tbuckley/cabot-search huggingface dataset:
Universal Screening for Hepatitis C Virus Infection
Authors: Camilla S. Graham, Stacey Trooskin
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
Neoadjuvant docetaxel and capecitabine in patients (Pts) with high-risk prostate cancer (PCa): Final results of a phase II trial
Authors: J. D. Friedman, U. Vaishampayan, D. Wood, A. Wu, D. Bradley, R. L. Dunn, J. Montie, F. H. Sarkar, R. Shah, M. Hussain
Journal: Journal of Clinical Oncology (2007)

5147 Background: Docetaxel is the most active cytotoxic agent in PCa. Pre-clinically docetaxel increases the expression of thymidine phosphorylase (TP), an enzyme responsible for activation of capecitabine to 5-fluorouracil. We assessed the activity and safety of neoadjuvant docetaxel and capecitabine (DC) in pts with high risk PCa. Methods: Non-metastatic PCa pts with clinical stage &gt;T2, or PSA = 15 ng/ml or biopsy Gleason sum (GS) = 8 received 3–6 cycles of docetaxel (36 mg/m 2 IV on days 1, 8, and 15) and capecitabine (1,250 mg/m 2 /day PO on days 5–18) q 28 days, followed by local therapy. The primary endpoint of this 2-stage phase II trial was rate of = 50% decline in PSA. Secondary endpoints included safety and correlative measures of treatment effect (qualitative changes in histology, tissue TP and survivin expression, and CK18Asp396 [apoptosis marker] in serum). Results: Fifteen pts were enrolled with median age of 58 years, median GS =8 and PSA of 23.2 ng/mL. Five pts met 1, 7 met 2, and 3 met 3 entry criteria. 14 pts completed 3 or more cycles of DC, with a median follow up of 17.5 months (9–34). Six of the 15 patients (40%) experienced a = 50% decline in PSA, which was below the 7 required for expansion of the study. Median testosterone did not change post therapy. Eleven pts underwent radical prostatectomy (RP), with no increase in surgical complications. Six pts had positive margins, and 2 had lymph node involvement. Of the 8 patients who underwent RP alone, 5 developed a biochemical recurrence in a median time of 11 months. Grade 3 or 4 toxicities were diarrhea(3), mucositis(2), hand foot syndrome(1) and neutropenia(2). Post versus pre therapy tissue had only mild chemotherapy-effects (4/7 samples), including focal clear cell changes, apoptosis/pyknosis, and necrosis. While there was no discernable pattern of increased TP expression, 4/7 specimens showed decreased survivin expression, suggesting a possible mechanism for chemotherapy-induced apoptosis. There was no correlation of PSA response and survivin expression and no increase in serum CK18Asp396. Conclusions: Docetaxel and capecitabine in the neoadjuvant setting is well tolerated, but results in modest pathologic and PSA responses. Supported by Sanofi- Aventis. No significant financial relationships to disclose.
Abstract P286: Sex-differences In The Prevalence Of Low Clinical Cardiovascular Health From Childhood To Middle-age
Authors: Liliana Aguayo, Amy Krefman, Orna Reges, Matthew M Davis, Darwin R Labarthe, Philip Greenland, Markus Juonala, Mika Kähönen, Terho Lehtimäki, R. Sue Day, Lydia A Bazzano, Linda Van Horn, Camilo F Alonso, Larry S. Webber, Katja Pahkala, Tomi T. Laitinen, Olli T Raitakari, Donald M Lloyd-jones, Norrina B Allen
Journal: Circulation (2020)

Introduction: This study examines sex differences in the prevalence of low clinical cardiovascular health (CVH) scores from ages 8-50 years old. Methods: Five cardiovascular cohorts (Bogalusa, Young Finns, HB!, CARDIA, and STRIP) were used to create a pooled cohort spanning from ages 8 to 50 years old. The American Heart Association criteria for poor, intermediate and ideal levels for 4 CVH factors (blood pressure, BMI, cholesterol, and glucose) were summed to calculate a clinical CVH score (range 0-8; higher being more ideal). Sex differences in the prevalence rates of low clinical CVH by age group (defined as a score ≤3) were estimated using logistic regression models. Results: Sex differences were examined among 9,386 participants with data on clinical CVH (56% female, 66% White and average follow-up time of 23 yrs). The prevalence of low clinical CVH increased for both men and women with age from 0.72% at age 8-14 yrs to 15% at 45-50 yrs of age in women and from 0.44% at ages 8-14 yrs to over 23% at ages 45-50 yrs in men. There were no significant sex differences in the prevalence of low clinical CVH at younger ages (8-20 years old, p&gt;0.05). Between the ages of 21-26 years old, males were 2 times more likely to have low clinical CVH than women (odds ratio [OR] 2.2, 95% confidence interval [CI], 1.4-3.4). Sex differences in the prevalence of low clinical CVH persisted through adulthood and with only a slight decrease by ages 45-50 years old (OR 1.6, 95%CI 1.4-1.9). Conclusions: Sex differences in the prevalence of low clinical CVH change over the lifetime. In childhood the prevalence of low clinical CVH is similar. By young adulthood, men are more than twice more likely to have low clinical CVH than women; that sex difference is maintained throughout middle age. Understanding the reasons for the growing sex differences in the prevalence of low clinical CVH with age may help to identify targets for primordial prevention, especially prevention strategies to target young men.
Abstract MP45: A Metabolome-wide Association Study of Plant Food Consumption With Blood Pressure
Authors: Linda M Oude Griep, Elena Chekmeneva, Jeremiah Stamler, Linda Van Horn, Queenie Chan, Martha Daviglus, Gary S Frost, Timothy M Ebbels, Elaine Holmes, Paul Elliott
Journal: Circulation (2020)

Background: Epidemiological evidence links blood pressure (BP) -lowering effects with fruit, vegetables, pulses, nuts but results are inconsistent and often rely on self-administered dietary assessment methods prone to random and systematic errors and potential under- or overestimation of relationships. Objective: To characterize urinary metabolic signatures of plant food intake (fruit, vegetables, pulses, and nuts) and subsequently to assess their associations with BP, validated across cohorts. Methods: We used untargeted metabolic profiling obtained by proton nuclear magnetic resonance spectroscopy ( 1 H NMR) of two timed repeated 24-hour urine collections derived from 2,032 free-living US participants, and replicated among 449 UK participants, all part of the cross-sectional International Study of Macro- and Micronutrients and Blood Pressure (INTERMAP) study. Associations of plant foods intakes from four 24-hour dietary recalls with 7,100 NMR features were evlauted using univariate linear regression analyses. Significant metabolites were structurally identified using analytical and statistical approaches. We compared extensively adjusted associations of plant food intake and urinary metabolites with BP in the total population (N=2,481). All analyses were extensively adjusted for potential confounders and accounted for multiple testing. Results: We found consistent, reproducible relationships of NMR signatures with plant food intake across repeated urine collections and between populations. Eleven urinary metabolites were identified and two remained unknown (1: δ 2.80 (s); 2: δ 1.16(s), 1.67 (s)). Twelve metabolites were directly correlated with plant foods ranging from 0.15 (P≤1x10 -11 ) to 0.49 (P≤5x10 -119 ), and phenylacetylglutamine was inversely associated (r=-0.18, P≤1x10 -5 ). In adjusted analyses, plant food intake was inversely associated with systolic BP (-1.29 mmHg; 95%CI: -2.38,-0.19), but not with diastolic BP. Metabolites inversely associated with systolic BP were hippurate (-2.67 mmHg;-3.71,-1.63), citrate (-2.50 mmHg; -3.55,-1.44), phenylacetylglutamine (-2.26 mmHg; -3.29,-1.23), unknown1 (-2.05 mmHg; -3.06,-1.04), 4-hydroxyhippurate (-1.45 mmHg; -2.44,-0.45), and unknown2 (-1.09 mmHg; -2.09,-0.09); with diastolic BP were phenylacetylglutamine (-1.12 mmHg; -1.84,-0.40), citrate (-1.02 mmHg; -1.76,-0.28), and unknown1 (-1.18 mmHg; -1.88,-0.47). Plant food-systolic BP associations were attenuated by further adjustment for citrate, hippurate, and unknown1, while hydroxyproline, proline and phenylacetylglutamine were potential effect modifiers. Conclusion: Urinary metabolites were consistently associated with plant food intake. Urinary metabolites that may underlie the plant food-BP association were gut-microbial co-metabolites and tricarboxylic acid cycle intermediates.
Efficacy and tolerability of a weekly schedule of docetaxel-cisplatin as first-line treatment for advanced non-small cell lung cancer (NSCLC)
Authors: D. Binder, M. Hackenthal, L. Graseck, H. Schweisfurth, C. Schäper, M. Krüll, B. Temmesfeld-Wollbrück, N. Suttorp, T. Beinert, K. Hellriegel
Journal: Journal of Clinical Oncology (2007)

18159 Background: Docetaxel-cisplatin, administered every 3 weeks, is an effective first-line chemotherapy for locally advanced or metastatic NSCLC. However, this regimen is commonly associated with neutropenia and neutropenic infections. Moreover, the extensive hydration required with cisplatin given every 3 or 4 weeks makes outpatient treatment difficult. We assessed the efficacy and tolerability of weekly docetaxel-cisplatin, which may be better tolerated than the standard regimen. Methods: Patients (pts) with histologically confirmed stage UICC IIIB (malignant effusion) or IV NSCLC were treated with docetaxel (35 mg/m 2 , 30 min. infusion) and cisplatin (25 mg/m 2 , 30-min. infusion) on Days 1, 8, and 15, every 4 weeks for 4–6 cycles. Pts received ondansetron 8 mg iv and dexamethasone 8 mg iv preceding every day of chemotherapy and oral dexamethasone 2 x 4 mg daily from the day before until the day after chemotherapy. NK1-antagonists were given at the investigator’s discretion. On each day of therapy, 2750 mL of fluid was infused over 3.5 h. Most pts were treated in an outpatient department. Safety was assessed using CTCAE v3.0. The primary endpoint was response rate (RECIST). Results: 45 pts were enrolled; efficacy and tolerability data were available for 43 pts. 12/45 pts achieved an objective response (11 partial; 1 complete; ITT response rate 27%). Median time to progression was 3.9 months. Pts received a median of 3 full cycles. 4 pts (9%) required dose reductions. No cases of neutropenic fever/infections or grade 2–4 thrombocytopenia were observed. Only 2 pts (5%) had grade 3 neutropenia. One pt (2%) experienced grade 3–4 nausea/vomiting. 5 pts died during therapy for reasons not unequivocally attributable to tumor progression (bacterial meningitis with normal neutrophil counts [n=1], pneumonia with normal neutrophil counts [n=1], pulmonary arterial embolism [n=1], unknown [n=2]). Conclusions: Docetaxel-cisplatin administered weekly was well tolerated. Hematologic toxicity and neutropenic fever were uncommon. Docetaxel-cisplatin can be safely administered with relatively low hydration volumes in an outpatient setting. Survival data will be presented. No significant financial relationships to disclose.
Abstract P331: Impact of Primary Care Access and Continuity of Care in Reduction of Hospital/Emergency Department Admissions in Patients With Hypertension: A Systematic Review
Authors: Divya Rajmohan, Konstantin Golubykh, Anastasiia Avdeeva, Ashraf Mahmood, Muhammad Sarmad Aleem, Shahnawaz Hashmi, Ankur Sah Swarnakar, Prajwol Shah, Robert Soltes, Imona Subedi, Reagan Achinefu, Rizwanulla Hameed
Journal: Circulation (2020)

Background: Hypertension, defined as a systolic blood pressure ≥140 mmHg and/or diastolic pressure ≥90 mmHg, is one of the most common chronic diseases (prevalence is 29.0% among adults) and is part of the Ambulatory Care Sensitive Conditions (ACSC). In most cases, hypertension is considered a secondary diagnosis because complications that could result from the disease are the reasons why patients with hypertension are admitted to the hospital and Emergency Department (ED). Thereby, preventive approaches are integral in the management of these complications and access to primary care along with continuity are considered to be crucial components of preventive medicine. Hypothesis: We assess the hypothesis that increased access to primary care and continuity of care can reduce ED visits along with hospitalization rates in patients with hypertension. Methods: We reviewed articles from years 2005 to 2019 from peer reviewed journals. All publications were written in English and were mostly from the United States. However, we also included studies from other countries for comparison. We identified 2115 articles in total: 784 from Science Direct, 687 from Pubmed and 644 from Google Scholar, using these keywords: Hypertension, Hospitalization, Emergency Department, Primary care, Ambulatory Care Sensitive Conditions. Based on the titles, we investigated abstracts of 198 potentially relevant articles. Abstracts were rated independently by each member of the pair of reviewers and scored for relevance (relevant/ non-relevant). The second step was to have the full text of the remaining studies (n = 146) reviewed by the same team to check whether papers met inclusion criteria. Through this process, 96 studies were excluded. A total of 50 studies remained and were included in our systematic review. Results: From 50 research articles that were included; 38 studies showed statistically significant (p &lt; 0.05) finding that increased access to primary care and its continuity decreases hospitalizations and/or ED admissions in patients with hypertension, 8 studies did not find statistically significant association between these factors. 4 studies showed statistically significant conclusion that general or family physicians as PCPs decrease hospitalization and ED admission rate in comparison with specialist physicians as PCP. Conclusion: We concluded that increased primary care access and its continuity are associated with a statistically significant decrease in the incidence of hospitalizations and/or ED visits for patients with hypertension.
Rapid establishment of laboratory diagnostics for the novel coronavirus SARS-CoV-2 in Bavaria, Germany, February 2020
Authors: Regina Konrad, Ute Eberle, Alexandra Dangel, Bianca Treis, Anja Berger, Katja Bengs, Volker Fingerle, Bernhard Liebl, Nikolaus Ackermann, Andreas Sing
Journal: Eurosurveillance (2020)

The need for timely establishment of diagnostic assays arose when Germany was confronted with the first travel-associated outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Europe. We describe our laboratory experiences during a large contact tracing investigation, comparing previously published real-time RT-PCR assays in different PCR systems and a commercial kit. We found that assay performance using the same primers and probes with different PCR systems varied and the commercial kit performed well.
USPSTF’s Hepatitis C Screening Recommendation—A Necessary Step to Tackling an Evolving Epidemic
Authors: Eli S. Rosenberg, Joshua A. Barocas
Journal: JAMA Network Open (2020)

Roger Chou, MD; Tracy Dana, MLS; Rongwei Fu, PhD; Bernadette Zakher, MBBS, MPH; Jesse Wagner, MA; Shaun Ramirez, MPH; Sara Grusing, BA; Janice H. Jou, MD, MHS
Abstract 37: Healthy Eating Patterns and Risk of Cardiovascular Disease: Results From Three Large Prospective Cohort Studies
Authors: Zhilei Shan, Yanping Li, Shilpa N Bhupathiraju, Dong Wang, Kathryn M Rexrode, Eric Rimm, Lu Qi, Walter Willett, Joann E Manson, Qibin Qi, Frank B Hu
Journal: Circulation (2020)

Introduction: The 2015-2020 Dietary Guidelines for Americans (DGAs) recommend three major healthy dietary patterns: the Healthy US-Style Eating Pattern, the Healthy Mediterranean-Style Eating Pattern, and the Healthy Vegetarian Eating Pattern, for all Americans with diverse cultural and personal food traditions. However, few studies have systematically examined the potential differences in associations of adherence to these recommended dietary patterns with long-term risk of cardiovascular disease (CVD). Hypothesis: We hypothesized that all three DGA-recommended dietary patterns were associated with lower risk of CVD, coronary heart disease (CHD), and stroke. Method: We evaluated data on 74 661 women in the Nurses’ Health Study (NHS), 90 864 women in NHS II, and 41 837 men in the Health Professionals Follow-Up Study (HPFS), who had repeated dietary data and had no history of type 2 diabetes, CVD, or cancer at baseline. Using the food and nutrient components, we calculated the Healthy Eating Index (HEI)-2015, Alternate Mediterranean Diet score (AMED), Healthful Plant-based Diet Index (HPDI), to measure adherence to the Healthy US-Style Eating Pattern, Healthy Mediterranean-Style Eating Pattern, and Healthy Vegetarian Eating Pattern, respectively. Multivariable Cox proportional-hazards regression was used to assess the associations of healthy eating index with CVD risk. Results: We documented 9 262 incident CVD cases (6 628 CHD and 2 701 stroke) during 1 976 026 person years of follow-up in the NHS, 1 916 CVD cases (1 267 CHD and 660 stroke) during 2 173 162 person years of follow-up in NHS II, and 10 203 CVD cases (8 750 CHD and 1 775 stroke) during 873 053 person years of follow-up in HPFS. When comparing the highest to the lowest quintiles, the pooled HRs (95% CIs) of CVD were 0.80 (0.77 to 0.84) for HEI-2015, 0.83 (0.79 to 0.87) for AMED, and 0.85 (0.81 to 0.89) for HPDI (all P for trend &lt;0.001). In addition, a 25-percentile increase in healthy eating scores was associated with 10% to 22% lower risk of CVD (pooled HR: HEI-2015, 0.78 [0.75 to 0.82]; AMED, 0.90 [0.88 to 0.92]; HPDI, 0.84 [0.81 to 0.88]). For CHD, the pooled HRs (95% CIs) per 20-percentile increase were 0.76 (0.73 to 0.80) for HEI-2015, 0.90 (0.87 to 0.92) for AMED, and 0.83 (0.79 to 0.87) for HPDI. For stroke, the pooled HRs (95% CIs) per 20-percentile increase were 0.86 (0.78 to 0.94) for HEI-2015, 0.90 (0.85 to 0.95) for AMED, and 0.90 (0.83 to 0.98) for HPDI. The inverse associations between healthy eating index and CVD risk persisted in analyses stratified by potential risk factors. Conclusions: In three large prospective cohorts with up to 32 years of follow-up, higher adherence to various healthy eating patterns was associated with lower risk of CVD, CHD, and stroke. Our findings support the DGA recommendations for multiple healthy eating patterns.
Continuous, noninvasive wireless monitoring of flow of cerebrospinal fluid through shunts in patients with hydrocephalus
Authors: Siddharth R. Krishnan, Hany M. Arafa, Kyeongha Kwon, Yujun Deng, Chun-Ju Su, Jonathan T. Reeder, Juliet Freudman, Izabela Stankiewicz, Hsuan-Ming Chen, Robert Loza, Marcus Mims, Mitchell Mims, KunHyuck Lee, Zachary Abecassis, Aaron Banks, Diana Ostojich, Manish Patel, Heling Wang, Kaan Börekçi, Joshua Rosenow, Matthew Tate, Yonggang Huang, Tord Alden, Matthew B. Potts, Amit B. Ayer, John A. Rogers
Journal: npj Digital Medicine (2020)

Hydrocephalus is a common disorder caused by the buildup of cerebrospinal fluid (CSF) in the brain. Treatment typically involves the surgical implantation of a pressure-regulated silicone tube assembly, known as a shunt. Unfortunately, shunts have extremely high failure rates and diagnosing shunt malfunction is challenging due to a combination of vague symptoms and a lack of a convenient means to monitor flow. Here, we introduce a wireless, wearable device that enables precise measurements of CSF flow, continuously or intermittently, in hospitals, laboratories or even in home settings. The technology exploits measurements of thermal transport through near-surface layers of skin to assess flow, with a soft, flexible, and skin-conformal device that can be constructed using commercially available components. Systematic benchtop studies and numerical simulations highlight all of the key considerations. Measurements on 7 patients establish high levels of functionality, with data that reveal time dependent changes in flow associated with positional and inertial effects on the body. Taken together, the results suggest a significant advance in monitoring capabilities for patients with shunted hydrocephalus, with potential for practical use across a range of settings and circumstances, and additional utility for research purposes in studies of CSF hydrodynamics.
Improving breast cancer screening for indigent minorities: A county hospital cancer center's experience
Authors: T. E. O'Brien, A. Peacock, J. T. Stevenson
Journal: Journal of Clinical Oncology (2007)

17020 Background: Indigent, minority women with breast cancer present with later stage disease, often because of lack of access to affordable screening tests. Breast exam and mammography are effective at early detection. A screening program targeting minority women is important, especially in an area with a high poverty rate. The most effective way to reach this population, though, has not been well established. Methods: From 11/03–7/05, 4 breast cancer screenings were performed at our cancer center which targeted poor, minority populations in the Cleveland area. Despite culturally appropriate advertisements and free exams by physicians, only 42 women were screened. To improve upon this, a bilingual community breast liaison was hired. An advisory council of community representatives was established which led to collaborations with over 100 neighborhood agencies. The venue for the screenings was changed to easily accessible locations (churches, shelters) and transportation was provided. Free clinical breast exams (CBE) were performed by experienced physicians and on-site mammograms (mam) were done. From 10/05–10/06, 7 community breast screenings were held. 403 women were screened and over 2000 were educated. Results: 98% were impoverished; 94% had an annual income of &lt;$25,000. 78% had no health insurance. Median age=46 (range 35–89). 31% Latino; 46% AA; 16% Caucasian. Many pts had not had a mam (91%) or CBE (84%) within the past year; many never had either screening test before (31% never had a mam and 17% never had a CBE). The most common reason for this was lack of insurance (60%). “Too young” was the second most common reason (7%). Most common reason for coming to screenings: free services (49%). Of 403 pts screened, 27/371 had abnormalities on CBE and 26/293 mam were abnormal. Thus far, 2 cases of breast cancer have been diagnosed (stages I and II). Conclusion: Indigent minority women do not receive adequate breast cancer screening due to many barriers, including cost. To reduce this disparity, our center targeted this population. After adjusting our approach, screening attendance markedly improved, increasing from 42 to 403 pts screened. This improvement was due to cancer center services being brought out to the community and an active engagement of community organizations. No significant financial relationships to disclose.