tbuckley/cabot-search huggingface dataset:
Safety and Efficacy of Minimally Interrupted Dabigatran vs Uninterrupted Warfarin Therapy in Adults Undergoing Atrial Fibrillation Catheter Ablation
Authors: Akihiko Nogami, Tomoo Harada, Yukio Sekiguchi, Ryuji Otani, Yukihiko Yoshida, Kentaro Yoshida, Yukiko Nakano, Norihito Nuruki, Shiro Nakahara, Masahiko Goya, Hideki Origasa, Yasuki Kihara, Kenzo Hirao, Kazutaka Aonuma
Journal: JAMA Network Open (2019)

<h3>Importance</h3> Uninterrupted dabigatran therapy reduces stroke risk in patients with nonvalvular atrial fibrillation (NVAF) undergoing ablation and is associated with a lower bleeding risk than uninterrupted warfarin therapy. Minimally interrupted direct oral anticoagulant therapy is widely used, but data from controlled studies are insufficient. <h3>Objective</h3> To compare the safety and efficacy of minimally interrupted dabigatran vs uninterrupted warfarin therapy in patients undergoing catheter ablation for NVAF. <h3>Design, Setting, and Participants</h3> The ABRIDGE-J (ABlation peRIoperative DabiGatran in use Envisioning in Japan) trial is a open-label, randomized clinical trial performed in 28 Japanese treatment centers. A total of 504 patients scheduled for NVAF ablation were enrolled; 500 were randomized to the study treatments; 499 received at least 1 dose of dabigatran etexilate (n = 248) or warfarin potassium (n = 251); and 442 underwent ablation (220 in the dabigatran group and 222 in the warfarin group). Data were collected from May 1, 2014, through September 14, 2015, and analyzed from March 7, 2017, through January 28, 2019. <h3>Interventions</h3> Appropriate dose anticoagulation was administered 4 weeks before and at least 3 months after ablation in all patients. Dabigatran therapy was interrupted before catheter ablation (holding of 1-2 doses) and resumed after ablation. <h3>Main Outcomes and Measures</h3> Primary end points were the incidence of embolism during the perioperative period and atrial thrombus just before the ablation. The main secondary end point was the incidence of major bleeding events until 3 months after ablation. <h3>Results</h3> Of the 442 patients who underwent ablation, 74.9% were men and the median age was 66 years (interquartile range, 59-71 years). Before ablation, 1 cerebral infarction and 1 thrombus in the left atrium occurred in the warfarin group, but no events occurred in the interrupted dabigatran group. After ablation, the mean (SD) incidence of major bleeding events was significantly lower with dabigatran (3 patients [1.4% {0.8%}; 95% CI, 0.4%-4.2%]) vs warfarin (11 patients [5.0% {1.5%}; 95% CI, 2.8%-8.8%];<i>P</i> = .03). No thromboembolic events occurred after ablation in the dabigatran group; 1 (0.5%) occurred in the warfarin group. <h3>Conclusions and Relevance</h3> In patients undergoing ablation for NVAF, anticoagulation with minimally interrupted dabigatran therapy did not increase thromboembolic events and was associated with fewer bleeding complications than uninterrupted warfarin therapy. <h3>Trial Registration</h3> umin.ac.jp Identifier:UMIN000013129
Intradermal-Stress-Lymphoscintigraphy in Early Detection and Clinical Management of Secondary Lymphedema
Authors: Girolamo Tartaglione, Giuseppe Visconti, Roberto Bartoletti, Stefano Gentileschi, Francesco Pio Ieria, Patrick M. Colletti, Domenico Rubello, Marzia Salgarello
Journal: Clinical Nuclear Medicine (2019)

Abstract Stress-lymphoscintigraphy evaluates the effects of exercise on lymph drainage. Results may predict outcomes of complex physical therapy as a first-line lymphedema treatment. Microsurgical approaches are best in patients with lymphangectasia or dermal backflow. Lymphatic pathway mapping helps plan lympho-venous anastomoses. For improved lymphatic visualization, we suggest a scan at rest, after a quick exercise (stepping or weight lifting for 2 min) and delayed scanning after prolonged symptom limited exercise (walking or hand squeezing for 30–40 min). In advanced lymphedema, identification of lymph pathways and residual regional lymph nodes might be difficult. In these patients, lymph node transplant is suggested.
Dynamics of some biochemical markers in blood of patients with soft tissue sarcoma.
Authors: Irina Aleksandrovna Goroshinskaya, Elena Vladimirovna Shalashnaya, Larisa Nikolaevna Vashchenko, Tatiana Valeryevna Ausheva Ausheva, Ludmila Anatolievna Nemashkalova
Journal: Journal of Clinical Oncology (2015)

e21518 Background: Frequent recurrence and hematogenous metastasis - the hallmark of soft tissue sarcomas (STS). Proper management of patients depends on early detection of process progression. The purpose of this study was to evaluate the diagnostic value of the content of some biochemical parameters in STS patients’ blood at different stages of the disease during follow-up. Methods: The study included 26 patients with STS without distant metastases initially and 16 patients with generalized form of STS that were on treatment and dynamic observation, the average age – 54.4 ± 2.5 years. Every three months in the blood of all patients C-reactive protein (CRP), haptoglobin (HG), α1-antitrypsin (α1-AT), myoglobin (MG) and activity of lactate dehydrogenase (LDH) and alkaline phosphatase (ALP) were determined at COBAS INTEGRA 400 analyzer (Roche). The results were compared with the data of a survey of 20 people without cancer pathology and somatic diseases (control). Results: In patients with relatively localized form of STS before treatment content of CRP increased by 13.9 times, levels of α1-AT, HG and MG at 60-97% compared with the control, the activities of LDH and ALP also increased – by 61 and 21%, respectively. After achievement of remission normalization of α1-AT and HG took place, CRP level decreased 7.8 times, although was higher than normal by 77% as well as the content of MG – by 38%. LDH activity was increased by 33%, but there was normalization of alkaline phosphatase. 3-6 months before detection of distant metastases an increase in the concentration of CRP by 4.8 times, α1-AT and HG by 57%, LDH activity by 28% were observed compared with values in remission. At the time of detection of distant metastases an increase in the content of CRP by 2.5 times and HG by 1.5 times as well as increase of enzyme activity and the level of MG by 20-76% were noted compared with the previous phase of the survey. Conclusions: The sharp increase in acute phase proteins and activation of energy enzymes at the stages of clinical supervision of patients with STS point to the possibility of manifestation of distant metastases. The most pronounced changes of CRP allow the use of this index for the prediction of STS metastasis.
FRI-148-Downregulation of innate and adaptive gene expression alleviated by host protein osteopontin in an immunocompetent model of hepatitis B infection
Authors: Sandra Phillips, Sameer Mistry, Ewald Doornebal, Antonio Riva, Jason Coombes, Wing Syn, Krishna Menon, Andreas Prachalias, Parthi Srinivasan, Nigel Heaton, Michail Pizanias, Ane Zamalloa, Melissa Preziosi, Rosa Miquel, Corina Cotoi, Maesha Deheragoda, Caroline Robinson, Roger Williams, Shilpa Chokshi
Journal: Journal of Hepatology (2019)
Food Is Medicine—The Promise and Challenges of Integrating Food and Nutrition Into Health Care
Authors: Dariush Mozaffarian, Jerold Mande, Renata Micha
Journal: JAMA Internal Medicine (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 Internal Medicine 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 Internal Medicine journal
Young adult cancer survivors’ expectations of physicians for reproductive and sexual health care.
Authors: Ying Wang, Pierre Camateros, Winson Y. Cheung
Journal: Journal of Clinical Oncology (2015)

9562 Background: Infertility and sexual dysfunction resulting from cancer therapies are often inadequately addressed by physicians, even though these issues cause significant distress for young adult cancer patients. In this study, we examined survivors’ expectations of their physicians regarding reproductive and sexual healthcare, and identified factors associated with these expectations. Methods: We surveyed patients aged 20 to 39 years who were diagnosed with solid tumors, evaluated at any 1 of 5 regional cancer centers in British Columbia, and alive at 2 or more years after their original diagnosis. Using multivariate regression models, we explored the relationships between patient expectations of their care and the factors associated with these expectations, while controlling for potential confounders. Results: With a survey response rate of 56%, a total of 447 patients were analyzed: median age was 35 years (IQR 31-38), 30% were men, 89% had ECOG 0, and 75% reported being in a relationship. Tumor sites included breast (222; 50%), testicular (126; 28%), gynecological (76; 17%), and colorectal (23; 5%). A significant proportion of patients received chemotherapy (65%) and radiation (47%) that posed the potential for infertility or sexual dysfunction. While the majority of patients expected their primary care providers (PCPs) and cancer specialists (CS) to share responsibility in addressing fertility and sexual health concerns (85% and 74%, respectively), a fair number of patients preferred that reproductive health be fully managed by CS (16% vs. 10%, p = 0.005) and that sexual health be mainly addressed by PCPs (31% vs. 21%, p < 0.0001). In regression analyses, prior discussions about infertility or sexual dysfunction conducted by oncologists increased the patient’s expectations of their ongoing involvement in these areas (p = 0.047 and p = 0.006, respectively). Conclusions: Young adult cancer survivors have specific expectations about physician roles in addressing reproductive and sexual health. As discussions can modify patient expectations, early and appropriate engagement of both CS and PCPs in such conversations can facilitate the development of effective shared-care models of follow-up.
LBP-16-Phase II trial to evaluate immunogenicity and safety of a new adjuvanted HBAI20 Hepatitis B vaccine in non-responders: BE RESPONDER.
Authors: Özgür Koc, Philippe de Smedt, Geert Robaeys, Pierre Van Damme, Jorge Almeida, Frank Falkenberg, Paul H.M. Savelkoul, Astrid Oude Lashof
Journal: Journal of Hepatology (2019)
THU-017-Glucagon like peptide-2 treatment improves liver and bile duct injury in the Mdr2-/- mouse model of sclerosing cholangitis
Authors: Moritz Menz, Lorenz Hinterleitner, Philipp Königshofer, Emina Halilbasic, Victoria Kunczer, Tatjana Stojakovic, Thomas Reiberger, Claudia Fuchs, Michael Trauner
Journal: Journal of Hepatology (2019)
FRI-067-Management of primary biliary cholangitis in the pre-obeticholic acid era, and the rate of non-response to ursodeoxycholic acid (UDCA), in a large real-world cohort of PBC patients in Italy: The CLEO-AIGO database
Authors: Umberto Vespasiani Gentilucci, Floriano Rosina, Luchino Chessa, Valeria Pace Palitti, Antonio Picardi, Michela Barlattani, Angelo Barlattani, Valentina Feletti, Alessandro Musetto, Teresa Zolfino, maurizio russello, Maria rita Cannavo, Raffaele Cozzolongo, Francesco Losito, Giovanni Garrucciu, Grazia Niro, Rosanna Fontana, Donato Bacca, Giada Cardinale, Alessandro Grasso, Silvia Storato, Gaetano Bertino, Evelise Frazzetto, Gaetano Scifo, Giuseppe D’adamo, Basilio Fimiani, Rodolfo Sacco, Angelo Ricchiuti, Antonio Ascione, Tundo Paolo, Marco Distefano, Pierluigi Tarquini, Aldo Marrone, Valeria Bardon, Francesco Di Candilo, Ruggiero Francavilla, Salvatore Madonia, Ernesto Claar, Luigi Elio Adinolfi, Claudio Puoti, Raffaele Mazziotti, Giuseppina Ubalducci, Maria D’antò, Carlo Clementi, Adriano Pellicelli, Antonio Izzi
Journal: Journal of Hepatology (2019)
Abstract 15778: Serum Uromodulin is Significantly Associated With Both Type 2 Diabetes and Prediabetes
Authors: Andreas Leiherer, Axel Muendlein, Christoph H Saely, Eva-Maria Brandtner, Alexandra Schuler, Peter Schwerzler, Arthur Mader, Karl-Martin Ebner, Peter Fraunberger, Heinz Drexel
Journal: Circulation (2017)

Introduction: Serum uromodulin has recently been described to be associated with chronic kidney disease and type 2 diabetes. Hypothesis: We aimed at testing the hypothesis that serum uromodulin is ...
Patient preparedness for chemotherapy, an unmet need.
Authors: Hien Tang, Betty Chan, Quioan N Gloria, Afsaneh Barzi
Journal: Journal of Clinical Oncology (2015)

e20681 Background: Efforts to educate cancer patients on treatment side effects are highly endorsed by professional societies including ASCO. While most physicians discuss treatment toxicities (T) with their patients, the amount and depth of information that need to be discussed can be overwhelming and thus critical information regarding nuances of T, including how to inform their provider of severe and serious T can get lost in translation. Methods: We designed a session to cover the most relevant chemotherapy principles such as regular monitoring of T, the expected time lines of T, appropriate interventions for common T, recommendation regarding urgency and mechanism for informing the providers of T, and issues to be discussed on the follow up visits. A pharmacist provided the information in a one-hour face-to-face meeting with the patient and family. To assess patients’ perception of this educational session and to incorporate their suggestions in the design of educational materials, we used a short survey to solicit their feedback. Results: The survey included 5 questions with the first question about referral source and the rest about patient’s perceived value of the educational session. The session was offered to 30 English-speaking patients, 16 new and 14 established patients. Although we did not have a formal follow up survey, more than 75% of new patients gave a positive feedback on the educational session to their providers on their follow up visit. Conclusions: The majority of the patients felt that the education empowered them to better care for themselves and improved the patient-provider communication. The results support a need for a coordinated chemotherapy education at the start of treatment and any change in therapy. Questions (answers) Answers Comments Received enough information about chemotherapy (Yes/No) 100% Yes Additional supportive information 7% requested additional info 1. Nutritional support 2. Preparedness for scans How the information will be used (A. increased knowledge of T, B. better communicate T with the providers, C. better understanding of the treatment process, D. be prepared for chemotherapy) A 93% B 73% C 83% D 80% Whether having the information earlier would have helped those who are not naïve to chemotherapy 93% Yes
Correlation between CD3+ tumor infiltrating lymphocytes and plasma cytokines in primary breast cancer patients.
Authors: Michal Mego, Silvia Cingelova, Zuzana Cierna, Dana Cholujova, Pavol Janega, Marian Karaba, Paulina Gronesova, Juraj Benca, Tomas Minarik, Viera Labudova, Daniel Pindak, Jozef Sufliarsky, Jozef Mardiak
Journal: Journal of Clinical Oncology (2015)

e22103 Background: Plasmacytokines and angiogenic factors (CAFs) seem to be promising biomarkers in breast cancer patients and are involved in tumor dissemination and progression. Infiltration of breast tumor with different subpopulations of immune cells is closely associated with prognosis and/or response to anticancer treatment. The aim of this study was to evaluate a relationship between TILs and serum CAFs in primary breast cancer patients. Methods: This prospective study included 149 primary BC patients treated by surgery from March 2012 to March 2013. Peripheral blood was collected before surgery and 51 plasma CAFs were analyzed using multiplex bead arrays while CD3+ tumor infiltrating lymphocytes in breast tumor were detected by immunohistochemistry. Hierarchical clustering analysis was done to identify groups of patients with different CAFs signature. Next, we evaluated the relationship between the CAFs signature and TILs, using univariate negative binomial regression and multivariate negative binomial regression model with known pathological data Results: In clustering analysis, there were identified two main types of CAFs – type I and type II. CAFs type I (TGF-B1, TGF-B2, VEGF, TGF-B3, MIP-1b, RANTES, IL-15, EOTAXIN, MCP-1, IL-9, PDGF-BB, G-CSF, GM-CSF, MIP-1a, IL-17, FGF-BASIC, IL-5, TNF-A, IL-1B, IL-8, IL-4, IFN-g, IL-13, IL-7, IL-12, IL-1RA, IL-2, IL-6 and IL-10) were highly intercorrelated with apparently high cohesion and based on their levels, there were formed high CAFs I group and low CAFs I groupof patients. Tumor lymphocyte infiltration was significantly different in these 2 groups. Median TILs count was 10 (95% CI 5-13) in high CAFs I group, vs. 5 (95% CI 3-10) in low CAFs I group, HR = 1.37 (95% CI 1.26-1.45, p = 0.0001). These findings were confirmed in multivariate analysis. CAFs type II were not associated with TILs. Conclusions: We identifiedplasma CAFs associated with CD3+ tumor infiltrating lymphocytes in primary tumor. These data could help to better understand relationship between cancer cells and immune system in breast cancer patients.
THU-396-Hepatitis C screening among the population of Georgia within the national elimination program
Authors: David Sergeenko, Maia Lagvilava, Ana Aslanikashvili, Maia Tsereteli, Davit Baliashvili, Vladimer Getia, Alexander Turdziladze, Irma Khonelidze, Maia Alkhazashvili, Ekaterine Adamia, Paata Imnadze, Amiran GAMKRELIDZE
Journal: Journal of Hepatology (2019)
TCTAP A-084 Significance of Vasa Vasorum Identified by Optical Coherence Tomography on Plaque Erosion in Patients with Acute Coronary Syndrome
Authors: Hirofumi Ohashi, Hirohiko Ando, Yuki Saka, Akihiro Suzuki, Shinichiro Sakurai, Yusuke Nakano, Katsuhisa Waseda, Hiroaki Takashima, Tetsuya Amano
Journal: Journal of the American College of Cardiology (2019)
PRDM9 Diversity at Fine Geographical Scale Reveals Contrasting Evolutionary Patterns and Functional Constraints in Natural Populations of House Mice
Authors: Covadonga Vara, Laia Capilla, Luca Ferretti, Alice Ledda, Rosa A Sánchez-Guillén, Sofia I Gabriel, Guillermo Albert-Lizandra, Beatriu Florit-Sabater, Judith Bello-Rodríguez, Jacint Ventura, Jeremy B Searle, Maria L Mathias, Aurora Ruiz-Herrera
Journal: Molecular Biology and Evolution (2019)

One of the major challenges in evolutionary biology is the identification of the genetic basis of postzygotic reproductive isolation. Given its pivotal role in this process, here we explore the drivers that may account for the evolutionary dynamics of the PRDM9 gene between continental and island systems of chromosomal variation in house mice. Using a data set of nearly 400 wild-caught mice of Robertsonian systems, we identify the extent of PRDM9 diversity in natural house mouse populations, determine the phylogeography of PRDM9 at a local and global scale based on a new measure of pairwise genetic divergence, and analyze selective constraints. We find 57 newly described PRDM9 variants, this diversity being especially high on Madeira Island, a result that is contrary to the expectations of reduced variation for island populations. Our analysis suggest that the PRDM9 allelic variability observed in Madeira mice might be influenced by the presence of distinct chromosomal fusions resulting from a complex pattern of introgression or multiple colonization events onto the island. Importantly, we detect a significant reduction in the proportion of PRDM9 heterozygotes in Robertsonian mice, which showed a high degree of similarity in the amino acids responsible for protein-DNA binding. Our results suggest that despite the rapid evolution of PRDM9 and the variability detected in natural populations, functional constraints could facilitate the accumulation of allelic combinations that maintain recombination hotspot symmetry. We anticipate that our study will provide the basis for examining the role of different PRDM9 genetic backgrounds in reproductive isolation in natural populations.
End of life (EOL) care in patients with metastatic lung cancer harboring EGFR-mutations.
Authors: Jessica Ruth Bauman, Zofia Piotrowska, Emily Scribner, Brandon Temel, Lecia V. Sequist, Rebecca Suk Heist, Jennifer S. Temel
Journal: Journal of Clinical Oncology (2015)

e20508 Background: Metastatic lung cancer is the leading cause of cancer-related death in the US. In the last decade, patients (pts) with EGFR mutations have benefitted from improved medical outcomes, including survival, with EGFR-directed targeted therapy. We sought to explore if these improvements in care outcomes might impact the delivery of EOL care in this population. Methods: We retrospectively reviewed medical records of pts at our center diagnosed with metastatic EGFR-mutant lung cancer from January 2009 to December 2012. We limited our review to pts who had at least one cancer therapy at MGH and who died by January 2015. Results: 61 pts were included. 44 pts (72%) were female. 42 pts (69%) received cancer-directed therapy within 30 days of death. Of these 42, 34 pts (81%) received oral chemotherapy, 3 (7%) received IV chemotherapy, and 5 (12%) received oral and IV chemotherapy. 41 pts (67%) were hospitalized within 30 days of death. The median number of total hospitalizations was 2 (0-8) and median number of total inpatient days was 16 (0-88). 24 pts (39%) had a palliative care outpatient visit and 43 (70%) had an inpatient palliative care consult at some point. Prior to death, 34 pts (56%) enrolled on hospice, 19 (31%) were never on hospice, and the hospice status of 8 (13%) was unknown. Of the 53 pts with known hospice status, median length of stay was 6 days (0-206). 33 pts (54%) died at home with hospice or in an inpatient hospice, 18 (30%) died in the hospital, 2 (3%) died at home without hospice, and location of death was unknown for 8 (13%). Conclusions: Pts with EGFR mutations had high rates of hospitalization and chemotherapy use in the last month of life, and many died in the hospital. These rates are higher than rates in the overall lung cancer population in published literature. Additionally, palliative care utilization was high, but only half enrolled on hospice before death. These data suggest that patients with EGFR mutations are receiving more intensive medical and cancer care at the EOL. Further study of EOL care and health service utilization in this unique patient population is warranted.
Gated Tomographic Radionuclide Angiography Using CZT Gamma Camera in Patients Receiving Cardiotoxic Chemotherapy
Authors: Matthieu Bailly, Gilles Le Rouzic, Gilles Metrard
Journal: Clinical Nuclear Medicine (2019)

Tomographic radionuclide angiography (TRNA) can monitor cardiac function in patients receiving cardiotoxic chemotherapy. Gamma cameras using CZT detectors enable dose reduction and quicker acquisitions. We report 80 patients who underwent a 7-minute TRNA acquisition after injection of 550-MBq Tc-labeled human serum albumin. Data were analyzed full and half. Image quality was not visually decreased. There was no significant difference in left ventricular systolic and diastolic volumes and in left and right ventricular ejection fractions between full and half data acquisitions (P < 0.0001). When injecting half activity, effective dose could be reduced to 1.92 mSv.