tbuckley/cabot-search huggingface dataset:
Chronic lymphocytic leukemia: An Indian experience.
Authors: Ajay Gogia, Ritu Gupta, Atul Sharma, Lalit Kumar, Vinod Raina, Lata Rani
Journal: Journal of Clinical Oncology (2019)

e19007 Background: Chronic lymphocytic leukemia (CLL) is the most common lymphoproliferative disorder in the West accounting for about 30% of leukemias, whereas in Indian subcontinent it accounts for 3-5% of all leukemias. We aimed to evaluate biological and molecular prognostic parameters as well as therapeutic considerations in CLL patients in India. Methods: We retrospectively analyzed 510 patients with CLL, who presented at our institute over a period of 18 years. Results: The median age of CLL patients at presentation was 60 years (range: 28 - 92 years) with male: female ratio = 3:1. The median total leukocyte count was 45X109/L . As per clinical Rai stage distribution 55 (10.08%) patients were in Stage 0, 92 (18%) in stage I, 174 (34%) in stage II, 92 (18%) in stage III and 97 (19%) were in stage IV. ZAP-70 was positive ( &gt; 20%) in 206 (57% , n = 361) , CD 38( &gt; 30%) in 107 (29% , n = 363), and CD49d was positive ( &gt; 30%) in 63 (50.3%, n = 127) cases. Beta-2 microglobulin (B2M) was elevated (≥3.5 mg/L) in 243 patients (70%, n = 347). One hundred and fifty six cases (57%, n = 273) were IGHV mutated and Del (17p) by FISH was observed in 18 cases (12%, n = 150). A total of 331 (64.9 %) patients required treatment wherein 155 patients (46.8%) received Chlorambucil-based, 110 ( 33.2%) received BR, 42 (12.6%) received Fludarabine based ( FC-7,FCR-35) and 41 patients received others regimen. Overall response rate seen with Chlorambucil, BR and Fludarabine based regimen was 67% ( CR-3.2%), 90% ( CR-45%) &amp; 88% ( CR-44%) respectively. Median event free survival (EFS) and overall survival (OS) and was 3.5 years and 5.5 years respectively, with median follow up period of 3.9 years. Clinical stage (Rai III/IV), elevated B2 M, IGHV-unmutated had statistically significant adverse impact on OS and EFS. Fludarabine based chemotherapy appeared toxic as half of patients developed febrile neutropenia and various infections whereas in BR , cutaneous side effects were more common(p = 0.001) . In early stage CLL, median time to first treatment was 22 months and; IGHV-unmutated, elevated B2M and CD38 positivity were significantly associated with shorter treatment free survival. Conclusions: This is the largest series of CLL reported from Asia. Clinical Rai Stage III/IV, unmutated IGHV and elevated B2M have statistically significant adverse impact on survival of patients with CLL. BR was better tolerated than fludarabine based regimen with similar responses and events.
Diagnostic Accuracy of FDG PET/CT in Suspected LVAD Infections
Authors: Marty C. Tam, Vaiibhav N. Patel, Richard L. Weinberg, Edward A. Hulten, Keith D. Aaronson, Francis D. Pagani, James R. Corbett, Venkatesh L. Murthy
Journal: JACC. Cardiovascular imaging (2019)
The 3i Conceptual Framework for Recognizing Patient Perspectives of Type 1 Diabetes During Emerging Adulthood
Authors: Benjamin Markowitz, Cheryl Pritlove, Geetha Mukerji, James V. Lavery, Janet A. Parsons, Andrew Advani
Journal: JAMA Network Open (2019)

<h3>Importance</h3> Early emerging adulthood, the developmental life stage roughly spanning between the ages of 18 and 24 years, can be a challenging time for individuals living with type 1 diabetes, being associated with an increased risk of acute complications, loss to follow-up, and the emergence of long-term diabetes complications. Few evidence-based interventions exist, and practice guidelines instead emphasize the importance of delivering individualized, developmentally appropriate care. <h3>Objective</h3> To inform the provision of tailored care and education by illuminating the individual lived experiences of emerging adults with type 1 diabetes. <h3>Design, Setting, and Participants</h3> This qualitative study used in-depth interviews conducted with 33 emerging adults living with type 1 diabetes between October 14, 2016, and May 16, 2017. Participants were recruited from 2 urban Young Adult Diabetes Clinics in the city of Toronto, Ontario, Canada, using a convenience sampling approach. Narrative analysis of participants' accounts was conducted inductively to define story typology. <h3>Main Outcomes and Measures</h3> Participant accounts of type 1 diabetes during childhood, adolescence, and emerging adulthood. <h3>Results</h3> Interviews were conducted with 33 participants aged 18 to 24 years (mean [SD] age at interview, 20.6 [1.7] years); 17 (51%) were women. Duration of diabetes ranged from 3 to 20 years (mean [SD] duration, 12.0 [4.8] years). Narrative analysis identified 3 distinct story types, or lenses, termed<i>ingrained</i>(n = 14),<i>intrusive</i>(n = 12), and<i>inconspicuous</i>(n = 7). Ingrained narratives portrayed an active integration of diabetes self-management into daily life. Intrusive narratives were characterized by stories of struggles for acceptance and striving for control. Inconspicuous narratives were differentiated by descriptions of a willingness to ignore diabetes and its attendant daily tasks with the goals of preserving normalcy and limiting distress. Mean levels of hemoglobin A<sub>1c</sub>were higher in participants conveying an intrusive lens narrative (mean [SD], 9.3% [1.6%]) than those conveying an ingrained lens (mean [SD], 7.4% [0.7%]) (difference between intrusive and ingrained, 1.9%; 95% CI, 0.8%-2.9%;<i>P</i> = .007) or an inconspicuous lens (mean [SD], 8.6% [1.5%]). <h3>Conclusions and Relevance</h3> Although every person is unique, there are commonalities in how emerging adults perceive and depict their experiences living with type 1 diabetes. Among the emerging adults interviewed in the present study, the 3i conceptual framework of ingrained, intrusive, and inconspicuous lenses encapsulated these commonalities. Recognition of the different psychosocial contexts surrounding type 1 diabetes during emerging adulthood may help health care professionals individualize their care accordingly.
Pearls in the Wrong Pockets
Authors: Pir Abdul Ahad Aziz Qureshi, Muhammad Talha Yaseen, Humayun Bashir, Imran Khalid Niazi
Journal: Clinical Nuclear Medicine (2019)

Idiopathic scrotal calcinosis, also called dystrophic scrotal calcinosis, is a rare benign condition that causes superficial intradermal scrotal calcifications. We present one such case of a 40-year-old married man who underwent PET/CT scan for staging workup of lymphoma and revealed this rare entity incidentally without any other testicular pathology.
Phase I trial of KOS-1584 (a novel epothilone) using two weekly dosing schedules
Authors: A. Stopeck, S. Moulder, S. Jones, J. Cohen, M. McDowell, G. Cropp, Z. Zhong, S. Wells, A. Hannah, H. Burris
Journal: Journal of Clinical Oncology (2007)

2571 Background: KOS-1584 is an epothilone with increased potency and improved pharmacologic profile (enhanced water solubility, tumor penetration and reduced CNS exposure). Methods: Define the MTD, toxicity, PK, pharmacodynamics (PD), and early activity of KOS-1584 when administered to pts with advanced malignancies via 1-hr infusion on one of 2 schedules: Days 1, 8 &amp; 15 every 4 weeks and Days 1 &amp; 8 every 3 weeks. PD: assessed by serial sampling of PBMCs for soluble and polymerized microtubules by immunoblot. Methods: 37 pts enrolled in 10 cohorts (0.8 - 25 mg/m 2 ) on the 4-week schedule (22 F; median age/ECOG/prior regimens of 56, 1 and 4, respectively). One pt has been enrolled at 16 mg/m 2 on the 3-week schedule. For the 4-week schedule: DLTs were observed at 20 and 25 mg/m 2 ; the 16 mg/m 2 cohort is being expanded (using antidiarrheal prophylaxis). All episodes of DLT except 1 involved diarrhea with increasing severity after successive infusions despite maximal supportive care; 1 pt had typhlitis upon biopsy. An ovarian cancer pt experienced DLT consisting of Grade 3 weakness, neutropenia and peripheral sensory neuropathy (this pt had high plasma drug concentrations, possibly related to pre-existing severe hypoalbuminemia and ascites). Common all-grade drug- related toxicities (n=37): nausea (51%), diarrhea, fatigue (both 49%), vomiting (32%), anorexia (24%), constipation (24%), peripheral sensory neuropathy (19%) and anemia (16%). Neutropenia/leucopenia (Grade 1–2) observed at 16–25 mg/m 2 dose levels. Except for the DLT involving peripheral neurotoxicity, all neurotoxicity was mild-to-moderate. PK (n=37): t½ 28.1 ± 8.7, Vz 627 ± 291 L, CL 18.0 ± 8.3 L/h. C max /AUC (25 mg/m 2 ): 1,069 ± 2,456 ng/mL, 3,764 ± 2,579 ng/mL*h. Dose proportional increase in AUC and C max observed. ↑polymerized microtubules observed with maximal effect at end of infusion. Antitumor activity: NSCLC (1pt: confirmed PR; 10 cycles), ovarian cancer (1pt: 40% ↓CA125; 6 cycles), and H&amp;N (1 pt: SD), these pts had all received doses ≥ 7.5 mg/m 2 . Conclusions: Accrual continues to define the optimal dose on both schedules; use of aggressive anti-diarrheal prophylaxis has been implemented. No significant financial relationships to disclose.
The Architecture of Autism Spectrum Disorder Risk
Authors: Amandeep Jutla, Hannah Reed, Jeremy Veenstra-VanderWeele
Journal: JAMA Psychiatry (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 Psychiatry 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 Psychiatry journal
Inguinal lymphadenopathy in an HIV seropositive patient
Authors: Ranjan Kumar Singh, Dipak Kumar
Journal: BMJ (2019)

A 40 year old man with HIV presented with a four week history of a painful mass in the left inguinal region and low grade fever. He had been taking antiretroviral drugs (tenofovir, lamivudine, and efavirenz) for the past four years. He had no recent history of animal scratch. Clinical examination revealed multiple massively enlarged fluctuant lymph nodes (3.5-4.5 cm) in the left inguinal region above and below the inguinal ligament, forming a “groove sign” (red arrow, fig 1). Some of the lymph nodes had broken down and formed sinuses. He had oedema of the lower part of the left leg. No …
High expression levels of CD90 to predict edema response to steroid treatment in glioblastoma multiforme (GBM) patients.
Authors: Cristobal Belda-Iniesta, Esther Holgado, Ricardo Hitt, Ricardo Prat, Javier De Castro, Inmaculada Ibañez de Cáceres, Rosario Perona, Angel Ayuso Sacido
Journal: Journal of Clinical Oncology (2013)

e13008 Background: GBM is the most aggressive brain tumour in the adult, with a median overall survival about 15 months. Patients usually present with many symptoms due to edema in addition of symptoms derived from the increasing tumour mass. Edema- dependent symptoms are currently treated with steroids. However, a number of patients do not respond to this therapy and almost all develop severe adverse effects. Currently, there is no biomarker that allows neuro-oncologists to predict edema response to steroid therapy. Methods: This is an observational study aimed to identify molecular markers based on massive expression analysis to predict edema response to steroids in patients diagnosed with GBM. Patients received dexamethasone (4mg bid) before surgery when high-grade glioma was suspected in contrast-enhanced brain MRI. 7 days later a second brain MRI was performed just before surgery to evaluate edema response according with RANO criteria. We collected neurological examinations at days -7 and -1 before surgery, surgical morbidity and time- to- recovery. Expression patterns (proliferative vs. mesenchymal) and a library of molecular markers related to both glioma-initiating cells and more differentiated cells from tumour mass were explored in tumoral and matched control samples from this cohort. Finally, we compared the expression levels of the selected molecular markers together with edema- responses after steroid therapy measured by brain MRI as well as with clinical values. Results: We recruited 54 patients and observed 32 edema- responses. We found that CD90 expression levels similar or above controls correlates with MRI response to steroids. Symptoms improvement and GBM resection without clinical worsening (p = 0.016). Nonetheless, we did not observed any association between CD90 expression level below controls and lack of response. Interestingly, we have observed that steroid responsiveness is not related with the proliferative and mesenchymal nature of the tumour. Conclusions: CD90 expression is a good predictor of edema response to dexamethasone and may be useful to identify candidates for steroid therapy.
Abstract P340: Information on Bedtimes and Wake Times Improves the Relation Between Self-Reported and Objective Assessments of Sleep in Adults
Authors: Marie-Pierre St-Onge, Ayanna Campbell, Ismel Salazar, Theresa Pizinger, Ming Liao, Brooke Aggarwal
Journal: Circulation (2018)

Introduction: Epidemiological studies often utilize self-reports to characterize total sleep time (TST). Studies provide discordant information on the association between self-reported and objective TST with some finding weak or no correlations and bias in reporting based on sex and body mass index. Objective: Our goal was to investigate the correlation between self-reported and objective measures of TST in a diverse sample of adult men and women volunteering to participate in sleep studies and determine whether sex, race/ethnicity, and weight status influence this association. Methods: Participants were individuals who screened for participation in sleep studies for whom we had &gt;7 d of wrist actigraphy sleep data (TST obj ) and subjective total sleep time (TST PSQI ) reported using the Pittsburgh Sleep Quality Index (PSQI) questionnaire (n=53 men and 60 women; n=67 minority/Hispanics; age 30.9±9.7y; BMI 26.2±3.2kg/m 2 ). Results: Average TST PSQI was greater than TST obj (0.63±0.99h, p&lt;0.0001). In univariate regression analyses, the difference between TST PSQI and TST obj did not vary by sex (ß=0.12, p=0.52), race/ethnicity (ß=0.15, p=0.48), age (ß=-0.01, p=0.27), or BMI (ß=0.04, p=0.13). Overall, there was no correlation between TST obj and TST PSQI (r=0.12, p=0.22), which did not vary when sex was analyzed separately (men: r=0.20, p=0.15; women: r=0.046, p=0.73). Interestingly, there were moderate and highly significant correlations between self-reported and objective assessments of bedtime (r=0.42, p&lt;0.0001) and wake time (r=0.35, p&lt;0.0001). We therefore used bedtime, waketime, and time to fall asleep information on the PSQI to calculate a new TST bed/wake . Average TST bed/wake was greater than TST obj (0.79±0.76h, p&lt;0.0001). This measure was correlated with TST obj (r=0.57, p&lt;0.0001); with strong correlation in women (r=0.76, p&lt;0.0001) and moderate correlation in men (r=0.36, p=0.0082). In univariate regression, the difference between TST bed/wake and TST obj varied by age (ß=-0.020, p=0.0051), BMI (ß=0.054, p=0.0021), race/ethnicity (ß=0.36, p=0.021), and sleep efficiency (ß=-0.089, p&lt;0.0001). Conclusions: Self-reported bedtimes and wake times were more accurately reported than estimated TST PSQI and provided a more reliable estimate of TST. In general, the degree of over-reporting was greater in younger and heavier individuals, non-White/Hispanics, and those with low sleep efficiency. Although self-reported assessments of sleep duration over-estimated objective measures by approximately 45 min, using information on habitual bedtimes, wake times, and time to fall asleep improved the relation in both men and women.
Fruit and Vegetable Intake and Risk of Posttransplantation Diabetes in Renal Transplant Recipients
Authors: António W. Gomes-Neto, Maryse C.J. Osté, Camilo G. Sotomayor, Else v.d. Berg, Johanna M. Geleijnse, Reinold O.B. Gans, Stephan J.L. Bakker, Gerjan J. Navis
Journal: Diabetes Care (2019)

OBJECTIVE Posttransplantation diabetes mellitus (PTDM) contributes to risk for cardiovascular morbidity and mortality in renal transplant recipients (RTRs). In the general population, consumption of a diet containing few fruits and vegetables predisposes to type 2 diabetes. The role of diet as a potential modifiable risk factor for PTDM has not been explored. Our focus was to investigate the prospective associations of fruit and vegetable intake with risk of PTDM in stable RTRs. RESEARCH DESIGN AND METHODS We included 472 adult RTRs who had a functioning graft ≥1 year. Fruit and vegetable intake was assessed by using a 177-item food frequency questionnaire. PTDM was defined according the American Diabetes Association’s diagnostic criteria for diabetes. RESULTS During 5.2 years of follow-up, 52 RTRs (11%) developed PTDM. Fruit intake was not associated with PTDM (hazard ratio [HR] 0.90 [95% CI 0.79–1.03] per 2log g/day; P = 0.13), whereas vegetable intake was inversely associated with PTDM (HR 0.77 [95% CI 0.63–0.94] per 2log g/day; P = 0.009). Mediation analyses revealed that ±50% of the association between vegetable intake and PTDM was mediated by variations in key components of the metabolic syndrome (i.e., HDL cholesterol, triglycerides, and waist circumference) as determined by the National Cholesterol Education Program’s Adult Treatment Panel III Expert Panel. CONCLUSIONS In this study vegetable intake, but not fruit intake, was associated with lower risk of PTDM in RTRs, likely largely through beneficial effects on key components of the metabolic syndrome. These findings further support accumulating evidence that supports a recommendation of higher vegetable intake by RTRs.
Perspectives of Medicare Advantage Plan Representatives on Addressing Social Determinants of Health in Response to the CHRONIC Care Act
Authors: Kali S. Thomas, Shayla N. M. Durfey, Emily A. Gadbois, David J. Meyers, Joan F. Brazier, Ellen M. McCreedy, Shekinah Fashaw, Terrie Wetle
Journal: JAMA Network Open (2019)

<h3>Importance</h3> The passage of the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act in 2018 allows Medicare Advantage (MA) plans, which enroll more than one-third of Medicare beneficiaries, greater flexibility to address members' social determinants of health (SDOH) through supplemental benefits. <h3>Objective</h3> To understand MA plan representatives' perspectives on the importance of addressing members' SDOH and their responses to the passage of the CHRONIC Care Act. <h3>Design, Setting, and Participants</h3> This semistructured qualitative interview study conducted via telephone from July 6, 2018, to November 7, 2018, included participants from 17 MA plans that collectively enrolled more than 13 million MA members (&gt;65% of the total MA market). Data analysis was conducted from September 18, 2018, to December 13, 2018. <h3>Main Outcomes and Measures</h3> Audio-recorded interviews were transcribed and then analyzed using a modified content analysis approach to identify major themes and subthemes. <h3>Results</h3> Thirty-eight participants representing 17 MA plans varying in region, star rating, and size were interviewed. Analysis of interviews revealed 3 key themes. The first theme was that participants increasingly recognize the value of addressing members' SDOH. The second theme was that participants had different perspectives on whether MA plans should directly address SDOH and how to do so. While some reported that they were taking advantage of the increased flexibility provided by the CHRONIC Care Act to design new benefits or partner with community-based organizations, others indicated that it was outside of their purview to directly address members' SDOH. The third theme was that participants described complex decision-making around how to provide supplemental benefits, including a need for evidence, return on investment, strong community partnerships, and guidance from the US Centers for Medicare &amp; Medicaid Services. <h3>Conclusions and Relevance</h3> These findings suggest that the changes in MA plans' benefit packages in response to the CHRONIC Care Act and their efforts to address SDOH will vary. Therefore, it is likely that MA enrollees will be differentially affected by the implementation of the CHRONIC Care Act.
Abstract 17906: Increasing Complexity of Sprint Fidelis Lead Extraction: A Single Center Experience
Authors: Madhu Reddy, Loren Berenbom, Namratha Reddy, Donita Atkins, Ramchandur Bhaktiani, Sudharani Bommana, Rhea Pimentel, Martin Emert, Raghu Dendi, Dhanunjaya Lakkireddy
Journal: Circulation (2012)

Background: Sprint fidelis (SF) lead is associated with a time-dependent increase in fracture rate. SF is considered a “relatively easily” extractable lead with low complication rate. However, the ...
Abstract P256: Increased Risk of Ischemic Stroke in Adolescents and Adults with Congenital Heart Disease
Authors: Lindsey M Duca, David Kao, Amber Khanna, Tessa Crume
Journal: Circulation (2017)

Introduction: Improvements in the treatment of congenital heart defects (CHD) have resulted in the majority of infants born with CHD surviving into adulthood. This new population of adolescents and adults living with CHD have unique challenges for lifelong care, such as suffering prematurely from ischemic strokes. Hypothesis: The aim of this analysis was to examine specific cardiovascular abnormalities that increase the risk of the early development of an ischemic stroke in individuals with CHD. Methods: This study included all patients diagnosed with CHD age 18-65 that sought medical care from 2011 to 2013 at the University of Colorado Hospital, the only adult CHD clinic in Colorado. There were 3,255 individuals mean±SD age of 47±13 years diagnosed with a CHD. Marelli groups were created to categorize the severity of CHD and cardiovascular comorbidities (atrial fibrillation, hypertension, congestive heart failure, and diabetes mellitus) were extracted from the medical records. Logistic regression models were performed to evaluate the association between cardiovascular comorbidities and risk for stroke, adjusting for age, sex, race, insurance status and CHD severity. Results: Of the 3,255 adolescents and young adults with CHD (52.3% male, 47.7% female), 146 (4.49%) were diagnosed with an ischemic stroke. The greatest proportion of ischemic strokes occurred in the shunt CHD severity group (Table). In the multivariable analysis of CHD patients, atrial fibrillation (OR=2.13, 95% CI 1.45-3.12, p=0.0001) and congestive heart failure (OR=2.60, 95% CI 1.52-4.44, p=0.0005) were associated with greater than a 2-fold increase in the odds of ischemic stroke after adjusting for age, sex, race, insurance status and CHD severity. Hypertension and diabetes mellitus were not associated with the risk of stroke. Conclusion: Cardiovascular comorbidities were strongly associated with the development of an ischemic stroke in adolescents and adults with CHD independent of CHD severity.