tbuckley/cabot-search huggingface dataset:
Impact of metformin on clinical outcomes among men with prostate cancer: A systematic review and meta-analysis.
Authors: Amit D Raval, Divyesh Thakker, Ami Vyas, Mohamad Salkini, Suresh Madhavan, Usha Sambamoorthi
Journal: Journal of Clinical Oncology (2015)

e16000 Background: Conflicting evidence exists regarding the beneficial effects of metformin in prostate cancer. Therefore, the current study was carried out to determine the association between metformin and clinical outcomes in prostate cancer using systematic review and meta-analysis. Methods: Original articles published in English until third week of July, 2014 were searched in electronic databases (Medline-Ovid, Scopus, The Cochrane Library, Web of Science, ProQuest) for studies on metformin use in prostate cancer. The clinical outcomes assessed were: development of biochemical recurrence, metastases or castration-resistant metastatic cancer (CRPC), all-cause and prostate cancer-specific mortality. Meta-analysis was performed to calculate the pooled hazard ratio (pHR) and their 95% confidence interval (95% CI). Heterogeneity between the studies was examined using I2 statistics. Sensitivity analysis was conducted to assess the robustness of findings and publication bias was assessed by the Egger's regression asymmetry test and contour plot. Results: Out of 230 retrieved citations, eight retrospective cohort studies and one nested-case-control study met the inclusion criteria. Metformin use was marginally associated with reduction in the risk of biochemical recurrence (pHR: 0.82, 95% CI: 0.67, 1.01, P-value = 0.06, I2 = 25%, 5 studies). Metformin use was not significantly associated with metastases (pHR: 0.59, 95% CI: 0.38-1.18, P-value = 0.14, I2 = 74%, 3 studies), all-cause mortality (pHR: 0.86; 95% CI, 0.65, 1.15, P-Value = 0.31, I2: 78%, 5 studies) and prostate cancer-specific mortality (pHR: 1.22, 95% CI: 0.58, 2.56, P-value = 0.60, I2 = 60%, 4 studies). Pooled estimates for all outcomes varied in sensitivity analysis by diabetes status and primary treatment of prostate cancer. Systematic review revealed mixed findings on metformin use and the risk of CRPC. Conclusions: Metformin may reduce the risk of biochemical recurrence in prostate cancer. Given the potential of selection-bias in the observational studies, randomized trials should be designed to assess the efficacy of metformin use in prostate cancer.
Undissected Axilla and Axillary Radiotherapy
Authors: Amit Goyal, Bruce Mann, Alastair Mark Thompson
Journal: JAMA Oncology (2019)

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 Oncology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Oncology journal
Fabrication of a Biocompatible Liquid Crystal Graphene Oxide–Gold Nanorods Electro‐ and Photoactive Interface for Cell Stimulation
Authors: Daniela Duc, Paul R. Stoddart, Sally L. McArthur, Robert M. I. Kapsa, Anita F. Quigley, Mitchell Boyd‐Moss, Simon E. Moulton
Journal: Advanced Healthcare Materials (2019)

Abstract For decades, electrode–tissue interfaces are pursued to establish electrical stimulation as a reliable means to control neuronal cells behavior. However, spreading of electrical currents in tissues limits its spatial precision. Thus, optical cues, such as near‐infrared (NIR) light, are explored as alternatives. Presently, NIR stimulation requires higher energy input than electrical methods despite introduction of light absorbers, e.g., gold nanoparticles. As potential solution, NIR and electrical costimulation are proposed but with limited interfaces capable of sustaining this stimulation technique. Here, a novel electroactive nanocomposite with photoactive properties in the NIR range is constructed by N ‐(3‐dimethylaminopropyl)‐ N ′‐ethylcarbodiimide hydrochloride/ N ‐hydroxysulfosuccinimide sodium (EDC)/NHS conjugation of liquid crystal graphene oxide (LCGO) to protein‐coated gold nanorods (AuNR). The liquid crystal graphene oxide–gold nanorod nanocomposite (LCGO–AuNR) is fabricated into a hydrophilic electrode‐coating via drop‐casting, making it appropriate for versatile electrode–tissue interface fabrication. UV–vis spectrophotometry results demonstrate that LCGO–AuNR presents an absorbance peak at 798 nm (NIR range). Cyclic voltammetry measurements further confirm its electroactive capacitive properties. Furthermore, LCGO–AuNR coating supports cell adhesion, proliferation, and differentiation of NG108‐15 neuronal cells. This biocompatible interface is anticipated, with ideal electrical and optical properties for NIR and electrical costimulation, to enable further development of the technique for energy‐efficient and precise neuronal cell modulation.
Preoperative radiotherapy for high-risk prostate cancer (PORT-PC) trial.
Authors: Himanshu Nagar, Silvia Formenti, Douglas Scherr, Jim C. Hu, Peter Schlegel, Josephine Kang, Brian D. Robinson, Francesca Khani, David M. Nanus, Scott T. Tagawa, Ana M. Molina, Bishoy Morris Faltas, Daniel Margolis, Christopher Barbieri
Journal: Journal of Clinical Oncology (2019)

TPS137 Background: Prostatectomy has become the most common treatment for high-risk prostate cancer. After prostatectomy, risk features for local recurrence include extra-capsular extension and/or seminal vesicle invasion (pT3 disease) and positive surgical margins. Post-operative radiotherapy is recommended for patients with pT3 disease, positive margins and/or Group Grade 4-5 and has been shown to reduce the risk of recurrence. In planning adjuvant radiotherapy, the clinical target volume is the prostate bed which is difficult to delineate once the prostate has been surgically removed and can be overestimated by following the location of surgical clips. As such, controversy exists as to the optimal target volume. Guidelines suggest including a significant portion of the posterior and inferior aspects of the bladder, and anterior aspect of the rectum exposing a significant amount of normal tissue to high dose radiation. Pre-operative radiotherapy potentially offers the following advantages: 1) reduced radiation dose to normal tissues; 2) ability to utilize stereotactic body radiotherapy (SBRT) with real-time MRI guidance 3) patient convenience with less fractions and 4) radiobiologic advantage of high dose per fraction treatment delivery. Methods: This is a modified dose escalation trial for patients with high-risk prostate cancer defined as cT3 on MRI or Group Grade 4-5 disease. Patients will sequentially undergo 1) placement of a rectal SpaceOAR, 2) SBRT on the ViewRay MRIdian linear accelerator and 3) prostatectomy. As a modified dose escalation study, patients will be accrued starting at 5 Gy x 5 (up to 8 Gy x 5) with 3 patients per cohort with Grade 4 or 5 gastrointestinal (GI) and/or genitourinary (GU) adverse event related to preoperative radiotherapy as an unacceptable dose limiting toxicity.The primary endpoint is that a patient can undergo a radical prostatectomy after SBRT without a post-operative GI or GU grade 4 or 5 toxicity within 30 days related to preoperative radiotherapy. Secondary objectives include assessment of acute toxicity and quality of life scores. Exploratory analyses include analysis of tumor and normal biopsied and resected tissue and serum markers and interpretation of pre- and post-SBRT MRIs. Clinical trial information: NCT03663218.
Doctors of a Certain Age
Authors: Vincent Quagliarello
Journal: Annals of Internal Medicine (2019)

On Being a Doctor19 March 2019Doctors of a Certain AgeVincent Quagliarello, MDVincent Quagliarello, MDYale University School of Medicine, New Haven, Connecticut (V.Q.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-2883 Audio Reading - “Doctors of a Certain Age” Audio. Michael A. Lacombe, MD, Annals Associate Editor, reads “Doctors of a Certain Age” by Vincent Quagliarello, MD Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail You know who we are, but you don't really know us. We're old physicians now—advancing into our fourth, fifth, or sixth decade of doctoring—and you see us everywhere. We grew up in a different environment, with different priorities, but we recognize that evolution happens for a reason. You hear us talk about our experiences, but often just the ones we want you to know about.You hear us talk about how we learned medicine before electronic health records. Before smartphones, e-mail, the Internet. About how we looked up literature in the medical library, photocopied papers, and read them. Most of ... Author, Article, and Disclosure InformationAffiliations: Yale University School of Medicine, New Haven, Connecticut (V.Q.)Corresponding Author: Vincent Quagliarello, MD, Department of Internal Medicine, PO Box 208056, Yale University School of Medicine, New Haven, CT 06520-8056; e-mail, vincent.[email protected]edu. PreviousarticleNextarticle Advertisement Audio Reading - “Doctors of a Certain Age” Audio. Michael A. Lacombe, MD, Annals Associate Editor, reads “Doctors of a Certain Age” by Vincent Quagliarello, MD Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 19 March 2019Volume 170, Issue 6Page: 418-419KeywordsBloodElectronic medical recordsOilsPatientsPsychiatry and mental healthRadiologistsResearch laboratoriesResidencySafetyUrine ePublished: 19 March 2019 Issue Published: 19 March 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Abstract P018: Smoking and Cognitive Decline at Older Age: Using Surveillance and Imputation to Deal With Differential Mortality
Authors: Aozhou Wu, A. R Sharrett, Jennifer A Deal, Karen Bandeen-Roche, Andreea Rawlings, Melinda C Power, Alden L Gross, David Couper, Michael Griswold, Thomas Mosley, Rebecca F Gottesman, Josef Coresh
Journal: Circulation (2019)

Background: Smoking is a risk factor for vascular diseases and likely associated with cognitive decline. However, observed associations may be impacted by higher cohort attrition, particularly mortality, among smokers. We incorporated surveillance data between visits using multiple imputation by chained equations (MICE) and assumed the Missing At Random mechanism in missing cognitive function. We assessed the impact of addressing the influence of differential visit attendance driven by mortality on the association of smoking with cognitive decline. Methods: We studied 4,960 participants in Atherosclerosis Risk in Communities (ARIC) Neurocognitive Study, who were free from dementia at baseline (2011-2013) with cognitive batteries at baseline and follow-up (2016-2017, N = 3,078). Cognitive decline was measured as change in standardized global cognitive factor scores. Self-reported smoking was collected at previous visits (1987-1998) and annual follow-up interviews (1998 to 2011) of the ARIC study, and pack years were estimated. We used baseline factor scores, dementia risk factors, and cognitive function screening at annual follow-ups and dementia surveillance information after baseline to impute missing factor scores. Cognitive decline was analyzed using linear regression on both complete data and using MICE. Results: Participants had a mean age of 75.7 (SD: 5.1) at the index visit. 59.6% (2956 of 4960) were female and 18.6% (921 of 4960) were African American. Smoking ≥25 pack-years prior to baseline was associated with moderately lower visit attendance and higher mortality at older age. The association of smoking with cognitive decline was stronger after addressing differential attrition driven by mortality using MICE for smoking ≥25 pack-years, with two-fold increase in the effect size (Table 1). Conclusions: Smoking, particularly of longer duration and intensity, is a risk factor for cognitive decline, with larger effect size when dealing with the differentially higher mortality among heavier smokers.
Dampness, mould, onset and remission of adult respiratory symptoms, asthma and rhinitis
Authors: Juan Wang, Mihkel Pindus, Christer Janson, Torben Sigsgaard, Jeong-Lim Kim, Mathias Holm, Johan Sommar, Hans Orru, Thorarinn Gislason, Ane Johannessen, Randi J. Bertelsen, Dan Norbäck
Journal: European Respiratory Journal (2019)

Study question Is dampness and indoor mould associated with onset and remission of respiratory symptoms, asthma and rhinitis among adults? Materials and methods Associations between dampness, mould and mould odour at home and at work and respiratory health were investigated in a cohort of 11 506 adults from Iceland, Norway, Sweden, Denmark and Estonia. They answered a questionnaire at baseline and 10 years later, with questions on respiratory health, home and work environment. Results Baseline water damage, floor dampness, mould and mould odour at home were associated with onset of respiratory symptoms and asthma (OR 1.23–2.24). Dampness at home during follow-up was associated with onset of respiratory symptoms, asthma and rhinitis (OR 1.21–1.52). Dampness at work during follow-up was associated with onset of respiratory symptoms, asthma and rhinitis (OR 1.31–1.50). Combined dampness at home and at work increased the risk of onset of respiratory symptoms and rhinitis. Dampness and mould at home and at work decreased remission of respiratory symptoms and rhinitis. The answer to the question Dampness and mould at home and at work can increase onset of respiratory symptoms, asthma and rhinitis, and decrease remission.
Thyroidectomy Versus Medical Management for Euthyroid Patients With Hashimoto Disease and Persisting Symptoms
Authors: Ivar Guldvog, Laurens Cornelus Reitsma, Lene Johnsen, Andromeda Lauzike, Charlotte Gibbs, Eivind Carlsen, Tone Hoel Lende, Jon Kristian Narvestad, Roald Omdal, Jan Terje Kvaløy, Geir Hoff, Tomm Bernklev, Håvard Søiland
Journal: Annals of Internal Medicine (2019)

Hashimoto disease is a chronic autoimmune thyroiditis. Despite adequate hormone substitution, some patients have persistent symptoms that may be the result of immunologic pathophysiology.To determine whether thyroidectomy improves symptoms in patients with Hashimoto thyroiditis who still have symptoms despite having normal thyroid gland function while receiving medical therapy.Randomized trial. (ClinicalTrials.gov: NCT02319538).Secondary care hospital in Norway.150 patients aged 18 to 79 years with persistent Hashimoto-related symptoms despite euthyroid status while receiving hormone replacement therapy and with serum antithyroid peroxidase (anti-TPO) antibody titers greater than 1000 IU/mL.Total thyroidectomy or medical management with hormone substitution to secure euthyroid status in both groups.The primary outcome was general health score on the Short Form-36 Health Survey (SF-36) at 18 months. Secondary outcomes were adverse effects of surgery, the other 7 SF-36 subscores, fatigue questionnaire scores, and serum anti-TPO antibody titers at 6, 12, and 18 months.During follow-up, only the surgical group demonstrated improvement: Mean general health score increased from 38 to 64 points, for a between-group difference of 29 points (95% CI, 22 to 35 points) at 18 months. Fatigue score decreased from 23 to 14 points, for a between-group difference of 9.3 points (CI, 7.4 to 11.2 points). Chronic fatigue frequency decreased from 82% to 35%, for a between-group difference of 39 percentage points (CI, 23 to 53 percentage points). Median serum anti-TPO antibody titers decreased from 2232 to 152 IU/mL, for a between-group difference of 1148 IU/mL (CI, 1080 to 1304 IU/mL). In multivariable regression analyses, the adjusted treatment effects remained similar to the unadjusted effects.Results are applicable only to a subgroup of patients with Hashimoto disease, and follow-up was limited to 18 months.Total thyroidectomy improved health-related quality of life and fatigue, whereas medical therapy did not. This improvement, along with concomitant elimination of serum anti-TPO antibodies, may elucidate disease mechanisms.Telemark Hospital.
Abstract P334: Effectiveness of a Questionnaire-based Survey in Improving Awareness of Rheumatic Heart Disease Among School-aged Children in India
Authors: Madhab Ray, Santanu Guha, Meghna Ray, Avik Karak, Basabendra Choudhury, Haroon Zubair, Bipasha Ray, Dakshin Gangadharamurthy, Prakash C Hazra, Santanu Goswami, Tara O’Meara, Eion Kelly, Harry P Selker, Robert Goldberg, Deepak L Bhatt
Journal: Circulation (2019)

Background: Rheumatic heart disease (RHD) is prevalent in low income countries, with a regional prevalence in South Asia of 2.2 per 1,000 children aged 10-16 years. Awareness among school children is very important for seeking effective secondary prophylaxis. We studied the current level of awareness in school-aged children and evaluated the effect of a 7-item questionnaire-based survey in improving awareness of RHD. The study was conducted in a rural district of India in August, 2017. The objectives were to assess the level of awareness of RHD and to evaluate the effect of a questionnaire-based survey in improving awareness. Methods: The study involved 8,646 students in the age group 10-16 years from 20 schools in Midnapore, India. We carried out a pre-test questionnaire survey, a multimedia presentation on RHD, and a post-test survey that assessed students’ knowledge and awareness of its incidence and prevalence, symptoms and signs, morbidity and mortality, ways to prevent and/or reduce the disease burden, and when to seek medical attention. The data were analyzed to evaluate improvement in the level of awareness by this intervention using a 29-point scoring system in 7 domains. Regression analysis was performed to identify the factors that may enhance awareness. Results: Awareness among the school children (mean age 13, 45% boys) was modest. There was a significant improvement in their knowledge after the intervention with the survey questionnaire and the presentation by the study team (Table). Regression analysis showed female sex and higher grade in school were major determinants for improvement of the knowledge level by this intervention (p &lt; 0.05 without any significant interaction noted between sex and grades in school). Conclusions: Current awareness among children about RHD is modest. A school-based intervention by administration of a survey questionnaire and presentation can help in improving the awareness about RHD and hopefully promote secondary prophylaxis to reduce the morbidity and mortality from the disease.
Hubert Sidney Sims Ryan
Authors: John Ryan
Journal: BMJ (2019)

Hubert Sidney Sims Ryan (“Hugh”) was born at Gilfach, Glamorgan, to Sydney and Alice Ryan. The family moved to Brynmawr where Hugh spent his early childhood, until the age of 8, which he remembered fondly. Then his family moved to Newport, where he spent his later childhood which he did not remember so fondly, especially his schooling. He left school at age 15.

His first job was as a clerk in Cambrian Brewery, Newport, which was owned by Lloyds and Yorath. He then became a telephone engineer with the Post Office.

When the second world war broke out he joined the Royal Air Force at age 20, as a wireless operator. He then became a navigator and flight …
Prevalence and race-based differences of suspected inherited renal cell cancer: Implications for genetic counseling referral and cancer susceptibility syndrome testing from a 10-year institutional experience.
Authors: Veda N. Giri, Hong Truong, Edouard John Trabulsi, William Kevin Kelly, Costas D. Lallas, Leonard G. Gomella
Journal: Journal of Clinical Oncology (2015)

e15606 Background: To gain insight into the scope of patients who may warrant genetic counseling and genetic testing for inherited renal cell cancer (RCC), we evaluated the overall prevalence of suspected inherited RCC based on recent consensus criteria and explored race-based differences in specific referral criteria from a 10-year institutional experience. Methods: We analyzed cancer registry data from 1133 patients (20.1% African American [AA], 76.3% white [Wh], and 3.6% others) who were diagnosed with RCC at our institution from 2004 to 2013. Consensus criteria from the American College of Medical Genetics and Genomics and National Society of Genetic Counselors were used to identify patients with suspected inherited RCC. Referral criteria included clear cell RCC diagnosed at age < 50 or papillary RCC (type I or type II). Since early onset RCC is increasingly being recognized as an independent indication of hereditary RCC, this was also evaluated and was defined broadly in our study as age at diagnosis < 50. Results: Overall, 22% of patients met criteria for referral for genetic counseling. More AA patients met referral criteria than Wh patients (29% vs. 20%, p = 0.004). AA patients were three times more likely than Wh patients to present with papillary RCC (15% vs. 5%, p < 0.001). However, Wh patients had significantly higher rates of early onset clear cell RCC (56% vs. 33%, p = 0.004 ). In the overall cohort, 19% had early onset RCC, with proportionally more AA than Wh patients (24% vs. 17%, p = 0.02). Conclusions: 1 in 5 RCC patients warrant referral for genetic evaluation for inherited cancer risk. Race-based differences may exist in referral indications for genetic counseling, which has implications for identifying potential underlying hereditary cancer syndromes.