tbuckley/cabot-search huggingface dataset:
Abstract P172: Relationship of Four Blood Pressure Indexes to Subclinical Cerebrovascular Diseases Assessed by Brain MRI in General Japanese Men
Authors: Ebtehal Salman, Aya Kadota, Takashi Hisamatsu, Hiroyoshi Segawa, Sayuki Torii, Akira Fujiyoshi, Keiko Kondo, Hisatomi Arima, Akihiko Shiino, Kazuhiko Nozaki, Katsuyuki Miura, Hirotsugu Ueshima
Journal: Circulation (2020)

Background: Blood pressure (BP) indexes (systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse pressure [PP], mean arterial pressure [MAP]) shows association with subclinical cerebrovascular diseases (SCVDs). Although various studies reported this association, there are still controversy in the effect size of long period versus short period of these indexes to SCVDs. Aim: Identifying the effect size of four BP indexes measured at two visits on SCVDs assessed by magnetic resonance imaging (MRI) in general Japanese men. Methods: Four office BP indexes were measured at two visits 4.5 years apart in general Japanese men aged 40-79 years. Participants without myocardial infarction or stroke history were analyzed (N=629). MRI obtained at 3 rd visit were investigated for prevalent of five SCVDs diagnosed as follows; lacunar infarction (LI)= any presence, periventricular hyperintensity (PVH)= Fazekas grade ≥2, deep subcortical white matter hyperintensity (DSWMH)= Fazekas grade ≥3, microbleeds= any presence, and intracranial arterial stenosis (ICAS)= ≥1% stenosis. Using multivariable logistic regression, we computed and compared odds ratio OR (95% CI) of each prevalent SCVD for 1 standard deviation higher of each of 4 BP indexes after adjusting for SCVDs’ conventional risk factors. Results: Participants’ mean age at Visit 1 was 63.9 years. Our results show all office BP indexes, except PP, similar association with MRI outcomes at both Visit 1 and Visit 2. SBP, DBP and MAP were associated with LI, PVH, DSWMH, microbleed and ICAS, while PP was associated with LI and ICAS only. Conclusion: In general Japanese men, BP indexes SBP, DBP and MAP measured at two distinct visits show similar association to all future MRI assessed SCVD, while PP shows association to LI and ICAS only.
Senescent T cells within suppressive tumor microenvironments: emerging target for tumor immunotherapy
Authors: Xia Liu, Daniel F. Hoft, Guangyong Peng
Journal: Journal of Clinical Investigation (2020)

The functional state of the preexisting T cells in the tumor microenvironment is a key determinant for effective antitumor immunity and immunotherapy. Increasing evidence suggests that immunosenescence is an important state of T cell dysfunction that is distinct from exhaustion, a key strategy used by malignant tumors to evade immune surveillance and sustain the suppressive tumor microenvironment. Here, we discuss the phenotypic and functional characteristics of senescent T cells and their role in human cancers. We also explore the possible mechanisms and signaling pathways responsible for induction of T cell senescence by malignant tumors, and then discuss potential strategies to prevent and/or reverse senescence in tumor-specific T cells. A better understanding of these critical issues should provide novel strategies to enhance cancer immunotherapy.
Does neo-adjuvant chemotherapy increase the risk of infection after limb salvage surgery for bone tumors?
Authors: S. Sankaranarayanan, V. Sokolovskiy, V. Voloshin, M. Aliev, V. Zubikov, D. Nisichenko, A. Sokolovskiy
Journal: Journal of Clinical Oncology (2007)

20532 Background: Neo-adjuvant chemotherapy is commonly used to eradicate the micro metastases and to prepare the patient for limb-salvage surgery. It helps the surgeon to get good oncological margin intraoperatively. Methods: Between the period of 1992 - 2005, 321 patients underwent limb salvage surgery for bone tumors at the Department of General Oncology (Bone &amp; Soft tissue tumors), N. N. Blokhin Russian Cancer Research Center &amp; Moscow Regional Clinical Research Institute, Moscow, Russian Federation. 230/321 patients (Group A) received neo-adjuvant chemotherapy. The course of chemotherapy ranges from 2 to 11 cycles. 95/321 patients (Group B) did not receive neo-adjuvant chemotherapy. The histological diagnoses were: 155 - High grade osteosarcoma, 38 - Giant cell tumor, 36 - Malignant fibrous histiocytoma, 29 - Chondrosarcoma, 25 - Periosteal osteosarcoma, 21 - Metastasis from other organs and 17 - Ewing's tumor. Results: In Group A, 27 patients (11.7%) and in Group B, 7 (7.3%) had infection of endoprosthetic bed. Suppression of the immune system by chemotherapeutic agents is the main reason for the higher incidence of infection in Group A. All the 27 patients in Group A and 2 patients in Group B had revisional endoprosthetic replacement. In group A 7/27 and in Group B none of the 7 patients died of post operative infection. The follow-up ranged from 1 - 13 years (mean follow-up 6 years). Discussion: In our opinion, it has a major disadvantage, i.e. it increases the risk of postoperative infection. How best to combine this drug is still unknown. In the future, therapy for bone tumors should be enhanced by advances in pharmacology, immunology, and molecular genetics that will lead to more efficacious, specific and less toxic treatments. An interdisciplinary team approach is needed in order to advance the goal of local tumor control, limb salvage with optimum extremity function, minimal morbidity and improved long term survival. No significant financial relationships to disclose.
Abstract P386: Pregnancy-related Risk Factors May Signal Additional Risk For Future Cardiovascular Disease
Authors: Shivani M Reddy, Tamy H Moraes Tsujimoto, Wanda Nicholson, Jason Fine
Journal: Circulation (2020)

Introduction: Emerging data suggest that pregnancy may be a window on the future of women’s cardiovascular health. Cardiovascular disease (CVD) guidelines recommend using the Pooled Cohort Equation (PCE) to assess 10-year CVD risk based on traditional risk factors. Less is known about the role of pregnancy-related factors, such as a history of small for gestational age (SGA) infants or breastfeeding, and the risk of CVD events in addition to the PCE. Hypothesis: We hypothesize that pregnancy-related complications and breastfeeding can affect the risk of future CVD risk in addition to traditional risk factors currently accounted for by the PCE. Methods: Using NHANES 1999-2006, a weighted sample of 3,913 women (representing 27,102,057 women in the US population), ages 40-79, with a history of pregnancy, but no prior CVD, was identified. Variables for SGA infants and breastfeeding were abstracted along with traditional risk factors. Less than 5% of women were missing data on these variables. CVD outcomes were defined as a composite of (1) CVD death and (2) surrogates for CVD death, in which diabetes or hypertension were a secondary cause of death. CVD outcomes and survival time were obtained from the NHANES Linked Mortality File. The PCE was used to estimate 10-year CVD risk. Bivariate and survival analyses using Cox proportional hazards models adjusting for PCE risk score were performed. For survival analysis, the cause-specific hazard function was estimated considering the time of death as censoring for women dying from causes other than CVD outcomes, as well as the time of follow-up for women that did not present the death event. Results: Among the sample, 504 (11.8%) women had a SGA infant and 2133 (54.5%) reported a history of breastfeeding. 198 (5.1%) women had the composite CVD death outcome. CVD outcomes were lower in women with a history of breastfeeding (97 of 2133) compared to those who did not breastfeed (96 of 1629). (2.6% vs. 4.2%, p=0.002) The opposite relationship was observed for women with a history of SGA infant (4.2% (29 of 504) vs. 3.2% (161 of 3232), p=0.2). PCE scores were associated with breastfeeding and SGA, potentially confounding those effects. Survival analyses, adjusting for continuous PCE risk scores, showed an inverse association of breastfeeding and CVD outcomes (HR 0.7, 95% CI 0.5 to 1.0) and a positive association of history of SGA infant and CVD outcomes. (HR 1.4, 95% CI 0.8 to 2.2) Conclusion: Specific pregnancy-related complications and breastfeeding may provide additional, relevant information about the risk of CVD risk events beyond traditional risk factors. While further research is needed to incorporate pregnancy outcomes into risk prediction models, it may be helpful for clinicians to counsel women about the potential impact of pregnancy-related factors and breastfeeding on future cardiovascular health.
Abstract P297: Sex Differences in Cardiovascular Risk Factors Before and After Ascertainment of Diabetes and Risk for Incident Cardiovascular Disease; The Coronary Artery Risk Development in Young Adults (CARDIA) Study
Authors: Michael BANCKS, Ehimare Akhabue, Jamal S Rana, Jared P Reis, Pamela Schreiner, Yuichiro Yano, Cora E Lewis
Journal: Circulation (2020)

Introduction: Prevalent diabetes mellitus (DM) in mid-life is a stronger risk factor (RF) for cardiovascular disease (CVD) mortality in women than men. However, it is unclear whether (1) changes in CVDRFs before and after incident DM differ by sex, and (2) if such differences are associated with the relationship of incident DM with subsequent CVD events. Hypothesis: Rates of change in CVDRFs after incident DM will be worse in women and incident DM will have a stronger association with CVD events in women than men. Methods: We included 4893 black and white CARDIA participants, ages 18-30 years at enrollment (1985-86). We ascertained incident DM (n=827) and assessed sex differences in annual change in body mass index (BMI); systolic and diastolic blood pressure (SBP/DBP); total, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) cholesterol before and after the ascertainment of DM using piecewise regression, stratified by race. We estimated hazard ratios (HR) for incident CVD over a median of 30.9 years of follow-up (range: 2, 32) and assessed effect modification between sex and DM. All analyses included adjustment for time-varying behavioral and clinical CVDRFs. Results: Age at DM ascertainment was lower for women than men (42.0 vs 45.8 years, sex-difference: 3.8, 95% confidence limits: 2.5, 5.0). Rates of change in CVDRFs before the ascertainment of DM did not differ by sex (Table). However, compared to men, women had greater annual changes in SBP, DBP, total cholesterol, and LDL, but not BMI and HDL, after DM. Median age at CVD did not differ by sex (48.8 years). Incident DM was associated with higher HR for incident overall CVD (HR: 1.45, 95%: 1.07, 1.96) and this association did not differ by sex (p interaction=0.8). Women had lower HR for incident CVD than men (HR: 0.57; 95%: 0.44, 0.74). Conclusion: While CVDRFs worsened more rapidly after DM for women, women had lower absolute and relative risks for incident CVD in mid-life than men. The association of incident DM by mid-life with subsequent CVD events did not differ by sex.
Abstract P389: Sleep Behavior Risk Score and BMI in a Sample of Adolescents Undergoing Bariatric Surgery
Authors: Jill L KAAR, Ishaah Talker, Samuel Russell, Thomas Inge, Stephen M Hawkins, Mark Aloia, Stacey Simon, Jaime Moore
Journal: Circulation (2020)

Objective: To examine sleep behaviors and their associations with health characteristics in a cohort of adolescents with severe obesity undergoing bariatric surgery at Children’s Hospital Colorado. Methods: A retrospective chart review of electronic medical records was performed. All patients receiving care at the Children’s Hospital Colorado (CHCO) Bariatric Surgery Center between 06/17-08/19 were included. Demographic, medical and family history, self-reported sleep behaviors, and laboratory measures were abstracted, including medical problem list (e.g., type 2 diabetes (T2D), hypertension) and body mass index (BMI). A sleep behavior risk score (SBRS) was developed using five criteria (short sleep defined as &lt;8 hrs/night, variability of sleep timing greater than 60 minutes, daytime naps, bedtime past midnight, and mobile devices in bed). Participants were classified as having a high SBRS if they met three or more of the criteria. T-tests were used to examine the differences between baseline health characteristics by SBRS score. Results: Data from 78 patients, aged 16.82.1, were reviewed. The majority of patients were female (71%), Hispanic (52%) and in 10-12 th grade in school (64%). Prior to surgery, 24% of the patients were diagnosed with hypertension and 20% with type 2 diabetes. The majority of patients (60%) had a high SBRS at baseline. High SBRS was significantly associated with higher baseline BMI (49.2 vs 45.0; p=0.03). SBRS score was not significantly associated with diagnosis of hypertension, type 2 diabetes, hyperlipidemia, or obstructive sleep apnea. Conclusions: In a population of adolescents seen in the Bariatric Surgery Center at CHCO, a majority of patients met criteria for high risk sleep behaviors, and worse sleep behaviors preoperatively were related to higher baseline BMI. A high SBRS may adversely impact adolescents’ overall health prior to surgery, which may have implications for weight loss success post-surgery. The evaluation for sleep health should be more rigorously evaluated and standardized as part of efforts to improve health outcomes in patients undergoing bariatric surgery.
First-line paclitaxel and cisplatin in patients with advanced squamous-cell carcinoma of the esophagus
Authors: X. Zhang, L. Shen, J. Li, Y. Li, J. Li, M. L. Jin
Journal: Journal of Clinical Oncology (2007)

15157 Objectives: To evaluate response rate, survival and toxicities of paclitaxel/cisplatin combination in patients with advanced or metastatic squamous-cell carcinoma of the esophagus. Methods: Thirty-nine patients with definite measurable indices and no prior chemotherapy were enrolled. Patients were treated with paclitaxel 175 mg/m 2 by 2-hour infusion day 1 and cisplatin 75 mg/m 2 infusion day 1. Treatment was repeated every 21 days. Results: Thirty-nine patients were enrolled. 35 patients were eligible to be evaluated for response. The overall response rate was 48.6% (95% confidence interval [CI], 0.31∼0.65) with complete and partial response rates of 2.8% and 45.7%, respectively. The median time to progression(TTP) was 7 months, and median survival time of all patients was 13 months. There was a significant difference in median overall survival between the patients who had received responding versus those who had not (p = 0.006). Median survival was 17 (95% CI, 11.9–22.0) and 10 months (95% CI, 7.6–12.35) for responding patients and non-responding patients, respectively. The 1-yr survival probability was 39%. Relief of dysphagia and pain were observed in 86.2% of the all patients. The most common toxicities were neutropenia and alopecia. There were no grade 4 clinical toxicities and treatment-related deaths were recorded in all patients. Conclusions: Paclitaxel and cisplatin is a promising treatment for patients with squamous-cell carcinoma of the esophagus. The toxicity of this regimen is within acceptable range. No significant financial relationships to disclose.
Abstract P353: Dietary Sodium Intake and Sodium Density in The United States: Estimates From Nhanes 2005-2006 and 2015-2016
Authors: Jiun-ruey Hu, Shivani Sahni, Kenneth J Mukamal, Courtney Millar, Yingfei Wu, Stephen P Juraschek
Journal: Circulation (2020)

Introduction: Current guidelines for sodium reduction focus on total daily sodium consumption (&lt;2300 mg/d) for an intake of 2100 kcal. However, calorie consumption varies substantially. Here, we quantify mean sodium intake, calorie intake, and sodium density across demographic groups in the US and over time. Hypothesis: We hypothesized that, compared to sodium density, total sodium may overestimate adherence to sodium recommendations, especially in older adults. Methods: In the National Health and Nutrition Examination Survey (NHANES), weighted mean sodium and energy intake was estimated in US adults as the average of two 24-hour dietary recalls. Sodium density was calculated as the mg of sodium per 1,000 kcal consumed. The prevalence of adherence to sodium intake (&lt;2300 mg/d) and sodium density (&lt;1.1 mg/kcal) limits was quantified by age group, self-reported sex, self-reported race/ethnicity, Calorie level (&lt;2100 kcal, ≥2100 kcal), and self-reported high blood pressure. Adherence prevalence estimates were compared between 2005-2006 and 2015-2016 survey periods by logistic regression adjusted for age, sex, and race/ethnicity. Methods: In 2015-2016, 24.8% of the US population (mean age 38 yr, 51% female, 12% black) adhered to the recommended &lt;2300 mg/d sodium intake, but only 5.6% achieved the recommended 1.1 mg/kcal sodium density (Table). In 2005-2006, these figures were 26.5% and 8.9%, respectively. While there was no change in adherence by total sodium consumption (P = 0.11), adherence by sodium density was significantly lower in 2015-2016 than 2005-2006 (P &lt; 0.001). The difference in adherence between total sodium and sodium density goals was greater among older adults (≥70 years), women, Hispanic adults, and adults consuming &lt;2100 kcal per day. Conclusions: In 2015-2016, &lt;6% of US adults consumed sodium densities at recommended levels. The prevalence of those achieving these goals is lower compared to 10 years prior. Further efforts to regulate population sodium intake are urgently needed.
Continuation of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in the Face of Kidney Disease Progression—Safe and Possibly Life Saving
Authors: Colette DeJong, Richard W. Grant
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
Multi-institutional phase II study of carboplatin-gemcitabine combination chemotherapy in elderly patients (pts) with advanced non-small cell lung cancer (NSCLC)
Authors: J. Sasaki, H. Uramoto, K. Kashiwabara, H. Kishi, E. Moriyam, S. Ushijima, S. Fujii, H. Senba, I. Okamoto
Journal: Journal of Clinical Oncology (2007)

18179 Background: Because elderly pts may tolerate platinum-based combination chemotherapy poorly, single-agent chemotherapy is selected for the treatment regimen. However, retrospective subgroup analyses have consistently indicated that elderly pts indeed benefit from platinum-based combination chemotherapy as well as their younger counterparts. This phase II study evaluated the efficacy and safety of carboplatin-gemcitabine combination chemotherapy in elderly pts with advanced NSCLC. Methods: Fifty-four pts aged more than 70 years old (median, 77; range, 70–88) with previously untreated advanced NSCLC were enrolled on this trial. Additional criteria included the presence of measurable lesions, an Eastern Cooperative Oncology Group performance status of 0 or 1, and adequate organ function. Pts received carboplatin at an area under the curve of 4 mg/ml/min on the first day and gemcitabine at 1000 mg/m2 on the first and eighth day of consecutive 3 week periods. The primary endpoint was to determine the objective response rate of this platinum-doublet regimen. The RECIST criteria were used to measure response. Results: Enrolled pts included 15/39 with stage IIIB/IV diseases. Fifty-one out of enrolled pts were eligible for efficacy and safety analyses. The median number of treatment cycles was 4 (range, 1–7). Fifteen partial responses (response rate: 29%) were obtained. The median TTP was 118 days. Hematological toxicities of grade 3/4 included leukopenia (46%), neutropenia (72%) and thrombocytopenia (50%). Non-hematological toxicities of grade 3/4 included nausea (6%), appetite loss (7%), fatigue (7%) and infection (9%). Conclusions: The combination carboplatin-gemcitabine at these doses has shown activity with a favorable toxicity profile for fit elderly pts with advanced NSCLC. No significant financial relationships to disclose.
The clinical experience in screening breast cancer using FDG-PET
Authors: Mai Mishima, Uhi Toh, Shino Nakagawa, Mari Fukunaga, Toshiro Yahara, Etsuyo Ogo, Kazuo Shirouzu
Journal: Cancer Research (2008)

3181  Purpose: The aim is to evaluate the efficacy of whole-body fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) in screening breast cancer involved the breast and axillary regions. Methods: 72 women with palpable breast tumor underwent PET scan for clinical diagnose and 8 women with positive uptake in screening whole body PET scan. Uptake PET breast lesions were evaluated by confirmatory standard staging studies, patients underwent computed tomography (CT), MRI, x-ray (XR), or pathology.Results: Of the 76 positive lesions, 66 (86.8%) were true positive (TP) for neoplastic disease, and 10 (13.2%) were false positive (FP) for non-neoplastic disease (mastopathy etc.). Of 4 PET negative lesions, 4(100%) were true negative for non-neoplastic disease. The sensitivity, specificity and accuracy for palpable breast mass were 100%, 44% and 93%, respectively. In contrast, those for the detection of metastatic axillary lymph node were 56%, 97% and 82%, respectively. The SUVmax value of TP cases was significant high than FP cases. Furthermore, the SUVmax value was also significant high in cases with the histology of a solid-tubular ductal carcinoma and/or Her2 strong 3+ expression. Conclusions: Whole-body FDG-PET indicated high sensitivity for palpable disease including primary breast cancer, but showed lower sensitivity in metastatic axillary lymph node. The application of PET scan may improve the detection of breast cancer and may be helpful in evaluation of axillary nodal staging.