tbuckley/cabot-search huggingface dataset:
Chemoradiation of resected gastric cancer: A 10-year follow-up of the phase III trial INT0116 (SWOG 9008)
Authors: J. S. Macdonald, J. Benedetti, S. Smalley, D. Haller, S. Hundahl, J. Jessup, J. Ajani, L. Gunderson, B. Goldman, J. Martenson
Journal: Journal of Clinical Oncology (2009)

4515 Background: INT0116 (SWOG 9008) was a prospectively randomized phase III trial of postoperative adjuvant therapy utilizing 5-FU/leucovorin plus external beam radiation in 582 eligible cases of resected stage IB-IV(M0) stomach and gastroesophageal junction cancers. Initial results (NEJM 345: 725, 2001) showed both overall and disease free survivals improved by chemoradiation. Methods:We now report INT0116 results with &gt;10years median follow-up. Exploratory subset outcomes are also reported. Results: INT0116 continues to show benefit for chemoradiation with hazard ratios (HR) for survival (HR=1.32, p=.004) and disease free survival (HR=1.51, p&lt;.001) favoring chemoradiation. Subset analyses were performed for sex, race, T and N stage, D-level of surgical resection, tumor location (proximal or other), histology (intestinal or diffuse) and Maruyama index. Chemoradiation benefited all subsets with the exceptions of women and diffuse histology. In women the HR for therapy was 1.0(0.68–1.45). The HR for therapy in diffuse histology cases was 0.97(0.62–1.40). Interaction between these factors is suggested as women were significantly more likely to have diffuse histology than men (56% versus 33%). A multivariate analysis of sex and histology did not detect an effect of sex once histology was included. These data suggest that sex may not be an independent variable for lack of response to chemoradiation but that diffuse histology may be. Long term toxicities were examined. Thirty-five second tumors occurred in 31 cases. Twenty-two occurred in chemoradiation cases and 9 in surgery only cases. Second tumors represented a spectrum of types of neoplasms commonly occurring in this age group (median age 60 years). Excessive numbers of tumors known to be caused by radiation and/or chemotherapy were not noted. More tumors may have occurred in the treated patients since their death rates were less than surgery only cases. Conclusions: With &gt;10 years median follow-up, survival remains improved in stage IB-IV (M0) gastric cancer cases treated with post-operative chemoradiaiton. All subsets benefit from this treatment with the exception of cases with diffuse histology. Women may be more likely to have diffuse histology gastric cancers. No increases in late toxic effects were noted. No significant financial relationships to disclose.
A Song Sung Sweet to Greet the Dead
Authors: Glenn Colquhoun
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
Complement-mediated oxidative damage of red cells impairs response to eculizumab in a G6PD-deficient patient with PNH
Authors: Michela Sica, Annamaria Pellecchia, Maria De Angioletti, Giovanni Caocci, Caterina Nannelli, Giorgio La Nasa, Lucio Luzzatto, Rosario Notaro
Journal: Blood (2020)
FRI0170 Anticardiolipin antibodies in systemic rheumatic diseases patients
Authors: D Unikiene, A Baranauskaite, N Misiuniene
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> Anticardiolipin antibodies (aCL) are quite common findings in patients with systemic rheumatic diseases. However, clinical significance of aCL presence still remains not completely clear despite some very well known clinical associations. <h3>Objectives</h3> The purpose of our study was to evaluate clinical significance of aCL in our patients with systemic rheumatic diseases. <h3>Methods</h3> We examined 242 pts who suffered from rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and systemic sclerosis (SS) and underwent treatment in Kaunas University of Medicine Rheumatology department. The control pts group (107 pts) was formed of healthy blood donors and pts without presence of any signs of rheumatic or immune disease. There were 216 (89%) women and 26 (11%) men aged 10 to 80 years (mean 51.4 ± 14.6 yr.) in study group. RA group consisted of 158 (65.3%) pts, SLE – of 53 (21.9%) pts, and SS group of 31 (12.8%) pts. Diagnosis was evaluated according to standard American Rheumatology Association criteria. Enzyme immunoassay test to detect aCL IgG was performed in all pts. <h3>Results</h3> Presence of aCL IgG was found in 38 (15.7%) pts out of 242 pts in the study group and in 6 (5.6%) control group pts. The incidence of aCL IgG was 30.2% in SLE pts, 29% in SS pts, and 8.2% in RA pts. There was significant difference in aCL IgG frequency between study pts and control groups, p = 0.009, and between SLE and SS pts and control pts as well (p = 0.000014 and 0.0002, respectively). However, there was similar aCL IgG incidence in RA and control pts. Age of pts with positive enzyme immunoassay (EIA) test was significantly lower as compared with negative EIA test pts (mean age 45.8 ± 15.8 yr. and 52.5 ± 14.1 yr., respectively, p = 0.009). However, this difference appeared to be significant in SLE pts only (p = 0.02). There was no significant difference in aCL IgG incidence in separate subsets of pts either in respect to sex, or disease activity, course, or duration. In fact, some clinical manifestations were strongly associated with the presence of aCL IgG. There was significant difference in incidence of livedo reticularis, subacute vein thrombosis, and thrombocytopenia between pts with positive and negative EIA test (p = 0.015, 0.0066, 0.001, respectively). The diagnosis of secondary antiphospholipid antibody syndrome (APS) was confirmed in 15 (6.2%) pts. There were 11 (20.7%) pts in SLE group, 2 (6.4%) pts in SS group, and 2 (1.3%) pts in RA group with this condition. The majority of those pts were aCL IgG – positive (p = 0,0001, as compared with aCL IgG – negative APS pts). <h3>Conclusion</h3> 1) Presence of aCL IgG was associated with some clinical manifestations such as livedo reticularis, subacute vein thrombosis, and thrombocytopenia, and antiphospholipid antibody syndrome in pts with systemic rheumatic diseases, 2) There was no association found between presence of aCL IgG and pts sex, disease activity, course, or duration.
The effects of dairy and dairy derivatives on the gut microbiota: a systematic literature review
Authors: Hajara Aslam, Wolfgang Marx, Tetyana Rocks, Amy Loughman, Vinoomika Chandrasekaran, Anu Ruusunen, Samantha L. Dawson, Madeline West, Eva Mullarkey, Julie A. Pasco, Felice N. Jacka
Journal: Gut Microbes (2020)

The effects of dairy and dairy-derived products on the human gut microbiota remains understudied. A systematic literature search was conducted using Medline, CINAHL, Embase, Scopus, and PubMed databases with the aim of collating evidence on the intakes of all types of dairy and their effects on the gut microbiota in adults. Risk of bias was assessed using the Cochrane risk-of-bias tool.The search resulted in 6,592 studies, of which eight randomized controlled trials (RCTs) met pre-determined eligibility criteria for inclusion, consisting of a total of 468 participants. Seven studies assessed the effect of type of dairy (milk, yogurt, and kefir) and dairy derivatives (whey and casein) on the gut microbiota, and one study assessed the effect of the quantity of dairy (high dairy vs low dairy). Three studies showed that dairy types consumed (milk, yogurt, and kefir) increased the abundance of beneficial genera Lactobacillus and Bifidobacterium. One study showed that yogurt reduced the abundance of Bacteroides fragilis, a pathogenic strain. Whey and casein isolates and the quantity of dairy consumed did not prompt changes to the gut microbiota composition. All but one study reported no changes to bacterial diversity in response to dairy interventions and one study reported reduction in bacterial diversity in response to milk intake.In conclusion, the results of this review suggest that dairy products such as milk, yogurt, and kefir may modulate the gut microbiota composition in favor to the host. However, the broader health implications of these findings remain unclear and warrant further studies.
Primary plasma cell leukemia mimicking a <scp>Pancoast</scp> tumor
Authors: Yorick Sandberg, Gert T. Verhoeven, Floor Weerkamp, Annemiek Broyl, Jasper Emmering, Leo M. Budel
Journal: American Journal of Hematology (2020)

A 56-year-old non-smoking man was referred to the orthopedic surgeon because of a 5-month history of worsening pain and swelling of the left shoulder. Physical examination revealed a mass around the left shoulder. Magnetic resonance imaging and computed tomography (CT) demonstrated a large Pancoast tumor with rib destruction and invasion of the chest wall and soft tissue (Figure 1A,B), showing hypermetabolic activity on FDG positron emission tomography (PET)-CT (Figure 1C). Peripheral blood (PB) examination showed hypercalcemia, anemia, thrombocytopenia, and a normal leukocyte count (8.3 × 109/L). More thorough examination of PB smears illustrated aberrant plasma cells with nucleoli (Figure 2A; May-Grünwald-Giemsa (MGG) stain, original magnification ×1000). Flow cytometry detected a clonal plasma cell population of 23%, positive for CD56 and negative for CD19 (Figure 2B,C). The bone marrow aspirate smear identified nearly complete replacement of normal hematopoietic cells by clonal plasma cells (Figure 2D; MGG stain, original magnification ×1000). Serum free light chain kappa level was 732.5 mg/L. Further cytogenetic exploration showed t(4;14)(p16;q32). All findings were consistent with primary plasma cell leukemia (pPCL). Left apical lung tumor biopsy demonstrated malignant cells that stained positive for CD138, CD38, CD56, and kappa light chains (Figure 2E; hematoxylin and eosin stain, original magnification ×200). Cells were negative for cytokeratin AE1/AE3, CD3, CD20, CD30, ALK1, EBV, PAX5, and CyclinD1. The patient started treatment with carfilzomib, lenalidomide and dexamethasone (KRd) which induced a complete response after four courses with regression of the pulmonary mass. Thus, KRd is a major treatment regimen in multiple myeloma1 and currently evaluated as induction therapy in a phase two study in pPCL. Apical lung tumors are usually non-small-cell lung cancers, also known as Pancoast tumors.2 Other malignancies than primary lung cancer should always be considered in the differential diagnosis, and a histopathological diagnosis is essential for management of the patient. None. Data sharing not applicable to this article as no datasets were generated or analysed during the current study
AB0207 Reflex sympathetic dystrophy associated with phenobarbital
Authors: JA Hernandez-Beriain, A Rosas, E Girona
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> Reflex sympathetic dystrophy (RSD) is a complex syndrome characterised by pain and oedema of one or more extremities, trophic skin changes and vasomotor instability. Long-term outcome is variable and can induce severe consequences. Barbiturates has been related with RSD in 15% of the cases. <h3>Objectives</h3> The aim of our work is to define long-term outcome and response to therapy of three patients with RSD following barbiturates use. <h3>Methods</h3> <h3>Results</h3> Main results are expressed in the next Table 1: <h3>Conclusion</h3> RSD can be induced with barbiturates therapy. In our experience barbiturates discontinuation is insufficient for improving and response to other therapies can be limited with significant long-term disability.
THU0040 Anaemia of chronic disease (acd) in a rodent model is similar to human acd and can be alleviated by aranesp treatment
Authors: K Cooke, G Stoney, W Sutherland, J Pistillo, J Del Castillo, G Molineux, M Coccia
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> We previously reported that ARANESP™ alleviates ACD in a rodent model of peptidoglycan-polysaccharide polymer (PG-APS) mediated inflammation. We report here the further characterisation of this model and the effects of ARANESP™ treatment on ACD. <h3>Objectives</h3> <h3>Methods</h3> Immunisation of Lewis rats with PG-APS induces chronic systemic inflammation characterised by relapsing arthritis and hepatic granulomas. Associated with the inflammation is acute, severe anaemia followed by chronic, moderately severe anaemia. As previously established, a 30 μg/kg dose of ARANESP™ every 2 weeks starting day 36 normalised peripheral blood (PB) haemoglobin levels by day 64. <h3>Results</h3> Acutely anaemic rats had greatly enhanced mean PB reticulocyte counts and greatly reduced mean RBC counts. Mean PB reticulocyte and RBC counts normalised during chronic anaemia, but RBC remained hypochromic and microcytic. Individual anaemic rats had transient increases in serum erythropoietin (EPO) concentrations. However, there was no significant difference in mean EPO concentrations compared to controls, which suggests EPO production was blunted. Histology of day 36 and day 112 anaemic rat spleen sections revealed greatly enhanced iron retention by splenic macrophages. In contrast, bone marrow (BM) macrophages were nearly devoid of iron. Serum iron concentratioans were significantly reduced by day 7 and remained low throughout the study. Interestingly, ARANESP™ treated rats showed decreased iron retention in macrophages and increased serum iron starting day 98. To identify which cytokines may contribute to the chronic anaemia of this model, peritoneal exudate cells (PEC) were isolated and challenged with PG-APS <i>in vitro. </i>Unstimulated PEC produced little or no cytokines. PG-APS challenged PEC from anaemic rats produced IL-1α, TNF-α, and IFN-γ. PG-APS challenged PEC from ARANESP™ treated anaemic rats trended towards reduced levels of these cytokines relative to anaemic PEC cultures. <h3>Conclusion</h3> In summary, we have shown this ACD model is similar to human ACD. Importantly, ARANESP™ treatment alleviates ACD in this model, thus indicating its potential therapeutic utility for human ACD.
Level of fatigue in colorectal cancer patients (ccp) receiving adjuvant chemotherapy
Authors: P. Heras, A. Hatzopoulos, K. Kritikos, S. Karagiannis
Journal: Journal of Clinical Oncology (2009)

e20612 The aim of the study was to assess the level of fatigue during and after adjuvant chemotherapy in ccp. Methods: 52 patients (age 30–73 years) with colorectal cancer were recruited between May 2005 and November 2008. Fatigue intensity was measured according to 10-score visual analog scale (VAS, 0-no fatigue, 10-fatigue as bad as it could possibly be) before the start of adjuvant chemotherapy, once weekly during chemotherapy, 20 days and 6 months after. Results: Over half of the patients (56%) demonstrated no fatigue before the start of adjuvant chemotherapy. Fatigue intensity increased gradιιally during chemotherapy. It highest in the last week of treatment 20 days after the end of chemotherapy, fatigue intensity was still higher than before treatment, but 6 months after it was lower than the pretreatment level (mean fatigue-VAS was 1.17, 2.41, 1.45 and 0.61, respectively). However, 17% of the patients defined their fatigue as 2 or more in VAS six months after chemotherapy had ended. About 1/4 of the patients reported nο fatigue during chemotherapy. Increased level of fatigue was associated with an increased need of rest. Patients with pain (pain-VAS 1 or more) manifested higher fatigue level in comparison with individuals without pain (mean fatigue-VAS 3.20 vs 1.02 in the last week of treatment). Older patients (&gt;65 years) estimated their fatique in the last week of treatment on lower level than younger patients (fatigue-VAS 1.79 vs. 2.83 No significant financial relationships to disclose.
Evaluation of 1-Year vs Shorter Durations of Adjuvant Trastuzumab Among Patients With Early Breast Cancer
Authors: Seema Gulia, Sadhana Kannan, Rajendra Badwe, Sudeep Gupta
Journal: JAMA Network Open (2020)

<h3>Importance</h3> The optimum duration of adjuvant trastuzumab among patients with early breast cancer is uncertain but of great therapeutic relevance. <h3>Objective</h3> To compare shorter durations with 1 year of adjuvant trastuzumab for patients with early breast cancer. <h3>Data Sources</h3> PubMed, Embase, Cochrane Central Register of Clinical Trials, and conference proceedings were searched from January 1, 2005, to June 30, 2019, for relevant randomized clinical trials (RCTs). <h3>Study Selection</h3> To be eligible, the trial had to be randomized, compare a shorter duration with 1 year of trastuzumab as adjuvant treatment, and include patients with early breast cancer. <h3>Data Extraction and Synthesis</h3> Individual patient data for disease-free survival (DFS) and overall survival (OS) were extracted from published survival curves of included RCTs; DFS and OS curves for each trial and the combined population were reconstructed. The DFS and OS hazard ratios (HRs) were estimated from the reconstructed survival curves as well as published estimates. The HR for DFS was used to test noninferiority using the median noninferiority margin of eligible RCTs. This study followed Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline. <h3>Main Outcomes and Measures</h3> The primary outcome was DFS; OS and cardiac toxic effects were secondary outcomes. <h3>Results</h3> There were 6 eligible RCTs with a median DFS noninferiority margin of 1.3 (range, 1.15-1.53), 5 of which had extractable individual patient data for 11 376 patients, 1659 DFS events, and 871 deaths. For shorter duration vs 1 year of trastuzumab, the 5-year DFS was 85.42% (95% CI, 84.41%-86.38%) vs 87.12% (95% CI, 86.15%-88.02%) (HR, 1.14; 95% CI, 1.03-1.25, 1-sided<i>P</i>for noninferiority = .004), and OS was 92.39% (95% CI, 91.61%-93.10%) vs 93.46% (95% CI, 92.73%-94.13%) (HR, 1.17; 95% CI, 1.02-1.33). Using trial-level published estimates from 6 RCTs, including 11 603 patients, 1760 DFS events, and 930 deaths, the HR for DFS was 1.15 (95% CI, 1.04-1.26; 1-sided<i>P</i>for noninferiority = .002) and, for OS, 1.17 (95% CI, 1.03-1.33). There was significantly less risk of congestive heart failure with shorter-duration trastuzumab (relative risk, 0.53; 95% CI, 0.38-0.74). <h3>Conclusions and Relevance</h3> In this study, a shorter duration of adjuvant trastuzumab was noninferior to its 1-year administration and resulted in lower rates of cardiac toxic effects. These results suggest that a shorter duration may be the preferred option for patients with low-risk disease or a predisposition to cardiac toxic effects.
Natural killer cell immunotypes related to COVID-19 disease severity
Authors: Christopher Maucourant, Iva Filipovic, Andrea Ponzetta, Soo Aleman, Martin Cornillet, Laura Hertwig, Benedikt Strunz, Antonio Lentini, Björn Reinius, Demi Brownlie, Angelica Cuapio, Eivind Heggernes Ask, Ryan M. Hull, Alvaro Haroun-Izquierdo, Marie Schaffer, Jonas Klingström, Elin Folkesson, Marcus Buggert, Johan K. Sandberg, Lars I. Eriksson, Olav Rooyackers, Hans-Gustaf Ljunggren, Karl-Johan Malmberg, Jakob Michaëlsson, Nicole Marquardt, Quirin Hammer, Kristoffer Strålin, Niklas K. Björkström
Journal: Science Immunology (2020)

Understanding innate immune responses in COVID-19 is important to decipher mechanisms of host responses and interpret disease pathogenesis. Natural killer (NK) cells are innate effector lymphocytes that respond to acute viral infections but might also contribute to immunopathology. Using 28-color flow cytometry, we here reveal strong NK cell activation across distinct subsets in peripheral blood of COVID-19 patients. This pattern was mirrored in scRNA-seq signatures of NK cells in bronchoalveolar lavage from COVID-19 patients. Unsupervised high-dimensional analysis of peripheral blood NK cells furthermore identified distinct NK cell immunotypes that were linked to disease severity. Hallmarks of these immunotypes were high expression of perforin, NKG2C, and Ksp37, reflecting increased presence of adaptive NK cells in circulation of patients with severe disease. Finally, arming of CD56bright NK cells was observed across COVID-19 disease states, driven by a defined protein-protein interaction network of inflammatory soluble factors. This study provides a detailed map of the NK cell activation landscape in COVID-19 disease.
Effect of six courses of neoadjuvant chemotherapy on pathological complete remission in advanced ovarian cancer
Authors: C. Zamagni, P. De Iaco, M. Rosati, N. Cacciari, F. Rosati, D. Rubino, A. A. Martoni
Journal: Journal of Clinical Oncology (2009)

5513 Background: The role and the duration of NACT in ovarian cancer are debated. A randomized trial comparing upfront surgery versus 3 courses of NACT (Vergote 2008) demonstrated similar survival, but less morbidity in favor of NACT. However, pathological complete remissions (pCR) were rare and 68% of pts still had lesions greater than 2 cm after 3 courses of NACT. The rate of pCR correlates with a better survival in other tumors, such as breast cancer, and its rate is higher after 6–8 courses of NACT. We conducted this study to verify the incidence of optimal pathological remission after 6 courses of NACT. Methods: Eligible pts had stage IIIC-IV EOC unsuitable for optimal upfront surgery and were treated with 6 cycles of carboplatin AUC 5 and paclitaxel 175 mg/sm, every 3 weeks before surgery. We considered as optimal pathological responders: 1) the pts with absence of cancer cells in surgical specimens, and 2) the pts with no macroscopic residual after surgery and with only small clusters or individual cancer cells in surgical specimens. All the other cases were considered as pathological nonresponders, even if a relevant shrinkage of tumor burden and an optimal surgical debulking were obtained. Results: 35 stage IIIC/IV pts were enrolled; 33 (94%) completed 6 courses of NACT. We observed 18 (51%) pathological responders, and 17 pathological nonresponders (as defined above). Overall, in 20 (57%) pts the goal of no residual tumor after surgery was achieved. After a median follow-up of 21 mo.s, 21 pts progressed (median PFS 15 mo.s) and 10 pts died. As expected, pts with tumor residual after surgery less than 1 cm survived significantly longer than patients with a greater residual (p .0005). The median overall survival was longer in pathological responders (median not reached) vs nonresponders (19.8 mo.s) (p.03). Conclusions: In our study an optimal pathological response occurred in 51% of cases after 6 cycles of carboplatin-paclitaxel, doubling the results described in the literature with 3 courses of NACT. Given that an optimal pathological response correlates with a longer survival compared to a sub-optimal one, a randomized study of 6 vs 3 courses of NACT in order to verify if the increase in pathological response rate will translate into a survival benefit is warranted. No significant financial relationships to disclose.