histologic response in some initial responders, but few initial nonresponders had a response. ClinicalTrials.gov no: NCT01642212.
Combined value of exhaled nitric oxide and blood eosinophils in chronic airway disease: the Copenhagen General Population Study
Authors: Yunus Çolak, Shoaib Afzal, Børge G. Nordestgaard, Jacob L. Marott, Peter Lange
Journal: European Respiratory Journal (2018)

We investigated whether the combination of increased exhaled nitric oxide fraction ( F eNO ) level and blood eosinophil count had an additive value in chronic airway disease in the general population. We included 4677 individuals aged 20–100 years from the Copenhagen General Population Study. Based on pre- and post-bronchodilator spirometry, self-reported asthma and smoking history, participants were subdivided into healthy never-smokers (n=1649), healthy ever-smokers (n=1581), asthma (n=449), chronic obstructive pulmonary disease (COPD) (n=404), asthma–COPD overlap (ACO) (n=138) and nonspecific airflow limitation (n=456). Compared to individuals with F eNO &lt;25 ppb and blood eosinophils &lt;0.3×10 9 cells·L −1 , age- and sex-adjusted odds ratios (95% CI) for wheezing were 1.54 (1.29–1.84) for individuals with F eNO ≥25 ppb or blood eosinophils ≥0.3×10 9 cells·L −1 and 2.14 (1.47–3.10) for individuals with F eNO ≥25 ppb and blood eosinophils ≥0.3×10 9 cells·L −1 . Corresponding odds ratios were 1.13 (0.91–1.41) and 1.83 (1.20–2.79) for sputum production, 1.54 (1.22–1.94) and 3.26 (2.16–4.94) for asthma, 1.03 (0.80–1.32) and 0.67 (0.36–1.27) for COPD and 1.32 (0.88–1.96) and 2.14 (1.05–4.36) for ACO. Among individuals reporting respiratory symptoms, predicting the type of chronic airway disease did not differ between the two biomarkers and did not improve by combining them. Combination of F eNO and blood eosinophils may have an additive value in characterising chronic airway disease in the general population but still needs to be investigated further with regard to clinical application.