tbuckley/cabot-search huggingface dataset:
Adjuvant chemotherapy with or without sequential radiation in resected pancreatic adenocarcinoma: Who will win RTOG 0848?
Authors: Ashwin Shinde, Richard Li, Scott Glaser, Mustafa Raoof, Vincent Chung, Gagandeep Singh, Susanne Warner, Yi-Jen Chen, Arya Amini
Journal: Journal of Clinical Oncology (2019)

334 Background: The current role of adjuvant radiation in the management of resected pancreatic adenocarcinoma (PC) is controversial. A prospective trial, RTOG 0848, is currently in process to determine optimal adjuvant therapy, comparing adjuvant chemotherapy (CT) with or without radiation (RT). We determined outcomes in this population using the National Cancer Database (NCDB). Methods: Patients with non-metastatic PC diagnosed from 2004 to 2015 were identified from the NCDB. Patients who underwent surgery and adjuvant chemotherapy were included. Patients who received RT were only included if RT began at least 4 months after CT, to emulate RTOG 0848 schema. A 6 month landmark analysis was performed. Overall survival (OS) was compared using log-rank Kaplan-Meier for univariate analysis (UVA), and Cox proportional hazards for multivariate analysis (MVA). Logistic regression was used to determine predictors of RT utilization and generate propensity scores. Results: We identified 16075 patients. Median follow-up was 30 months, 37 months for survivors. Patients received sequential RT in 9.5% of cases. On UVA, sequential RT demonstrated OS benefit compared to adjuvant chemotherapy alone (3-year OS 44.6% vs 35.3%, p &lt; 0.001). RT utilization was more likely with diagnosis after 2010, age ≤ 65 years, private insurance, higher income, ≤ 10 miles to treatment facility, treatment in the northeast, node positive disease, positive margins, and head of pancreas primary. On MVA, benefit to RT on OS was maintained (HR 0.68, 95% CI 0.63-0.73, p &lt; 0.001). Other factors that improved OS included diagnosis after 2010, no comorbidity, non-government insurance, higher income, and treatment at academic facility. Factors that predicted for worse OS included increasing pathologic tumor and nodal staging, positive margins, and CA 19-9 above a cut-off of 90. After propensity-adjustment, OS benefit was maintained for RT (HR 0.68, p &lt; 0.001). Conclusions: In a large national database analysis, sequential RT improves survival in patients who receive at least 4 months of adjuvant chemotherapy following upfront resection for pancreatic adenocarcinoma. The results of RTOG 0848 are awaited to confirm these findings.
Management of first-trimester miscarriage: a systematic review and network meta-analysis
Authors: Bassel H. Al Wattar, Nilaani Murugesu, Aurelio Tobias, Javier Zamora, Khalid S Khan
Journal: Human Reproduction Update (2019)

First-trimester miscarriage affects up to a quarter of women worldwide. With many competing treatment options available, there is a need for a comprehensive evidence synthesis.We conducted a systematic review and network meta-analysis to assess the effectiveness and safety of treatment options for first-trimester miscarriage: expectant management (EXP), sharp dilation and curettage (D+C), electric vacuum aspiration (EVAC), manual vacuum aspiration (MVA), misoprostol alone (MISO), mifepristone+misoprostol (MIFE+MISO) and misoprostol plus electric vacuum aspiration (MISO+EVAC).We searched MEDLINE, Embase, CINAHL, AMED and Cochrane Library from inception till June 2018. We included randomized trials of women with first-trimester miscarriage (<14 weeks gestation) and conducted a network meta-analysis generating both direct and mixed evidence on the effectiveness and side effects of available treatment options. The primary outcome was complete evacuation of products of conception. We assessed the risk of bias and the global network inconsistency. We compared the surface under the cumulative ranking curve (SUCRA) for each treatment.A total of 46 trials (9250 women) were included. The quality of included studies was overall moderate with some studies demonstrating a high risk of bias. We detected unexplained inconsistency in evidence loops involving MIFE+MISO and adjusted for it. EXP had lower effectiveness compared to other treatment options. The effectiveness of medical treatments was similar compared to surgery. Mixed evidence of low confidence suggests increased effectiveness for MIFE+MISO compared to MISO alone (RR 1.49, 95% CI: 1.09-2.03). Side effects were similar among all options. Fewer women needed analgesia following EVAC compared to MISO (RR for MISO 0.43, 95% CI: 0.27-0.68) and in the EXP group compared to EVAC (RR 2.07, 95% CI: 1.25-3.41). MVA had higher ranking (low likelihood) for post-treatment infection and serious complications (SUCRA 87.6 and 79.2%, respectively) with the highest likelihood for post-treatment satisfaction (SUCRA 98%).Medical treatments for first-trimester miscarriage have similar effectiveness and side effects compared to surgery. The addition of MIFE could increase the effectiveness of MISO and reduce side effects, although evidence is limited due to inconsistency. EXP has lower effectiveness compared to other treatment options.Systematic review registration: Prospero CRD42016048920.
Spirometry and Impulse Oscillometry Trajectories in an Inner-City Longitudinal Birth Cohort at High Risk for Asthma.
Authors: Sima Ramratnam, Alexandre Lockhart, Agustin Calatroni, Leonard B. Bacharier, Daniel J. Jackson, Robert A. Wood, Meyer Kattan, Peter O'Connor, Cynthia M. Visness, Peter J. Gergen, James E. Gern
Journal: Journal of Allergy and Clinical Immunology (2019)
PREDIMED trial of Mediterranean diet: retracted, republished, still trusted?
Authors: Arnav Agarwal, John P A Ioannidis
Journal: BMJ (2019)

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Abstract MP09: Geographic Disparities in Rates of End-Stage Renal Disease and Organ Supply in Gulf States Compared to Non-Gulf States
Authors: Rhiannon D Reed, Brittany A Shelton, Deanna M McWilliams, Margaux N Mustian, Paul A MacLennan, Deirdre Sawinski, Jayme E Locke
Journal: Circulation (2018)

Background: Organ Procurement Organizations are responsible for procuring and allocating organs for transplantation from deceased donors in Donation Service Areas (DSAs). The Final Rule prohibits geographic disparities in access to organs, but the current kidney allocation system does not account for potential supply variations based on disease burden and other population characteristics within DSAs. As such, regions with traditionally high rates of comorbid disease, such as the Gulf States region, may be disadvantaged if local supply is limited. Methods: Using data from the 2016 Robert Wood Johnson Foundation County Health Rankings, the Scientific Registry of Transplant Recipients public reports, and the United States Renal Data System, we compared comorbid disease prevalence, rates of end-stage renal disease (ESRD), and expected organ donation rates by Gulf States location. Results: Prevalence of African American ethnicity, diabetes, fair/poor self-rated health, physical inactivity, food insecurity, and uninsurance were higher among DSAs in the Gulf States region vs. non-Gulf States (Table). Conversely, the prevalence of non-Hispanic White ethnicity, college education, and median household income were higher among non-Gulf States. The rate of ESRD varied by DSA, ranging from &lt; 162 cases per 100,000 to &gt; 225 cases per 100,000 (Figure). Median rate of ESRD was 214.4 per 100,000 among DSAs in the Gulf States, vs. 187.1 per 100,000 in the non-Gulf States (p=0.003). Expected rate of organ donation per 100 eligible deaths was 71.1 in Gulf States and 75.4 in non-Gulf States (p=0.01). Conclusion: Higher rates of ESRD were observed in the Gulf States region, suggesting a greater need for organs than non-Gulf States. However, fewer donors were estimated in Gulf States, likely due to high comorbid disease burden, compared to non-Gulf States. These data suggest the need to examine allocation policy to prevent geographic disparities in access to deceased donor transplantation.
Abstract 20527: Growing Burden of Cerebrovascular Disease Mortality in an 11-Year Study, Yazd, Iran
Authors: Mojtaba Mirzaei, Mahboobehsadat Mirzadeh, Mohsen Mirzaei
Journal: Circulation (2017)

Introduction: Previous studies regarding the public health burden of cerebrovascular disease (CVD) stratified by age are limited. Years of potential life lost (YPLL) is a well-defined indicator that provides an overall image of the impact of disease mortality in society. Methods: We obtained mortality data for CVD (ICD10 codes of I60-I69) and all causes in 2000-2010 from Yazd provincial death registration system. This registry integrates data from hospitals, forensics, and cemeteries for Yazd residents. Based on age at death and life expectancy of each age-sex group, we calculated YPLL due to CVD and all causes using the method of 2010 global burden of disease study. We compared YPLL due to CVD with total YPLL in various age groups and investigated its annual trend. Results: We included 6344 records of CVD deaths (M/F ratio: 0.85). Mean age at death was 77.5±11.5 years (Males:76.7±12.1, Females:78.1±10.8). CVD death rate increased from 39.10 per 100000 in 2000 to 67.48 in 2010. Similarly, the proportion o...
Central Mechanisms of Glucose Sensing and Counterregulation in Defense of Hypoglycemia
Authors: Sarah Stanley, Amir Moheet, Elizabeth R Seaquist
Journal: Endocrine Reviews (2019)

Glucose homeostasis requires an organism to rapidly respond to changes in plasma glucose concentrations. Iatrogenic hypoglycemia as a result of treatment with insulin or sulfonylureas is the most common cause of hypoglycemia in humans and is generally only seen in patients with diabetes who take these medications. The first response to a fall in glucose is the detection of impending hypoglycemia by hypoglycemia-detecting sensors, including glucose-sensing neurons in the hypothalamus and other regions. This detection is then linked to a series of neural and hormonal responses that serve to prevent the fall in blood glucose and restore euglycemia. In this review, we discuss the current state of knowledge about central glucose sensing and how detection of a fall in glucose leads to the stimulation of counterregulatory hormone and behavior responses. We also review how diabetes and recurrent hypoglycemia impact glucose sensing and counterregulation, leading to development of impaired awareness of hypoglycemia in diabetes.
The Path to Diagnostic Excellence Includes Feedback to Calibrate How Clinicians Think
Authors: Ashley N. D. Meyer, Hardeep Singh
Journal: JAMA (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 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
Abstract 20721: Death Despite Enalapril Therapy vs. Survival Despite Placebo in the Studies of Left Ventricular Dysfunction (SOLVD) Trial: Insights into the Role of Traditional Risk Factors for Mortality in Heart Failure and Reduced Ejection Fraction (HFrEF)
Authors: Phillip H Lam, Daniel J Dooley, Apostolis Tsimploulis, Cherinne Arundel, Ross Fletcher, Javed Butler, Prakash Deedwania, Michel White, Ioannis Kanonidis, Charity Morgan, Wen-Chih Wu, Richard M Allman, Wilbert Aronow, George Howard, Gregg C Fonarow, Ali Ahmed
Journal: Circulation (2016)

Background: In the SOLVD trial, 2569 patients with HFrEF (EF≤35%) were randomly assigned to receive either placebo (n=1284) or enalapril (n=1285). During a mean follow-up of 41 months, all-cause mo...
Comparisons of in-house wheat skin prick test extracts for the diagnosis of wheat dependent exercise induced anaphylaxis (WDEIA)
Authors: Siwaporn Sapsaprang, Thunyatorn Phisitbuntoon, Punchama Pacharn, Witchaya Srisuwatchari, Nualanong Visitsunthorn, Orathai Jirapongsananuruk
Journal: Journal of Allergy and Clinical Immunology (2019)
Alan George Gordon
Authors: Patrick Gordon
Journal: BMJ (2019)

Alan George Gordon was born in Belfast, the youngest of four brothers, all of whom studied medicine at Queens University. He qualified in 1953, initially intending to be a GP. He wanted to complete his national service before applying for a partnership and took up a post as captain in the Royal Army Medical Corps in 1955. He was posted to the new obstetric unit at the British Military Hospital in Hong Kong, where he worked until 1958. He completed training in gynaecology in Belfast, and met his wife to be, Mary, whom he married in 1963. He was appointed consultant in obstetrics and gynaecology in Hull in 1965, and led a busy professional life with a large patient following and regular on calls.

In 1968 he started using laparoscopy, initially for inspecting the …
Prolonged Remission Achieved in a Relapsing Idiopathic Multicentric Castleman Disease Patient with a Novel, Targeted Treatment Approach
Authors: David C Fajgenbaum, Dustin Shilling, Helen L Partridge, Sheila K Pierson, Jason R Ruth, Christopher Sheild Nabel, Katie Stone, Vandana Chaturvedi, Michael B. Jordan, Adam D. Cohen, Vera Krymskaya, Arthur H Rubenstein, Frits van Rhee, Thomas S Uldrick
Journal: Blood (2017)
Abstract B077: 3D reconstruction and machine learning-based analysis of prostate cancer from histologic images
Authors: Pekka Ruusuvuori, Mira Valkonen, Kimmo Kartasalo, Tapio Visakorpi, Matti Nykter, Leena Latonen
Journal: Cancer Research (2018)

Abstract Prostate cancer is multifocal in nature, and histologic grading is the key clinical prognostic factor. Imaging-based tools are required for decreasing the subjectivity of histologic grading, providing quantitative information of the tissue and the pathologic changes in it, and to allow quantitative associations of histologic alterations with other types of information collected from the tissues, such as genomic data. To enable imaging-based diagnosis, methods for quantifying both the naturally occurring heterogeneity of normal tissue and morphologic changes due to pathology need to be developed. On the other hand, accurate distinction of early pathologic changes from natural variation could provide novel information about development of tumors. Furthermore, the 3-dimensional evolution and growth patterns of tumors should be considered as, traditionally, histologic scoring mostly relies on individual tissue sections extracted from their spatial context. To build nonsubjective histologic analysis tools, and to model the multifocality of prostate cancer within the organ, we use analysis of histologic images to quantitatively describe prostate cancer. We present an approach for 1) imaging the whole organ into digital pathology slides, 2) reconstruction of the 3D structure of the organ based on the histologic images, and 3) both feature-based and deep learning-based quantitative analysis of the digital images. Our approach enables characterization of tissue morphology with numerical descriptors, enabling subsequent analysis, such as determining the likelihood of pathologic changes. Our current efforts show how heterogeneity in prostate tissue due to spatial location or cancer can be quantified with image-derived features. In addition, we use mouse prostate as a model to visualize and reconstruct a whole organ from high-resolution whole-slide images, and combine tissue type classification in the 3D reconstruction. Further development of these methods and their application for human samples will improve our understanding of human prostate pathologies and cancer evolution within the 3D environment of the organ. Citation Format: Pekka Ruusuvuori, Mira Valkonen, Kimmo Kartasalo, Tapio Visakorpi, Matti Nykter, Leena Latonen. 3D reconstruction and machine learning-based analysis of prostate cancer from histologic images [abstract]. In: Proceedings of the AACR Special Conference: Prostate Cancer: Advances in Basic, Translational, and Clinical Research; 2017 Dec 2-5; Orlando, Florida. Philadelphia (PA): AACR; Cancer Res 2018;78(16 Suppl):Abstract nr B077.
Randomized phase-II trial evaluating induction therapy with idarubicin and etoposide plus sequential or concurrent azacitidine and maintenance therapy with azacitidine
Authors: R. F. Schlenk, D. Weber, W. Herr, G. Wulf, H. R. Salih, H. G. Derigs, A. Kuendgen, M. Ringhoffer, B. Hertenstein, U. M. Martens, M. Grießhammer, H. Bernhard, J. Krauter, M. Girschikofsky, D. Wolf, E. Lange, J. Westermann, E. Koller, S. Kremers, M. Wattad, M. Heuser, F. Thol, G. Göhring, D. Haase, V. Teleanu, V. Gaidzik, A. Benner, K. Döhner, A. Ganser, P. Paschka, H. Döhner
Journal: Leukemia (2019)

The aim of this randomized phase-II study was to evaluate the effect of substituting cytarabine by azacitidine in intensive induction therapy of patients with acute myeloid leukemia (AML). Patients were randomized to four induction schedules for two cycles: STANDARD (idarubicin, cytarabine, etoposide); and azacitidine given prior (PRIOR), concurrently (CONCURRENT), or after (AFTER) therapy with idarubicin and etoposide. Consolidation therapy consisted of allogeneic hematopoietic-cell transplantation or three courses of high-dose cytarabine followed by 2-year maintenance therapy with azacitidine in the azacitidine-arms. AML with CBFB-MYH11, RUNX1-RUNX1T1, mutated NPM1, and FLT3-ITD were excluded and accrued to genotype-specific trials. The primary end point was response to induction therapy. The statistical design was based on an optimal two-stage design applied for each arm separately. During the first stage, 104 patients (median age 62.6, range 18-82 years) were randomized; the study arms PRIOR and CONCURRENT were terminated early due to inefficacy. After randomization of 268 patients, all azacitidine-containing arms showed inferior response rates compared to STANDARD. Event-free and overall survival were significantly inferior in the azacitidine-containing arms compared to the standard arm (p < 0.001 and p = 0.03, respectively). The data from this trial do not support the substitution of cytarabine by azacitidine in intensive induction therapy.
Sidedness in metastatic colorectal carcinoma: Which are the factors which influence the prognosis?
Authors: Maria Kogay, Ludovic Evesque, Antoine Falcoz, Angelique Saint, Gerard Cavaglione, Renaud Schiappa, Guillaume Baudin, Gerard A. Milano, Emmanuel Chamorey, Eric Francois
Journal: Journal of Clinical Oncology (2019)

497 Background: Recent reports demonstrate prognostic and predictive impacts of the location of the primary tumor in metastatic colorectal cancer (mCRC). Our retrospective analysis aimed to determine the influence of primary site on metastatic distribution and disease evolution. Methods: From our database all patients (pts) with mCRC (except transverse carcinoma) treated from 1/12/2007 to 1/12/2016 in our institution were collected. Univariate and multivariate analyses were performed to identify predictors of overall survival (OS). Results: A total of 284 pts with available data were analyzed: 83 with Right-sided Colon Cancer (RCC) (29%), 123 with Left-sided Colon Cancer (LCC) (43%) and 78pts with Rectal Cancer (RC) (28%). Hepatic, lung, lymph nodes and peritoneal metastases were respectively found in 63%, 36%, 23% and 20% of the population. The incidence or number of liver metastases were not influenced by sidedness (p = 0.06), LCC presented more bilobar involvement compared to RCC and RC (p = 0.017). Peritoneal carcinomatosis was significantly correlated to colon cancer (p = 0.002), whereas lung metastases were more common in RC (p &lt; 0.001). Patients with RCC more often presented distal lymph node involvement (p = 0.008). RAS mutation status was known for 241pts (80%), of those 110 (37%) were RAS mutated with no significant differences between RCC, LCC and RC (p = 0.4), BRAF mutation (p = 0.007) was more common in RCC. On a multivariable analysis, primary tumor resection (PTR) and complete response after first line therapy were associated with a better OS but only a trend was observed for LCC and RC. Lung, lymph and peritoneal metastasis were associated with worse OS (Table). Conclusions: These results suggests that mCRC had different clinical presentation at diagnosis, the association with molecular features may explain the independent prognostic factor for OS of the sidedness. [Table: see text]
Nonlesional Atopic Dermatitis Skin Shows Alterations in Langerhans Cells in Close Proximity to Tight Junction Fragmentation
Authors: Takeshi Yoshida, Mike P. Cahill, Angus R. Fung, Eric L. Simpson, Mark Boguniewicz, Jon M. Hanifin, Anna De Benedetto, Gloria L. David, Patrick M. Schlievert, Donald Y.M. Leung, Lisa A. Beck
Journal: Journal of Allergy and Clinical Immunology (2019)
Extreme Physical Activity and Coronary Artery Calcification—Running Heavily and Safely With “Hearts of Stone”
Authors: Carl J. Lavie, Ulrik Wisløff, Roger S. Blumenthal
Journal: JAMA Cardiology (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 Cardiology 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 Cardiology journal
Contribution of non-HLA incompatibility between donor and recipient to kidney allograft survival: genome-wide analysis in a prospective cohort
Authors: Roman Reindl-Schwaighofer, Andreas Heinzel, Alexander Kainz, Jessica van Setten, Kira Jelencsics, Karin Hu, Bao-Li Loza, Michael Kammer, Georg Heinze, Petra Hruba, Alena Koňaříková, Ondrej Viklicky, Georg A Boehmig, Farsad Eskandary, Gottfried Fischer, Frans Claas, John C Tan, Tom J Albert, Jigar Patel, Brendan Keating, Rainer Oberbauer
Journal: The Lancet (2019)