tbuckley/cabot-search huggingface dataset:
Avascular necrosis of the jaw in multiple myeloma (MM) patients (pts) treated with bisphosphonates (BP)
Authors: L. Curreli, A. D. Palmas, G. Latte, A. Murgia, A. Gabbas
Journal: Journal of Clinical Oncology (2007)

18538 Background: Oral cavity avascular bone necrosis (ABN) has been recently reported as an emerging serious complication in pts receiving BP for the treatment of hypercalcemia related to MM or metastatic solid tumors. Methods: We report the cases of 6 pts with MM treated initially with pamidronate and later with zoledronic acid (ZA). Results: Pts characteristics : M/F 3/3; mean age 58.4 (46–78); 4 IgG κ,1 γ and 1 κ MM; 5 St IIIA and 1 IIIB; mean history of disease 61.3 mo. (23–103); 5 pts had a relapsing MM refractory to several lines of therapy but 1 pt had received only high dose dexametazone (D); 2 pts had received autologous stem cell transplantation and 1 pt allogenic bone marrow transplantation; mean n.° of BP doses was 41.3 (17–81). At the time of ABN onset all pts were receiving ZA along with, respectively: D (2 pts); cyclophosphamide plus D (1 pt), bortezomib plus D (2 pts) and oral melphalan (1 pt). ABN was localized in 2 pts at alveolar bone of the right maxilla and presented as an inflammation of the gum, followed by a painful bone exposure. In the other 4 pts ABN was localized at mandible and presented as dental abscesses followed in 2/4 pts by cutaneous fistulization. Treatment has included in all pts discontinuation of ZA, antibiotics, chlorhexidine mouthwashes, pain control, minor regional débridement, and bone trimming. In 1 pt a more aggressive surgical approach was attempted at an other Institution and postoperative course was complicated by massive haemorrhage and complete loss of chewing. Four pts dead with progressive disease with a mean overall survival after ABN presentation of 6 mo.; 2 pts are alive after 3 and 4 mo. after ABN presentation; however in all pts ABN significantly worsened quality of life. Conclusions: Oral cavity ABN is a severe complication in refractory MM pts receiving BP. Mechanisms of action of BP that determine a reduction in osteoclastic activity and an accumulation of nonvital osteocytes with microfractures of old mineral matrix appear to play an important role. However other causes may be involved as a long history of disease; an uncontrolled progressive disease; type and doses of previous and present therapies, primarily steroids; status of oral cavity and teeth of pts and possibly the n.° of doses of BP. No significant financial relationships to disclose.
The Alopecia Areata Consensus of Experts (ACE) study: Results of an international expert opinion on treatments for alopecia areata
Authors: Nekma Meah, Dmitri Wall, Katherine York, Bevin Bhoyrul, Laita Bokhari, Daniel Asz Sigall, Wilma F. Bergfeld, Regina C. Betz, Ulrike Blume-Peytavi, Valerie Callender, Vijaya Chitreddy, Andrea Combalia, George Cotsarelis, Brittany Craiglow, Jeff Donovan, Samantha Eisman, Paul Farrant, Jack Green, Ramon Grimalt, Matthew Harries, Maria Hordinsky, Alan D. Irvine, Satoshi Itami, Victoria Jolliffe, Brett King, Won-Soo Lee, Amy McMichael, Andrew Messenger, Paradi Mirmirani, Elise Olsen, Seth J. Orlow, Bianca Maria Piraccini, Adriana Rakowska, Pascal Reygagne, Janet L. Roberts, Lidia Rudnicka, Jerry Shapiro, Pooja Sharma, Antonella Tosti, Annika Vogt, Martin Wade, Leona Yip, Abraham Zlotogorski, Rodney Sinclair
Journal: Journal of the American Academy of Dermatology (2020)
Covid-19: retired doctors could be asked to return to work, says Hancock
Authors: Elisabeth Mahase
Journal: BMJ (2020)

Recently retired doctors may be asked to return to work as part of the UK’s covid-19 response, according to health secretary Matt Hancock.

Speaking on The Andrew Marr Show on 1 March, Hancock said this option is being considered, but that it was “not something we need right now.”

The government is currently developing contingency plans—expected later this week—and prime minister Boris Johnson will chair a meeting of the COBRA emergency committee today (2 March). So far, 40 people in the UK have tested positive for the virus.

“The big challenge for the NHS in the event of covid-19 becoming widespread is NHS staff not being able to come to work because they are ill or self-isolating. …
Prognostic factors for survival after embolization of hepatic metastases in uveal melanoma
Authors: A. Yamamoto, I. Chervoneva, K. Sullivan, D. Eschelman, C. Gonsalves, M. J. Mastrangelo, D. Berd, K. Feeney, M. Terai, T. Sato
Journal: Journal of Clinical Oncology (2007)

8562 Background: Liver is the most common site of metastasis (&gt;80%) in patients with uveal melanoma. Embolization of the hepatic artery has been used to control hepatic metastases. Methods: Uveal melanoma patients with hepatic metastases embolized with iodized poppy seed oil and gelatin sponge, and either BCNU (chemoembolization, CE) or GM-CSF (immunoembolization, IE) during periods when each of these drugs was the agent of first choice, were evaluated. Prognostic factors that predict OS and progression free survival (PFS) in the liver (PFS-L) and in the extra-hepatic systemic organs (PFS-S) were analyzed univariately using the log-rank test and multivariately using Cox proportional hazards model. The following parameters were evaluated: age, gender, pre-existing extrahepatic metastases (EHM), LDH, AST, ALP, and treatment modality (CE or IE). Results: A total of 53 uveal melanoma patients with &lt; 50% liver involvement with melanoma were analyzed. In comparison to the 19 patients (14 males/5 females) who underwent CE, the 34 patients who underwent IE (12 males/22 females) have significantly better OS (14.1 vs. 9.7 months, p=0.012) and PFS-S (10.2 vs. 4.8 months, P=0.013) in univariate analyses. Female patients outlived male patients (14.2 vs. 9.7 months, p=0.005). In Cox model, the shorter OS was associated with male gender (hazard ratio (HR)=2.1; 95% CI, 1.1–4.0; p=0.020), and marginally related to EHM (HR=1.8; 95% CI, 1.0–3.4; p=0.052). Independent predictors of shorter PFS-S included older age (HR=1.04 per year; 95% CI: 1.01–1.06; p=0.007), EHM (HR=2.1; 95% CI, 1.1–3.8; p=0.017), and CE (HR=2.1; 95% CI, 1.2–3.8; p=0.012). The gender-by-treatment interaction was also considered in all Cox models, but it was not significant. None of the covariates was a predictor of PFS-L in univariate or multivariate analyses. Conclusions: IE and female gender were found to be positive prognostic factors for survival after embolization of hepatic metastases. No significant financial relationships to disclose.
Neonatal Early-Onset Sepsis Calculator and Antibiotic Therapy
Authors: Qi Zhang, Wenquan Niu
Journal: JAMA Pediatrics (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 Pediatrics 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 Pediatrics journal
Abstract P244: Association Between Early Life Trauma and Change in HRV During Mental Stress Among Patients With Recent Myocardial Infarction
Authors: Ye Ji Kim, Oleksiy Levantsevych, MhmtJamil Alkhalaf, Majd Soudan, J Douglas Bremner, Arshed A Quyyumi, Brad Pearce, Lisa Elon, Tene T Lewis, Paolo Raggi, Viola Vaccarino, Amit J Shah
Journal: Circulation (2020)

Background: Early-life traumatic experiences have been associated with increased cardiovascular disease risk. Little is known about how early-life traumatic experiences may affect changes in autonomic function during mental stress among young subjects post-MI. Objective: We hypothesized that those with high exposure to early-life trauma, compared to those with low exposure to early-life trauma, would have increased autonomic dysfunction at baseline, worse stress reactivity, and slower autonomic recovery. Methods: We evaluated 321 subjects with a history of recent myocardial infarction who underwent a laboratory-based mental stress speech task. HRV was measured at rest (T0), during mental stress (T1), and during recovery (T2) with ambulatory electrocardiographic monitoring. We evaluated low frequency (LF) HRV as the primary outcome because of its relationship with baroreflex sensitivity, psychological stress, and cardiovascular disease outcomes. Early life trauma was assessed using the Early Trauma Inventory Self Report - Short Form (ETI-SF) and a binary variable was calculated using one SD above the mean of the ETI-SF score, a previously validated cutpoint, to indicate high early-life trauma exposure and low otherwise. Sociodemographic factors, including race, highest education attained, age, and gender, were considered as potential confounders in multiple linear regression models. Differences amongst stress, rest, and recovery metrics were evaluated as outcomes in separate models. Results: Of 321 subjects with HRV data, 284 were included in the final analytic sample after excluding those with missing covariates. The mean age was 50.7 ± 6.7, 49% were female (139), and 64% were African-American (182); 260 (88.4%) reported experiencing high levels of early-life trauma. There were no associations between early-life trauma during baseline HRV (T0), reactivity to stress (T1 - T0), and prolonged reactivity (T2 - T0). However, those with high early-life trauma had reduced HRV during recovery from stress compared to those with low early-life trauma (T2 - T1; Beta (95% CI) = -0.37 (-0.73, -0.01)). Results were similar after adjustment for sociodemographic factors and did not vary by race/ethnicity or gender. Conclusion: Among subjects with recent MI, high exposure to early-life trauma is associated with prolonged stress-induced autonomic dysfunction during stress and recovery, while the low exposure subjects revert to baseline HRV levels during recovery. This may indicate greater stress-induced cardiotoxicity in those exposed to early life trauma.
Doctors must not delay treating patients who are unable to consent over concerns of coercion
Authors: Clare Dyer
Journal: BMJ (2020)

The vice president of the Court of Protection has again warned doctors not to delay treating patients who are unable to give consent to treatment because of concerns about having to coerce or restrain them.1

Mr Justice Hayden repeated the message he gave in January in the case of a 71 year old woman with a tumour on her face which became inoperable after delays in treating her.2

In the latest case, involving a woman in her 60s with grade 2 endometrial cancer, Hayden called the case into court …
Protein S protects against allergic bronchial asthma by modulating Th1/Th2 balance
Authors: Kentaro Asayama, Tetsu Kobayashi, Corina N. D'Alessandro‐Gabazza, Masaaki Toda, Taro Yasuma, Hajime Fujimoto, Tomohito Okano, Haruko Saiki, Atsuro Takeshita, Kentaro Fujiwara, Valeria Fridman D’Alessandro, Kota Nishihama, Toshiaki Totoki, Ryo Inoue, Yoshiyuki Takei, Esteban C. Gabazza
Journal: Allergy (2020)

Bronchial asthma is a chronic disease characterized by inflammation, obstruction, and hyperresponsiveness of the airways. There is currently no curative therapy for asthma. Type 2 helper T cell response plays a critical role in the pathogenesis of the disease. Protein S is a glycoprotein endowed with anticoagulant, anti-inflammatory, and anti-apoptotic properties. Whether protein S can suppress bronchial asthma and be useful for its therapy is unknown.To address this question here we compared the development of allergen-associated bronchial asthma between wild type and protein S-overexpressing transgenic mice. Mice were sensitized and challenged with ovalbumin. We also evaluated the circulating levels of total and active protein S in patients with bronchial asthma and healthy controls.The circulating level of total protein S and of its active form was significantly decreased in patients with bronchial asthma compared to controls. Allergic protein S transgenic mice showed a significant reduction of airway hyperresponsiveness, lung tissue inflammatory cell infiltration, lung levels of Th2 cytokines and IgE compared to their wild-type counterparts. Administration of exogenous human protein S also decreased airway hyperresponsiveness and Th2-mediated lung inflammation in allergic wild-type mice compared with their untreated mouse counterparts. Human protein S significantly shifted the Th1/Th2 balance to Th1 and promoted the secretion of Th1 cytokines (IL-12, tumor necrosis factor-α) from dendritic cells.These observations suggest the strong protective activity of protein S against the development of allergic bronchial asthma implicating its potential usefulness for the disease treatment.
Abstract MP33: Association of Cardiac Troponin T and Troponin I With Peripheral Neuropathy in Older Adults: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Caitlin W Hicks, Dan Wang, Olive Tang, Kunihiro Matsushita, Ron Hoogeveen, Christie M Ballantyne, Xiaoming Jia, Elizabeth Selvin
Journal: Circulation (2020)

Introduction: There is growing evidence that high sensitivity troponin I (hs-cTnI) and high sensitivity troponin T (hs-cTnT) are associated with distinct clinical characteristics and perform differently for cardiovascular risk stratification. The comparative associations of hs-cTnI and hs-cTnT with microvascular complications, such as peripheral neuropathy (PN), have not been quantified. Methods: We conducted a cross-sectional analysis of 2,974 black and white participants in the ARIC study who underwent monofilament PN testing at visit 6 (2016-2017, age 71-94 years). Hs-cTnI and hs-cTnT were measured in serum and categorized according to population tertiles. We used logistic regression to assess the associations of hs-cTnI and hs-cTnT with PN among adults with and without diabetes after adjusting for traditional risk factors. Results: Overall, 38% of participants had evidence of PN. Median hs-cTnI and hs-cTnT levels were 3.3ng/L (IQR 2.2-5.2) and 11.0ng/L (8.0-16.0) for participants with PN and 2.6ng/L (1.8-4.0) and 8.0ng/L (6.0-12.0) for participants without PN, respectively. Only hs-cTnT was significantly associated with PN after adjusting for traditional risk factors ( Figure, panel A ) and after mutually adjusting for both troponin measurements ( Figure, panel B ). The association of hs-cTnT with PN was similar for adults with and without diabetes (P=0.62 for interaction). Conclusions: PN was common among older adults with and without diabetes. Hs-cTnI and hs-cTnT had distinct associations with PN, with a more robust association for hs-cTnT. These findings add to the growing body of knowledge regarding differences in the use of high sensitivity troponin assays for monitoring risk in the general population.
Abstract P152: Racial Disparities In The Prevalence Of Peripheral Artery Disease And Diabetes And Amputation Rates Among Medicare Patients
Authors: Mark A Eid, J Aaron Barnes, Zachary Wanken, David H Stone, Bjoern Suckow, Barbara Gladders, Richard J Powell, Mark A Creager, Philip P GOODNEY
Journal: Circulation (2020)

Background: Patients with peripheral artery disease (PAD) and diabetes are at increased risk for nontraumatic amputations. The associations of race with amputation risk among patients with both PAD and diabetes is not well understood in recent national patient cohorts. Methods: Using data from the Centers for Medicare and Medicaid Services from 2007-2016, we identified a cohort of patients concurrently diagnosed with both PAD and diabetes (N= 10,506,254). Patients were followed from time of diagnosis to identify major and minor amputation events, and stratified by race (Black, White, Hispanic) in order to determine differences in outcomes. We examined associations between the regional prevalence of PAD and diabetes and amputation rates, at the level of the state and the hospital referral region (HRR). Results: The average rate of amputation between 2007 and 2016 was 0.3 amputations per 1000 Medicare patients. When analyzed by race, Black patients had an almost 3-fold higher rate of amputation as compared to White patients (0.89 v 0.36 per 1000 patients, P&lt;0.001) and a 2-fold higher rate as compared to Hispanic patients (0.89 v 0.39 per 1000 patients, P&lt;0.001). States with larger populations of Black patients with diabetes and PAD had higher rates of amputation. We also observed a direct and significant association between regional prevalence of PAD and diabetes and amputation risk for both White and Black patients (R 2 =0.36 and 0.25 respectively); some states such as Mississippi had disproportionately higher amputations rates among Black patients for a given prevalence of PAD and diabetes (Figure 1). Conclusion: Black patients with PAD and diabetes are at disproportionally higher risk for amputation. Moreover, regional prevalence of concomitant PAD and diabetes is closely related to amputation risk across races.
Abstract P247: Associations of 25-year Smoking Patterns With Year 30 Cardiac Structure and Function: Longitudinal Results From the CARDIA Study
Authors: Allison J Carroll, Ravi B Patel, Laura A Colangelo, David R Jacobs, Amanda R Mathew, Joseph Kang, Donald M Lloyd-Jones, Brian Hitsman
Journal: Circulation (2020)

Background: Smoking exposure has a strong dose-dependent relation with cardiovascular disease (CVD). Less is known about how patterns of exposure may impact CVD. In this study, we hypothesized that patterns of high or persistent smoking for 25 years would have worse myocardial structure and function at 30 years, while patterns of quitting smoking would be similar to never smokers. Methods: Data were from 5115 black and white, men and women, aged 18-30 years at baseline (1985) in the CARDIA study. Group-based trajectory modeling (SAS proc traj ) identified smoking patterns from 1985-2010 among 3178 participants with echocardiogram at year 30 (2015). Adjusted linear regression analyses assessed associations between trajectory group with left ventricular (LV) structure (LV mass, LV diastolic dimension, left atrial volume), LV function (ejection fraction, circumferential strain, global longitudinal strain), and right ventricular function (E/A, average e’, E/e’). Interactions between smoking trajectory X sex, race, and BMI with echo measures were also assessed. Results: Seven smoking trajectory groups were identified (Figure). Trajectory group was significantly associated with cardiac structure, including LV mass ( p &lt;.001) and LV diastolic dimension ( p =.003). For example, LV mass was greater among all smoking groups (except declining heavy smokers, n=49) compared to nonsmokers (all p s&lt;.05); moreover, compared to heavy smokers, minimal smokers ( p =.008) and quitters ( p =.047) had smaller LV mass (Figure). Trajectory group was not associated with cardiac function (all p s&gt;.10). None of the interactions with trajectory group was significant (all p s&gt;.05). Conclusions: Any level of smoking during young adulthood was associated with poorer cardiac structure, but not function, compared to never smokers. Patterns of minimal and declining smoking also had significantly better structure than heavy smoking. These results suggest that quitting and reducing smoking may help preserve or restore cardiac structure over time.
Assessment of gynecological malignancies based on pathologic reports in five general hospitals in Tehran (1995–2005)
Authors: S. Momtahen, A. Sadreddin Kazzazi, M. Kadivar
Journal: Journal of Clinical Oncology (2007)

5550 Background: Various histological types of gynecological tumors may develop from different etiological aspects. The observed differences in cancer incidence are mainly due to different individual and social risk factors. Step toward establishing a nation wide registry is being taken in this study. Methods: To give a relative frequency of female genital tract malignant tumors in Iran we designed a cross-sectional study included 450 women with definite diagnosis of gynecological cancer based on pathologic reports in five pathologic centers, Iran University of Medical sciences, Tehran, 1995–2005. WHO classification of gynecological tumors and International Federation of Gynecology and Obstetrics (FIGO) were used as basis of study. Spss 14 and correlation test was used for data analysis. Results: The average age of diagnosis was (50±0.7). 49.6% were menopausal. 82.7% were multipar. 89.8% were nonsmoker. 9.3% had history of using OCP. Ovarian cancers (55.5%), uterus cancers (24.9%) and cervical cancers (19.6%) were diagnosed. Surface epithelial-stromal tumor was the most frequent type of ovarian tumors (78.4%). Endometrial adenocarcinoma (70.5%) and squamous cell carcinoma (83%) were most frequent types of uterus and cervical cancers respectively.Well differentiated tumors were seen in 45%, 37% and 36% of uterus, cervical and ovarian tumors. In tumors of uterus and cervix the most frequent stage of diagnosis was stage IIA. The most metastatic diagnosed cases were seen between ovarian tumors (39.7%). Conclusions: Comparison with data published as review articles in NEJM till 2006, the most frequent gynecologic cancer in our study (ovarian cancer) is different to them; also the median age of our patients is lower than them. [Table: see text] No significant financial relationships to disclose.