tbuckley/cabot-search huggingface dataset:
Impact of inflammatory bowel disease on urologic oncology surgical outcomes and costs of care.
Authors: Ilana Goldberg, Steven Lee Chang, Shilajit Kundu, Eric A. Singer
Journal: Journal of Clinical Oncology (2020)

470 Background: Recent studies suggest an association between genitourinary malignancies and inflammatory bowel disease (IBD). Our objective was to investigate clinical and financial impacts of IBD on common major urologic cancer surgeries: radical prostatectomy (RP), radical cystectomy (RC), radical nephrectomy (RN), and partial nephrectomy (PN). Methods: Using ICD9 codes, the Premier Hospital Database was queried for patients who underwent one of four surgeries: RP, RC, RN, or PN from 2003 to 2015. The cohort was segregated into IBD patients and non-IBD patients. Multivariable logistic regression models were used to determine the independent impact of IBD on complication rates (by Clavien-Dindo classification and organ system) and readmission rates. Hospital cost differences between the two cohorts, adjusted to 2016 US dollars, were examined with multivariable quantile regression models. Results: Our study population included 220,192 patients with urological malignancies, 5165 (0.4%) of whom had IBD. After controlling for clinicodemographic variables, there were significantly higher odds for any complication (Clavien ≥1) for IBD patients compared to non-IBD controls for RC (Odds ratio [OR]: 3.04, 95% confidence interval [CI]: 1.25-7.43), RN (OR: 1.57, 95% CI: 1.1-2.23), and PN (OR: 1.5, 95% CI: 1.02-2.22). Specifically, IBD patients had significantly more gastrointestinal, infectious, and soft tissue complications. Readmission rates were significantly higher for IBD patients who underwent RC (OR: 2.50, 95% CI: 1.17-5.35) and PN (OR: 1.81, 95% CI: 1.17-2.80). Hospital costs were significantly elevated for IBD patients, ranging from +$893 (95% CI: 108-1677) to +$6261 (95% CI: 1861-10660). Conclusions: There was a significantly higher overall complication rate for IBD patients undergoing RC, RN, or PN compared to the non-IBD cohort. Hospital readmission rates were significantly higher for the IBD cohort who underwent RC and PN. Hospital costs associated with surgery were also increased for IBD patients. These findings may be important when counseling IBD patients about surgical outcomes and during development of enhanced recovery pathways or bundled payment programs.
Covid-19 — Navigating the Uncharted
Authors: Anthony S. Fauci, H. Clifford Lane, Robert R. Redfield
Journal: New England Journal of Medicine (2020)

Covid-19 — Navigating the Uncharted Fauci, Lane, and Redfield comment on the early clinical features and epidemiology of cases reported in Wuhan, China, along with current mortality data, noting th...
Treatment decision making in metastatic prostate cancer (mPC).
Authors: Frank Schumacher, Jiahui Xu, Laura Oswald, Benjamin Lee, Brian Gonzalez, Hui Zhang, Alicia K. Morgans
Journal: Journal of Clinical Oncology (2020)

e17552 Background: Multiple treatments with similar efficacy exist for mPC, leaving patients (pts) with complicated treatment choices. Shared decision-making (SDM) can facilitate treatment decisions. The extent to which SDM is used in mPC is unknown. We assessed mPC pt, caregiver, and physician perceptions of decision locus of control (DLOC) (SDM vs. physician- or pt-directed decisions), and the degree of agreement between groups. Methods: Pt/caregiver/physician triads completed surveys of decision-making practices between 12/2016 and 11/2017 after a clinic visit in which a decision occurred. Pts were included only if they had a caregiver present. To evaluate the degree of agreement between pt, caregiver, and physician perceptions of DLOC, we used the quadratic-weighted kappa coefficient (κ). Agreement was evaluated on an overall basis and by pt age group (5-year increments). Results: 50 pt/caregiver/physician triads participated, with median pt age of 72 yo. Most pts were white (96%) and married (90%). A majority of pts, caregivers, and physicians reported SDM (66%, 56%, and 52%, respectively). No group reported completely pt-directed decisions. Pts and physicians demonstrated agreement about DLOC for most encounters (weighted κ = 0.35; P = 0.01). Overall, pts and physicians agreed on the DLOC in 44% of cases, and SDM was the most common agreed-upon DLOC (36%). Relative to physicians, 34% of pts reported more pt influence on DLOC, and 22% of pts reported less pt influence on DLOC. In contrast, caregiver reports of DLOC were independent of physician reports (weighted κ = 0.23; P = 0.55). Overall, caregivers and physicians agreed on DLOC in 38% of cases, and SDM was the most common agreed-upon DLOC (32%). Relative to physicians, 46% of caregivers reported more pt influence on DLOC and 16% of caregivers reported less pt influence on DLOC. There was a statistically significant difference in the degree of agreement by pt age group between pts and physicians (P = 0.045) and caregivers and physicians (P = 0.002), although no specific pattern according to pt age was noted. Conclusions: A majority of pts, caregivers, and physicians reported SDM occurring in routine clinical visits for mPC. Pts reported a higher degree of agreement with their physicians in DLOC than caregivers. Both pts and caregivers perceived greater pt influence on treatment choice than physicians. Efforts to explore the association between SDM, pt satisfaction, and quality of life are ongoing.
FLT-PET At 6 Weeks Predicts Response Assessed by CT at 12 Weeks in Melanoma Patients Treated With Pembrolizumab
Authors: Randy Yeh, Megan H. Trager, Emanuelle M. Rizk, Grace G. Finkel, Luke W. Barker, Richard D. Carvajal, Larisa J. Geskin, Gary K. Schwartz, Lawrence Schwartz, Laurent Dercle, Yvonne M. Saenger
Journal: Clinical Nuclear Medicine (2020)

Purpose Investigate the ability of 18 F-fluorothymidine (FLT) PET combined with CT at 6 weeks to predict treatment response at 12 weeks after treatment with pembrolizumab. Methods Five patients with unresectable stage IV melanoma were included in this single-institution pilot study. Patients underwent FLT-PET/CT (baseline and 6 weeks) and CT (baseline and 12 weeks). FLT-PET/CT response and CT response were assessed using PET Response Criteria in Solid Tumors and immune Response Evaluation Criteria in Solid Tumors, respectively. Patients were categorized as responders (complete response, partial response) and nonresponders (stable disease, progressive disease). Agreement between 6-week FLT-PET/CT and 12-week CT was calculated using Cohen kappa's agreement. Eight baseline FLT-PET/CT parameters were extracted: SUV max , SUV peak , SUV SD , SUV mean , proliferative tumor volume, total lesion proliferation, bone marrow–to–liver SUV max ratio, and spleen-to-liver SUV max ratio. Eight delta-parameters were extracted at 6 weeks by calculating variation in FLT uptake as percentage change from baseline. Results Agreement between 6-week FLT-PET/CT and 12-week CT was kappa = 0.615, P = 0.025. Three of 5 patients were categorized as responders on CT by immune Response Evaluation Criteria in Solid Tumors. At baseline, responders had a lower mean proliferative tumor volume and a higher bone marrow–to–liver SUV max ratio. At 6 weeks, responders demonstrated a decrease in tumor volume and tumor proliferation. Conclusions Our study illustrates the potential for FLT-PET/CT as an early predictor of response for patients with metastatic melanoma on anti-PD1 immunotherapy. Larger studies are indicated to confirm these findings.
Inhibition of LSD1 in MDS progenitors restores differentiation of CD141Hi conventional dendritic cells
Authors: Pragya Srivastava, Stephanie L. Tzetzo, Eduardo Cortes Gomez, Kevin H. Eng, Sheila N. Jani Sait, Joseph B. Kuechle, Prashant K. Singh, Kitty De Jong, Kyle R. Wiatrowski, Jennifer Peresie, Ava Dimitroff, Miranda L. Lynch, Jianmin Wang, Scott I. Abrams, Elizabeth A. Griffiths, Michael J. Nemeth
Journal: Leukemia (2020)
Abstract 12454: Vildagliptin Attenuates Cardiac Hypertrophy and Improves Ventricular Efficiency Through FGF21 Expression in Pressure-overloaded Mouse Heart
Authors: Nozomi Furukawa, Norimichi Koitabashi, Hiroaki Sunaga, Masaru Obokata, Yogi Umbarawan, Mas R Syamsunarno, Aiko Yamaguchi, Hiroki Matsui, Tomoyuki Yokoyama, Masahiko Kurabayashi
Journal: Circulation (2016)

Introduction: Basic and clinical studies have shown that Dipeptidyl Peptidase-4 (DPP-4) inhibitor an anti-hyperglycemic agent, has cardioprotective effects through angiogenesis, anti-hypertrophy or anti-apoptosis effect. However, recent clinical trials in patients with diabetes raise a concern about DPP-4 inhibitor’s effect on heart failure. Based on the controversy, we performed precise analyses for cardiac energy metabolism and cardiac performance in hypertrophied heart induced by pressure-overload mouse model with or without diabetes. Methods and Results: Non-diabetic C57Bl6 mice (BL6) and type2 diabetic C57Bl6 mice produced by high fat diet (diet-induced obesity, DIO) were treated with or without a DPP-4 inhibitor, vildagliptin (VLD) after inducing pathological cardiac hypertrophy by transverse aortic constriction (TAC). After 3-week treatment, VLD attenuated cardiac hypertrophy and dysfunction compared with vehicle (Veh) treated animals in BL6. However these effects were not observed in DIO mice. Myocardial energy substrate assay using 12 C-FDG (glucose tracer) and 132 I-BMIPP (free fatty acid tracer) showed that not only glucose uptake but also free fatty acid uptake were increased with VLD treatment in TAC heart. Gene expression analysis showed that fibroblast growth factor (FGF) 21, a protein which has been shown to have a critical role in energy metabolism, was increased in heart with VLD treatment. In vitro experiments showed that VLD administration increased FGF21 expression dose-dependently in cultured human cardiac fibroblasts but not in neonatal cardiomyocytes, suggesting that fibroblast-mediated FGF21 expression may regulate energy metabolism in stressed heart. Conclusions: VLD has a beneficial effect on myocardial energy metabolism associating with an improvement of ventricular performance in hypertrophied heart, partially through upregulation of FGF21. However, these beneficial effects in heart may be attenuated under type2 diabetic condition.
Cerebral Embolic Protection Devices in Transcatheter Aortic Valve Replacement—Effective in Stroke Prevention?
Authors: Rohan Khera, Saket Girotra
Journal: JAMA Internal Medicine (2020)

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
A phase I/II trial of sitravatinib (sitra) combined with nivolumab (nivo) in patients (pts) with advanced clear cell renal cell cancer (aCCRCC) that progressed on prior VEGF-targeted therapy.
Authors: Pavlos Msaouel, Peter F. Thall, Ying Yuan, Xuemei Wang, Eric Jonasch, Jianjun Gao, Matthew T. Campbell, Amishi Yogesh Shah, Paul Gettys Corn, Alda Tam, Kamran Ahrar, Priya Rao, Kanishka Sircar, Hirak Der-Torossian, Nizar M. Tannir
Journal: Journal of Clinical Oncology (2020)

612 Background: Sitra is a receptor tyrosine kinase (RTK) inhibitor targeting TAM receptors (Tyro3, Axl, MerTK), split family receptors (VEGFR2 and c-Kit) and c-Met. Inhibition of these RTKs has direct biological activity against aCCRCC and can also enhance immunotherapy with nivo by reducing immunosuppressive regulatory T-cells, myeloid derived suppressor cells, and type 2 tumor-associated macrophages. We therefore hypothesized that the addition of sitra to nivo will produce higher clinical activity than nivo alone. Methods: The objective of this phase I/II trial is to evaluate the safety and efficacy of sitra + nivo in pts with aCCRCC that progressed on up to two prior VEGF-targeted therapies. Eligibility criteria were similar to those used for CheckMate 025. The late-onset Bayesian EffTox design is used to account for potential late-onset immune-related toxicities, and allow optimal dose-finding of sitra from four dose levels (60, 80, 120, 150 mg/day) continuously based on both efficacy and toxicity. Additional objectives include estimation of survival times and correlative biomarkers. Results: A total of 38 pts have enrolled as of 22 October 2019 with 34 pts evaluable for response at ≥12 weeks. Tumor reductions have been noted in 28/34 pts (82.3%) with objective responses demonstrated in 13/34 pts (ORR = 38.2%), median progression-free survival of 10.5 months (95% CI 7.6 – 13.5), and 23/34 pts (67.6%) achieving disease control ≥ 6 months. Toxicities requiring dose-reduction of sitra within 12 weeks from treatment initiation have been noted in 14/34 pts (41.2%). The most common treatment-related adverse events include fatigue, diarrhea, palmar-plantar erythrodysesthesia, hypertension, and elevated lipase. There was one nivo-related Grade 5 event (myasthenia gravis). Updated dose-finding, safety and efficacy data will be presented. Conclusions: The combination of sitra + nivo has not demonstrated unexpected safety signals and produces higher objective responses and longer disease control compared with what is historically expected with nivo alone in pts with aCCRCC that progressed on prior VEGF-targeted therapy. Clinical trial information: NCT03015740.
Visible Light‐Responsive Dynamic Biomaterials: Going Deeper and Triggering More
Authors: Teresa L. Rapp, Cole A. DeForest
Journal: Advanced Healthcare Materials (2020)

Photoresponsive materials have been widely used in vitro for controlled therapeutic delivery and to direct 4D cell fate. Extension of the approaches into a bodily setting requires use of low-energy, long-wavelength light that penetrates deeper into and through complex tissue. This review details recent reports of photoactive small molecules and proteins that absorb visible and/or near-infrared light, opening the door to exciting new applications in multiplexed and in vivo regulation.
Evolution of skin prick test and specific IgE values of venom immunotherapy in daily clinical practice
Authors: Cristiana Solorzano Zepeda, Isabel Perez Allegue, Alicia Barra Castro, Jonnathan Acevedo Galvis, Dario Antolin-Amerigo, David Gonzalez de Olano, Belen De La Hoz
Journal: Journal of Allergy and Clinical Immunology (2020)
Exploratory Analysis to Identify Candidates Benefitting from Combination Therapy of Transarterial Chemoembolization and Sorafenib for First-Line Treatment of Unresectable Hepatocellular Carcinoma: A Multicenter Retrospective Observational Study
Authors: Zhexuan Wang, Enxin Wang, Wei Bai, Dongdong Xia, Rong Ding, Jiaping Li, Qiuhe Wang, Lei Liu, Junhui Sun, Wei Mu, Hui Zhao, Xingnan Pan, Guoliang Shao, Xiaoli Zhu, Guowen Yin, Haibin Shi, Jianbing Wu, Zhengyu Lin, Shufa Yang, Jueshi Liu, Wenhui Wang, Xu Zhu, Yong Lv, Jing Li, Hui Chen, Wenjun Wang, Kai Li, Xulong Yuan, Tanlei Yu, Jie Yuan, Xiaomei Li, Jing Niu, Zhanxin Yin, Jielai Xia, Daiming Fan, Guohong Han
Journal: Liver Cancer (2020)

&lt;b&gt;&lt;i&gt;Introduction:&lt;/i&gt;&lt;/b&gt; The benefits of combining transarterial chemoembolization (TACE) and sorafenib (TACE-S) over TACE alone for treatment of unresectable hepatocellular carcinoma (HCC) remain controversial. Yet, such populations are heterogeneous in terms of baseline characteristics. &lt;b&gt;&lt;i&gt;Objective:&lt;/i&gt;&lt;/b&gt; To investigate the predictors of survival benefits from added sorafenib and identify the potential candidates for TACE-S. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; This multicenter observational study was conducted in 17 Chinese tertiary hospitals for patients with unresectable, liver-confined HCC. Eligible patients with performance status score of ≤1 and Child-Pugh score of ≤7 were treated with TACE or TACE-S. Interactions between treatment and baseline variables were evaluated to find indicators for survival benefits, based on which the patients were stratified. Multivariate models adjusted for baseline characteristics or propensity score were used to compare overall survival (OS) and time to tumor progression (TTP). &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; From January 2009 to December 2015, 1,719 consecutive patients received TACE (&lt;i&gt;n&lt;/i&gt; = 1,406) or TACE-S (&lt;i&gt;n&lt;/i&gt; = 313). Although TACE-S compared with TACE improved TTP (adjusted hazard ratio [HR] 0.75, &lt;i&gt;p&lt;/i&gt; = 0.008), no difference in OS was observed (adjusted HR 0.87, &lt;i&gt;p&lt;/i&gt; = 0.090). Nevertheless, the tumor burden (sum of maximum diameter of largest tumor [cm] and tumor number) and albumin-bilirubin (ALBI) score independently predicted the survival benefits from added sorafenib (interaction &lt;i&gt;p&lt;/i&gt;&amp;#x3c; 0.001). For patients with either moderate tumor burden (7–13) or low ALBI score (no more than –2.8) defined as candidates, TACE-S prolonged OS (adjusted HR 0.73, &lt;i&gt;p&lt;/i&gt; = 0.003) and TTP (adjusted HR 0.72, &lt;i&gt;p&lt;/i&gt; = 0.014) compared to TACE alone, whereas its superiority disappeared in non-candidates. &lt;b&gt;&lt;i&gt;Conclusions:&lt;/i&gt;&lt;/b&gt; Not all unresectable HCC patients but those with moderate tumor burden or low ALBI score achieve survival benefits from TACE-S compared with TACE alone. Future randomized controlled trials focusing on the subset are warranted.
Dial-In Mobile Service Enables Patient Feedback on Community Health Care
Authors: Bridget M. Kuehn
Journal: JAMA (2020)

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 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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
31P S-Vegf (Vascular Endothelial Growth Factor) as Predictive Factor in Response to Anthracycline Based Chemotherapy in Patients with Locally Advanced Breast Cancer
Authors: D. Arya, B.J. Parikh, P.M. Shah, S.N. Shukla, K.M. Patel, A.S. Anand, S.S. Talati, S.A. Shah, A.A. Patel, B.B. Parekh
Journal: Annals of Oncology (2012)
Dose-related Allergic Reactions Decrease Over Time During Peanut Oral Immunotherapy in a Large, Randomized, Double-blind, Placebo-controlled, Phase 2 Study
Authors: Andrew Long, Natasha Purington, Sandra Andorf, Katherine O'Laughlin, Shu-Chen Lyu, Sayantani Sindher, Monali Manohar Manohar, Scott Boyd, Robert Tibshirani, Holden Maecker, Kaori Mukai, Mindy Tsai, Manisha Desai, Sharon Chinthrajah, Stephen Galli, Kari Nadeau
Journal: Journal of Allergy and Clinical Immunology (2020)
Comparison between oncological outcomes of primary versus salvage radical cystectomy for urothelial carcinoma of the bladder.
Authors: Seyedeh Sanam Ladi Seyedian, Zhoobin Bateni, Soroush T. Bazargani, Daniel Zainfeld, Jie Cai, Gus Miranda, Leslie Ballas, Sumeet Bhanvadia, Anne K. Schuckman, Hooman Djaladat, Siamak Daneshmand
Journal: Journal of Clinical Oncology (2020)

585 Background: This study aims to compare oncologic outcomes among patients who underwent salvage radical cystectomy (sRC) for recurrent urothelial carcinoma (UC) of the bladder following radiotherapy (RT) with primary radical cystectomy (pRC). Methods: We retrospectively reviewed the data of 3705 primary consented cystectomy patients of our IRB-approved bladder cancer database from Jan 1971 to June 2017 who underwent radical cystectomy for urothelial carcinoma of the bladder. Clinical and pathological data at the time of both RT and RC was collected. Patients with non-UCs and those receiving radiation for non-UCs were excluded. Multivariate analyses was performed to identify prognostic factors after RC for overall survival and recurrence-free survival. Results: 3050 patients were identified who underwent radical cystectomy for UC of the bladder. Of these, 128 patients (4.2%) underwent sRC following radiotherapy (RT). Patient characteristics including age, BMI, gender, and comorbidities were similar between the groups. Complications rates between the groups were similar at 30 days (43% sRC vs 39% pRC patients, p=0.41) and 90 days (52% sRC vs 48% pRC, p=0.42). Patients receiving sRC were less likely to receive a continent diversion (p&lt;0.001). Five-year overall survival following sRC was 47% in comparison to 63% for those undergoing pRC (p&lt;0.001) (Fig 1). However, no significant difference in five-year recurrence free survival was found (61% sRC vs 68% pRC; p=0.15). On multivariate analysis, sRC (HR 1.37, p=0.048), pathologic tumor stage ≥pT3a (HR 2.6, P &lt; 0.001) and lymph node metastases (HR 2.5, P &lt; 0.001) were associated with increased risk of local recurrence after radical cystectomy. Conclusions: Patients undergoing sRC are less likely to receive a continent urinary diversion and are at increased risk of local recurrence following cystectomy in comparison to patients receiving primary cystectomy.