tbuckley/cabot-search huggingface dataset:
Oncotype DX Recurrence Score and treatment choices according to ethnicity.
Authors: Allan Louie Espino Cruz, Sameer Desale, Sandra M. Swain, Raquel Nunes
Journal: Journal of Clinical Oncology (2016)

e12010 Background: The Recurrence Score (RS) result (Oncotype DX) guides the use of adjuvant chemotherapy (CTX) in women with hormone receptor positive, early stage breast cancer (BC). Treatment decisions are further affected by patients’ (pts) and physicians’ preferences. We aimed to evaluate the role of race and other factors as determinants of treatment choices after RS testing. Methods: We included 224 female pts with BC treated at our institution between 2005 and 2014 who had RS results available. Use of CTX and reasons determining treatment choices in each RS group (low < 18, intermediate 18-30, and high ≥ 31) were compared between African American (AA) and non-AA pts using Chi square and two-sided Fisher exact tests. Demographic information, number of co-morbidities, staging and tumor characteristics were also collected. Results: Of the 224 women, (74%) were AA and 58 (26%) were non-AA (19.6% Whites, 4.4% Asians, and 2% others). Median age was 63 yrs. Most pts had stage I disease. 55% had a low RS, 33% had an intermediate RS, and 12% had a high RS. The distribution of RS results was similar between AA and non-AA (p = 0.42). 8% of pts in the low RS group received CTX due to pt preference, or unfavorable pathologic characteristics. In the intermediate RS group, 55.4% did not receive CTX due to pt concerns or physician’s uncertainty regarding benefits of CTX; conversely, 44.6% received CTX per physician’s recommendation. In the high RS group, CTX was withheld in 14% of patients due to pt’s fear of side effects, or presence of medical co-morbidities. In each RS group, use of CTX and determinants of treatment decisions were similar between AA and non-AA pts (low RS p = 1.00, intermediate RS p = 0.86, high RS p = 1.00). Conclusions: In our study, there were no differences in the distribution of RS, CTX use, and determinants for treatment choices according to race. As expected, the group with an intermediate RS had the least uniform use of CTX but this was not affected by race. In all RS categories, decisions regarding treatment were modulated by pt preference, physician’s opinion or both.
Changes over time of papillary thyroid carcinoma and total thyroidectomy rates.
Authors: Mitchell Steven Wachtel, Shengping Yang, Joehassin Cordero, Vadivel Ganapathy
Journal: Journal of Clinical Oncology (2016)

e13081 Background: Prior analyses have uncovered increases in thyroid carcinoma, but concluded these were largely artifacts of increased detection of small tumors. We hypothesized that examination of the Surveillance, Epidemiology, and End Results (SEER) and National Hospital Discharge Survey (NHDS) databases would shed light on the nature of the increasing rates of thyroid carcinoma. Methods: 1992-2012 rates and standard errors for the different types and sizes of thyroid carcinomas were obtained from SEER. 1999-2010 rates and standard errors of total thyroidectomies and proportions of total thyroidectomies with thyroid carcinoma were obtained from NHDS. Joinpoint regression analyzed changes in rates over time, estimating annual percent changes (APC) in rates, joinpoints, and testing for parallelism to discern differences in APC. Results: SEER. With age taken into account, genders lacked APC differences. After correction for misclassification, papillary carcinoma showed a steady increase over the time period. Although an initial relatively rapid rise in microcarcinoma rates, from 1.7/100,000 in 1992 to 6.6/100,000 in 2008, with estimated APC 9.0 (95% CI 8.5, 9.5), might have contributed to an overall increase in papillary carcinoma diagnoses, there was still a rise in larger tumor rates from 4.0 in 1992 to 10.1 in 2012, with estimated APC 5.3 (95% CI 5.0, 5.6), was still present. NHDS. Whereas total thyroidectomy rates increased from 68.6/100,000 in 1999 to 139.2/100,000 in 2010, with estimated APC 9.0 (95% CI 6.4, 11.6), corresponding percents of total thyroidectomies with thyroid carcinoma fell from 65.6% in 1999 to 36.3% in 2010, with estimated APC -3.0 (95% CI -0.7, -5.2). Conclusions: Rates of carcinoma larger than microcarcinoma increased. Proportions of total thyroidectomies with cancer decreased. Increasing rates of non-neoplastic diseases treated by total thyroidectomy, not increased diagnoses of smaller tumors, most likely caused the observed rise in rates of papillary carcinoma.
Traitement par colle biologique des fistules post-opératoires en chirurgie colorectale
Authors: P Godeberge, A Blain, C Christidis, C Denet, H Levard, F Mal, T Perniceni, B Gayet
Journal: Endoscopy (2009)

Introduction: La morbidité des fistules après chirurgie colorectale est élevée et leur traitement est difficile. Leur obturation par injection de colle de fibrine a été ponctuellement publiée. Ce travail présente les résultats d'une étude prospective chez 14 patients.
Efficacy study of sequential therapy with anthracycline, taxane, and eribulin in patients with HER2-negative locally advanced breast cancer (JBCRG-17).
Authors: Naoto Kondo, Yoshinori Ito, Ippei Fukada, Shoichiro Ohtani, Masaya Hattori, Eriko Tokunaga, Nobuki Matsunami, Kohjiro Mashino, Taijiro Kosaka, Masahiko Tanabe, Daisuke Yotsumoto, Kosho Yamanouchi, Masataka Sawaki, Masahiro Kashiwaba, Hidetaka Kawabata, Katsumasa Kuroi, Satoshi Morita, Shinji Ohno, Masakazu Toi, Norikazu Masuda
Journal: Journal of Clinical Oncology (2016)

1027 Background: Neoadjuvant chemotherapy is an integral component for locally advanced breast cancer (LABC). The sequence of taxanes (T) followed by anthracyclines (A) has been the standard of care for almost 20 years. Sequential administration of Eribulin (E) followed by A/T would have a greater response rate for women with LABC. Methods: In this single-arm, multicenter, Phase II prospective study, the patients (pts) received 4 cycles of FEC-regimen and 4 cycles of taxane. After A/T-regimen, 4 cycles of E (1.4 mg/m2, d1 and d8, q 21 days) were administered followed by surgical resection. The primary end point was the clinical response rate. The secondary end points were pCR rate, safety and overall/recurrence-free survival. Eligible pts were women aged 20 or older, with histologically confirmed invasive breast cancer, clinical Stage IIIA (T2-3 and N2 only), Stage IIIB, and Stage IIIC, HER2-negative. Results: A preplanned interim analysis aimed to validate trial assumption was conducted after treatment of 20 pts and demonstrated that cPD rates in E-phase were significantly higher (30%) than the assumption. Therefore, the Independent Data Monitoring Committee recommended stopping the study. Finally, 53 pts were enrolled and 26 pts received A/T/E-regimen. Among 26 pts, the median age at diagnosis was 49 (32-67), 69% (18/26) of pts were hormone receptor (HR)-positive, and 31% (8/26) of pts were HR-negative. Clinical staging was as follows: Stage IIIA: 23%(6/26); Stage IIIB: 23%(6/26); and Stage IIIC: 54%(14/26). The overall observed clinical response rates (RRs) were 73% (19/26); RRs were 77% (20/26) in AT-phase and 23% (6/26) in E-phase. Thirty percent (8/26) of pts had progression disease in E-phase and 6 pts of whom had achieved cCR/PR in AT-phase. pCR rates were 16%. Reported grade > 3 AEs related to E were neutropenia (42%), white blood cell decrease (27%), febrile neutropenia (7.6%), weight gain (3.8%), and weight loss (3.8%). Conclusions: There was no additional effect of sequential administration of eribulin followed by A/T-regimen for LABC pts. Long-term clinical outcomes are being prospectively followed in all patients, and biomarker analyses are ongoing. Clinical trial information: 000009639.
The influence of hormone receptor status on the association of age and race/ethnicity on breast cancer specific mortality among the HER2-positive subtypes.
Authors: Vincent Caggiano, Carol Parise
Journal: Journal of Clinical Oncology (2016)

e12076 Background: HER2-positive(HER2+) breast cancer is often considered a single subtype. However, 4 subtypes, based on expression of ER and PR have been identified. The purpose of this study was to determine how age and race affect the risk of breast cancer mortality for the HER2+ subtypes. Methods: We identified 34,256 cases of first primary female invasive HER2+ breast cancer: ER+/PR+/HER2+(n = 16,351), ER+/PR-/HER2+(n = 5,766), ER-/PR+/HER2+(n = 678) and ER-/PR-/HER2+(n = 11,461) from the California Cancer Registry. The subtypes were also combined into the single HER2+ category. Cox regression adjusted for stage, grade, year of diagnosis, socioeconomic status, and treatment was used to assess the risk of mortality for age and race/ethnicity for the HER2+ subtypes and the combined HER2+ category. The risk of mortality for women ≤ 45(younger) and ≥ 70(older) was compared to that of women 46-69. The risk for blacks, Hispanics, and Asian/Pacific Islanders (APIs) was compared with the risk for white women of the same subtype or category. Hazard ratios and 95% confidence intervals were reported. Results: For the combined HER2+ category, older (1.68;1.55-1.82) and black women (1.28;1.15-1.42) had an increased risk of mortality and APIs (0.89; 0.81-0.97) had a decreased risk. The ER+/PR+/HER2+ had similar results as the combined HER2+ category. Race was not significant for the ER+/PR-/HER2+ but older women were at higher risk (1.45;1.21-1.74). Age and race were not associated with risk of mortality for the ER-/PR+/HER2+. For the ER-/PR-/HER2+(the molecularly defined HER2-overexpressing subtype), younger (1.16;1.04-1.30) and older (1.69;1.50-1.90) women had an increased risk. Black women had a similar risk of mortality while APIs had a reduced risk (0.80;0.70-0.92). Conclusions: When HER2+ breast cancer is considered a single category without regard to hormone receptor status, black and older women have an increased risk of mortality and Asian Pacific Islanders have a reduced risk. However, when taking ER and PR into account, the risk of mortality for both age and race/ethnicity varies.
Incidence of gonococcal and chlamydial infections and coverage of two laboratory surveillance networks, France, 2012
Authors: G La Ruche, Y Le Strat, M Fromage, B Berçot, A Goubard, B de Barbeyrac, P Sednaoui, E Cambau, F Lot
Journal: Eurosurveillance (2015)

Surveillance of sexually transmitted diseases in France is based on voluntary networks of laboratories and clinicians. Despite the importance of incidence data in improving knowledge about the national context and in international comparisons, such data were not previously available. During nationwide quality control of laboratories, mandatory for all laboratories, we conducted a survey in June 2013 to estimate the incidence rates of gonococcal and chlamydial infections for 2012 and to estimate the proportion of diagnoses performed (coverage) by the country's two laboratory-based sentinel networks for these diseases. Estimated incidence rates for 2012 were 39 per 100,000 persons aged 15 to 59 years for gonorrhoea and 257 per 100,000 persons aged 15 to 49 years for chlamydia. These rates were consistent with the average levels for a group of other Western countries. However, different estimates between countries may reflect disparate sources of surveillance data and diverse screening strategies. Better comparability between countries requires harmonising data sources and the presentation of results. Estimated coverage rates of the gonococcal and chlamydial infection surveillance networks in France in 2012 were 23% and 18%, respectively, with substantial regional variations. These variations justify improving the representativeness of these networks by adding laboratories in insufficiently covered areas.
Phase 3 (P3) study of quizartinib (Q) or placebo (P) with induction (IND) and consolidation chemotherapy (CON) and as maintenance (MN) in patients (pts) with newly diagnosed (NDx) <i>FLT3</i>-ITD–positive acute myeloid leukemia (AML): the QuANTUM-First study.
Authors: Harry Paul Erba, Mark J. Levis, Mikkael A. Sekeres, Herve Dombret, Sergio Amadori, Oleg Zernovak, Derek Edward Mires, NanXiang Ge, James Hanyok, Susan Macintyre, Sugun Gokmen, Guy Gammon, Richard F Schlenk
Journal: Journal of Clinical Oncology (2016)

TPS7073 Background: Internal tandem duplications (ITDs) are commonly observed FLT3 mutations in AML and are a very poor prognostic factor for duration of response and overall survival (OS). While standard chemotherapy (SC) induces a high rate of complete remission (CR) in FLT3-ITD AML, the relapse rate is high with a median time to relapse of ≈6 months vs 9-11 months for other AML subtypes (Levis M. ASH Education Book 2013:220-226). Currently, no approved therapies target the FLT3-ITD mutation. Q is an oral, highly potent, and selective FLT3-ITD inhibitor. Q monotherapy results in composite CR (CRc) rates up to ≈46% in relapsed/refractory FLT3-ITD+ AML (Levis M, ASCO 2014 [abstr 7093]). Q has been safely administered with SC in pts with NDx AML (Burnett AK, ASH 2013 [abstr 622]). Here, we describe a P3, randomized, double-blind, P-controlled trial of Q in combination with IND and CON and as MN in pts with NDx FLT3-ITD+ AML. Methods: Pts 18-75 years old with NDx FLT3-ITD+ AML are eligible. During IND, cytarabine (CY) 100 mg/m2/d will be given for 7 days along with investigator’s choice of anthracycline (either daunorubicin 60 mg/m2/d or idarubicin 12 mg/m2/d) on D1-3. Q/P will be given QD for 14 days starting on C1 D8. If pts require a second cycle of IND, investigators may choose a standard 7+3 or 5+2 regimen with Q/P starting on D8 or 6, respectively. Pts achieving CR, CR with incomplete platelet recovery (CRp), or CR with incomplete neutrophil recovery (CRi) after IND will receive CON. Options include high-dose (HD) CY plus Q/P, allogeneic hematopoietic stem cell transplant (alloHSCT), or HD CY plus Q/P followed by alloHSCT. Pts with CR, CRp, or CRi after CON will receive Q/P MN therapy for a maximum of 12 cycles. The primary endpoint is centrally adjudicated event-free survival, and key secondary endpoints are OS, CR rate, CRc rate, and % of pts achieving CR with no evidence of minimal residual disease (MRD) following IND. MRD will be assessed by a PCR-based assay that detects residual FLT3-ITD mutation. The study will enroll ≈536 pts at 250 centers worldwide (NCT02668653). Results: NA Conclusions: NA Clinical trial information: NCT02668653.
Practical Considerations for the US Preventive Services Task Force Recommendations on Obesity in Children and Adolescents
Authors: Jason P. Block, Emily Oken
Journal: JAMA Internal Medicine (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 Internal Medicine 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 Internal Medicine journal
Erythema With Nonscarring, Tense Blister Formation Without Circulating Anti-BP180 Antibodies
Authors: Hikari Otake-Irie, Teruki Dainichi, Kenji Kabashima
Journal: JAMA Dermatology (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 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
Niche-mediated depletion of the normal hematopoietic stem cell reservoir by Flt3-ITD–induced myeloproliferation
Authors: Adam J. Mead, Wen Hao Neo, Nikolaos Barkas, Sahoko Matsuoka, Alice Giustacchini, Raffaella Facchini, Supat Thongjuea, Lauren Jamieson, Christopher A.G. Booth, Nicholas Fordham, Cristina Di Genua, Deborah Atkinson, Onima Chowdhury, Emmanouela Repapi, Nicki Gray, Shabnam Kharazi, Sally-Ann Clark, Tiphaine Bouriez, Petter Woll, Toshio Suda, Claus Nerlov, Sten Eirik W. Jacobsen
Journal: The Journal of Experimental Medicine (2017)

Although previous studies suggested that the expression of FMS-like tyrosine kinase 3 (Flt3) initiates downstream of mouse hematopoietic stem cells (HSCs), FLT3 internal tandem duplications (FLT3 ITDs) have recently been suggested to intrinsically suppress HSCs. Herein, single-cell interrogation found Flt3 mRNA expression to be absent in the large majority of phenotypic HSCs, with a strong negative correlation between Flt3 and HSC-associated gene expression. Flt3-ITD knock-in mice showed reduced numbers of phenotypic HSCs, with an even more severe loss of long-term repopulating HSCs, likely reflecting the presence of non-HSCs within the phenotypic HSC compartment. Competitive transplantation experiments established that Flt3-ITD compromises HSCs through an extrinsically mediated mechanism of disrupting HSC-supporting bone marrow stromal cells, with reduced numbers of endothelial and mesenchymal stromal cells showing increased inflammation-associated gene expression. Tumor necrosis factor (TNF), a cell-extrinsic potent negative regulator of HSCs, was overexpressed in bone marrow niche cells from FLT3-ITD mice, and anti-TNF treatment partially rescued the HSC phenotype. These findings, which establish that Flt3-ITD–driven myeloproliferation results in cell-extrinsic suppression of the normal HSC reservoir, are of relevance for several aspects of acute myeloid leukemia biology.
Impressive Paget Disease of the Lumbar Spine Masks the Coexisting Multiple Myeloma
Authors: Xiao Zhong, Yunxia Ye, Xiaohong Ou
Journal: Clinical Nuclear Medicine (2017)

Multimodality imaging, including MRI, bone scintigraphy, and FDG PET/CT, was performed to evaluate a 49-year-old man who had right hip and lower limb pain for 4 months because possible malignancy was suspected. All 3 modalities showed obvious Paget disease of the lumbar spine. However, less impressive increased activity was also noted on FDG PET/CT images. Subsequent laboratory tests and pathology examination leads to diagnosis of multiple myeloma. Our case further confirms the notion that it is insufficient to focus on the most obvious and unintentionally overlook the less impressive findings in interpreting nuclear medicine images.
A Structured Review of Antithrombotic Therapy in Peripheral Artery Disease With a Focus on Revascularization
Authors: Connie N. Hess, Lars Norgren, Gary M. Ansel, Warren H. Capell, John P. Fletcher, F. Gerry R. Fowkes, Anders Gottsäter, Kerry Hitos, Michael R. Jaff, Joakim Nordanstig, William R. Hiatt
Journal: Circulation (2017)

Peripheral artery disease affects &gt;200 million people worldwide and is associated with significant limb and cardiovascular morbidity and mortality. Limb revascularization is recommended to improve function and quality of life for symptomatic patients with peripheral artery disease with intermittent claudication who have not responded to medical treatment. For patients with critical limb ischemia, the goals of revascularization are to relieve pain, help wound healing, and prevent limb loss. The baseline risk of cardiovascular and limb-related events demonstrated among patients with stable peripheral artery disease is elevated after revascularization and related to atherothrombosis and restenosis. Both of these processes involve platelet activation and the coagulation cascade, forming the basis for the use of antiplatelet and anticoagulant therapies to optimize procedural success and reduce postprocedural cardiovascular risk. Unfortunately, few high-quality, randomized data to support use of these therapies after peripheral artery disease revascularization exist, and much of the rationale for the use of antiplatelet agents after endovascular peripheral revascularization is extrapolated from percutaneous coronary intervention literature. Consequently, guideline recommendations for antithrombotic therapy after lower limb revascularization are inconsistent and not always evidence-based. In this context, the purpose of this structured review is to assess the available randomized data for antithrombotic therapy after peripheral arterial revascularization, with a focus on clinical trial design issues that may affect interpretation of study results, and highlight areas that require further investigation.