tbuckley/cabot-search huggingface dataset:
Association of Cost Savings and Surgical Quality With Single-Vendor Procurement for Spinal Implants
Authors: Collin W. Blackburn, Nicolas R. Thompson, Joseph E. Tanenbaum, Allen J. Passerallo, Thomas E. Mroz, Michael P. Steinmetz
Journal: JAMA Network Open (2019)

Significant cost savings can be achieved from consolidating purchases of spinal implants with a single vendor. However, it is currently unknown whether sole-source contracting or vendor rationalization more broadly affects patient care.To describe the single-vendor procurement of spinal implants, characterize the economic benefits of sole-source contracting, and gauge whether vendor rationalization is associated with a diminished quality of care.This retrospective cohort study assessed adult patients receiving single-level lumbar interbody fusions at a single institution from January 1, 2009, to July 31, 2017. Exclusion criteria included multilevel fusions and prior spinal fusions.Patients were analyzed based on the number of vendors available to surgeons at the time of the patient's surgery. January 1, 2009, to December 31, 2010, was defined as the multivendor period (10 vendors); January 1, 2011, to December 31, 2014, was defined as the dual-vendor period; and January 1, 2015, to July 31, 2017, was defined as the single-vendor period.Rates of 12-month revision surgery, complications, 30-day readmissions, and postoperative patient-reported outcomes, as measured by 5-dimension European Quality of Life (EQ-5D) and Patient-Reported Outcomes Measurement Information System-Global Health (PROMIS-GH) utilities. Propensity score weighting was performed to control for confounding. The Holm method was used to correct for multiple testing. Annual cost savings associated with the dual-vendor and single-vendor periods were also reported.A total of 1373 patients (mean [SD] age, 59.2 [12.6] years; 763 [55.6%] female; 1161 [84.6%] white) were analyzed. Rates of revisions after adjusting for confounding were 3.2% (95% CI, 1.5%-6.7%) for the multivendor period, 4.5% (95% CI, 3.1%-6.5%) for the dual-vendor period, and 3.0% (95% CI, 1.7%-5.0%) for the single-vendor period. Complication rates were 5.3% (95% CI, 2.7%-10.1%) for the multivendor period, 7.2% (95% CI, 5.4%-9.6%) for the dual-vendor period, and 6.4% (95% CI, 4.6%-8.8%) for the single-vendor period. Readmission rates were 14.2% (95% CI, 9.7%-20.2%) for the multivendor period, 12.6% (95% CI, 10.1%-15.5%) for the dual-vendor period, and 9.7% (95% CI, 7.4%-12.7%) for the single-vendor period. Revisions, complications, and patient-reported outcomes were statistically equivalent across all periods. Readmissions were not statistically equivalent but not statistically different. The savings attributable to vendor rationalization were 24% for the dual-vendor and 21% for the single-vendor periods.The single-vendor procurement of spinal implants was associated with significant cost savings without evidence of an associated decline in the quality of care. Large hospital systems may consider sole-source purchasing as a viable cost reduction strategy.
Characterization of a Genetically Engineered HUDEP2 Cell Line Harboring a Sickle Cell Disease Mutation As a Potential Research Tool for Preclinical Sickle Cell Disease Drug Discovery
Authors: Dipti Gupta, Sarah Sturtevant, Benjamin Vieira, Yukio Nakamura, Sriram Krishnamoorthy, Melanie Demers
Journal: Blood (2019)
Changes in Noninsurance and Care Unaffordability Among Cancer Survivors Following the Affordable Care Act
Authors: Xuesong Han, Ahmedin Jemal, Zhiyuan Zheng, Ann Goding Sauer, Stacey Fedewa, K Robin Yabroff
Journal: JNCI Journal of the National Cancer Institute (2019)

Abstract Background Little is known about changes in socioeconomic disparities in noninsurance and care unaffordability among nonelderly cancer survivors following the Affordable Care Act (ACA). Methods Cancer survivors aged 18–64 years nationwide were identified from the Behavioral Risk Factor Surveillance System. Trend and difference-in-differences analyses were conducted to examine changes in percent uninsured and percent reporting care unaffordability pre–(2011 to 2013) and post–(2014 to 2017) ACA Medicaid expansion, by sociodemographic factors. Results A total of 118 631 cancer survivors were identified from Medicaid expansion (n = 72 124) and nonexpansion (n = 46 507) states. Following the ACA, percent uninsured and percent reporting care unaffordability decreased nationwide. Medicaid expansion was associated with a 1.8 (95% confidence interval [CI] = 0.1 to 3.5) percentage points (ppt) net decrease in noninsurance and a 2.9 (95% CI = 0.7 to 5.1) ppt net decrease in care unaffordability. In stratified analyses by sociodemographic factors, substantial decreases were observed in female survivors, those with low or medium household incomes, the unemployed, and survivors with multiple comorbidities. However, we observed slightly increased percentages in reporting noninsurance (ppt = 1.7; 95% CI = −1.2 to 4.5) and care unaffordability (ppt = 3.1, 95% CI = −0.4 to 6.5) in nonexpansion states between 2016 and 2017, translating to 67 163 and 124 160 survivors, respectively. Conclusion We observed reductions in disparities by sociodemographic factors in noninsurance and care unaffordability among nonelderly cancer survivors following the ACA, with largest decreases in women, those with low or medium income, multiple comorbid conditions, the unemployed, and those residing in Medicaid expansion states. However, the uptick of 82 750 uninsured survivors in 2017, mainly from nonexpansion states, is concerning. Ongoing monitoring of the effects of the ACA is warranted, especially in evaluating health outcomes.
LAM-003, a Novel Oral Heat Shock Protein 90 Inhibitor for Treatment of Acute Myeloid Leukemia, Including Wild-Type and FMS-like Tyrosine Kinase 3 (FLT3)-Mutant Disease
Authors: Neil Beeharry, Sean Landrette, Jeff Grotzke, Sophia Gayle, Marylens Hernandez, Stephanie Halene, Peter R Young, Langdon L Miller, Tian Xu, Jonathan Rothberg, Henri Lichenstein
Journal: Blood (2019)
PARP1-Mediated Alt-NHEJ Repair Is a Therapeutic Target in Multiple Myeloma
Authors: Daniele Caracciolo, Giada Juli, Francesca Scionti, Gaetanina Golino, Mariamena Arbitrio, Emanuela Altomare, Katia Todoerti, Katia Grillone, Maria Teresa Di Martino, Marco Rossi, Antonino Neri, Pierosandro Tagliaferri, Pierfrancesco Tassone
Journal: Blood (2019)
Diagnosis and Nonsurgical Management of Osteoarthritis
Authors: A C JONES
Journal: Annals of the Rheumatic Diseases (1997)

Diagnosis and Nonsurgical Management of Osteoarthritis . By Kenneth D Brandt. (Pp 225; $17.95.) Caddo, OK: Professional Communications Inc, 1996. ISBN 1-884735-09-6.

Thought provoking, exciting, punchy but sometimes leaving the reader wishing the book was longer—not always the case with many textbooks. Dr Brandt has performed a superb task in condensing much of the current knowledge and indeed theory of osteoarthritis into such a compact and readable book. It is subdivided into four …
Rammya Mathew: We need to rise above racist abuse and challenge attitudes
Authors: Rammya Mathew
Journal: BMJ (2019)

The recent case of Radhakrishna Shanbhag, a senior trauma and orthopaedic surgeon who was asked by a patient if a white doctor could do his operation instead, has hit the headlines.1 It shines a light on how prevalent racist attitudes are in today’s society. It also raises the question of how the NHS should deal with such requests—which are more common than you might imagine.

The obvious answer is to have a zero tolerance policy, where patients who discriminate against NHS staff for any reason are reprimanded for their behaviour. Many doctors expressed disbelief that the …
Oral Contraceptives and Liver Damage
Authors: H. Adlercrutz, E. Ikonen
Journal: BMJ (1964)

Her blood-pressure was 120/80.Investigation showed a haemoglobin of 12.3 g./100 ml. and a total white cell count of 9,700/c.mm.The E.S.R. was 18 mm. in the first hour.Cerebro- spinal fluid examination showed two lymphocytes per c.mm. and a protein of 40 mg.per 100 ml.X-ray examination of the skull and chest was normal.A left carotid angiogram was normal.A lumbar air encephalogram was also normaL An electroencephalogram showed delta activity at 2j cycles per second in the left fronto-temporal area.She improved rapidly over the course of the next four weeks, although she still showed some nominal dysphasia when last seen on 5 July 1963.A written report about her on 7 April 1964 revealed that she had then made a complete recovery.Oral contraceptive regime.-Thepatient started taking Enavid on 19 April 1963.She took two tablets daily from 19-23 April.She then had heavy menstrual bleeding lasting from 24 to 28 April.From 29 April to 17 May she took one tablet of Enavid daily.Because she developed very slight vaginal bleeding from 7 May she was advised to discontinue the tablets on 17 May.On 5 June, with her menstrual period two weeks overdue, she took two Enavid tablets.The next day she became ill on the flight to London.She stopped taking the tablets and her periods returned to normal in July.Case 2.-Mrs.X. Y., aged 26, was seen at the West Middlesex Hospital on 27 December 1963 by Mr. Douglas Langley.She complained that six weeks previously she noticed that " some- thing was wrong with her vision" on waking.Examination revealed a congruous left upper quadrantic field defect.She was seen in the neurological clinic on 17 January 1964.There were no abnormal physical signs apart from the field defect; in particular the pulse was regular, there was no cardiac murmur, no bruit to be heard over the cranium, and no tenderness of the calves.The field defect was unchanged when she was seen again on 10 April 1964.In her past history she had epileptic seizures at the age of 17 years, was taking phenobarbitone, and had no further seizures since the age of 19 years.Oral contraceptive regime.-Thepatient had had two normal pregnancies in 1959 and 1961.She started taking Ortho-Novin (norethisterone
EPID-31. EFFICIENT STUDY OF SURGICALLY TREATED MENINGIOMA THROUGH CLINICAL DATA STANDARDIZATION
Authors: Karolyn Au, Farshad Nassiri, Kate Drummond, Michael Jenkinson, Thomas Santarius, Jill Barnholtz-Sloan, Christine jungk, Francesco DiMeco, Evanthia Galanis, Andrea Saladino, Yueren Zhou, Suganth Suppiah, Kenneth Aldape, Gelareh Zadeh, Laila Poisson
Journal: Neuro-Oncology (2019)

Abstract With increasing epidemiological and biological studies on meningiomas, standardized clinical data capture will be necessary to interpret results across studies and to translate them to clinical practice. To meet this need for consistent clinical data capture, the International Consortium on Meningioma, has developed a set of common data elements (CDEs), to be used across clinical and biological research. Building from terminology used in clinical practice and ongoing studies, we used a consensus-of-experts approach to arrive at a set of standardized and vetted data elements. Areas of focus include patient characteristics, patient history, radiological and intra-operative description, histological diagnosis and molecular testing, non-surgical interventions, and surveillance. These data elements are implemented in Research Electronic Data Capture (REDCap) forms. With REDCap implementation, components of the CDE set can be selected and instituted in a local REDCap instance for efficient study start-up. The scope of the current CDE set focuses on surgically treated meningioma. However, modular forms provide flexibility and to allow the scope to be expanded to include non-surgically treated meningioma. Dissemination plans are underway to introduce the CDEs to neuro-oncology researchers and clinicians through publication and presentations, where feedback will be solicited. Adoption of CDEs for research will improve consistency and interpretability across studies, expediting research in this frequently occurring tumor.
Antidepressants and the Risk of Suicidal Behaviors
Authors: Iradj Maany
Journal: JAMA (2004)

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
EXTH-69. NANOTHERAPEUTICS FOR NEUROSURGICALLY-APPLIED DRUG DELIVERY
Authors: Catherine Vasey, Vincenzo Taresco, Stuart Smith, Cameron Alexander, Ruman Rahman
Journal: Neuro-Oncology (2019)

Abstract Despite multimodal treatment, the median survival of Glioblastoma multiforme (GBM) patients remains less than 15 months, in considerable part due to diffusely infiltrative disease. Better treatment methods are necessary to eradicate residual tumour burden remaining beyond the resection cavity boundary. It is hypothesised that incorporating drug-loaded polymer pro-drug nanoparticles into a biodegradable microparticulate paste will lead to efficacious local delivery. We report the formulation of numerous self-assembling cytocompatible nanoparticles, based on different linear and branched polymeric architectures, amenable for localised intra-cavity delivery post-surgery. The polymers were synthesised by ring-opening polymerisation with organic catalysts, leading to controlled reaction kinetics and greater potential biomedical applicability. A simple nanoprecipitation technique was employed to gain nanoparticles with the size range of 60–130 nm, depending on the initial monomer ratios and polymeric architectures. Successful biocompatibility studies of the self-assembling nanoparticles have been carried out in vitro on the U87 glioma cell line. We demonstrated that copolymerisation of a monomer with functional capability enabled the successful conjugation of doxorubicin to the polymer chain. We will discuss strategies to incorporate pH-sensitive linkers to the polymeric backbone, which would allow controlled drug release in acidic microenvironments. Based on an increasing understanding of GBM intra-tumour heterogeneity, the capability to deliver multiple therapeutic moieties from single formulations is clinically-relevant. Thus, we hypothesised that polymers with a greater degree of branching over traditional linear structures would lead to greater drug loading, and successfully tested this hypothesis through the encapsulation of olaparib. Future work will assess the efficacy of the polymer pro-drug nanoparticles against both commercial and primary cell lines, and safety/efficacy of intra-cavity delivery using orthotopic syngeneic allografts, thus giving a more therapeutically-relevant insight into the activity of the formulations. This is the first study incorporating polymer pro-drugs of this type into an existing localised micro-scale delivery system for GBM therapies.
PATH-20. INVESTIGATION OF CLINICALLY AGGRESSIVE SPINAL CORD EPENDYMOMA THROUGH METHYLATION ANALYSIS
Authors: Nicole Briceno, Zied Abdullaev, Elizabeth Vera, Francine Blumental De Abreu, Martha Quezado, Svetlana Pack, Liqiang Xi, Mark Raffeld, Mark Gilbert, Kenneth Aldape, Terri Armstrong
Journal: Neuro-Oncology (2019)

Abstract Spinal ependymoma is a rare, often low-grade tumor, for which the clinical course and prognosis has been poorly defined. Classification has relied on histological criteria, as there are few defining molecular mutations, causing controversy in diagnosis and grading. DNA methylation analysis with the brain tumor classifier was used on tumor tissue from 37 patients identified from the Neuro-Oncology Branch Natural History Study and selected Collaborative Ependymoma Research Network (CERN) Tissue Repository. These were histologically diagnosed with non-myxopapillary spinal ependymoma (92% grade II and 8% grade III), with 12 designated “poor performers” (50% male, median age 30 years) defined by a progression free survival of less than two years (median 7 months) with at least one recurrence. Alternatively, the 25 “good performers” (56% male, median age 43 years) had no progression with a follow-up time greater than 5 years (median 84 months). Methylation classification matched to “spinal ependymoma” in 33% of the poor performer cases while 8% matched myxopapillary or RELA-fusion ependymoma and 50% were no-match. For the good performers, 52% agreed with histological diagnosis, 28% matched myxopapillary and 20% were no-match. Interestingly, we noted high-level MYCN amplification by copy number analysis in two (17%) cases, neither of which matched to a defined methylation class, and both of which were in the poor performers group. Overall, methylation results reveal complex biology in conventional spinal cord ependymomas, most evident in an increase of no-match cases in the poor performers group. Of importance, the no-match cases contain evidence of a potentially new diagnostic entity characterized by both a poor prognosis and MYCN amplification. For further elucidation of this entity, a larger cohort of patients with expanded clinical criteria has been identified for further testing.
A Gain of Function Mutation in JAK2 Is Frequently Found in Patients with AML-M2 and Normal Karyotype.
Authors: Nerea Marcotegui, Idoya Lahortiga, Iria Vazquez, Jose L. Vizmanos, Ion Cristobal, Cristina Ormazabal, Eva Bandres, Maria J. Larrayoz, Carmen Vicente, Maria J. Calasanz, María D. Odero
Journal: Blood (2005)
Naive and Non Naive CD4+ and CD8+ T Cell Subsets Distribution in Blood and Marrow Grafts and Their Impact on Patients’ Outcome after Allogeneic Stem Cell Transplantation.
Authors: Ibrahim Yakoub-Agha, Pasquine Saule, Claudine Grutzmacher, Pascale Cracco, Leo Magro, Francis Bauters, Florence Villard, Stephane Depil, Jean-Pierre Jouet, Jean Paul Dessaint, Myriam Labalette
Journal: Blood (2004)
Better Engraftment of Single-Unit Unrelated Cord Blood Transplantation in Patients with Acquired Severe Aplastic Anemia Not Respond to IST Using Conditioning Regimen without ATG
Authors: Wan Xiang, Baolin Tang, Huilan Liu, Xiaoyu Zhu, Kaidi Song, Wen Yao, Xuhan Zhang, Guangyu Sun, Zimin Sun
Journal: Blood (2019)
Outcome of surgical resection for pathologic Nx and N0 non-small cell lung cancer (NSCLC)
Authors: R. U. Osarogiagbon, J. W. Allen, A. Farooq, M. Ninan, T. W. Ratliff
Journal: Journal of Clinical Oncology (2009)

7513 Background: Metastasis to lymph nodes (LN) connotes poor prognosis in NSCLC. Sufficient LN must be examined to accurately determine LN negativity. Patients with no LN examined (pNx) may be incompletely staged and erroneously assigned to a low risk group. To evaluate this possibility, we compared the survival of patients with node negative disease and at least 1 LN examined (pN0) to those with pNx. Methods: Retrospective analysis of all resections for NSCLC from January 1, 2004 to December 31, 2007 identified through a search of pathology databases at hospitals in the Memphis Metropolitan Area. Benign and metastatic disease, pre-operative chemo/radio therapy, bronchoalveolar cell, small cell lung, carcinoid tumors and repeat lung resection were excluded. Date of death was obtained from a National Death Index search. Variables were compared by chi-squared test, survival estimates calculated by Kaplan Meier analysis, survival estimates compared by log-rank test. Results: 746 of 809 resections met inclusion criteria. 86 (11.5%) were pNx and 510 (68.4%) pN0. Demographic and histologic characteristics were similar ( Table 1 ). 55.8% of the pNx group had sublobar resection, compared to 5.7% of pN0 (p&lt;0.0001). 179 pN0 patients (35.1%) had only hilar-intrapulmonary LN (stations 10–14), median 3 (range 1–18) examined. 46 patients (9.02%) had only mediastinal LN (stations 1–9), median 2 (1–13); 281 patients (55.1%) had both stations 10–14 and 1–9, median 7 (2–45). 85% of pN0 patients had &lt;10 LNs examined. 3-year survival estimate for the T1NxM0 vs T1N0M0 patients was 69% vs 70% (p= 0.14); for T2NxM0 vs T2N0M0 it was 25% vs 65% (p &lt;0.01). Conclusions: A high percentage of patients (11.5%) undergoing surgical resection for NSCLC had pNx. These patients were more likely to have sublobar resections. Most (85%) patients with pN0 had &lt;10 nodes examined and a large proportion (35.1%) had no mediastinal LNs, raising the possibility of understaging. Patients with pT2NxM0 did significantly worse than those with pT2N0M0. [Table: see text] [Table: see text]
Clonal Competition Models to Understand Progression and Resistance in Myeloma
Authors: Santiago Barrio, Larissa Haertle, Umair Munawar, Lucia Martin, Isabel Cuenca, Cornelia Vogt, Andoni Garitano-Trojaola, Matteo Claudio Da Via', Miguel Gallardo, Thorsten Stuehmer, Hermann Einsele, Leo Rasche, Joaquin Martinez-Lopez, Martin Kortüm
Journal: Blood (2019)
Lenalidomide and Rituximab Maintenance Therapy after Front-Line Induction Chemoimmunotherapy in Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma
Authors: Julie E Chang, Vaishalee P. Kenkre, Christopher D. Fletcher, Aric C. Hall, Natalie Scott Callander, Kyungmann Kim, Grace Yi Chen, Kaitlin Chambers
Journal: Blood (2019)
Single Arm, Single Centre Prospective Study to Assess the Effect of Therapeutic Drug Monitoring (TDM) Based Dosage Adjustment of Posaconazole on the Incidence of Invasive Fungal Infections (IFIs) in AML Patients on Induction Chemotherapy on Posaconazole Prophylaxis
Authors: Manju Sengar, Mounika Boppana, Hasmukh Jain, Vikram Gota, Bhausaheb Bagal, Anant Gokarn, Murari Gujrar, Madhavi Ambotkar
Journal: Blood (2019)