tbuckley/cabot-search huggingface dataset:
Voice of cancer patients (VoCP): Patient perceptions regarding use of marijuana and its derivatives in cancer.
Authors: Sangeeta Aggarwal, Jyoti Bhowmick, Rishi Sharma, Manish Singh, Rahul Kumar Gond, Isa Dash, Alok Aggarwal
Journal: Journal of Clinical Oncology (2018)

228 Background: Despite legal controversies, medical Marijuana use is increasingly accepted for mitigating side effects from chemotherapy in cancer patients. In this study we analyzed cancer patient perception and experience on the use of Marijuana and its derivatives. Methods: We collected 15.7 million freely shared messages from cancer patients from 52 unrestricted web forums. Using our VoCP platform based on techniques artificial intelligence, we processed unstructured text and analyzed these messages to extract relevant information and experiences on the use of Marijuana and its derivatives. Results: Of 15.7 million messages, 27,510 messages from 11,244 distinct users discussed Marijuana and cancer. 2,770 users had firsthand experience and shared 5,251 messages. Overall, 876 users (1,150 messages) were satisfied, 319 users (332 messages) were dissatisfied, and the remaining 1,575 did not say. Common reasons for use of Marijuana included nausea (526), insomnia (526), appetite (165), pain (122), weight loss (102), fatigue (57), anxiety (60), gastroparesis (27), and neuropathy (11). Questions asked by patients were related to people’s experience with marijuana, availability, preparations, efficacy, legality views, and side effects. Common cancer types where marijuana use was discussed were breast (3745), lung (1,476), colorectal (675), head and neck (405), pancreatic (239), stomach/esophagus (485), lymphoma (512), CNS tumors (499), and unspecified type (1,869). Methods of use discussed by ,1338 users and included smoking (875), oils (368), tincture (31), capsules (11), and other edibles (41). Source of obtaining marijuana mentioned as legal organization / licensed practitioner (254), online (34), friends and family (33), and growing ( 34). 1,111 messages discussed availability of marijuana. 2,912 messages discussed legal issues concerning Marijuana. 1,737 said that it is legal in their states and 1,179 said that it is illegal. Conclusions: Marijuana and its derivatives are increasingly being used by cancer patient to mitigate cancer and treatment-related side effects, and the use is increasing as recreational use of marijuana is being legalized in more states.
Matrix metalloproteinases and tissue inhibitor of metalloproteinase-1 in the cerebrospinal fluid of children with central nervous system malignancies
Authors: Kathleen Scorsone, Susan Blaney, Lisa Bomgaars, Elizabeth Kassner, Stacey Berg
Journal: Cancer Research (2004)

1824   Purpose: Matrix metalloproteinases (MMPs) have been implicated in tumor metastasis and angiogenesis, as well as in a variety of other normal and pathological processes. Most MMPs are secreted as latent proenzymes that are enzymatically activated. In this study, we measured the concentrations of MMP-2, MMP-9 and a tissue inhibitor of matrix metalloproteinases, TIMP-1, in the cerebrospinal fluid (CSF) of children with meningeal malignancies. Control CSF samples were obtained at the time of routine lumbar puncture from children with leukemia without CSF involvement. Experimental Design: MMPs were measured using a zymography assay with a limit of quantitation of 1 ng/ml. TIMP-1 concentrations were measured by enzyme-linked immunoassay (ELISA). Comparisons between patient and control samples were performed using the Wilcoxon-Mann-Whitney rank sum test. Results: Latent MMP-2 was detected in all CSF samples and similar concentrations were measured in CSF from patients with active meningeal cancer (322 ± 312 ng/ml, median ± standard deviation) and in control CSF (287 ± 115 ng/ml) (p = 0.32). In contrast, latent MMP-9 was present in 24/28 (86%) of patient samples but in only 1/18 (6%) of control samples. The median concentration of MMP-9 in patient samples was 11 ± 29 ng/ml (p
When should anti-cancer treatment be ended? Why and when to discontinue palliative chemotherapy.
Authors: Yuurin Kondo, Maria Michiko Nakajima, Go Nakajima, Kazuhiko Hayashi
Journal: Journal of Clinical Oncology (2018)

41 Background: Currently, palliative chemotherapy (PC) near the end of life is frequently discussed. It is important to know when it is appropriate to end PC to maintain the best quality of life. The criteria for discontinuation of anti-cancer therapy are often “exacerbation of patient’s condition,” “problems with toxicity,” or “patient refusal.” However, there is no clear agreement regarding when to end PC. Ending treatment is one of the most difficult decisions for oncologists. The purpose of this study was to determine clear reasons for the discontinuation of PC and to gain an understanding of the current situation regarding explanation of prognosis in clinical practice. Methods: This retrospective study included 144 patients with incurable cancer who had received PC and died between January 2014 and November 2016. We examined the reasons for discontinuation of PC and whether patients had completed end-of-life discussions, including a discussion of life expectancy, when their PC was terminated. Results: Causes of discontinuation of PC were as follows: 8.3% patient’s desire, progressive disease (PD) in 48.5%, poor performance status (PS) in 20.1%, and toxicity in 17.4%. In patients who chose to end anticancer therapy voluntarily, all patients received a clear explanation of their prognosis, including life expectancy. Among 67 patients with PD, 45 (67.1%) received information regarding their prognosis; 17 of 29 patients (58.6%) with poor PS received similar information. Among patients who ended PC due to toxicity, only 8 of 25 patients (32%) completed end-of-life discussions, including a discussion of life expectancy. In addition, death within 1 month from the discontinuation of PC occurred in 0 cases where treatment was discontinued due to patient’s desire, 10 cases (15%) due to PD, 10 cases (34.4%) due to PS, and 7 cases (28%) due to toxicity. Conclusions: This study shows that patients who discontinued treatment due to poor PS or toxicity had a shorter interval between the final PC and death. Moreover, it indicated that the details of the end-of-life discussion might be influenced by the reason for discontinuation of PC, including or excluding a discussion of life expectancy.
The impact of emergency general surgery on end-of-life care among older patients with metastatic cancer.
Authors: Katherine C Lee, Elizabeth J. Lilley, Daniel Sturgeon, Stuart R. Lipsitz, Joaquim M Havens, Eric Roeland, Zara Cooper
Journal: Journal of Clinical Oncology (2018)

56 Background: Despite high post-discharge mortality among older patients with metastatic cancer who undergo emergency general surgery (EGS), little is known about the impact of EGS on the type of end-of-life care received. We sought to examine the association between EGS and established markers of high intensity or poor quality end-of-life care for cancer patients. Methods: This retrospective cohort study used 2001-2013 Surveillance, Epidemiology, and End Results-Medicare to identify beneficiaries 65 years or older, diagnosed initially with stage IV cancer (lung, colorectal, breast, ovarian, pancreatic, or melanoma), who received one of the seven highest-burden EGS operations, and died within 180 days of surgery. Non-EGS controls were exact-matched by age, sex, race, cancer type, and cancer diagnosis date then assigned a pseudo-exposure date corresponding to the EGS date. Conditional logistic regression adjusting for region and Charlson score was performed among pairs discharged alive to compare location of death (facility or home/hospice), healthcare utilization (hospitalization, intensive care unit (ICU) stay, emergency department (ED) visit) in the last 30 days of life, and hospice use (death in hospice, hospice enrollment less than three days from death). Results: Among 1,129 matched pairs, EGS patients had higher odds of death in facility (OR [95% CI]: 1.29 [1.05 - 1.58]) as well as hospitalization (1.83 [1.54 - 2.18]), ICU stay (2.05 [1.66 - 2.53]) or ED visit (1.76 [1.47 - 2.10]) in the last 30 days of life compared to non-EGS patients. EGS patients had higher odds of dying in hospice (1.22 [1.02 - 1.45]), but also experienced higher odds of hospice enrollment less than three days from death (1.72 [1.20 - 2.46]). Conclusions: Older patients with metastatic cancer who survive EGS experienced higher intensity end-of-life care than similar non-EGS patients. Such EGS patients may benefit from targeted interventions during the emergent hospitalization to improve the end-of-life care received.
Reply to Nicholas G. Zaorsky, Daniel E. Spratt, and Pierre Blanchard's Letter to the Editor re: Marco Moschini, Emanuele Zaffuto, Pierre I. Karakiewicz, et al. External Beam Radiotherapy Increases the Risk of Bladder Cancer When Compared with Radical Prostatectomy in Patients Affected by Prostate Cancer: A Population-based Analysis. Eur Urol 2019;75:319–28
Authors: Marco Moschini, Emanuele Zaffuto, Agostino Mattei, Pierre I Karakiewicz, Shahrokh F Shariat
Journal: European Urology (2018)
Survival outcomes and end of life use of immunotherapy (IO) supplied free of charge for cancer patients.
Authors: Rajiv Agarwal, Andrew S. Epstein, Leonard B. Saltz
Journal: Journal of Clinical Oncology (2018)

62 Background: IO has increased both hope and uncertainty for patients (pts) with cancer. Many pts who do not qualify for trials have received IO from manufacturers free of charge (“compassionate use” or “expanded access”). We report the survival outcomes of such pts using free IO at Memorial Sloan Kettering Cancer Center (MSK). Methods: Pharmacy dispensing logs from 1/1/2015 to 12/31/2017 were reviewed to identify cancer pts who received free ipilimumab (I), nivolumab (N), or pembrolizumab (P) at MSK’s clinics and inpatient hospital. Outcomes and IO use relative to the end of life were analyzed. Results: Outpatient use: n = 484 pts, with 10 pts using free IO in more than one case: median age 61 (range 18 - 93); 222 women, 262 men. 99% had metastatic or locally advanced disease; 6 pts received adjuvant IO. IO case distribution: 303 P, 3 I, 134 N, and 55 with variable combinations of I/N. Median number of doses per pt: 4. Table shows progression free survival (PFS) rates by cancer type. Of 317 known pt deaths, 90 pts received IO in the last 30 days of life. 17 pts initiated IO as an inpatient: median age 57 (range 25-79); 10 women, 7 men. IO case distribution: 12 P, 3 N, and 2 I/N. Median number of doses per pt: 1. The median overall survival from first dose was 24 days. No pts achieved 3-month PFS and 12 pts received IO in the last 30 days of life. Conclusions: To date, this is the largest published cohort of pts who received IO free of charge. IO started in patients too sick to be outpatient was ineffective. Ongoing analyses are examining response relative to mutational burden, healthcare-associated costs, and key end-of-life outcomes for this patient population. [Table: see text]
Aortic Stenosis—50 Years of Discovery
Authors: Robert O. Bonow, Patrick T. O’Gara
Journal: JAMA Cardiology (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 Cardiology 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 Cardiology journal
Mental Health Act must be updated to give patients power over care, says review
Authors: Nigel Hawkes
Journal: BMJ (2018)

People detained under the Mental Health Act deserve to be treated with respect and dignity and to have their views properly taken into account, an independent review of the act commissioned by the prime minister has recommended.1

Too often people in a mental health crisis are treated as criminals, locked in police cells, or taken handcuffed to secure accommodation in the back of police cars or vans. Although incarceration might be in their best immediate interests—and is often so acknowledged by those who experience it—the way it is implemented is no longer in keeping with the times, says the review, which was chaired by Simon Wessely, a past president of the Royal College of Psychiatrists.

The review proposes a series of reforms that aim to shift the balance of power between patients and professionals. Most urgently, it seeks a better deal for people of black and ethnic minority background, who are disproportionately represented among people given community treatment orders.

The review team did not want to do away with CTOs altogether, as more radical …
Principles for Patient and Family Partnership in Care: An American College of Physicians Position Paper
Authors: Wendy K. Nickel, Steven E. Weinberger, Phyllis A. Guze
Journal: Annals of Internal Medicine (2018)

In this position paper, the American College of Physicians (ACP) examines the rationale for patient and family partnership in care and reviews outcomes associated with this concept, including greater adherence to care plans, improved satisfaction, and lower costs. The paper also explores and acknowledges challenges associated with implementing patient- and family-centered models of care. On the basis of a comprehensive literature review and a multistakeholder vetting process, the ACP's Patient Partnership in Healthcare Committee developed a set of principles that form the foundation for authentic patient and family partnership in care. The principles position patients in their rightful place at the center of care while acknowledging the importance of partnership between the care team and patient in improving health care and reducing harm. The principles state that patients and families should be treated with dignity and respect, be active partners in all aspects of their care, contribute to the development and improvement of health care systems, and be partners in the education of health care professionals. This paper also recommends ways to implement these principles in daily practice.
Abstract P317: Area Traffic Density Contributes to the Risk of Gestational Diabetes in a Sample of Central Ohio Pregnancies
Authors: Claire E Bollinger, Sejal Patel, Darryl B Hood, Julie K Bower
Journal: Circulation (2017)

Background: The prevalence of gestational diabetes mellitus (GDM) in the US and the state of Ohio is approximately 9.0%. GDM is associated with increased risks for mother and child, including macrosomia, preterm birth, preeclampsia, and development of type 2 diabetes. In addition to known risk factors, the role of exposure to environmental pollutants in development of GDM warrants further investigation. Because exposure to traffic-related pollutants has been shown to influence the development of type 2 diabetes, we assessed the contribution of exposure to high traffic to the development of GDM during pregnancy among women without prior diabetes history. Methods: A population of 275 pregnant women in Ohio reported perceived exposure to high traffic areas and health behaviors. Clinical information and addresses were obtained through their electronic health records. Using ArcMap TM 10.2.2 (ESRI), addresses were geocoded to assess individual exposures, and linked with area exposures and demographic indicators at the level of the census block group from EJScreen (EPA). A woman was classified as “near” a major roadway if one fell within a 500m buffer of her home. Distance to nearest major roadway was also calculated. Logistic regression was used to examine the association between quintiles of traffic exposure at the census block group level, self-reported proximity, individual-level proximity, health behaviors, and demographic factors with development of GDM. Because assessment of individual-level exposures may be difficult to use in clinical and large scale population settings, a model was also fit using only data publically available from EJScreen and self-report. Results: The prevalence of GDM was 8.0% (22/275) and distribution of demographics factors were similar between those with and without GDM. After adjustment for potential confounders, quintile of traffic exposure was significantly associated with development of GDM (p=.036). Compared to those residing in block groups in the lowest quintile, the odds of GDM for those in the second quintile were 8.1 times greater [95% CI 1.2, 56.3] and for those in fourth quintile were 10.4 times greater [95% CI 1.6, 67.6]. Addition of individual-level proximity factors did not significantly improve the model (p=.08). Conclusions: This study suggests that living in an area with high traffic density contributes to the risk of developing GDM. For both the clinical practitioner and public health researcher it is difficult or impractical to obtain individual level environmental exposure data. From our analysis, the individually calculated exposure proxies did not significantly improve the fit of the model. We suggest examining ways to combine self-report measures with existing environmental data, such as EJScreen, to identify populations at elevated risk.
Targeting FOXA1-mediated repression of TGF-β signaling suppresses castration-resistant prostate cancer progression
Authors: Bing Song, Su-Hong Park, Jonathan C. Zhao, Ka-wing Fong, Shangze Li, Yongik Lee, Yeqing A. Yang, Subhasree Sridhar, Xiaodong Lu, Sarki A. Abdulkadir, Robert L. Vessella, Colm Morrissey, Timothy M. Kuzel, William Catalona, Ximing Yang, Jindan Yu
Journal: Journal of Clinical Investigation (2018)

Prostate cancer (PC) progressed to castration resistance (CRPC) is a fatal disease. CRPC tumors develop resistance to new-generation antiandrogen enzalutamide through lineage plasticity, characterized by epithelial-mesenchymal transition (EMT) and a basal-like phenotype. FOXA1 is a transcription factor essential for epithelial lineage differentiation. Here, we demonstrate that FOXA1 loss leads to remarkable upregulation of transforming growth factor beta 3 (TGFB3), which encodes a ligand of the TGF-β pathway. Mechanistically, this is due to genomic occupancy of FOXA1 on an upstream enhancer of the TGFB3 gene to directly inhibit its transcription. Functionally, FOXA1 downregulation induces TGF-β signaling, EMT, and cell motility, which is effectively blocked by the TGF-β receptor I inhibitor galunisertib (LY2157299). Tissue microarray analysis confirmed reduced levels of FOXA1 protein and a concordant increase in TGF-β signaling, indicated by SMAD2 phosphorylation, in CRPC as compared with primary tumors. Importantly, combinatorial LY2157299 treatment sensitized PC cells to enzalutamide, leading to synergistic effects in inhibiting cell invasion in vitro and xenograft CRPC tumor growth and metastasis in vivo. Therefore, our study establishes FOXA1 as an important regulator of lineage plasticity mediated in part by TGF-β signaling, and supports a novel therapeutic strategy to control lineage switching and potentially extend clinical response to antiandrogen therapies.
Health systems' capacity to provide post-abortion care: a multicountry analysis using signal functions
Authors: Onikepe O Owolabi, Ann Biddlecom, Hannah S Whitehead
Journal: The Lancet Global Health (2018)

Abortion-related mortality is one of the main causes of maternal mortality worldwide. Laws often restrict the provision of safe abortion care, yet post-abortion care is a service that all countries have committed to provide to manage abortion complications. There is minimal evidence on the capacity of national health systems to provide post-abortion care.
Seeing the Present Through the Past
Authors: Maya Overby Koretzky
Journal: JAMA (2018)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Endocarditis After Transcatheter Pulmonary Valve Replacement
Authors: Doff B. McElhinney, Lars Sondergaard, Aimee K. Armstrong, Lisa Bergersen, Robert F. Padera, David T. Balzer, Te-Hsin Lung, Felix Berger, Evan M. Zahn, Robert G. Gray, William E. Hellenbrand, Jacqueline Kreutzer, Andreas Eicken, Thomas K. Jones, Peter Ewert
Journal: Journal of the American College of Cardiology (2018)