tbuckley/cabot-search huggingface dataset:
Etiologic agents in 54 consecutive febrile neutropenia (FN) isolates in a general hospital in Medellín, Colombia.
Authors: Carlos Alberto Betancur, Mauricio Lema, Giovanna Arcila
Journal: Journal of Clinical Oncology (2012)

e19604 Background: The etiology of FN is well established in the US and the EU. Less is known about it in Colombia. This cohort attempts to fill this void. Methods: We collected prospectively the information on all FN cases with an established etiology that were admitted to the Clínica SOMA (A 160 bed-facility in Medellín, Colombia) from September 2010 to October 2011. FN was defined as the coexistence of an absolute neutrophile count (ANC) &lt;500 and a temperature &gt;38.3 degrees Celsius following cytotoxic chemotherapy for cancer. Results: Fifty four cases of FN with known etiology were found. Twenty four in males and 30 in females. Age range from 16 to 73 years-old (median: 42). Acute lymphoblastic leukemia was the underlying diagnosis in 16 (30%), acute myelogenous leukemia in 13 (24% ), and non-Hodgkin’s lymphoma in 11 (20%). HyperCVAD (with o without rituximab), IdaFlag, bortezomib and HiDAC account for 17 (31%), 12 (22%), 7 (13%), and 5 (9%) cases, respectively. FN occurred 2 to 32 days after chemotherapy (average of 10 days). In 20 (37%) cases ANC on admission was 0, and the average ANC on admission was 120. In 51 cases germs were isolated in the blood (94%). Gram-negative bacilli were isolated in 38 cases (76%), S. aureus in 4 (7%), Candidemia was established in 4 patients (2 with C. krusei and 2 with C. parapsilosis). Pulmonary aspergillosis was established in one case. Of note, two cases of hospital-acquired Legionella pneumophila were found (Table). All patients recovered to non-neutropenic ANC with resolution of the infections. No deaths due to FN occurred in this group of patients. Conclusions: In this cohort from Colombia we found a large predominance of gram-negative bacilli and the isolation of L. Pneumophilla, an unusual pathogen in FN. This pattern differs from the usual germ mix reported in other series. [Table: see text]
A Study of Illness in a Group of Cleveland Families
Authors: Lois P. McCorkle, Richard G. Hodges, George F. Badger, John H. Dingle, William S. Jordan
Journal: New England Journal of Medicine (1955)

THE question of whether or not an excessively large number of common respiratory infections, chiefly "common colds," in a child constitutes an indication for tonsillectomy continues to receive a variety of answers.1 2 3 4 5 Most recent lists of indications, however, do not include the frequent occurrence of common respiratory diseases per se as a major or primary indication for this operation.2 , 3 The closely related question of whether or not a reduction in the incidence of common upper respiratory infections may be expected after tonsillectomy has been given considerable attention. The answer has been sought in several ways, including follow-up studies of patients . . .
Trends in Cough and Cold Medicine Recommendations for Children in the United States, 2002-2015
Authors: Daniel B. Horton, Tobias Gerhard, Brian L. Strom
Journal: JAMA Pediatrics (2019)

diary-estimated total sleep time was now associated with melatonin use.Discussion | This study estimated a prevalence of 6% of melatonin use in school-aged children, indicating that 1 in 17 children is likely to take melatonin at least once a week.This is despite the unknown effects of the use of melatonin in children. 1 We found that caregiver-and child-reported sleep problems and sleep diary-reported shorter total sleep time were associated with melatonin use.The most likely explanation for our findings is that perceived poor sleep is an indication for melatonin use.Indeed, a previous study indicates that parents administer over-the-counter melatonin in 12-year-old children to improve sleep problems. 1However, melatonin is often taken without prescription or good advice on dosage and timing of administration.If melatonin is taken wrongly, for example by administering it shortly before bedtime, it can actually worsen sleep. 6However, the current study is cross sectional, precluding any inference about temporality.The use of melatonin in school-aged children is common, although potentially harmful effects of melatonin use in children are unknown.Longitudinal and well-controlled studies are urgently needed to identify the effectiveness and potential negative consequences of melatonin use in children.This would provide the evidence to formulate clinical guidelines for the indication and dosage of melatonin in children, which is pressing issue as melatonin is currently freely available.
A prospective phase II study of induction chemotherapy and nimotuzumab for resectable locally advanced head and neck squamous cell carcinoma.
Authors: Xiaoying Zhao, Ye Guo, Yongxue Zhu, Yu Wang, Guopei Zhu, Chaosu Hu, Qinghai Ji
Journal: Journal of Clinical Oncology (2012)

e16039 Background: We incorporated nimotuzumab, a humanized monoclonal antibody against the epidermal growth factor receptor (EGFR), into the induction chemotherapy for resectable locally advanced head and neck squamous cell carcinoma (LAHNSCC), aiming to evaluate the efficacy and toxicity of this novel combination. Methods: In this single-institute, prospective phase II study, patients with histologically confirmed and potentially resectable (T2-4, N0-3, M0) LAHNSCC were treated with induction therapy of nimotuzumab (400 mg day 1, cisplatin 75 mg/m² day 1, and 5-FU 750 mg/m² days 1-5) for 2 cycles. Radical surgery or radiotherapy/chemoradiotherapy was used as subsequent local therapy. The primary endpoints were overall response rate and pathological complete response (pCR). Results: Of 40 enrolled patients, 25 had stage IV disease and 20 had N2-3 node involvement. The most common tumor primary was hypopharynx (40%) and 9 patients had an oropharyngeal carcinoma. After induction therapy, the overall response rate was 87.2% and 24 patients got a T or N downstage. Twenty-seven patients underwent radical surgery and pCR was found in 4 patients (14.8%). After surgery, 25 patients received adjuvant radiotherapy or chemoradiatherapy depending on the risk factors. For responding patients after induction, radiotherapy, usually concurrently combined with high-dose cisplatin was given to 12 patients as local therapy with a median dose of 60 Gy. One patient with stable disease after induction refused surgery and was treated with second-line chemotherapy in an attempt to pursue organ-preservation. There were no more than 10% of grade 3/4 toxicities induced by induction therapy. Only one patient experienced with mild rash. One patients developed grade 2 renal dysfunction after first cycle and chose immediate surgery. With a median follow-up time of 13.9 months (3.8-29.9), 1-year progression-free and overall survival rate were 80% and 83.3%, respectively. Conclusions: For resectable LAHNSCC, nimotuzumab plus chemotherapy as an induction therapy is highly effective with tolerable toxicities.
Cluster of <i>Sphingomonas paucimobilis</i> Bacteremias Linked to Diversion of Intravenous Hydromorphone
Authors: Jillianna Wasiura, Brahm H Segal, Katherine M Mullin
Journal: New England Journal of Medicine (2019)

Sphingomonas Outbreak from Tap Water–Diluted Opiate A cluster of cases of Sphingomonas paucimobilis bacteremia was discovered, and the bacteremias were noted to be caused by intravenous administrat...
Approaching individualized care with a clinical tissue proteomics methodology.
Authors: Donald Joseph Johann, Sumana Mukherjee, DaRue Prieto, Josip Blonder
Journal: Journal of Clinical Oncology (2013)

e22180 Background: The vast majority of therapy plans for cancer patients are derived categorically. Currently, large and time lengthy clinical trials supply the oncology community with aggregate population and survival statistics. Although this approach has been successful there are known shortfalls. More specifically, since the inherent molecular heterogeneity of the solid tumor under study has not been examined, it is not surprising that results may vary widely across individual patients. Therefore, what is needed is a rationally-based molecular profiling of an individual patient's tumor, in a timely manner. The aim is to link the best drug(s) to the individual patient's cancer based on objective molecular data, thus maximizing therapeutic efficacy and minimizing toxicity. Methods: Presented is a new form of a protein-based molecular profiling approach developed utilizing LC/MS-MS. Importantly, this method has the same tissue and time requirements as IHC. A total of 30 breast tumors and 10 normal breast samples were analyzed. Tumors consisted of 10 ER+, 10 HER2+, and 10 triple negative. Custom software was developed. First, to better illustrate the molecular circuitry of the tumor, proteomic data was rendered as a virtual wiring diagram. This was done on a per tumor basis thus graphically illustrating the molecular traffic intensities. Second, computationally deriving a numeric similarity score to allow for easier comparison of molecular circuitry. Results: Biologically relevant proteins (p53, ER, HER2, Ki67) including driver oncoproteins were found. Effective molecular profiling of breast cancer at the protein level was achieved and the established clinical tumor subtypes were discriminated by unsupervised clustering. A visualized simulation of an estrogen carcinogenesis network was also developed. Experimentally identified proteins and expression levels were mapped and objectified onto known cancer pathways contained in the network. Conclusions: Since the tissue quantity and time requirements are the same as IHC the approach is clinically practical. The approach is discovery based and complementary to IHC but is not dependent on antibodies. This method shows promise as a research tool in a clinical trial.
The ABCD-10 Risk Prediction Model for In-Hospital Mortality Among Patients With Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis
Authors: Ashar Dhana, Rannakoe Lehloenya
Journal: JAMA Dermatology (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 Dermatology 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 Dermatology journal
Advancing cancer care and prevention in the Caribbean: a survey of strategies for the region
Authors: Dingle Spence, M Austin Argentieri, Glennis Andall-Brereton, Benjamin O Anderson, Catherine Duggan, Curt Bodkyn, Freddie Bray, Tracey Gibson, Wendy Gomez Garcia, Natalie Greaves, Sumit Gupta, Virginia Hobday, Felicia McLean, Les Mery, Marisa Nimrod, Oscar Ocho, Corrine Sin Quee-Brown, Guillermo Tortolero-Luna, Alexandra E Shields
Journal: The Lancet Oncology (2019)
TFEB Mediates Immune Evasion and Resistance to mTOR Inhibition of Renal Cell Carcinoma via Induction of PD-L1
Authors: Cai Zhang, Yaqi Duan, Minghui Xia, Yuting Dong, Yufei Chen, Lu Zheng, Shuaishuai Chai, Qian Zhang, Zhengping Wei, Na Liu, Jing Wang, Chaoyang Sun, Zhaohui Tang, Xiang Cheng, Jie Wu, Guoping Wang, Fang Zheng, Arian Laurence, Bing Li, Xiang-Ping Yang
Journal: Clinical Cancer Research (2019)

Despite the FDA approval of mTOR inhibitors (mTORi) for the treatment of renal cell carcinoma (RCC), the benefits are relatively modest and the few responders usually develop resistance. We investigated whether the resistance to mTORi is due to upregulation of PD-L1 and the underlying molecular mechanism.The effects of transcription factor EB (TFEB) on RCC proliferation, apoptosis, and migration were evaluated. Correlation of TFEB with PD-L1 expression, as well as effects of mTOR inhibition on TFEB and PD-L1 expression, was assessed in human primary clear cell RCCs. The regulation of TFEB on PD-L1 was assessed by chromatin immunoprecipitation and luciferase reporter assay. The therapeutic efficacies of mTORi plus PD-L1 blockade were evaluated in a mouse model. The function of tumor-infiltrating CD8+ T cells was analyzed by flow cytometry.TFEB did not affect tumor cell proliferation, apoptosis, and migration. We found a positive correlation between TFEB and PD-L1 expression in RCC tumor tissues, primary tumor cells, and RCC cells. TFEB bound to PD-L1 promoter in RCCs and inhibition of mTOR led to enhanced TFEB nuclear translocation and PD-L1 expression. Simultaneous inhibition of mTOR and blockade of PD-L1 enhanced CD8+ cytolytic function and tumor suppression in a xenografted mouse model of RCC.These data revealed that TFEB mediates resistance to mTOR inhibition via induction of PD-L1 in human primary RCC tumors, RCC cells, and murine xenograft model. Our data provide a strong rationale to target mTOR and PD-L1 jointly as a novel immunotherapeutic approach for RCC treatment.
Artificial intelligence, complex system analysis and simulation modeling in recognition of N1–2 lymph node metastases of non-small cell lung cancer
Authors: O. Kshivets
Journal: Journal of Clinical Oncology (2006)

17123 Background: Precise recognition of N1–2 lymph node metastases (RLN) of non-small cell lung cancer (LC) means great importance in prediction LC patients (LCP) survival after surgery. We examined the immunologic factors associated with LCP with N0 and N1–2. Methods: In trial (1987–2005) the data of consecutive 289 LCP after complete pneumonectomies/lobectomies and mediastinal lymph node dissection (age = 58.1 ± 0.5 years; tumor size = 4.4 ± 0.1 cm; m = 260, f = 29) with pathologic stage I-III (T1–4N0–2M0) (squamous = 169, adenocarcinoma = 102, large cell = 18; G1 = 67, G2 = 110, G3 = 112; T1 = 100, T2 = 114, T3 = 54, T4 = 21; N0 = 147, N1 = 70, N2 = 72; pneumonectomies = 135, bi/lobectomies = 154) was reviewed. Variables selected for ED study were input levels of 64 immunity blood parameters, sex, age. Representativeness of samplings was reached by means of randomisation based on unrepeated random selection. Logistic regression, clustering, discriminant analysis, neural networks computing, structural equation modeling, Monte Carlo and bootstrap simulation were used to determine any significant regularity. Results: Logistic regression modeling displayed that RLN of LC significantly depended on: CDw26, CD16, phagocytic number, ratio of lymphocytes, T-lymphocytes, CD4+2H to LC cells (P = 0.003–0.043). Neural networks computing, genetic algorithm selection and bootstrap simulation revealed relationships between N1–2 and blood IgM (rank = 1), eosinophils (2), T-lymphocytes (3), CD8 (4), phagocytic number (5), CD8+VV (6), CDw26 (7), B-lymphocytes (8), IS2 (9), CD4 (10), CD4+2H (11), NST-A2 (12), monocytes (13), index of thymus function (14), IgA (15). Conclusions: Correct RLN of LC was 79.2% by logistic regression (odds ratio = 15.65), 82.0% by discriminant analysis and 99.6% by neural networks computing (area under ROC curve = 0.99; error = 0.059). No significant financial relationships to disclose.
Therapeutics of Infancy and Childhood.
Journal: JAMA (1903)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Association of<i>US News &amp; World Report</i>Top Ranking for Gastroenterology and Gastrointestinal Operation With Patient Outcomes in Abdominal Procedures
Authors: Sahil Gambhir, Shaun Daly, Areg Grigorian, Sarath Sujtha-Bhaskar, Colette S. Inaba, Marcelo W. Hinojosa, Brian R. Smith, Ninh T. Nguyen
Journal: JAMA Surgery (2019)

<h3>Importance</h3> The<i>US News &amp; World Report</i>(<i>USNWR</i>) annual ranking of the best hospitals for gastroenterology and gastrointestinal operations provides guidance and referral of care for medical and surgical gastrointestinal conditions. <h3>Objective</h3> To investigate whether<i>USNWR</i>top-ranked hospitals for gastroenterology and gastrointestinal surgical procedures are associated with improvements in patient outcomes, compared with nonranked hospitals, in common advanced laparoscopic abdominal operations. <h3>Design, Setting, and Participants</h3> This study used the Vizient database, which contains administrative, clinical, and financial inpatient information of index hospitalizations for US academic centers and their affiliated hospitals that are members of Vizient. Data were obtained on advanced laparoscopic abdominal operations performed from January 1, 2017, through December 31, 2017, at<i>USNWR</i>top-ranked hospitals (n = 16 296 operations) and nonranked hospitals (n = 35 573 operations). Abdominal operations included bariatric, colorectal, and hiatal hernia procedures. Operations on patients younger than 18 years, emergent cases, conversion cases, and patients with extreme severity of illness were excluded. <h3>Main Outcomes and Measures</h3> Outcome measures included in-hospital mortality, mortality index (observed to expected mortality ratio), serious morbidity, length of stay, and cost. <h3>Results</h3> A total of 51 869 advanced laparoscopic abdominal operations were performed at 351 academic health centers and their community affiliates. Of these procedures, 16 296 (31.4%) were performed at 41 top-ranked hospitals and 35 573 (68.6%) at 310 nonranked hospitals. The annual case volume at top-ranked hospitals was 397 compared with 114 at nonranked hospitals. Between top-ranked and nonranked hospitals, no significant differences were found in in-hospital mortality (0.04% vs 0.07%;<i>P</i> = .33) or serious morbidity (1.06% vs 1.02%;<i>P</i> = .75). Compared with nonranked hospitals, advanced laparoscopic abdominal operations performed at top-ranked hospitals had higher mean costs ($7128 [$4917] vs $7742 [$6787];<i>P</i> &lt; .01) and longer mean lengths of stay (2.38 [2.60] days vs 2.73 [3.31] days;<i>P</i> &lt; .01). <h3>Conclusions and Relevance</h3> Although, among academic centers, the annual volume of advanced laparoscopic abdominal operations was 3-fold higher for<i>USNWR</i>top-ranked hospitals compared with nonranked hospitals, the volume did not appear to be associated with improved patient outcomes.
Local Pulse Wave Velocity: Theory, Methods, Advancements, and Clinical Applications
Authors: P. M. Nabeel, V. Raj Kiran, Jayaraj Joseph, V. V. Abhidev, Mohanasankar Sivaprakasam
Journal: IEEE Reviews in Biomedical Engineering (2019)

Local pulse wave velocity (PWV) is evolving as one of the important determinants of arterial hemodynamics, localized vessel stiffening associated with several pathologies, and a host of other cardiovascular events. Although PWV was introduced over a century ago, only in recent decades, due to various technological advancements, has emphasis been directed toward its measurement from a single arterial section or from piecewise segments of a target arterial section. This emerging worldwide trend in the exploration of instrumental solutions for local PWV measurement has produced several invasive and noninvasive methods. As of yet, however, a univocal opinion on the ideal measurement method has not emerged. Neither have there been extensive comparative studies on the accuracy of the available methods. Recognizing this reality, makes apparent the need to establish guideline-recommended standards for the measurement methods and reference values, without which clinical application cannot be pursued. This paper enumerates all major local PWV measurement methods while pinpointing their salient methodological considerations and emphasizing the necessity of global standardization. Further, a summary of the advancements in measuring modalities and clinical applications is provided. Additionally, a detailed discussion on the minimally explored concept of incremental local PWV is presented along with suggestions of future research questions.
Barriers to enrollment of patients with recurrent diffuse large B-cell lymphoma (DLBCL) in clinical trials.
Authors: Ashley Marton, Sarit E. Assouline, Abbas Kezouh
Journal: Journal of Clinical Oncology (2013)

e19520 Background: Research into novel therapies for relapsed/refractory DLBCL may be hindered by the perception these patients are difficult to capture in clinical trials. We performed a retrospective analysis of all DLBCL at our institution from 01/2006 to 03/2012 to identify hurdles to trial enrolment. Methods: All DLBCL cases were identified through the hospital tumor registry. Patients were included in the analysis if they had any diagnosis of DLBCL relapsed or refractory to standard therapy. Baseline demographic and clinical characteristics, details of treatment, responses, relapse, evaluation for clinical trials and participation in clinical trials were determined by review of hospital charts. Results: Of a total of 284 patients, 76 had relapsed/refractory disease, 10 of 20 had a successful ASCT, and there is insufficient data on 1 patient. Of the remaining 65, 11 (17%) made it to trial. The median age was 65, 34 were male, median number of prior therapies was 2, 74% had at least one comorbidity and 46% had at least 2, 62% of patients had de novo DLBCL, 18% transformed and 20% composite. 81% of cases were discussed at tumor board. Reasons for failing to enroll on trial included prohibitive comorbidity (21%), rapid progression (15%), decision for palliation (15%), prior second malignancy (9%), thrombocytopenia (13%), CNS disease (9%), proximity to ASCT (2%), no protocol for DLBCL (6%), palliative radiation (6%). Conclusions: We demonstrate that 17% of patients with DLBCL not responding to standard therapy make it to trial, the remainder does not mainly beacause of comorbidity and rapid progression. Similar barriers were found for solid tumor patients (Lara, JCO 2001) and a similar accrual rate was seen in relapsed non-small cell lung cancer (Baggstrom,J Thor Oncol 2011) . Relapsed DLBCL is a population for whom clinical trial research is challenging but possible.