tbuckley/cabot-search huggingface dataset:
Burnout and level of mental functioning in oncology staff.
Authors: Adelina Alcorta-Garza, Fernando Alcorta-Nuñez, Oscar Vidal-Gutiérrez, Juan Francisco Gonzalez-Guerrero, Antonio César Garza-Guerrero, Marco Vinicio Gómez-Meza, Ángel Enrique Alcorta-Garza
Journal: Journal of Clinical Oncology (2019)

10513 Background: The Burnout Syndrome takes relevance for its investigation since 1986, when Maslach developed a survey for its study with 3 subscales that include the symptoms generated by exhaustion and chronic labor stress. Health workers are especially vulnerable to the development of this syndrome, which is greater centers with exposure to patients with severe and/or chronic ailments. Thus, the mental structure maturity level with which the individual functions takes relevance, since it is linked to the quality of judgment of the clinician. Few studies consider this aspect because of the complexity of having the instruments and professionals to assess it. It has been questioned whether Burnout or this occupational exhaustion damages the quality of life of the individual, and if it also negatively impacts their work performance, and the quality of care provided to patients. Methods: Observational, cross-sectional and correlational study. It analyses the relationship between Burnout and the characteristics of the mental-structural functioning level in oncology staff, and its association with the level of functionality of the mental structures within the work environment. Prior validation of the instrument was conducted, FIAD-15, with acceptable Alpha of 0.81. Results: Data were obtained from 1,060 subjects, including administrative, nursing and medical members of the Oncology Service staff, as well as, students. Out of these, 1,036 subjects answered the questionnaire appropriately and were considered in the analysis. 413 (39.86%) presented Burnout. The prevalence was higher in men (45.17%) than in women (34.56%). A significant association was found between Burnout frequency and levels of mental functioning. On the functionality of the mental structures, 80% had functional, high and intermediate levels, while 20% of the total population showed a borderline level of functionality (severe). In women, Burnout frequency was higher in borderline levels, followed by those of functional and high level. In men, Burnout was higher in those at the borderline level, followed by functional and intermediate; it was much lower in high level subjects. Conclusions: The mental structure functionality levels found in the oncology staff are associated with Burnout; which is lower in men with structures with high functionality and in women in the intermediate level. Subjects with borderline structures suffer greater Burnout. Further studies should be carried out to support these findings in the future and open new lines of research.
Abstract 14907: Prognostic Role of Dobutamine Stress Contrast Echo in Patients With Known or Suspected Coronary Artery Disease in Different Age Groups and Its Additive Value Over Traditional Risk Factors
Authors: Constantina Aggeli, Ioannis Felekos, Polychronis Stergiou, Georges Roussakis, Stellios Kastellannos, Vasiliki Kakiouzi, Christodoulos Stefanadis
Journal: Circulation (2013)

Purpose: Dobutamine stress contrast echo (DSCE) has been successfully implemented in clinical practice for the assessment of coronary artery disease (CAD). The aim of this study was to evaluate the...
Ticagrelor or Prasugrel in Patients with Acute Coronary Syndromes
Authors: Stefanie Schüpke, Franz-Josef Neumann, Maurizio Menichelli, Katharina Mayer, Isabell Bernlochner, Jochen Wöhrle, Gert Richardt, Christoph Liebetrau, Bernhard Witzenbichler, David Antoniucci, Ibrahim Akin, Lorenz Bott-Flügel, Marcus Fischer, Ulf Landmesser, Hugo A. Katus, Dirk Sibbing, Melchior Seyfarth, Marion Janisch, Duino Boncompagni, Raphaela Hilz, Wolfgang Rottbauer, Rainer Okrojek, Helge Möllmann, Willibald Hochholzer, Angela Migliorini, Salvatore Cassese, Pasquale Mollo, Erion Xhepa, Sebastian Kufner, Axel Strehle, Stefan Leggewie, Abdelhakim Allali, Gjin Ndrepepa, Helmut Schühlen, Dominick J. Angiolillo, Christian W. Hamm, Alexander Hapfelmeier, Ralph Tölg, Dietmar Trenk, Heribert Schunkert, Karl-Ludwig Laugwitz, Adnan Kastrati
Journal: New England Journal of Medicine (2019)

The relative merits of ticagrelor as compared with prasugrel in patients with acute coronary syndromes for whom invasive evaluation is planned are uncertain.In this multicenter, randomized, open-label trial, we randomly assigned patients who presented with acute coronary syndromes and for whom invasive evaluation was planned to receive either ticagrelor or prasugrel. The primary end point was the composite of death, myocardial infarction, or stroke at 1 year. A major secondary end point (the safety end point) was bleeding.A total of 4018 patients underwent randomization. A primary end-point event occurred in 184 of 2012 patients (9.3%) in the ticagrelor group and in 137 of 2006 patients (6.9%) in the prasugrel group (hazard ratio, 1.36; 95% confidence interval [CI], 1.09 to 1.70; P = 0.006). The respective incidences of the individual components of the primary end point in the ticagrelor group and the prasugrel group were as follows: death, 4.5% and 3.7%; myocardial infarction, 4.8% and 3.0%; and stroke, 1.1% and 1.0%. Definite or probable stent thrombosis occurred in 1.3% of patients assigned to ticagrelor and 1.0% of patients assigned to prasugrel, and definite stent thrombosis occurred in 1.1% and 0.6%, respectively. Major bleeding (as defined by the Bleeding Academic Research Consortium scale) was observed in 5.4% of patients in the ticagrelor group and in 4.8% of patients in the prasugrel group (hazard ratio, 1.12; 95% CI, 0.83 to 1.51; P = 0.46).Among patients who presented with acute coronary syndromes with or without ST-segment elevation, the incidence of death, myocardial infarction, or stroke was significantly lower among those who received prasugrel than among those who received ticagrelor, and the incidence of major bleeding was not significantly different between the two groups. (Funded by the German Center for Cardiovascular Research and Deutsches Herzzentrum München; ISAR-REACT 5 ClinicalTrials.gov number, NCT01944800.).
Practicing What We Preach — Ending Physician Health Program Bans on Opioid-Agonist Therapy
Authors: Leo Beletsky, Sarah E. Wakeman, Kevin Fiscella
Journal: New England Journal of Medicine (2019)

Interview with Dr. Catherine Lucey on the identification and treatment of opioid use disorder in medical students. (09:38)Download Clinicians and their professional organizations have been at the vanguard of advancing the expansion of opioid-agonist therapy for opioid use disorder. It is therefore ironic that physician health programs often mandate abstinence-based models of treatment for OUD.
Targeting Glioblastoma Stem Cells through Disruption of the Circadian Clock
Authors: Zhen Dong, Guoxin Zhang, Meng Qu, Ryan C. Gimple, Qiulian Wu, Zhixin Qiu, Briana C. Prager, Xiuxing Wang, Leo J.Y. Kim, Andrew R. Morton, Deobrat Dixit, Wenchao Zhou, Haidong Huang, Bin Li, Zhe Zhu, Shideng Bao, Stephen C. Mack, Lukas Chavez, Steve A. Kay, Jeremy N. Rich
Journal: Cancer Discovery (2019)

Abstract Glioblastomas are highly lethal cancers, containing self-renewing glioblastoma stem cells (GSC). Here, we show that GSCs, differentiated glioblastoma cells (DGC), and nonmalignant brain cultures all displayed robust circadian rhythms, yet GSCs alone displayed exquisite dependence on core clock transcription factors, BMAL1 and CLOCK, for optimal cell growth. Downregulation of BMAL1 or CLOCK in GSCs induced cell-cycle arrest and apoptosis. Chromatin immunoprecipitation revealed that BMAL1 preferentially bound metabolic genes and was associated with active chromatin regions in GSCs compared with neural stem cells. Targeting BMAL1 or CLOCK attenuated mitochondrial metabolic function and reduced expression of tricarboxylic acid cycle enzymes. Small-molecule agonists of two independent BMAL1–CLOCK negative regulators, the cryptochromes and REV-ERBs, downregulated stem cell factors and reduced GSC growth. Combination of cryptochrome and REV-ERB agonists induced synergistic antitumor efficacy. Collectively, these findings show that GSCs co-opt circadian regulators beyond canonical circadian circuitry to promote stemness maintenance and metabolism, offering novel therapeutic paradigms. Significance: Cancer stem cells are highly malignant tumor-cell populations. We demonstrate that GSCs selectively depend on circadian regulators, with increased binding of the regulators in active chromatin regions promoting tumor metabolism. Supporting clinical relevance, pharmacologic targeting of circadian networks specifically disrupted cancer stem cell growth and self-renewal. This article is highlighted in the In This Issue feature, p. 1469
Failure of Dolutegravir First-Line ART with Selection of Virus Carrying R263K and G118R
Authors: Nadine Lübke, Björn Jensen, Falk Hüttig, Torsten Feldt, Andreas Walker, Alexander Thielen, Martin Däumer, Martin Obermeier, Rolf Kaiser, Elena Knops, Eva Heger, Saleta Sierra, Mark Oette, Thomas Lengauer, Jörg Timm, Dieter Häussinger
Journal: New England Journal of Medicine (2019)

Emergence of HIV-1 Resistance to Dolutegravir In this case report, the emergence of HIV-1 resistance to dolutegravir is identified early after the initiation of antiretroviral treatment.
Characterisation of clinical and immune reactivity to barley and rye ingestion in children with coeliac disease
Authors: Melinda Y Hardy, Amy K Russell, Catherine Pizzey, Claerwen M Jones, Katherine A Watson, Nicole L La Gruta, Donald J Cameron, Jason A Tye-Din
Journal: Gut (2019)

Barley and rye are major components of the Western diet, and historic feeding studies indicate that they cause clinical effects in patients with coeliac disease (CD). This toxicity has been attributed to sequence homology with immunogenic wheat sequences, but in adults with CD, these cereals stimulate unique T cells, indicating a critical contribution to gluten immunity independent of wheat. Clinical and immune feeding studies with these grains in children with CD are sparse. We undertook a barley and rye feeding study to characterise the clinical and T-cell responses in children with CD.42 children with human leucocyte antigen (HLA)-DQ2.5+ (aged 3-17 years) consumed barley or rye for 3 days. Blood-derived gluten-specific T cells were tested for reactivity against a panel of barley (hordein) and rye (secalin) peptides. Hordein and secalin-specific T-cell clones were generated and tested for grain cross-reactivity. T-cell receptor sequencing was performed on sorted single cells. T-cell responses were compared with those observed in adults with CD.90% of the children experienced adverse symptoms, mostly GI, and 61% had detectable gluten-specific T-cell responses targeting peptides homologous to those immunogenic in adults. Deamidation was important for peptide reactivity. Homozygosity for HLA-DQ2.5 predicted a stronger T-cell response. Gluten-specific T cells showed striking similarities in their cross-reactivity between children and adults.Barley and rye induce a consistent range of clinical and T-cell responses in children with CD. The findings highlight the importance of a series of dominant hordein and secalin peptides pathogenic in children with CD, some independent of wheat, which closely correspond to those seen in adults.
An Introduction to Pharmacognosy.
Journal: JAMA (1905)

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
Association of low P27 with loss of hormone receptors in small (T1a/b) breast cancers
Authors: J. Wu, D. Mirchandani, J. A. Smith, G. Inghirami, D. Roses, A. Zeleniuch-Jacquotte, F. Muggia
Journal: Journal of Clinical Oncology (2006)

624 Background: P27 kip1 is a nuclear protein that controls the cell cycle by inhibiting cyclin dependent kinases. In breast cancer cell lines, both estrogen and her-2/neu degrade p27 through the ubiquitin-proteasome pathway. T1N0M0 breast cancers with high p27 expression have excellent long-term survival (Loda et al, Cancer Research 1998), now we examine the association of low p27 and other prognostic factors in these patients. Methods: 122 T1N0M0 infiltrating ductal carcinoma were examined using immunohistochemistry. Specific monoclonal antibodies were used against estrogen receptor (ER), progesterone receptor (PR), Her-2/neu, p53 and p27. Percentage of cells stained were considered negative (or low for p27) if: ER &lt;10%, PR &lt;10%, p53&lt;40%, her-2/neu DAKO score ≤ 1+, p27 (nuclear stain) &lt;50%. Results: In T1a/bN0M0 tumors, 4/5 (80%) of low p27 tumors were also hormone receptor negative, while only 5/63 (8%) of the high p27 tumors were hormone receptor negative (P&lt; 0.001, Fisher’s exact test). Although T1cN0M0 tumors showed a similar trend [4/12 (33%) of low p27 vs. 7/42 (17%) of high p27 tumors were hormone receptor negative], the difference was not statistically significant. No correlation was seen between low p27, her-2/neu, or p53 mutation. Conclusion: There is an association of low p27 and loss of hormone receptors in T1a/bN0M0 breast cancers, which may identify a subset of patients with a worse prognosis. Exploring the causes of p27 dysregulation (e.g., ubiquitin ligase overexpression) may shed further light on the significance of these associations. [Table: see text] No significant financial relationships to disclose.
Influence of Baseline Disease Characteristics and Exposure to Obinutuzumab on Clinical Outcome in Patients with Previously Untreated Advanced Follicular Lymphoma Treated with Obinutuzumab-Based Immunochemotherapy in the GALLIUM Trial
Authors: Candice Jamois, Ekaterina Gibiansky, Leonid Gibiansky, Vincent Buchheit, Pauline Baumlin, Denis Sahin, Guillaume Cartron, Robert Marcus, Wolfgang Hiddemann, John F Seymour, Jonathan C Strefford, Georgina Meneses-Lorente, Nicolas Frey, Günter Fingerle-Rowson
Journal: Blood (2017)
Multimodality treatment combining chemotherapy, liver surgery, peritoneal resection and hyperthermic intraperitoneal chemotherapy (HIPEC) for metastatic colorectal cancer (mCRC) patients with synchronous liver metastases (LM) and peritoneal carcinomatosis (PC): A multicenter study of the French Association of Surgery.
Authors: Rea Lo Dico, Guillaume Passot, Dominique Elias, Gerard Lorimier, Francois Quenet, Marc Pocard
Journal: Journal of Clinical Oncology (2013)

e14534 Background: Pts with synchronous PC and LM are generally considered for exclusive systemic palliative chemotherapy only. Aggressive surgical approaches combining hepatectomy associated to peritoneal resection with curative intent remain controversial in such a setting and almost no data are available on such patients.The aim of this prospective cohort was to assess morbidity, mortality, disease-free survival (DFS) and overall survival (OS) of peritoneal and liver mCRC patients (pts) treated with an aggressive therapeutic approach combining surgical treatment of liver and peritoneal lesions followed by HIPEC. Methods: All patients registered in the French Association of Surgeryprospective database with PC and synchronous LM who had undergone cytoreductive surgery and LM resection followed by intraperitoneal chemotherapy were analysed. The primary endpoint was survival from the time of surgery. The following criteria were recorded and analyzed: sex, age, differentiation and localization of the primary tumor, lymph node involvement (pN+), peritoneal cancer index (PCI), completeness of cytoreduction of peritoneal carcinomatosis, number of associated liver metastases. Results: From 1993 to 2011, 101 pts with PC and LM were analyzed. After a mean follow-up of 25 months, the median OS and DFS, were respectively 24.9 and 9.5 months. Post-operative morbidity and mortality was 14.8 and 0%, respectively. In pts with a complete cytoreductive surgery OS was 29 months (n=), as compared to 4 months in pts (n=) with incomplete cytoreduction (p=0.0001). Rectal primary tumor, PCI of 13 or more, pN+ status, and more than 3 LM were not identified as independent factors for poor OS. Conclusions: This multicenter study confirms that prolonged survival can be achieved in selected patients suitable for PC and LM surgery if they underwent multimodality treatment including surgical treatment of PC and LM with curative intent, using intraperitoneal chemotherapy.
Leveraging European infrastructures to access 1 million human genomes by 2022
Authors: Gary Saunders, Michael Baudis, Regina Becker, Sergi Beltran, Christophe Béroud, Ewan Birney, Cath Brooksbank, Søren Brunak, Marc Van den Bulcke, Rachel Drysdale, Salvador Capella-Gutierrez, Paul Flicek, Francesco Florindi, Peter Goodhand, Ivo Gut, Jaap Heringa, Petr Holub, Jef Hooyberghs, Nick Juty, Thomas M. Keane, Jan O. Korbel, Ilkka Lappalainen, Brane Leskosek, Gert Matthijs, Michaela Th. Mayrhofer, Andres Metspalu, Arcadi Navarro, Steven Newhouse, Tommi Nyrönen, Angela Page, Bengt Persson, Aarno Palotie, Helen Parkinson, Jordi Rambla, David Salgado, Erik Steinfelder, Morris A. Swertz, Alfonso Valencia, Susheel Varma, Niklas Blomberg, Serena Scollen
Journal: Nature Reviews Genetics (2019)
Neoadjuvant chemoradiotherapy (NACRT) in patients with locally advanced rectal cancer (RC): Results of a phase I/II trial in Japan.
Authors: Takafumi Koyama, Daisuke Gomi, Ozaki Yukinori, Yoshiaki Nakamura, Masafumi Nagano, Makio Mike, Nobuyuki Kano, Yu Oyama
Journal: Journal of Clinical Oncology (2013)

e14670 Background: NACRT for patients with RC has been shown to increase the chance of sphincter preservation and local control, and has become the standard of care in stage T3/T4 rectal carcinoma in western countries. NACRT decreases the need for abdominoperineal resection (APR) that results in permanent colostomy and sexual/urinary dysfunction. In Japan, NACRT has not been utilized in RC and its value is unconfirmed. Thus, we performed a phase I/∥study to assess the toxicity and efficacy of NACRT. Methods: Eligibility criteria included histopathologically confirmed locally advanced adenocarcinoma with reasonable PS. Radiotherapy (RT) consisted of 5040 cGy in 28 fractions, and was delivered six times a week to the pelvis with individually shaped portals. Chemotherapy consisted of oral capecitabine (1650 mg/m2/day) or fluorouracil as a continuous infusion (225 mg/m2/day) on each RT day. Surgery was performed within 6-8 weeks after chemoradiation (CRT). Tumor response to CRT was measured using a radiologic scale, called the RECIST, and by pathologic examination of resected specimen. CTCAE v3.0 was used for evaluation of toxicity. Results: Fifty-two patients were enrolled in the study. Forty-nine (92%) patients completed CRT without treatment interruptions: 1 patient had temporary treatment interruption due to toxicity or noncompliance and 3 patienst had definitive treatment interruption. The incidence of Grade 3 lower gastrointestinal toxicity was only 9%. After NACRT, computed tomography showed that 14 patients had PR and 38 had SD. Resection was performed in 48 patients (low anterior resection in 34 and abdominoperineal resection in 14). Surgical resection resulted in R0 and R1 in 44 and 4 patients, respectively. At a median follow-up of 21.5 months (range: 4-69 months), local recurrence or tumor progression occurred in 2 patients and distant metastasis in 7. The median overall survival was 47 months. Conclusions: Our data confirm the safety and efficacy of NACRT using capecitabine/5FU in Japanese patients with locally ARC. We suggest that NACRT is the preferred treatment approach since it can provide increased resectabilility and possibly a superior rate of local control.
Transient elastography for screening of liver fibrosis: Cost-effectiveness analysis from six prospective cohorts in Europe and Asia
Authors: Miquel Serra-Burriel, Isabel Graupera, Pere Torán, Maja Thiele, Dominique Roulot, Vincent Wai-Sun Wong, Indra Neil Guha, Núria Fabrellas, Anita Arslanow, Carmen Expósito, Rosario Hernández, Grace Lai-Hung Wong, David Harman, Sarwa Darwish Murad, Aleksander Krag, Guillem Pera, Paolo Angeli, Peter Galle, Guruprasad P. Aithal, Llorenç Caballeria, Laurent Castera, Pere Ginès, Frank Lammert
Journal: Journal of Hepatology (2019)
Prognostic impact of immunohistochemically defined germinal center B-cell and nongerminal center B-cell subtypes of diffuse large B-cell lymphoma in rituximab era.
Authors: Yabing Cao, Ying Huang, Sheng Ye, Tongyu Lin
Journal: Journal of Clinical Oncology (2012)

e18517 Background: Diffuse large B-cell lymphoma (DLBCL) can be molecularly subtyped as either germinal center B-cell (GCB) or non-GCB. The role of rituximab(R) in these two groups remains unclear. Methods: We studied 204 patients with de novo DLBCL (107 treated with CHOP; 97 treated with R-CHOP); patients being stratified into GCB and non-GCB on the basis of BCL-6, CD10 and MUM1 protein expression. The relationships between clinical characteristics, survival data and immunophenotype were studied. Results: The median follow-up was 51months for CHOP group and 56 months for R-CHOP group. The 5-year overall survival (OS) in the CHOP and R-CHOP group was 50.4% and 66.6% (p=0.031), respectively. GCB patients had a better 5-year OS than non-GCB patients whether treated with CHOP (65.0% vs. 40.9%; p=0.011). In contrast, there’s no difference in the 5-year OS for the GCB and non-GCB with R-CHOP (76.5% vs. 61.3%; p=0.141). In non-GCB subtype, additional rituximab improved survival than CHOP (61.3% vs. 40.9%; p=0.0303). Conclusions: These results indicated that addition of rituximab to standard chemotherapy eliminate the prognostic value of immunohistochemically defined GCB and non-GCB phenotypes in DLBCL by improving the prognostic value of non-GCB subtype of DLBCL
Reply
Authors: Alexis Mathian, Suzanne Mouries‐Martin, Karim Dorgham, Hans Yssel, Zahir Amoura
Journal: Arthritis & Rheumatology (2019)

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