tbuckley/cabot-search huggingface dataset:
A community oncology palliative program: Early results for cost and quality measures within OCM program claims data.
Authors: Adil Jamal Akhtar, Jeffrey Margolis, Karma Maxwell, Andrew A. Muskovitz, Richard Philip Zekman, Karna Sheth, Samer Ballouz, Yusuf Qamruzzaman, Mohammed Ibrahim, Tammy Scott-Barney, Lexi Stortz, Maria Fabbiano
Journal: Journal of Clinical Oncology (2019)

11585 Background: Oncology Care Model (OCM) is an initiative of the Centers for Medicare and Medicaid Innovation which aims to provide higher quality and more coordinated oncology care while lowering the cost. Oncology Division of Michigan Health Professionals (MHP) participates in OCM. Palliative and End of Life care was identified as one of the quality improvement areas. A community oncology Palliative care (PC) program was launched in October 2017. Methods: The multidisciplinary PC team was led by Board certified palliative care and hospice physicians. Patients appropriate for PC referral were identified by participating medical oncologists. Patients were contacted by the PC team. If the patients agreed a Nurse Practitioner (NP) would assess and follow the patients at home. Care was coordinated by the NP’s in communication with the palliative care team and the primary medical oncologists. Last 30-day (limited by the OCM episode or patient death) OCM program claims data was analyzed by IntegraConnect. Results: From October 2017 to October 2018 a total of 273 patients were referred to the PC program. Fifty-eight patients were identified as having OCM episodes, of these 36 patients had claims data through June 30, 2018. Twenty patients accepted and were engaged with PC,16 patients declined or were unable to reach for PC and formed the comparison group. Even when drug and office costs were excluded, PC engaged patients spent 17% less versus the comparison group (93k vs 112k) in last 30-day claims data. PC engaged patients had a lower acute care facility costs which accounted for 50% (46k) of reimbursement, compared with 95% (105k) for the comparison group. Fourteen OCM patients referred to Palliative program died within episode. 80% (8/10) of engaged patients met quality measure for OCM-3, at least 3 days in hospice vs. 0% (0/4) of patients who declined palliative care, before episode-death. Conclusions: Palliative engaged OCM patients experienced more care at their homes at a lower cost. Palliative program improved practice performance in OCM-3 quality measure. MHP Palliative program is reaching patients in OCM episodes but the numbers are still small.
Efficacy and Safety of Second- or Third-Line Nab-Paclitaxel plus Durvalumab in Patients with Advanced NSCLC (ABOUND.2L+)
Authors: D Morgensztern, R Govindan, M Cobo, S Ponce Aix, P E Postmus, C Lewanski, J Bennouna, J Fischer, O Juan-Vidal, D Stewart, A Ardizzoni, R Bhore, M Wolfsteiner, M Reck, D Talbot, T J Ong
Journal: Journal of Thoracic Oncology (2018)
Peripheral Circulating Exosome-Mediated Delivery of miR-155 as a Novel Mechanism for Acute Lung Inflammation
Authors: Kangfeng Jiang, Jing Yang, Shuai Guo, Gan Zhao, Haichong Wu, Ganzhen Deng
Journal: Molecular Therapy (2019)

Emerging evidence has revealed that excessive activation of macrophages may result in an adverse lung inflammation involved in sepsis-related acute lung injury (ALI). However, it has never been clearly identified whether peripheral circulating serum exosomes participate in the pathogenesis of sepsis-related ALI. Therefore, the purposes of our study were to investigate the effect of serum exosomes on macrophage activation and elucidate a novel mechanism underlying sepsis-related ALI. Here we found that exosomes were abundant in the peripheral blood from ALI mice and selectively loaded microRNAs (miRNAs), such as miR-155. In vivo experiments revealed that intravenous injection of serum exosomes harvested from ALI mice, but not control mice, increased the number of M1 macrophages in the lung, and it caused lung inflammation in naive mice. In vitro, we demonstrated that serum exosomes from ALI mice delivered miR-155 to macrophages, stimulated nuclear factor κB (NF-κB) activation, and induced the production of tumor necrosis factor alpha (TNF-α) and interleukin (IL)-6. Furthermore, we also showed that serum exosome-derived miR-155 promoted macrophage proliferation and inflammation by targeting SHIP1 and SOCS1, respectively. Collectively, our data suggest the important role of circulating exosomes secreted into peripheral blood as a key mediator of septic lung injury via exosome-shuttling miR-155. Emerging evidence has revealed that excessive activation of macrophages may result in an adverse lung inflammation involved in sepsis-related acute lung injury (ALI). However, it has never been clearly identified whether peripheral circulating serum exosomes participate in the pathogenesis of sepsis-related ALI. Therefore, the purposes of our study were to investigate the effect of serum exosomes on macrophage activation and elucidate a novel mechanism underlying sepsis-related ALI. Here we found that exosomes were abundant in the peripheral blood from ALI mice and selectively loaded microRNAs (miRNAs), such as miR-155. In vivo experiments revealed that intravenous injection of serum exosomes harvested from ALI mice, but not control mice, increased the number of M1 macrophages in the lung, and it caused lung inflammation in naive mice. In vitro, we demonstrated that serum exosomes from ALI mice delivered miR-155 to macrophages, stimulated nuclear factor κB (NF-κB) activation, and induced the production of tumor necrosis factor alpha (TNF-α) and interleukin (IL)-6. Furthermore, we also showed that serum exosome-derived miR-155 promoted macrophage proliferation and inflammation by targeting SHIP1 and SOCS1, respectively. Collectively, our data suggest the important role of circulating exosomes secreted into peripheral blood as a key mediator of septic lung injury via exosome-shuttling miR-155.
Phenotype in an Infant with <i>SOD1</i> Homozygous Truncating Mutation
Authors: Peter M Andersen, Ulrika Nordström, Konstantinos Tsiakas, Jessika Johannsen, Alexander E Volk, Tatjana Bierhals, Per Zetterström, Stefan L Marklund, Maja Hempel, René Santer
Journal: New England Journal of Medicine (2019)

Absence of SOD1 Activity and Motor Neuron Syndrome In a child with a homozygous truncating mutation in SOD1, SOD1 activity in red cells was absent and fibroblasts grew only with oxygen deprivation....
Semiquantitative analysis of line blot assay for myositis-specific and myositis-associated antibodies: a better performance?
Authors: Ilaria Cavazzana, Micaela Fredi, Franco Franceschini
Journal: Annals of the Rheumatic Diseases (2019)

Semiquantitative analysis of line blot assay for myositis-specific and myositis-associated antibodies: a better performance?We read with interest the letter of Espinosa-Ortega F et al 1 comparing line immunoblot assay (LIA) and immunoprecipitation (IP) performance in the detection of myositis-specific antibody (MSA) and myositis-associated antibody (MAA).The authors found a global moderate agreement between tests, with a very good agreement for anti-signal recognition particle (SRP), anti-Ku and anti-small ubiquitin-like modifier activating enzyme (SAE1); a good agreement for anti-hystidil-tRNA synthetase (Jo-1) and a moderate agreement for anti-PM/Scl, anti-melanoma differentiation-associated gene 5 (MDA5) and anti-transcription intermediary factor 1 (TIF1 gamma).We previously analysed the performance of LIA (Euroline Autoimmune Inflammatory Myopathies 15 Ag (IgG) Euroimmun, Lubeck, Germany) and IP, revealing a lower global agreement (k:0.30), and different rate of agreement for single specificities, 2 compared with Espinosa-Ortega observation.In particular, we found a lower agreement rate for anti-Jo-1, PM/Scl and anti-Ku and higher agreement rate for anti-MDA-5, anti-TIF1 gamma and anti-Mi-2.Although the nature of antigens was the same (ie, native for Jo-1 and recombinant for others), we tried to find a reason for such discrepancies, separately analysing the concordance basing on the semiquantitative level of positivities of LIA.Considering only high positive (+++) values, we obtained a better agreement for anti-Mi-2 antibodies (from global k: 0.50 to high-positive k: 0.79) and anti-MDA-5 (from global k:0.63 to high-positive k:0.85).No difference of agreement rate was observed between tests if considering only high or moderate/ high positivities by LIA for anti-Jo-1, anti-nuclear matrix protein (NXP-2) and anti-TIF1 gamma.No comparisons have been made for non-Jo-1 anti-synthetases antibodies, anti-SRP and anti-SAE due to low number of positive sera.The introduction of commercial LIA improved the diagnostic accuracy of myositis patients, given that the routine use of IP is very hard in clinical practice.Anyway, some discrepancies between laboratories still remains, maybe due to the known lack of analyte-specific controls and calibrators with a possible inter-manufacturers variability. 3Maybe, considering only high or moderate positivities could help the clinician to avoid false positive, in particular when multiple MSA specificities have been detected, considered a rare event in inflammatory myositides.
Hypospadias Prevalence and Trends in International Birth Defect Surveillance Systems, 1980–2010
Authors: Xiao Yu, Natasha Nassar, Pierpaolo Mastroiacovo, Mark Canfield, Boris Groisman, Eva Bermejo-Sánchez, Annukka Ritvanen, Sonja Kiuru-Kuhlefelt, Adriana Benavides, Antonin Sipek, Anna Pierini, Fabrizio Bianchi, Karin Källén, Miriam Gatt, Margery Morgan, David Tucker, M. Aaurora Canessa, Rosa Gajardo, Osvaldo M. Mutchinick, Elena Szabova, Melinda Csáky-Szunyogh, Giovanna Tagliabue, Janet D. Cragan, Wendy N. Nembhard, Anke Rissmann, Dorit Goetz, Carol Bower, Gareth Baynam, R. Brian Lowry, Juan A. Leon, Wei Luo, Jocelyn Rouleau, Ignacio Zarante, Nicolas Fernandez, Emmanuelle Amar, Saeed Dastgiri, Paolo Contiero, Laura E. Martínez-de-Villarreal, Barry Borman, J.E.H. Bergman, Hermien E.K. de Walle, Charlotte A. Hobbs, Amy E. Nance, A.J. Agopian
Journal: European Urology (2019)
LILRB4 expression in CMML and MDS based on response to hypomethylating agents.
Authors: Kelly Sharon Chien, Caleb A. Class, Guillermo Montalban-Bravo, Koji Sasaki, Kiran Naqvi, Irene Ganan Gomez, Yue Wei, Hui Yang, Rashmi Kanagal-Shamanna, Hagop M. Kantarjian, Guillermo Garcia-Manero
Journal: Journal of Clinical Oncology (2019)

e18550 Background: Leukocyte immunoglobulin-like receptor B4 (LILRB4) is expressed on M4 and M5 monocytic acute myeloid leukemia (AML) cells and leads to negative regulation of immune cell activation via T cell suppression. Its expression and role in chronic myelomonocytic leukemia (CMML) and myelodysplastic syndrome (MDS) are unknown. We investigated LILRB4 expression in patients with CMML and MDS and correlated it with response to hypomethylating agent (HMA) therapy. Methods: We evaluated bone marrow samples from 19 patients with CMML and 27 patients with MDS from 2008-2014. Transcriptomic and splicing analysis by RNA sequencing were performed on CD34-positive cells in CMML and MDS patient samples in addition to AML or MDS cell lines (n = 6). Gene set enrichment analysis was used to identify pathways associated with increased LILRB4 expression. Results: By the WHO 2016 classification for CMML, there were 8 CMML-0, 5 CMML-1, and 6 CMML-2 patients, and there were 2 low-risk, 8 intermediate-1-risk, 12 intermediate-2-risk, and 5 high-risk MDS patients by IPSS. A total of 12 CMML patients and 27 MDS patients received HMA, with 6 and 12 showing response, respectively. RNA expression of LILRB4 was increased in CMML patients when compared to MDS patients and healthy controls (q &lt; 0.1) with no difference in expression based on risk groups. Pathway analysis revealed upregulation of PD-1 signaling (p = 0.004), CTLA-4 signaling (p = 0.004), and inflammatory response (p = 0.004), and gene correlates revealed a positive association with CTLA-4 expression (p = 0.05). LILRB4 expression was slightly increased in CMML patients who responded to HMAs (q &gt; 0.1). In cell lines, LILRB4 was expressed in MOLM13 (AML M5), SKM1 (AML M5), and U937 (histiocytic lymphoma), with an increase in HMA-sensitive MOLM13 cells compared to HMA-resistant MOLM13 cells (q &lt; 0.01) and no difference based on HMAs seen in other cell lines. Conclusions: LILRB4 expression is increased in CMML, with further increase in those exhibiting response to HMA therapy. It is positively correlated with immune checkpoint signaling pathways, particularly CTLA-4 expression. This may set the basis for exploring the possibility of anti-LILRB4 and anti-CTLA-4 combinations.
Residence in an inner city is more important than ethnic origin
Authors: M. Lavender, N. M I Black
Journal: BMJ (1995)

EDITOR,--The recent increase in the rates of notification of tuberculosis has called into question the effectiveness of current policies to control tuberculosis. Until we have a clearer understanding of the possible reasons behind this increase in incidence, case finding and effective treatment are unlikely to reverse the trend. We therefore welcome the contribution by N Bhatti and colleagues for two reasons.1 Firstly, they show that the increase in tuberculosis is not due to an improvement in the notification system but reflects …
Incidental Finding of Acute Lymphocytic Leukemia in a Prostate-Specific Membrane Antigen PET/CT
Authors: Christian Acksteiner, Brett Sounness
Journal: Clinical Nuclear Medicine (2019)

PSMA PET/CT is known to show uptake in various benign and malignant processes. The following PSMA PET/CT was performed for prostate carcinoma staging (Gleason 3 + 4 left apex; PSA 5.8). It shows incidental diffuse PSMA marrow uptake, not typical for prostate metastatic disease. No treatment had been commenced at the time of the scan. Serology and bone marrow biopsy showed B-cell acute lymphocytic leukemia. Focal PSMA uptake in the right ischium was correlated with a T1 hypointense lesion on a previous MRI and was convincing for a skeletal metastasis. Alternative diagnoses in diffuse skeletal PSMA uptake need therefore to be considered.
NBTXR3, a first-in-class radioenhancer hafnium oxide nanoparticle, plus radiotherapy versus radiotherapy alone in patients with locally advanced soft-tissue sarcoma (Act.In.Sarc): a multicentre, phase 2–3, randomised, controlled trial
Authors: Sylvie Bonvalot, Piotr L Rutkowski, Juliette Thariat, Sébastien Carrère, Anne Ducassou, Marie-Pierre Sunyach, Peter Agoston, Angela Hong, Augustin Mervoyer, Marco Rastrelli, Victor Moreno, Rubi K Li, Béatrice Tiangco, Antonio Casado Herraez, Alessandro Gronchi, László Mangel, Teresa Sy-Ortin, Peter Hohenberger, Thierry de Baère, Axel Le Cesne, Sylvie Helfre, Esma Saada-Bouzid, Aneta Borkowska, Rodica Anghel, Ann Co, Michael Gebhart, Guy Kantor, Angel Montero, Herbert H Loong, Ramona Vergés, Lore Lapeire, Sorin Dema, Gabriel Kacso, Lyn Austen, Laurence Moureau-Zabotto, Vincent Servois, Eva Wardelmann, Philippe Terrier, Alexander J Lazar, Judith V M G Bovée, Cécile Le Péchoux, Zsusanna Papai
Journal: The Lancet Oncology (2019)
Biomodulatory therapy approach with lenalidomide in combination with pioglitazone, dexamethasone, and metronomic low-dose chemotherapy with treosulfan in patients with relapsed/refractory multiple myeloma &gt; second-line.
Authors: Daniel Heudobler, Tanja Elger, Stephanie Mayer, Christina Hart, Martin Vogelhuber, Matthias Grube, Joachim Hahn, Florian Lüke, Diana Ditz, Andreas Günther, Martin Gramatzki, Burkhard Schmidt, Peter Ferenczy, Wolfgang Herr, Michael Rechenmacher, Albrecht Reichle
Journal: Journal of Clinical Oncology (2019)

8037 Background: Nowadays, therapy for relapsed or refractory multiple myeloma (rrMM) usually consists of multi-targeted combination regimens for achieving complete remission. In this context, resistance resembles a therapeutic challenge that may be overcome by novel biomodulatory therapies communicatively reprogramming dysregulated cellular and intercellular homeostasis in neoplasia. Methods: The present, prospective phase II, one-arm, one-stage multi-center, open label trial, following phase I, focused on reprogramming myeloma and adjacent stroma cells in order to control rrMM beyond &gt; 2nd-line treatment and following lenalidomide resistance in prior line. Adults with rrMM were eligible for receiving continuously, oral, daily dexamethasone 1mg, pioglitazone 45mg, low-dose treosulfan as metronomic chemotherapy ( 250mg bid) and lenalidomide 15mg, respectively, until disease progression. Results: Thirty-nine patients (mean time since diagnosis, 5.7 years; 66.7% with age &gt; 60 years) had received a median of 5.5 (range 2 to 10) prior treatments. 89.5% of the patients were refractory to last therapy (all IMiD resistant), and 48.7% had received autologous stem-cell transplants. The overall response rate (CR, VGPR) was 17.9%. Eighteen patients (46.2%) had partial response or better; ten patients (25.6%) had stable disease. The disease control rate (DCR) was 71.8%. Time-to-progression was not significantly different between IMiD refractory patients and those relapsing following prior IMiD therapy or between high-risk versus non-high-risk cytogenetics. The median progression-free survival (PFS) and overall survival was 5.6 months (95% confidence interval [CI], 3.8 to 8.5) and 17.6 months (95% [CI], 14.9 to 39.2), respectively. The major AE (NCI-CTCAE grade) with grade ≥ 3 and relation to study drugs was hematologic toxicity (N = 31, 67.4%). Due to scheduled dose reductions, this was associated with only 7 (15.2%) grade ≥ 3 infections. Conclusions: The favorable safety profile, encouraging efficacy and equivalent median PFS between biomodulatory and modern targeted therapy in a historic comparison reveal a proof of concept of combined biomodulatory therapy in patients with heavily pretreated and IMiD-resistant rrMM, which should be further evaluated. Clinical trial information: NCT001010243.
Nonfamilial Multiple Trichoepithelioma
Authors: Isadora Zago Miotto, Ricardo Romiti
Journal: JAMA Dermatology (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 Dermatology 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 Dermatology journal
Unexpected Lymphatic Drainage of the Treated Breast
Authors: Richard Raghoo, Lenka M. Pereira Arias-Bouda, Renato A. Valdés Olmos
Journal: Clinical Nuclear Medicine (2019)

Abstract This case highlights the use of lymphoscintigraphy with SPECT/CT in patients with previous chest and/or axillary surgery. A 67-year-old woman with a history of left breast carcinoma treated with lumpectomy and radiotherapy, and a second lumpectomy of the ipsilateral breast for a second breast carcinoma, underwent a lymphoscintigraphy for a new left breast lesion. Planar images visualized an alternative lymphatic drainage to the contralateral axilla and to the left paravertebral area. SPECT/CT confirmed sentinel nodes in both stations.
Trial of Galcanezumab in Prevention of Episodic Cluster Headache
Authors: Peter J. Goadsby, David W. Dodick, Massimo Leone, Jennifer N. Bardos, Tina M. Oakes, Brian A. Millen, Chunmei Zhou, Sherie A. Dowsett, Sheena K. Aurora, Andrew H. Ahn, Jyun-Yan Yang, Robert R. Conley, James M. Martinez
Journal: New England Journal of Medicine (2019)

Episodic cluster headache is a disabling neurologic disorder that is characterized by daily headache attacks that occur over periods of weeks or months. Galcanezumab, a humanized monoclonal antibody to calcitonin gene-related peptide, may be a preventive treatment for cluster headache.We enrolled patients who had at least one attack every other day, at least four total attacks, and no more than eight attacks per day during a baseline assessment, as well as a history of cluster headache periods lasting at least 6 weeks, and randomly assigned them to receive galcanezumab (at a dose of 300 mg) or placebo, administered subcutaneously at baseline and at 1 month. The primary end point was the mean change from baseline in the weekly frequency of cluster headache attacks across weeks 1 through 3 after receipt of the first dose. The key secondary end point was the percentage of patients who had a reduction from baseline of at least 50% in the weekly frequency of cluster headache attacks at week 3. Safety was also assessed.Recruitment was halted before the trial reached the planned sample size of 162 because too few volunteers met the eligibility criteria. Of 106 enrolled patients, 49 were randomly assigned to receive galcanezumab and 57 to receive placebo. The mean (±SD) number of cluster headache attacks per week in the baseline period was 17.8±10.1 in the galcanezumab group and 17.3±10.1 in the placebo group. The mean reduction in the weekly frequency of cluster headache attacks across weeks 1 through 3 was 8.7 attacks in the galcanezumab group, as compared with 5.2 in the placebo group (difference, 3.5 attacks per week; 95% confidence interval, 0.2 to 6.7; P = 0.04). The percentage of patients who had a reduction of at least 50% in headache frequency at week 3 was 71% in the galcanezumab group and 53% in the placebo group. There were no substantial between-group differences in the incidence of adverse events, except that 8% of the patients in the galcanezumab group had injection-site pain.Galcanezumab administered subcutaneously at a dose of 300 mg once monthly reduced the weekly frequency of attacks of episodic cluster headache across weeks 1 through 3 after the initial injection, as compared with placebo. (Funded by Eli Lilly; ClinicalTrials.gov number, NCT02397473.).