tbuckley/cabot-search huggingface dataset:
Real-world stem cell mobilization (PBSC) patterns in MM pts receiving autologous transplant (ASCT).
Authors: Parameswaran Hari, Omar Davila, Andrea Pope, Mehdi Hamadani
Journal: Journal of Clinical Oncology (2020)

e20536 Background: PBSC mobilization (MOB) and apheresis is mandatory prior to ASCT and pose clinical, logistical, and financial challenges at transplant centers. This has resulted in considerable practice variation and a variety of local algorithms. Traditionally MOB was performed using G-CSF in the recovery phase after administration of chemotherapeutic agents such as cyclophosphamide (CTX). G-CSF alone (G) or G-CSF w/plerixafor (G+P) are other options. We compared the current US patterns of mobilization in a prospective observational study between OCT2017 and SEP2019. Methods: Consecutive pts (n = 690) undergoing MOB for upfront MM ASCT were prospectively enrolled from 20 participating centers. Specially designed data collection forms were used to collect resource utilization and complications in the peri-mobilization period. Based on a presurvey of center practices, 4 patterns of MOB were identified: CTX, G, G+P, or P Rescue of suboptimal G MOB. Results: CTX was the least common strategy (n = 52) followed by G (95) or G+P (252) or P Rescue (291). Presumed disease control and center preference were reasons for using CTX. Pt and disease characteristics were similar among groups with notable exceptions: CTX was less common in pts with higher SCr and more in those with higher beta2 microglobulin. CTX group had fewer pts in ≥VGPR status (31% vs. 60-71%). Triplet induction was used in 83% (RVD in 73% of pts) and resulted in ≥VGPR status in 61%. CTX was associated with 26% incidence of complications including a 4% hospitalization rate. Blood/platelet transfusions were needed in 15 and 12% respectively in CTX group but &lt; 3% in other groups. A median of 8 million/kg CD34 cells were collected across all groups. Apheresis was completed in 2 days in 89% of G+P group vs. 70-75% of pts in the other groups. MOB was successful in 99% of cases overall with only 10 pts needing remobilization. 33% of CTX MOBand 63% of P Rescue group needed P resulting in 66% overall P use. With 98% pts still alive,clinical results of ASCT are not mature. Conclusions: CTX MOB is less used in clinical practice in the US for MM while P use was 66% in this large prospective study. CTX MOB seems to be preferred in some centers in those with suboptimal induction responses but was associated with higher complication rate. Planned G+P approach resulted in the fastest time to goal and less apheresis sessions. These data should inform overallMOB decision-making in the era of increasing apheresis needs for cellular therapies. [Table: see text]
Clinical outcomes and economic burden for bladder cancer patients: An analysis from a Swedish cancer registry.
Authors: Joaquim Bellmunt, Thomas Powles, Roger Henriksson, Gary D. Steinberg, Nurgul Batyrbekova, Frida Schain, Sarah Fleming, Waleed Shalaby, Arlene O. Siefker-Radtke
Journal: Journal of Clinical Oncology (2020)

5026 Background: To investigate the clinical and economic disease burden for patients (pts) with non-muscle invasive bladder cancer (NMIBC), muscle invasive bladder cancer (MIBC), and metastatic urothelial carcinoma (mUC) using a Swedish bladder cancer registry. Methods: Pts diagnosed with bladder cancer in the Stockholm Gotland region between 2005-2013 were included and followed until May 31, 2015 or until death. MIBC was classified if a T, N, M at diagnosis was T2, T3, T4, N1, N2, N3, or M1, otherwise pts were classified as NMIBC. All diagnostic and therapeutic interventions were captured and differentiated. Inpatient and outpatient healthcare resource utilization (days) and associated costs (US $) were also analyzed. Results: 3587 bladder cancer pts were identified (NMIBC-2728; MIBC-859) with a median observation time of 49.7 (Q1-Q3: 27.8-78.7) versus 17.2 (Q1-Q3: 6.5-39.3) months. 5-year survival for patients with NMIBC at diagnosis was 71.3% (95% CI; 69.5-73.3) and 26.4% (95%CI; 23.4-29.8) for MIBC. By year 1, survival for MIBC-T2, T3, and T4 was 66%, 41.7%, and 28.4%, respectively. Progression from NMIBC to MIBC was estimated in 19.4% (528/2728) of pts. In year 1, 84% (2,275/2,728) of TURBT procedures were performed on NMIBC pts. Over the next 2-10 years of follow-up, 11,035 repeat TURBT procedures were undertaken in this cohort. In the 859 MIBC pts, 607 TURBT procedures and 333 radical cystectomies occurred in year 1. In the same cohort, 28.3% (243/859), 15.5% (78/505), and 8.6% (29/338) received systemic chemotherapy in years 1, 2, and 3, respectively. Total health resource utilization (HRU) cost for the NMIBC and MIBC cohorts is provided in Table. Median HRU cost per person-year was estimated at $30,470 for MIBC versus $9,228 for NMIBC in year 1. For MIBC-T2, T3, and T4, median cost per person-year was $30,154, $33,917, and $38,959 in year 1, respectively. Conclusions: This retrospective analysis accomplished its primary purpose to provide a real-world understanding for the clinical and economic impact of bladder cancer over a 10-year period when treatment interventions were relatively consistent. Total HRU Costs for Patients with NMIBC and MIBC per Follow-up Year (Years 1 to 5). [Table: see text]
Ultrasound-guided regional anesthesia alleviates pain after percutaneous liver biopsy
Authors: Qing-hong Jing, Wei-de Dai
Journal: BMJ (2010)

The aim of this study is to evaluate the application of untrasound-guided local anesthesia in alleviation of pain after percutaneous liver biopsy.The clinical results of 1417 cases of percutuneous liver biopsy were retrospectively analyzed.In 896 patients under ultrasound-guided local anesthesia 51 felt pain after liver biopsy,while in 521 patients whose local anesthesia without ultrasound guidance,143 felt pain (5.7% vs.27.4%,X~2=118.63,P＜0.01).The results indicate ultrasound-guided local anesthesia can effectively alleviate pain after percutaneous liver biopsy.

Key words: 
Ultrasonography,Doppler,color; Biopsy,needle
Hyperprogression in cancer patients on immunotherapeutic agents.
Authors: Sumi Dey, Midhhath Afza Munavar Ali, Valerie Gunchick, Joshua Bugbee, Vaibhav Sahai
Journal: Journal of Clinical Oncology (2020)

3575 Background: Patients (pts) treated with checkpoint inhibitors (CPI) may uncommonly experience accelerated progression in their tumor burden when compared to their rate of progression prior to receiving CPI. This hyperprogression has been varyingly defined and no biomarker has yet been identified. Methods: We reviewed the database from the Tumor Response Assessment Core (TRAC) at University of Michigan to identify these patients. Hyperprogression was defined as increase in tumor burden per specific immune RECIST criteria by at least 40% from baseline on the first follow-up scan with a minimum increase of 10 mm, and at least 2 times rate of growth than observed prior to start of CPI therapy. Results: Out of 741 pts who underwent baseline and 1st follow-up assessment enrolled on 118 trials, 302 (34.4%) pts received immunotherapy alone or in combination with chemotherapy/targeted agents across 49 trials. Of them, 15 pts (5%) with 5 females (33%) and median age of 63 years (range, 44 -72) met criteria for hyperprogression. The primary cancers included lung (5), colorectal (2), renal (2), biliary (1), pancreatic (1), esophageal (1), bladder (1), small bowel (1), and melanoma (1). The median time to hyperprogression was 67 (range 42-110) days, and the mean survival was 7.9 months from trial enrollment. We did not identify any clinical factor or specific CPI therapy that associated with hyperprogression. Exploratory biomarker analysis of genomic (gene panel assay) and immune subsets of tissue microenvironment (multiplex staining) is underway. Conclusions: This is the largest cohort investigated for hyperprogression across multiple cancers in literature. The rate of hyperprogression observed is less than previously reported in literature, and physicians need to be aware of this possibility while administering CPI to their patients.
Genomic landscape of FGF/FGFR pathway alternations across 12,372 pan-cancer patients.
Authors: Yongmei Yin, Wei Zuo, He Yan, Zhengyi Zhao, Yuzi Zhang, Jing Zhao, Longgang Cui, Guoqiang Wang, Shangli Cai, Yuezong Bai, Wei Li, Hao Wu
Journal: Journal of Clinical Oncology (2020)

e13503 Background: The fibroblast growth factor/fibroblast growth factor receptor (FGF/FGFR) signaling pathway is involved in diverse biological processes and plays a crucial role in carcinogenesis. FGFR targeted therapies have shown great promise in the treatment of a multitude of malignancies. This study aimed to assess the alternations of FGF/FGFR pathway and explore the potential relationships between the genetic alternations in a pan-cancer setting. Methods: Next-generation sequencing was conducted with formalin-fixed, paraffin-embedded tumor specimens from 12,372 Chinese cancer patients with over 21 tumor types, including lung cancer (n = 3557), liver cancer (n = 1433), colorectal cancer (n = 1310), biliary tract cancer (n = 960), gastric cancer (n = 758), etc. Somatic mutations including single nucleotide variations (SNVs), amplifications, and fusions were analyzed, and microsatellite instability status was also assayed. Results: Of all patients, the frequency of genomic alterations in FGF/FGFR pathway (FGF3/4/6/10/14/19/23 and FGFR1-4) ranged from 54.1% (86/159) in esophagus cancer, 40.7% (112/275) in bladder/urinary tract cancer, 28.4% (73/257) in head and neck cancer to 5.3% (5/95) in prostate cancer and 4.0% (22/548) in kidney cancer. Amongst all, the highest mutational prevalence fell in FGFR SNV (5.13%) and FGF amplification (5.08%), followed by FGF SNV (3.90%), FGFR amplification (2.89%), FGFR fusion (0.88%), and FGF fusion (0.06%). Partial co-occurrence was observed between alternations of FGFR1 and 11q13 (FGF3/4/19) and between FGF6 and FGF23. On the other side, alternations of FGFR1, FGFR2, FGFR3, and FGFR4 were found to be mutually exclusive ( p&lt; 0.001). In addition, microsatellite instability was found to be positively correlated with FGF/FGFR pathway mutation ( p&lt; 0.001), while was negatively correlated with pathway amplifications ( p= 0.002). Conclusions: Our study investigated the molecular landscape of FGF/FGFR pathway alternations and the interplay between co-occurrence and mutual exclusivity between pathway genes in a large pan-cancer cohort. FGF/FGFR pathway mutations occurs in a variety of solid tumors, indicating that these patients may benefit from FGFR inhibitors.
Curative effect of invasive percutaneous plate osteosynthesis technique combined with locking plate for segmental fractures of the humeral shaft
Authors: Shuaigong Zhang, Feng Lin, Yuping Liu, Feng Zhang, Bing Shen
Journal: BMJ (2017)

Eleven patients with segmental fractures of the humeral shaft were treated with invasive percutaneous plate osteosynthesis (IPPO) technique combined with locking plate from June 2012 to November 2015. The patients were followed up for 6-18 months with an average of 11 months. All fractures were healed. There were no axillary nerve injury, wound infection, radial nerve palsy, internal fixation loosening, delayed union, nonunion and humeral head necrosis among all patients. The Constant-Murley function score was 86.5±2.2 at the last follow-up. The Neer shoulder function scores were excellent in 7 cases, good in 3 cases and fair in 1 case. The patients obtained good shoulder function. The results suggest that IPPO technique combined with locking plate to treat segmental fractures of the humeral shaft has the advantages of less trauma, early functional exercise and early functional recovery.


Key words: 
Humeral fractures; Fracture fixation, internal; Bone plates
改良三腔导尿管尿道灌注预防及治疗前列腺窝炎及尿道炎临床分析
Authors: 魏民, 张正福, 王力群, 丁德武, 付聪, 侯钦丽
Journal: BMJ (2007)

2003年1月至2007年1月我们在临床工作中发现,前列腺电切术后患者术后留置导尿管并行膀胱冲洗,易出现前列腺窝炎及尿道炎,患者出现尿道烧灼感,会阴及肛门胀痛,局部水肿致拔出导尿管后排尿困难,重者不能排尿.对此目前尚无其他特殊治疗方法.本研究采用改良三腔导尿管行前列腺窝及尿道灌注甲硝唑预防及治疗前列腺窝炎及尿道炎101例,疗效满意,现报告如下。
The impact of residual metabolic primary tumor volume after completion of thoracic irradiation in patients with inoperable stage III NSCLC.
Authors: Olarn Roengvoraphoj, Arteda Gjika, Erik Mille, Julian Taugner, Lukas Käsmann, Chukwuka Eze, Claus Belka, Farkhad Manapov
Journal: Journal of Clinical Oncology (2020)

9049 Background: The metabolic tumor volume (MTV) is a functional and volumetric PET/CT parameter that has been investigated in recent years with respect to its predictive and prognostic value in different tumor entities. In this study, we investigated the role of residual MTV after completion of thoracic irradiation in inoperable stage III non-small cell lung cancer (NSCLC). Methods: We analyzed retrospective and prospective data of 56 patients with inoperable stage III NSCLC treated with chemoradiotherapy (CRT) and chemoradioimmunotherapy (CRT-IO). All patients received an 18F-FDG-PET/CT 3 to max. 6 months after completion of thoracic irradiation. The measurement of the residual MTV of the primary tumor was performed by calculating the SUVmean of the liver + 2SD as threshold. The patients were divided into the following groups: residual-MTV &lt; 1ml; residual-MTV 1-25ml and residual-MTV &gt; 26ml. Survival, local recurrence, and distant metastasis rates were calculated using the Kaplan-Meier method from the last day of thoracic irradiation. Results: The median follow-up was 45 months (range 16-74) in the CRT group and 16 months in the CRT-IO group (range13-19). Twenty-two (39%) patients had a residual MTV &lt; 1ml (1st group), 19 (34%) a residual MTV between 1-25ml (2nd group) and 15 (27%) a residual MTV &gt; 25ml (3rd group) after completion of thoracic irradiation. Median overall survival was 61, 20 and 12 months (p = 0.006) in the 1st, 2nd and 3rd groups, respectively. 12-month survival was 86%, 50% and 33% after CRT vs. 88%, 71% and 50% after CRT-IO in the 1st, 2nd and 3rd groups, respectively. The median time to in-field recurrence in the 1st, 2nd and 3rd groups was 51, 20 and 15 months (p = 0.011). The prognostic value of the residual MTV on OS was confirmed exclusively in the CRT patient cohort (p = 0.04), but not in the CRT-IO patient cohort (p = 0.174). Residual MTV demonstrated no influence on the local recurrence rate in the CRT-IO patient cohort, but only in patients treated with CRT (p = 0.007). Conclusions: Patients with inoperable stage III NSCLC in whom the residual MTV was &lt; 1ml after completion of thoracic irradiation showed significantly better survival than patients with a residual MTV of 1-25ml and MTV &gt; 25ml. The subgroup analysis confirmed the prognostic value of residual MTV only in patients who received chemoradiotherapy without consolidation immunotherapy.
Association between bacterial homoplastic variants and radiological pathology in tuberculosis
Authors: Louis Grandjean, Joha Monteserin, Robert Gilman, Julia Pauschardt, Sakib Rokadiya, Cesar Bonilla, Viviana Ritacco, Julia Rios Vidal, Julian Parkhill, Sharon Peacock, David AJ Moore, Francois Balloux
Journal: Thorax (2020)

Background Understanding how pathogen genetic factors contribute to pathology in TB could enable tailored treatments to the most pathogenic and infectious strains. New strategies are needed to control drug-resistant TB, which requires longer and costlier treatment. We hypothesised that the severity of radiological pathology on the chest radiograph in TB disease was associated with variants arising independently, multiple times (homoplasies) in the Mycobacterium tuberculosis genome. Methods We performed whole genome sequencing (Illumina HiSeq2000 platform) on M. tuberculosis isolates from 103 patients with drug-resistant TB in Lima between 2010 and 2013. Variables including age, sex, HIV status, previous TB disease and the percentage of lung involvement on the pretreatment chest radiograph were collected from health posts of the national TB programme. Genomic variants were identified using standard pipelines. Results Two mutations were significantly associated with more widespread radiological pathology in a multivariable regression model controlling for confounding variables (Rv2828c.141, RR 1.3, 95% CI 1.21 to 1.39, p&lt;0.01; rpoC.1040 95% CI 1.77 to 2.16, RR 1.9, p&lt;0.01). The rpoB.450 mutation was associated with less extensive radiological pathology (RR 0.81, 95% CI 0.69 to 0.94, p=0.03), suggestive of a bacterial fitness cost for this mutation in vivo. Patients with a previous episode of TB disease and those between 10 and 30 years of age also had significantly increased radiological pathology. Conclusions This study is the first to compare the M. tuberculosis genome to radiological pathology on the chest radiograph. We identified two variants significantly positively associated with more widespread radiological pathology and one with reduced pathology. Prospective studies are warranted to determine whether mutations associated with increased pathology also predict the spread of drug-resistant TB.
Abstract 12793: Warfarin Use Prompting Significant Intervention in the Emergency Department: Acute Hemorrhage and Bleeding Concerns
Authors: Charles V Pollack, W. Frank Peacock, Alex Frost, Steven H Silber, Richard A Bernstein, Geno Merli, Babak S Jahromi, James D Douketis, Todd C Villines, Greg Fermann, Gregory J Fiore, John Fanikos
Journal: Circulation (2018)

Introduction: The SOAR (Safety of Oral Anticoagulants Registry) project is an ongoing observational study of the impact of oral anticoagulation therapy in patients presenting for emergency departme...
Impact of tuberculosis on mortality and healthcare resource utilization in cancer patients: A nationwide inpatient sample analysis.
Authors: Ishaan Vohra, Prasanth Lingamaneni, Vatsala Katiyar, Krishna Rekha Moturi, Sindhu Janarthanam Malapati, Sunny R K Singh, Shweta Gupta
Journal: Journal of Clinical Oncology (2020)

e13625 Background: Tuberculosis (TB) is a major public health concern. Patients with malignancy are at increased risk of developing TB as a result of depressed cellular immunity. The aim of the study is to analyze the prevalence, mortality and healthcare resource utilization of cancer patients with TB. Methods: Adult patients with malignancy and TB (cases) were identified using ICD10 code from Nationwide Inpatient Sample database 2017 and their data was compared to cancer patients without TB (controls). Univariate and multivariable logistic and Poisson regression models were used to analyze mortality and healthcare resource utilization. Results: Among 2,099,294 adult cancer patients admitted in 2017, 1115 were found to have TB. Majority (84%) had pulmonary TB. Mean age of patients was 60.3 years with 65% males and white predominance (33%). Overall prevalence of TB in cancer population was 51.3/100,000 patients, with highest being in Hodgkin lymphoma (182.6/100,000) followed by and MDS/ MPN patients (113.2/100,000) (p &lt; 0.01). Among solid organ malignancies, lung cancer had the highest prevalence of TB (92.1/100,000). After adjusting for the demographic and patient related variables, TB was found to be an independent risk factor for mortality in cancer patients (adjusted HR 1.7, 95% CI 1.13-2.66, p = 0.017). The mortality of cases during inpatient stay was 10.2% compared to 6.2% in controls. The mean length of stay for cases was 12.4 days vs 6.3 days in controls (adjusted coef +6.12, 95% CI 3.64-8.59, P &lt; 0.001) and mean hospital charges in cases was $136,026 vs $67,381 in controls (adjusted coef 68,680, 95% CI 39,053.5-98,306.9, p &lt; 0.001). On multivariate analysis, predictors of mortality in cancer patients with TB were older age, malnutrition, uninsured status, higher Charlson comorbidity score ( = &gt; 3), ICU care, venous thrombo-embolism and Acute renal failure requiring dialysis. Conclusions: TB significantly increases the morbidity and mortality in cancer patients. Widespread TB screening, prompt recognition of infection and treatment can considerably reduce health care costs. [Table: see text]
Surgery vs Endoscopy for Early Treatment of Chronic Pancreatitis
Authors: Yang-Yang Qian, Liang-Hao Hu, Zhuan Liao
Journal: JAMA (2020)

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 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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
Effectiveness of cinacalcet in combination with calcitriol for secondary hyperparathyroidism in patients with maintenance hemodialysis
Authors: Guijiang Sun, Fang Wei, Haibo Yu, Bo Li, Haiyan Chen, Ruining Zhang, Bo Wang, Jia Meng, Hongye Dong
Journal: BMJ (2018)

One hundred and twenty maintenance hemodialysis patients with secondary hyperparathyroidism were randomly assigned to receive cinacalce, calcitriol or combination of cinacalce and cacitriol for treatment, with 40 cases in each group. Patients were followed up for 12 months; and the blood tests, echocardiography, examinations for osteoporosis and soft tissue calcification were performed every month. After 3 months of treatment, the serum levels of parathyroid hormone were decreased in all three groups (P<0.01); while the parathyroid hormone decreased more markedly with less influence on serum calcium and phosphorus levels in combination group. There were no significant changes in alkaline phosphatase, osteoporosis and cardiac valve calcification after treatment, compared with before treatment. There were no cases of hypercalcemia and hypocalcemia appearing in combination group after treatment. The study indicates that the combination of cinacalcet with calcitriol has better therapeutic effect for treatment of secondary hyperparathyroidism in maintenance dialysis patients.


Key words: 
Hemodialysis; Secondary hyperparathyroidism; Cinacalcet; Calcitriol