tbuckley/cabot-search huggingface dataset:
A Woman in Her Early 70s With Altered Mental Status and Left-Sided Weakness
Authors: Daniel J. Wallman, Patrick Field
Journal: JAMA Cardiology (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 Cardiology 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 Cardiology journal
TCTAP A-073 Effect of Gender on Complications and Follow Up Events in Diabetes Mellitus Patients Who Underwent Percutaneous Transluminal Coronary Angioplasty
Authors: Maddury Jyotsna, Indrani Garre, Naveen Kumar Murki, Lalita Nemani, Kumar Achukatla
Journal: Journal of the American College of Cardiology (2019)
THU-036-First description of the immune checkpoint receptor landscape in decompensated cirrhosis and ACLF
Authors: Douglas Corrigall, Nicola Harris, Dhruti Devshi, Sarah Fairclough, Gavin Wright, Jonel Trebicka, Carlo Alessandria, Paolo Angeli, Rajiv Jalan, Joan Claria, Richard Moreau, Vicente Arroyo, Roger Williams, Antonio Riva, Shilpa Chokshi
Journal: Journal of Hepatology (2019)
THU-458-Identification of relevant oncogenes in RAS-activated primary liver cancer using a targeted screening approach
Authors: Christian Lechler, Shuang Dong, Saumya Manmadhan, Thomas Rösner, Birgit Kohnke-Ertel, Katja Steiger, Carolin Mogler, Julien Sage, Roland Schmid, Ursula Ehmer
Journal: Journal of Hepatology (2019)
Engineering Mechanics for Successive States in Canine Left Ventricular Myocardium
Authors: DANIEL D. STREETER, WILLIAM T. HANNA
Journal: Circulation Research (1973)

The relations between end-diastolic ( D ) and end-systolic ( S ) fiber angles (α) and sarcomere lengths ( s ) have been previously studied at different sites in canine left ventricular myocardium. However, no postulates have been advanced for predicting a and s in successive states of the ejection cycle ( D or S) or at different sites in one state when the semimajor ( Z ) and semiminor (R) axes of the wall surfaces for successive states and the fiber orientations and sarcomere lengths at one site in one state are known. In this study, the myocardial fibers were regarded as the matrix of a myocardial continuum: they are prisoners of the heart wall and must comply with the movements of the wall. Using the same values as in the preceding article, the wall was treated as a nested set of truncated ellipsoidal shells of revolution with shell volumes preserved from D to S. Both confocal and nonconfocal configurations were analyzed. In each shell, the fibers were assumed to follow a "helical" path with a constant advance in each turn about the Z axis (the simplest possible path). The results of this assumption were compatible with previously reported values of a and s measured at various sites in the left ventricular free wall in states D and S . These results suggest a postulate for the heart wall: in the beating heart, each muscle fiber changes direction and length uniquely as the wall changes shape.
Response to Comment on Sims et al. Proinsulin Secretion Is a Persistent Feature of Type 1 Diabetes. Diabetes Care 2019;42:258–264
Authors: Emily K. Sims, Henry T. Bahnson, Julius Nyalwidhe, Leena Haataja, Asa K. Davis, Cate Speake, Linda A. DiMeglio, Janice Blum, Margaret A. Morris, Raghavendra G. Mirmira, Jerry Nadler, Teresa L. Mastracci, Santica Marcovina, Wei-Jun Qian, Lian Yi, Adam C. Swensen, Michele Yip-Schneider, C. Max Schmidt, Robert V. Considine, Peter Arvan, Carla J. Greenbaum, Carmella Evans-Molina
Journal: Diabetes Care (2019)

In a cohort of 319 individuals with long-duration type 1 diabetes (T1D), we found that 89.9% of participants with undetectable stimulated C-peptide had measurable fasting or stimulated serum proinsulin (1). To ensure the validity of our results, we performed rigorous validation of the Millipore human intact and Des (31,32) proinsulin radioimmunoassay that included spike-in experiments using insulin, C-peptide, and proinsulin; independent calculation of a lower limit of detection; assessment of inter- and intra-assay coefficients of variation; analysis of linearity of dilution; analysis of samples pre- and postpancreatectomy; analysis of effects of increased insulin autoantibody titers; and quantitative validation of our findings using mass spectrometry (1). The letter by Steenkamp et al. (2) in response to our article suggests the Millipore assay may overestimate proinsulin levels compared with the ALPCO STELLUX human total proinsulin ELISA. The authors’ concerns are based on their finding that, using the ALPCO assay, proinsulin was detected in only 16% of random samples from a smaller subset of C-peptide–negative individuals from the same T1D Exchange Residual C-peptide Study (3).

Quantitative immunoassay performance differences between different assay platforms are not surprising due to antibody interactions with different epitopes on native antigens …
FRI-490-The real world practice of systemic therapies in patients with advanced hepatocellular carcinoma in Japan: what has changed since lenvatinib approval?
Authors: Susumu Maruta, Sadahisa Ogasawara, Yoshihiko Ooka, Masanori Inoue, Norio Itokawa, Masamichi Obu, Atsuyoshi Seki, Yuki Haga, Shinichiro Okabe, Ei Itobayashi, Masanori Atsukawa, Ryosaku Azemoto, Hideaki Mizumoto, nobuyuki sugiura, Takahiro Maeda, Kazufumi Kobayashi, Eiichiro Suzuki, Shingo Nakamoto, Shin Yasui, Akinobu Tawada, Tetsuhiro Chiba, Makoto Arai, Tatsuo Kanda, Hitoshi Maruyama, Naoya Kato
Journal: Journal of Hepatology (2019)
Doctors who make single clinical mistake are unlikely to face full GMC investigation under new process
Authors: Abi Rimmer
Journal: BMJ (2019)

The General Medical Council (GMC) says that it will reduce the number of its full investigations into single, one-off mistakes by doctors.

The change comes after the regulator’s two year pilot, since 2016, of a provisional inquiry process for single clinical incidents. Under this new system a complaint or referral was followed by gathering information quickly from sources such as medical records, experts, responsible officers, and the doctors themselves to assess any ongoing risk to patients. The GMC then decided in each case whether a full investigation was required. …
Safety and efficacy of pomalidomide (POM), dexamethasone (DEX), and pegylated liposomal doxorubicin (PLD) for patients with relapsed/refractory multiple myeloma (RRMM).
Authors: James R. Berenson, Laura Stampleman, Alberto Bessudo, Peter Rosen, Leonard M. Klein, Thomas B. S. Woliver, Marshall S. Flam, Shahrooz Eshaghian, Youram Nassir, Regina A. Swift, Robert A. Vescio
Journal: Journal of Clinical Oncology (2015)

8591 Background: Treatment with POM and DEX has shown efficacy in RRMM patients (pts), even in those refractory to lenalidomide (LEN). In this phase (Ph) 1/2 trial, we investigated the POM-DEX-PLD combination using a modified dose and schedule (28-days) for RRMM pts. Methods: Ph1 pts had progressive MM at study entry. Ph2 pts were refractory to LEN (progressive disease (PD) while receiving LEN or relapsed within 8 weeks of last dose). POM was administered orally on days 1-21 of a 28-day cycle, while DEX (40 mg) and PLD (5 mg/m2) were infused on days 1, 4, 8, and 11. The maximum tolerated dose (MTD) of POM was established at 4 mg; however, because 58.8% of the pts enrolled in Ph2 developed ≥ grade 3 (Gr3) neutropenia, the dose of POM was reduced to 3 mg. Results: As of December 1st 2014, 56 pts were enrolled, 44 of them in Ph2 and 45 pts had discontinued treatment. Pts had received a median of 4 prior treatments (range, 1-18). Median number of cycles for all pts and those enrolled in Ph2 was 3 (range, 1-8). Median follow-up time for all pts was 4 months (range, 0.2-22 months), whereas that of Ph2 pts was 3.8 months (range, 0.2-12 months). Overall response (ORR) and clinical benefit rates (CBR) were 35%and 47%, respectively. Nine pts (16%) showed stable disease (SD) while 13 (24%) pts exhibited PD. For LEN refractory pts (N = 44), ORR and CBR were 32 % and 48%, respectively, with 6 pts (14%) showing SD and 15 pts (34%) displaying PD.Ph2 pts receiving POM at 3 mg (N = 28) showed an ORR and CBR of 43% and 61%, respectively. Progression-free survival was 5.23 months. Common ≥ Gr3 adverse events were neutropenia (38.2%), lymphopenia (20.0%), hyponatremia (9.1%), and thrombocytopenia (5.5%). One pt died of Gr5 sepsis. Conclusions: The combination of POM at 3 mg, PLD and DEX given in 28-day cycles is safe and effective for the treatment of MM pts refractory to LEN. Clinical trial information: NCT01541332.
Upfront whole brain radiotherapy for multiple brain metastases in patients with EGFR-mutant lung adenocarcinoma
Authors: C. Li, J. Guo, L. Zhao, F. Hu, W. Nie, H. Wang, X. Zheng, Y. Shen, P. Gu, Y. Zhang, X. Zhang
Journal: Annals of Oncology (2019)

Background: This study aimed to evaluate the efficacy of upfront whole-brain radiotherapy (WBRT) in epidermal growth factor receptor (EGFR)-mutant lung adenocarcinoma with multiple brain metastases (BM). Methods: 195 patients with EGFR mutations who had multiple BM at preliminary diagnosis were included and retrospectively reviewed in this study. Patients were administered for following treatments in a multi-disciplinary setting: upfront WBRT followed by EGFR-TKI, concurrent EGFR-TKI and WBRT and upfront EGFR-TKI followed by WBRT. A disease specific graded prognostic assessment (GPA) was performed for all the patients. The treatment response and overall survival (OS) were evaluated. Results: The median OS of these patients was 27 months. Objective response rate (ORR) was much better in upfront WBRT group than other two groups (P = 0.004). Moreover, patients receiving upfront WBRT (n = 67) had longer OS than the concomitant group (36 vs. 25 months; P = 0.006) and the upfront EGFR-TKI group (36 vs. 25 months; P < 0.0001). The prognosis of patients with different GPA scores significantly differed (p < 0.0001). In subgroup of concomitant and upfront EGFR-TKI groups, patients with higher GPA scores (2-3) had more favorable prognosis compared with those with lower scores (0-1.5) (27 versus 25 months; P = 0.023). Patients receiving EGFR-TKI concurrently with WBRT had superior OS than those receiving upfront EGFR-TKI with high GPA scores. (37 versus 17 months; P = 0.023). Conclusions: The use of upfront WBRT in EGFR-mutated lung adenocarcinoma patients with multiple BM improves ORR and OS. More importantly, patients with high GPA scores are recommended to receive WBRT soon after EGFR-TKI therapy. Legal entity responsible for the study: The authors. Funding: National Natural Science Foundation of China (No.81502450) and Science and Technology Commission of Shanghai Municipality, China (No.18441904700). Disclosure: All authors have declared no conflicts of interest.
In utero gene editing for monogenic lung disease
Authors: Deepthi Alapati, William J. Zacharias, Heather A. Hartman, Avery C. Rossidis, John D. Stratigis, Nicholas J Ahn, Barbara Coons, Su Zhou, Hiaying Li, Kshitiz Singh, Jeremy Katzen, Yaniv Tomer, Alexandra C. Chadwick, Kiran Musunuru, Michael F. Beers, Edward E. Morrisey, William H. Peranteau
Journal: Science Translational Medicine (2019)

Prenatal CRISPR gene editing results in efficient pulmonary epithelial cell editing and ameliorates a mouse model of a congenital lung disease.
Frequency of unsafe storage, use, and disposal practices of opioids among cancer patients presenting to the Emergency Center (EC).
Authors: Akhila Sunkepally Reddy, Julio Silvestre, Maxine De la Cruz, Jimin Wu, Diane D Liu, Eduardo Bruera, Knox H. Todd
Journal: Journal of Clinical Oncology (2015)

e20720 Background: Prescription opioid abuse is on the rise in the U.S. It is reported that 75% of the abusers obtain the drug from an acquaintance. Improper opioid storage, use, and disposal may lead to increased availability of the drug for abuse by others. Our aim was to determine the opioid storage, use, and disposal patterns in patients presenting to the EC of a comprehensive cancer center. Methods: We surveyed 113 cancer patients receiving opioids for at least 2 months and collected information regarding opioid use, storage, and disposal. Unsafe storage was defined as storing the opioids in plain sight and sharing or losing their opioids was defined as unsafe use. Results: The median age was 53 years, 55% were female, and 64% were white and 86% had advanced cancer. 19% of the patients had history of illicit drug use and 24% reported that drug abuse is prevalent in their neighborhood. 59% obtained the opioid from their oncologist and 6% believed they were prescribed more medication than required. Of the 113 respondents, 36% stored opioids in plain sight, 53% kept them hidden but unlocked, and only 15% locked their opioids. 73% agreed that they would use a lockbox to store their opioids if given one, 78% were unaware of proper opioid disposal methods, and 67% had unused opioids at home. Only 13% previously received education about safe disposal of opioids. Patients who reported that others have asked them for their pain medications (P = .004) and those who would use a lockbox if given one (P = .019) were more likely to keep them locked. 13 patients (12%) used opioids unsafely by either sharing (5%) or losing (8%) them. Patients who reported to being prescribed more pain pills than required (P = .032), others having asked them for their pain pills (P = .06), being unemployed (P = .07), and those who were unaware of drug take-back programs (P = .06) were more likely to participate in unsafe use. Overall, 77% (87) of the patients reported unsafe storage, unsafe use, or possessed unused opioids at home. Conclusions: A large number of cancer patients improperly and unsafely store, use, or dispose of opioids. More research is urgently needed to determine whether patient education has an effect on minimizing prescription opioid abuse.
The difference of clinical characteristics between patients with exon 19 deletion and those with L858R mutation in non-small cell lung cancer.
Authors: Yaxiong Zhang, Dacheng He, Shiyang Kang, Wenfeng Fang, Shaodong Hong, Jin Sheng, Yanna Tang, Li Zhang
Journal: Journal of Clinical Oncology (2015)

e19074 Background: Recent studies have demonstrated exon 19 deletion (19 Del) and exon 21 L858R mutation (L858R) are two different types of sensitive EGFR (epidermal growth factor receptor) mutations in non-small cell lung cancer (NSCLC). Whether there are some differences between those two groups in baseline clinical characteristics is still unclear. Methods: We enrolled consecutive 1271 NSCLC patients detected with either 19 Del or L858R and collected their baseline clinical characteristics including age, sex, complication, smoking & drinking status, body mass index (BMI), TNM stage, historical type, differentiation, tumor maximum diameter (TMD) and CEA level. Chi-square test and multivariate logistic regression analysis were used to compare the difference. Results: We found a bigger percentage of 19 Del in younger patients group ( < = 50 yrs) than L858R (P < 0.001) through Chi-square test. Besides, patients with 19 Del have higher risk of lymph node metastasis (P < 0.001). However, there were no significant differences in other items of clinical characteristics between 19 Del and L858R. Multivariate analysis showed similar significant results. Subgroup analysis in different age groups (10 y as an interval) and N stages (stratified by N0, N1, N2 and N3) also indicated above-mentioned trends. Conclusions: NSCLC patients with 19 Del are more likely to be young and have lymphatic metastasis than those with L858R. Age and N stage might be considered in predicting EGFR mutation type in NSCLC. Item 19 Del (N) L858R (N) Chi-square test Multivariate analysis P-value OR LL (95% CI) UL (95% CI) P-value Age—yrs > 50 432 510 0.000 0.661 0.481 0.908 0.011 < = 50 200 129 1 Sex Male 288 291 0.992 Female 344 348 Complication Yes 151 175 0.130 0.882 0.655 1.188 0.409 No 374 354 1 Smoke Yes 136 127 0.444 No 386 402 Drink Yes 80 75 0.618 No 442 452 BMI—kg/m2 > = 24 165 175 0.700 < 24 301 303 T-stage 1-2 314 332 0.673 3-4 118 117 N-stage 0 126 185 0.000 1 1234 296 253 1.719 1.264 2.337 0.001 M-stage 0 259 280 0.157 1 1 228 205 0.874 0.646 1.183 0.384 Historical type Adenocarcinoma(ADC) 486 490 0.527 Non-ADC 35 30 Differentiation High 63 73 0.371 Moderate 182 193 Low 226 206 TMD—cm < = 3 179 196 0.713 > 3 75 88 CEA—ng/ml < = 5 165 171 0.901 > 5 223 227
PD-L1, PD-1, and CTLA-4 as prognostic biomarkers in resected non-small cell lung cancer.
Authors: Taofeek Kunle Owonikoko, Jeanne Kowalski, Sungjin Kim, Bhakti Dwivedi, Zhengjia Chen, Madhusmita Behera, William Mayfield, Robert C. Hermann, Lieping Chen, Fadlo Raja Khuri, Suresh S. Ramalingam, Gabriel Sica
Journal: Journal of Clinical Oncology (2015)

7551 Background: Reliable assessment of predictive or prognostic biomarker is critical for successful incorporation of immune checkpoint inhibitors into lung cancer management. We assessed the prognostic relevance of immune checkpoint mediators in resected NSCLC. Methods: We determined PD-L1 expression by immunohistochemistry using our instituional tumor bank samples. Mutations, expression and copy number variations (CNV) in genes encoding for PD1, PD-L1 and CTLA-4 were assessed using TCGA data. Survival estimates were performed by the Kaplan-Meier method. Differences in disease free and overall survival (DFS, OS) between patients with high or low PD-L1 protein expression were assessed by univariate and multivariate survival analyses using Cox proportional hazards model using different cutpoint definitions of staining intensity (0, 1, 2, 3), percent cell staining (0-100%) and immunoscore (0-300). Prognostic impact of genetic alterations was assessed in the overall population and in subsets of adenocarcinoma, squamous, smokers and non smokers. Results: We employed 208 institutional NSCLC samples (Caucasian 199, African American 9; Male/Female 101/107; squamous 63, non squamous 138) and 763 NSCLC cases from the TCGA database. PD-L1 protein expression was higher in smokers, non squamous cancers and females but not significantly different by race, tumor stage or grade. Low PD-L1 immunoscore in cancer cells ( < 10 vs. ≥ 10, < 35 vs. ≥ 35, or < 33.33 vs. ≥ 33.33) and in adjacent normal tissue (0 vs. > 0, < 10 vs. ≥ 10, or < 2 vs ≥ 2) was significantly associated with a higher risk of recurrence and poor OS. High tumor to normal ratio for PD-L1 staining was also associated with higher risk of recurrence and poorer OS. Mutations in CTLA4, PD-1 and PD-L1 genes were very rare. No association of CTLA-4 or PD-L1 gene expression differences or CNV with survival in patients groups defined by histology or smoking status.. High ratio of PD-1 gene expression in tumor to normal was associated with higher median OS [3.8 (1.8, 6.6) vs. 1.6 (0.5, 5.4) years; p = 0.022]. Conclusions: PD-L1 protein expression is higher in females, non squamous cancers and smokers. PD-L1 protein but not PD-L1 gene expression may be a useful prognostic marker in resectable NSCLC.
PS-091-Targeted disruption of TGF-B activation by an AVB1 integrin inhibitor significantly reduces liver fibrosis in CCl4 mice and Human NASH liver slices
Authors: johanna schaub, Martin Decaris, Maureen Reilly, Gail Lee, Shamra Martin, Vickram Rao, Chun Chen, Meghi Rexhepaj, Perna Kotak, Lisa Hooi, Katarina Leftheris, Jake Cha, Irene Lepist, Patrick Andre, Scott Turner
Journal: Journal of Hepatology (2019)
BP-C1 in treatment of patients with stage IV breast cancer: A randomized, double-blind, placebo-controlled multicenter study and additional open-label treatment phase.
Authors: Stig Einride Larsen, Alexey Manikhas, Ekaterina Trishkina, Marina Matrosova, Elena Poddubuskaya, Steen Lindkaer Jensen
Journal: Journal of Clinical Oncology (2015)

e12086 Background: The aims were to compare the efficacy and tolerability of a new benzene-poly-carboxylic acids complex with cis-diammineplatium (II) (BP-C1) versus equal looking placebo and to investigate the long-term tolerability of BP-C1 in treatment of patients with metastatic breast cancer. Methods: A randomized, double blind, placebo controlled multi-center study was performed. Patients allocated to placebo switches to BP-C1 after 32 days of treatment. Patients completed 32 days of treatment offers to continue BP-C1 open label for additional 32 days. Thirty patients were given daily intramuscular injection of 0.035 mg/kg bw BP-C1 or placebo in 32 days. NCI Bethesda (CTC-NCI), EORTC QOL-C30 and BR23 recorded at screening and after every 16 days of treatment. CT performed at screening and every 32-day. Results: The sum of target lesions increased 2.4% in the BP-C1 group and 14.3% in placebo. Only the increase in the placebo group was significant (p = 0.013). The difference between the group was significant in favor of BP-C1 (p = 0.04). Significant difference (p = 0.026) in favour of BP-C1 regarding RECIST classification. The sum of lesions slightly increased in the patient receiving 64 days of continuous BP-C1 treatment and 68.4% classified as responders. The Sum CTC-NCI toxicity score increased non-significantly in the BP-C1 group, but significantly in placebo (p = 0.05). The sum toxicity score reduces in the patients receiving 64 day of BP-C1 from 9.2 at screening to 8.9 at Day 48, but increased again to 10.6 during follow-up. “Breast cancer related pain and discomfort” and “Breast cancer treatment problem last week” were significantly reduced (p = 0.02) in the BP-C1 group and slightly increased in placebo. “Breast cancer treatment problem last week” was significantly reduced in the BP-C1 group (p = 0.02) and slightly increased in placebo. “Breast cancer related pain and discomfort”, Breast cancer treatment problem last week” and “Physical activity problem” significantly reduces during the 64 days of BP-C1 treatment (p ≤ 0.05) Conclusions: BP-C1 reduces the cancer growth, is well tolerated, improves quality-of-life and has few mainly mild AE.
FRI-099-PD-1+ monocytes and macrophages contribute to impaired microbial clearance following acute liver failure
Authors: Evangelos Triantafyllou, Cathrin Gudd, Rooshi Nathwani, Francesca Trovato, Lucia Possamai, Rebecca Morrison, Christine Bernsmeier, Vishal Patel, Wafa Khamri, Robert Goldin, Julia Wendon, Mark McPhail, Kevin Woollard, Mark Thursz, Charalambos Antoniades
Journal: Journal of Hepatology (2019)