tbuckley/cabot-search huggingface dataset:
Progressive Neurological Impairment and an Enhancing Brainstem Lesion in a Middle-aged Man
Authors: Sasha Gupta, Lloyd Damon, Jeffrey M. Gelfand
Journal: JAMA Neurology (2019)

A 53-year-man presented with numbness in his right arm and difficulty walking, and a computed tomographic scan showed infiltrative soft tissue within the pericardium and intra-atrial septum and throughout the retroperitoneum. What is your diagnosis?
Biomarker Analyses of Response to Cyclin-Dependent Kinase 4/6 Inhibition and Endocrine Therapy in Women with Treatment-Naïve Metastatic Breast Cancer
Authors: Richard S. Finn, Yuan Liu, Zhou Zhu, Miguel Martin, Hope S. Rugo, Véronique Diéras, Seock-Ah Im, Karen A. Gelmon, Nadia Harbeck, Dongrui R. Lu, Eric Gauthier, Cynthia Huang Bartlett, Dennis J. Slamon
Journal: Clinical Cancer Research (2019)

Abstract Purpose: Preclinical data identified the cyclin-dependent kinase 4/6 (CDK4/6) inhibitor palbociclib as synergistic with antiestrogens in inhibiting growth of hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2−) human breast cancer models. This observation was validated clinically in the randomized, placebo-controlled, phase III PALOMA-2 study. Experimental Design: To determine markers of sensitivity and resistance to palbociclib plus letrozole, we performed comprehensive biomarker analyses, investigating the correlation with progression-free survival (PFS), on baseline tumor tissues from PALOMA-2. Results: Despite a broad biomarker search, palbociclib plus letrozole demonstrated consistent PFS gains versus placebo plus letrozole, with no single biomarker or cassette of markers associated with lack of benefit from combination treatment. Palbociclib plus letrozole confers efficacy on both luminal A and B patients. Higher CDK4 levels were associated with endocrine resistance which was mitigated by the addition of palbociclib, whereas lower PD-1 levels were associated with greater palbociclib plus letrozole benefit. Tumors with more active growth factor signaling, as exemplified by increased expression of FGFR2 and ERBB3 mRNA, appeared to be associated with greater PFS gain from the addition of palbociclib. Conclusions: These data underscore the importance of CDK4/6 signaling in HR+/HER2− breast cancer and suggest that the interplay between steroid hormone and peptide growth factor signaling could drive dependence on CDK4/6 signaling. See related commentary by Anurag et al., p. 3
Evaluation of mental and social adaptation of patients with breast cancer.
Authors: Kristina Kondrateva, Tatiana Semiglazova, Boris Kasparov, Margarita Vagaitseva, Margarita Zernova, Anton Krutov, Anna Alekseenko, Petr Krivorotko, Vladimir Semiglazov, Aleksey Belyaev, Vladislav Semiglazov
Journal: Journal of Clinical Oncology (2019)

e23167 Background: In 2018, in the N.N. Petrov National Medical Research Center of Oncology, there was conducted a study of the effectiveness of a mental and social adaptation of patients to the disease and treatment in the framework of The International Classification of Functioning, Disability and Health (ICF). Methods: The patients with breast cancer (n = 28, mean age 31 ±7) were examined at the stages of diagnosis and admission to the hospital. The basis of the study is the «Narcissism Evaluation Test», EORTC QLQ-C30, as well as the following ICF domains: Body function - global psychosocial functions (b122), temperament and personality functions (b126), energy and drive functions (b130), sleep functions (b134), attention functions (b140), psychomotor functions (b147), emotional functions (b152), thought functions (b160), higher-level cognitive functions (b164). Activity and participation- doing housework (d640), family relationships (d760), intimate relationships (d770), acquiring, keeping and terminating a job (d845). Results: The increase in values (7.26–13.61; p &lt; 0.05) on the “Depersonalization” scale indicates an attempt to dissociate from threatening processes in oneself by means of dissociation and splitting, to preserve the coherence of the personality structure. This tendency can be viewed as an attempt by the patient to deny that destabilization affects his personality and lifestyle, which leads to the experience of melancholia as an attempt at destruction of Self-Concept. Such reactions are classified by us within the framework of psychogenic, i.e. conditionally normal in the situation of cancer, however, it was shown that the pathology of “psychogeny” significantly reduces the quality of life and social adaptation. For example, in 11 patients, there is a decrease in the quality of life (62.85; p &lt; 0.05), disturbed sleep, emotions, energy and drive functions (b134, b152, b130), and there are difficulties in the resumption of labor activities (d845). Conclusions: Experiencing the threat to the integrity of Self-Concept launches psychological defenses, as a result of which a rapid regression of Self-Concept occurs before the primary narcissism. Psychogenic reactions during pathologization contribute to the patient’s social and mental maladjustment.
Ophthalmologist who misled patients about treatment benefits is struck off
Authors: Clare Dyer
Journal: BMJ (2019)

A prominent consultant ophthalmologist has been struck off the UK medical register after a tribunal found that his private eye hospital used high pressure sales techniques to persuade patients to pay for treatments that offered no realistic prospect of helping them.

Muhammad “Bobby” Qureshi, 49, misled patients who were often desperate into believing that he could improve their vision, a medical practitioners tribunal found. Many had the incurable progressive condition wet age-related macular degeneration.

Qureshi on occasion could become evasive or aggressive if patients complained that the promised benefits had not materialised, the tribunal heard. When one patient told him that she still could not read after surgery, despite his assurances …
The CAROLE (CArdiac Related Oncologic Late Effects) Study: A Phase II, single-arm feasibility trial.
Authors: Lindsay Puckett, Shahryar Saba, Sonia Henry, Stacey Rosen, Elise Rooney, Alison Laxer, Philip Gilbo, Karalyn Pappas, Katherine Eacobacci, Amitha Kapyur, Justin Robeny, Samaria Filosa, Samantha Musial, Anisha Chaudhry, Rahul Chaudhry, Martin Lesser, Adam Riegel, Jessica Charlton, Sariah Ramoutarpersaud, Lucille Lee
Journal: Journal of Clinical Oncology (2019)

11569 Background: Long-term breast cancer survivors are at risk of late effects from cardiotoxic (tox) radiation (RT) and chemotherapy (chemo). However, there is a paucity of data to recommend appropriate cardiac screening for those ~10 years (yrs) after diagnosis (dx). This phase II, single arm study assessed multimodality screening in a heterogeneous cohort of long-term survivors. Methods: Our prospective, single center pilot study enrolled 201 (of 200 planned) eligible patients (pts): age 18-65 at dx, with treatment (tx) for breast cancer (any stage/tx) in 2004-2011 (≥6 yrs prior), with no cardiac disease (dz) at dx. The primary endpoint was presence of any cardiac dz (preclinical or clinical) on electrocardiogram (EKG), echocardiogram (echo), or coronary artery calcium CT (CAC CT); secondary endpoint included clinical (clin) dz alone. Subgroups assessed were: no tox chemo or RT (no tox), tox RT (left-sided) alone, tox chemo (anthracycline) alone, and both tox chemo and tox RT (tox chemoRT). Results: After enrollment (6/2017-7/2018), 200 pts had sufficient data for analysis. Median age was 50 (29-65) at dx, 63 (37-77) at imaging, and interval (dx to imaging) was 11.5 (6.7-14.5) yrs. There were 44% no tox, 31.5% tox RT, 16% tox chemo, and 8.5% tox chemoRT pts. Among all pts, 77.6% displayed evidence of any cardiac dz, 51.5% had clin dz. Per modality, rates of any and clin dz were: 27.1%/10% EKG, 50.0%/25.3% echo, and 50.8%/45.8% CAC CT. Among subgroups, these rates were: 73.9%/53.4% no tox, 82.5%/58% tox RT, 75%/38.7% tox chemo, and 82.4%/35.3% tox chemoRT (NS on χ2 test, p = .58/p = .15). Multivariable logistic regression with tox RT, tox chemo, and age as covariates, showed no significant tox RT (NS) or tox chemo effect (NS), however, increasing age was significantly associated with higher incidence of cardiac dz (p &lt; 0.01; OR = 1.12 per yr, 95% CI: 1.07-1.18). Conclusions: Among pts with a median of &gt; 10 yrs post breast cancer tx, multimodality CAROLE screening was feasible and showed high rates of cardiac dz (any/clin = 77.6%/51.5%) among all subgroups, including those without tox tx. This study provides evidence for long-term cardiac screening in a diverse group of breast cancer survivors and provides a novel pathway for evaluation. Clinical trial information: NCT03235427.
In type 2 diabetes, intensive glucose control for 5.6 years did not differ from usual care for major CV events at 14 years
Authors: Gaetano Santulli
Journal: Annals of Internal Medicine (2019)

ACP Journal Club17 September 2019In type 2 diabetes, intensive glucose control for 5.6 years did not differ from usual care for major CV events at 14 yearsGaetano Santulli, MDGaetano Santulli, MDEinstein College–Montefiore University Hospital, New York, New York, USA, University of Naples “Federico II”, Naples, Italy (G.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/ACPJ201909170-031 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationReaven PD, Emanuele NV, Wiitala WL, et al; VADT Investigators. Intensive glucose control in patients with type 2 diabetes—15-year follow-up. N Engl J Med. 2019;380:2215-24. https://pubmed.ncbi.nlm.nih.gov/31167051Clinical Impact RatingsGIM/FP/GP: Cardiology: Endocrinology: References1 Santulli G. Editorial: Cardiovascular disease and diabetes. Front Endocrinol (Lausanne). 2019;10:314. [PMID: 31156559] Google Scholar2 Zonszein J, Brownlee M. Hemoglobin A1c targets for glycemic control with pharmacologic therapy. [Letter]. Ann Intern Med. 2018;169:512-3. [PMID: 30285194] Google Scholar3 Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HA. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med. 2008;359:1577-89. [PMID: 18784090] Google Scholar4 Deedwania P, Acharya T. Cardiovascular protection with anti-hyperglycemic agents. Am J Cardiovasc Drugs. 2019;19:249-57. [PMID: 30767126] Google Scholar Author, Article, and Disclosure InformationAffiliations: Einstein College–Montefiore University Hospital, New York, New York, USA, University of Naples “Federico II”, Naples, Italy (G.S.)This article was published at Annals.org on 3 September 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byOxymatrine Inhibits Twist-Mediated Renal Tubulointerstitial Fibrosis by Upregulating Id2 Expression 17 September 2019Volume 171, Issue 6Page: JC31KeywordsGlucoseHbA1cHeart failureIschemic strokeMortalityMyocardial infarctionRenal analysisRenal failureStatinsType 2 diabetes ePublished: 17 September 2019 Issue Published: 17 September 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Benefits of Magnetic Resonance Imaging for Patients Presenting With Low-risk Transient or Persistent Minor Neurologic Deficits
Authors: Margy E. McCullough-Hicks, Gregory W. Albers
Journal: JAMA Neurology (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 Neurology 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 Neurology journal
From Hong Kong Diabetes Register to JADE Program to RAMP-DM for Data-Driven Actions
Authors: Juliana C.N. Chan, Lee-Ling Lim, Andrea O.Y. Luk, Risa Ozaki, Alice P.S. Kong, Ronald C.W. Ma, Wing-Yee So, Su-Vui Lo
Journal: Diabetes Care (2019)

In 1995, the Hong Kong Diabetes Register (HKDR) was established by a doctor-nurse team at a university-affiliated, publicly funded, hospital-based diabetes center using a structured protocol for gathering data to stratify risk, triage care, empower patients, and individualize treatment. This research-driven quality improvement program has motivated the introduction of a territory-wide diabetes risk assessment and management program provided by 18 hospital-based diabetes centers since 2000. By linking the data-rich HKDR to the territory-wide electronic medical record, risk equations were developed and validated to predict clinical outcomes. In 2007, the HKDR protocol was digitalized to establish the web-based Joint Asia Diabetes Evaluation (JADE) Program complete with risk levels and algorithms for issuance of personalized reports to reduce clinical inertia and empower self-management. Through this technologically assisted, integrated diabetes care program, we have generated big data to track secular trends, identify unmet needs, and verify interventions in a naturalistic environment. In 2009, the JADE Program was adapted to form the Risk Assessment and Management Program for Diabetes Mellitus (RAMP-DM) in the publicly funded primary care clinics, which reduced all major events by 30-60% in patients without complications. Meanwhile, a JADE-assisted assessment and empowerment program provided by a university-affiliated, self-funded, nurse-coordinated diabetes center, aimed at complementing medical care in the community, also reduced all major events by 30-50% in patients with different risk levels. By combining universal health coverage, public-private partnerships, and data-driven integrated care, the Hong Kong experience provides a possible solution than can be adapted elsewhere to make quality diabetes care accessible, affordable, and sustainable.
Abstract 20033: A Systematic Analysis of Heart Rate Recovery Within the First Minute After Exercise as a Predictor of Mortality
Authors: Yordi J van de Vegte, Ruben N Eppinga, Pim van der Harst, Niek Verweij
Journal: Circulation (2017)

Background: Heart rate recovery (HRR), most often described as the decrease of heart rate at 1 minute after cessation of exercise, has proven to be a predictor of all-cause mortality and death of c...
Use of Human Induced Pluripotent Stem Cell–Derived Cardiomyocytes in Preclinical Cancer Drug Cardiotoxicity Testing: A Scientific Statement From the American Heart Association
Authors: Gary Gintant, Paul Burridge, Lior Gepstein, Sian Harding, Todd Herron, Charles Hong, José Jalife, Joseph C. Wu
Journal: Circulation Research (2019)

It is now well recognized that many lifesaving oncology drugs may adversely affect the heart and cardiovascular system, including causing irreversible cardiac injury that can result in reduced quality of life. These effects, which may manifest in the short term or long term, are mechanistically not well understood. Research is hampered by the reliance on whole-animal models of cardiotoxicity that may fail to reflect the fundamental biology or cardiotoxic responses of the human myocardium. The emergence of human induced pluripotent stem cell-derived cardiomyocytes as an in vitro research tool holds great promise for understanding drug-induced cardiotoxicity of oncological drugs that may manifest as contractile and electrophysiological dysfunction, as well as structural abnormalities, making it possible to deliver novel drugs free from cardiac liabilities and guide personalized therapy. This article briefly reviews the challenges of cardio-oncology, the strengths and limitations of using human induced pluripotent stem cell-derived cardiomyocytes to represent clinical findings in the nonclinical research space, and future directions for their further use.
Annals Graphic Medicine - Progress Notes: How Is Residency?
Authors: Michael Natter
Journal: Annals of Internal Medicine (2019)

Web Exclusives17 September 2019Annals Graphic Medicine - Progress Notes: How Is Residency?FREEMichael Natter, MDMichael Natter, MDNYU School of Medicine, New York, New York (M.N.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/G19-0053 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Download figure Download PowerPoint Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: NYU School of Medicine, New York, New York (M.N.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=G19-0002.Author/Illustrator Information: Michael Natter, MD, is a current internal medicine resident at NYU School of Medicine and a graduate of Sidney Kimmel Medical College of Thomas Jefferson University in Philadelphia. His artwork is inspired by his medical training, patient encounters, and the human condition. A type 1 diabetic, Dr. Natter views himself as a patient as well as a doctor and plans to pursue a fellowship in endocrinology to help others who also share his disease. You can find more of his illustrations, stories, and comics on Instagram (www.instagram.com/mike.natter) and Twitter (@mike_natter).About Progress Notes: Progress Notes explores the everyday emotional, clinical, humorous, and ethical challenges of the medical residency training process. As implied by the title of the series, these pieces act as a visual bildungsroman, graphically dissecting the subtext of what it means to be a young doctor in today's medical world. Progress Notes appears monthly in Annals Graphic Medicine at Annals.org. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byNavigating and Leveraging Social Media 17 September 2019Volume 171, Issue 6Page: W29-W30KeywordsConflicts of interestDisclosureEmotionsEndocrinologyFellowshipsGraduate medical educationResidency ePublished: 17 September 2019 Issue Published: 17 September 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
The pharmacogenomics of inhaled corticosteroids and lung function decline in COPD
Authors: Ma'en Obeidat, Alen Faiz, Xuan Li, Maarten van den Berge, Nadia N. Hansel, Philippe Joubert, Ke Hao, Corry-Anke Brandsma, Nicholas Rafaels, Rasika Mathias, Ingo Ruczinski, Terri H. Beaty, Kathleen C. Barnes, S.F. Paul Man, Peter D. Paré, Don D. Sin
Journal: European Respiratory Journal (2019)

Inhaled corticosteroids (ICS) are widely prescribed for patients with chronic obstructive pulmonary disease (COPD), yet have variable outcomes and adverse reactions, which may be genetically determined. The primary aim of the study was to identify the genetic determinants for forced expiratory volume in 1 s (FEV 1 ) changes related to ICS therapy. In the Lung Health Study (LHS)-2, 1116 COPD patients were randomised to the ICS triamcinolone acetonide (n=559) or placebo (n=557) with spirometry performed every 6 months for 3 years. We performed a pharmacogenomic genome-wide association study for the genotype-by-ICS treatment effect on 3 years of FEV 1 changes (estimated as slope) in 802 genotyped LHS-2 participants. Replication was performed in 199 COPD patients randomised to the ICS, fluticasone or placebo. A total of five loci showed genotype-by-ICS interaction at p&lt;5×10 −6 ; of these, single nucleotide polymorphism (SNP) rs111720447 on chromosome 7 was replicated (discovery p=4.8×10 −6 , replication p=5.9×10 −5 ) with the same direction of interaction effect. ENCODE (Encyclopedia of DNA Elements) data revealed that in glucocorticoid-treated (dexamethasone) A549 alveolar cell line, glucocorticoid receptor binding sites were located near SNP rs111720447. In stratified analyses of LHS-2, genotype at SNP rs111720447 was significantly associated with rate of FEV 1 decline in patients taking ICS (C allele β 56.36 mL·year −1 , 95% CI 29.96–82.76 mL·year −1 ) and in patients who were assigned to placebo, although the relationship was weaker and in the opposite direction to that in the ICS group (C allele β −27.57 mL·year −1 , 95% CI −53.27– −1.87 mL·year −1 ). The study uncovered genetic factors associated with FEV 1 changes related to ICS in COPD patients, which may provide new insight on the potential biology of steroid responsiveness in COPD.
Abstract 44: Interaction Of Osr1 And Tbx5 Is Involved In The Mouse Limb And Heart Development
Authors: LinglinXie, LunZhou, PatrickOlson, JacyO’Keefe, QiangFu
Journal: Circulation Research (2014)

Mutations of TBX5 cause Holt-Oram syndrome (HOS) in human, a disease characterized by upper limb and heart defects. Mouse embryos of Osr1 knockout caused similar heart defects, while the upper limb defects have never been reported. By genetically marking Osr1expressing cells in mice, using Osr1:CreERT2, we showed that Osr1 expression cells contribute to the atrial septum progenitors between E8.0 and E11.0, and to the forelimb after E9.0. The expression of Osr1 in the forelimb showed a gradient decreasing pattern from the digit 5 to digit 1. Conditional-Tbx5 haploinsuffiency, using Osr1:CreERT2, compound with Osr1 haploinsuffiency induced more incidence of atrial septal defects (ASDs) and double outlet right ventricle (DORV). Forty percent of these embryos also had digit defects: the digits are either missing, fused or lack normal identity, which were not observed in mouse embryos of either Osr1 or Tbx5 haploinsuffiency. Detailed study of the cardiac progenitors of the compound haploinsufficinecy for Tbx5 ...
Association of Treatment With Metformin vs Sulfonylurea With Major Adverse Cardiovascular Events Among Patients With Diabetes and Reduced Kidney Function
Authors: Christianne L. Roumie, Jonathan Chipman, Jea Young Min, Amber J. Hackstadt, Adriana M. Hung, Robert A. Greevy, Carlos G. Grijalva, Tom Elasy, Marie R. Griffin
Journal: JAMA (2019)

Before 2016, safety concerns limited metformin use in patients with kidney disease; however, the effectiveness of metformin on clinical outcomes in patients with reduced kidney function remains unknown.