tbuckley/cabot-search huggingface dataset:
Offlabel nab-paclitaxel: Gemcitabine chemotherapy in advanced pancreatic cancer—A monoinstitutional experience.
Authors: Giovanni Lo Re, Davide Adriano Santeufemia, Antonino Ius, Alessandro Del Conte, Luisa Foltran, Giovanni Maria Fadda, Stefano Maria Basso, Wally Marus, Giordano Bruno Chiara, Angelo Stuto, Giancarlo Tosolini, Sandro Sulfaro, Roberto Spaziante, Gianluigi Nicolosi, Gianni Boz, Paolo Mancinelli, Salvatore Tumolo, Ettore Bidoli, Cinzia Cozzi
Journal: Journal of Clinical Oncology (2014)

e15239 Background:: Metastatic pancreatic cancer (MPC) is a chemo-resistant disease with poor prognosis. Nab-paclitaxel–Gemcitabine shows superiority on Gemcitabine alone (Von Off DD et al, NEJMed 2013 ) and so it could represent the new treatment standard. Aim of our study is to report its feasibility and activity in unselected (real-word) MPC patients Methods: A retrospective review of data obtained from patients (pt) diagnosed with locally advanced (LA) or MPC who received “Off label” chemotherapy (consisting of Nab-paclitaxel 125 mg/m2 Gemcitabine 1 g/m2 day1,8,15 q 28 which was administered for 3-6 cycles (cy) or until progression or unacceptable toxicity) was performed. Results: from April 2012 to January 2014, 37 pt (LA 6, M 31), were treated at our institution. 29 pt were naïve while 8 pt were pre-treated. 20 were M and 17 F respectively with a median age of 66 years (range 40-82); median PS 1(range 0-2). Sites of disease were pancreas in 19, liver in 21, nodes in 10, lung in 6, peritoneum in 13, other in 3. Median basal Ca 19.9 level was 1734 (range 2-120.000 U/mL). Globally 157 cy, with a median of 4 (range 1-11 cy), were administered. 9 of 37 patient were unevaluable (early suspension in 8, too early in 1). Response: CR 3, PR 4, SD 15, PD 6. ORR and DCR were 19% (CL 95% 8%-30%) and 59 % (CL 95% 44%-74%) respectively. Median response duration was 8 mos. The most common adverse events of grade 3 or higher were anemia (5 pt) piastrinopenia (2 pt) neutropenia (6 pt), fatigue (1 pt), and neuropathy (6 pt). In a univariate analysis from prognostic factors (age, PS, gender, stage, white blood cell, haemoglobin(Hgb), FAL, HDL, Ca 19.9 basal , Ca 19.9 reduction, cy number and PS, HDL (< 204 vs >204 U/L (p: 0,049), cy >4 vs <4 (p:<0,001), PS 0 vs 2 (p:0,003) had a significant correlation to overall survival (OS). In a multivariate analysis cy >4 vs <4 (HR 95% 12,85 (2,42-68,23) (p=0,003) and PS HR 95% 0,03 (0,003-0,30) (p=0,003) maintains the statistical significance on OS.The median PFS and OS were 6,2 and 9,2 mos respectively. Conclusions: in the real-world practice nab-Paclitaxel-Gemcitabine schedule can be considered safe, moderately toxic and active in MPC. PS and treatment duration were significant prognostic factors on OS.
Revisional Bariatric Surgery and Choosing the First Procedure
Authors: Ricardo Cohen
Journal: JAMA Surgery (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 Surgery 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 Surgery journal
Association of elevated levels of AR and PAKT in the diagnostic prostate needle biopsy with a greater risk for disease progression: Implications for prognostic models and future treatment decision making.
Authors: Michael J. Donovan, Faisal M Khan, Richard Scott, Gerardo Fernandez
Journal: Journal of Clinical Oncology (2014)

e16007 Background: We previously developed a biopsy pre-treatment systems-based risk assessment assay for patients recently diagnosed with prostate cancer (PCA) and demonstrated the importance of androgen receptor (AR) levels for predicting outcome. We sought to evaluate whether the phosphorylated form of the serine threonine kinase PAKT, in addition to AR in the biopsy tissue, was associated with disease progression and whether such a combination along with clinical features could be useful to develop improved risk stratification models. Methods: We evaluated paraffin embedded prostate biopsy specimens from 305 patients, mean age 64y, median PSA 7.6, 48% GS6, 42% GS7, with cT1c-T3 prostate cancer treated with surgery and followed for a median of 8 years. Biopsies were probed with multiple immunofluorescent assays which included AR, PAKT, AMACR, Ki67 and CK18. Novel image analysis techniques were employed to derive quantitative biomarker feature values. Multivariate models were constructed to predict disease progression with the C index to estimate performance. Results: Increasing AR and PAKT protein levels in the de novo biopsy specimen were univariately and significantly associated with outcome (p-value 0.005 and <0.001, respectively). A multivariate model which included AR, PAKT and the biopsy Gleason score accurately predicted time to disease progression with a CI 0.77, hazard ratio 5.2, sensitivity 71%, and specificity 81%. Conclusions: Inclusion of quantitative biologic attributes will continue to enhance and possibly replace traditional PCA grading systems. AR and PAKT levels in the diagnostic biopsy support a more aggressive PCA phenotype, worthy of future investigation.
Benefit of adjuvant treatment in stages II and III colon cancer: Experience at the Ramón y Cajal University Hospital.
Authors: Olga Martinez Saez, Arantzazu Martínez Barquín García, Cristina Saavedra Serrano, Elena Corral de la Fuente, Juan José Serrano Domingo, Roberto Martín Huertas, Maria Villamayor Delgado, FEDERICO LONGO, Pablo Reguera Puertas, Vanessa Pachon, Mercedes Rodríguez Garrote, Carmen Guillen, Alfredo Carrato, Reyes Ferreiro Monteagudo
Journal: Journal of Clinical Oncology (2018)

842 Background: The standard adjuvant treatment for patients with stage III colon cancer is 6 months with fluoropyrimidines and oxaliplatin. The Intergroup Trial INT-0035 was the first large-scale study to demonstrate a significant reduction in the risk of death with adjuvant FU plus levamisole in patients with stage III colon cancer. In the MOSAIC study, the addition of oxaliplatin to fluoropyrimidines in patients with resected stage II to III colon cancer showed OS and DFS benefit of oxaliplatin. However, no significant benefit was observed in either DFS or OS in patients with stage II disease, therefore the benefit of adjuvant chemotherapy is still controversial in those patients. Methods: We retrospectively included patients with stages II and III colon cancer that were operated between 2009 and 2014 in the University Ramón y Cajal Hospital from Madrid. We calculate DFS and OS at 48 months and we perform a multivariable Cox model analysis to estimate the benefit of the chemotherapy in each stage. The model was further adjusted by including the following confounders: ECOG-PS, number or removed nodes ( &lt; 12 or ≥ 12), grade and age. A covariate was considered a confounder factor if the difference between the adjusted and unadjusted coefficient of chemotherapy varied &gt; 10%. Stata 13.1 was used to analyze the data. Results: 564 patients were identified (281 stage II and 283 stage III). 259 received chemotherapy and 305 did not. The median follow-up in the entire cohort was 49 months. The median DFS and OS were not reached at the moment of the analysis. DFS and OS at 48 months were both 78.5%. Globally, chemotherapy did not improve DFS (HR 1.05, p: 0.83) but OS was significantly better (HR 0.47, p: 0.001). By stage, chemotherapy did not improve DFS in stage II (HR: 1.6, p: 0.2) nor OS (HR 0.76, p: 0.43). In stage III, chemotherapy showed a trend to improve DSF (HR: 0.61, p: 0.075) and did improve OS (HR: 0.31, p &lt; 0.0001). Conclusions: The multivariable analysis showed a chemotherapy benefit in patients with stage III colon cancer, with a 39% reduction in the risk of recurrence and a 69% in the risk of death; however, in stage II patients these benefits were not found either in DFS or OS.
The hypervirulent Coxiella burnetii Guiana strain compared in silico, in vitro and in vivo to the Nine Mile and the German strain
Authors: C. Melenotte, A. Caputo, Y. Bechah, H. Lepidi, J. Terras, M. Kowalczewska, F. Di Pinto, C. Nappez, D. Raoult, F. Brégeon
Journal: Clinical Microbiology and Infection (2019)
A Phytophthora Effector Suppresses Trans-Kingdom RNAi to Promote Disease Susceptibility
Authors: Yingnan Hou, Yi Zhai, Li Feng, Hana Z. Karimi, Brian D. Rutter, Liping Zeng, Du Seok Choi, Bailong Zhang, Weifeng Gu, Xuemei Chen, Wenwu Ye, Roger W. Innes, Jixian Zhai, Wenbo Ma
Journal: Cell Host & Microbe (2018)
Use of PCR for diagnosing bacteremia and fungemia in neutropenic cancer patients with fever.
Authors: Pournima D. Navalkele, Michael Callaghan, Alexander Pietroski, Deepak Kamat
Journal: Journal of Clinical Oncology (2014)

e21030 Background: Infection in neutropenia is a potentially fatal complication of chemotherapy in cancer patients. Approximately one-third neutropenia episodes are associated with fever, however, infectious etiology is documented in only 10-45%. Bacteremia occurs in approximately 10-20% of patients with febrile neutropenia (FN). Even though fungal infections occur in less than 5% of patients with FN, they can be fatal. Since molecular diagnostic methods are not only rapid but are sensitive and specific for identifying pathogens in sterile fluid such as blood, it is imperative that such methods be used. Methods: We hypothesized that PCR using probes for conserved bacterial and fungal ribosomal DNA will aid in early identification of pathogens in children with cancer that develop FN after chemotherapy. Institutional IRB approval was obtained for this pilot study. We included cancer patients less than 18 years of age with FN in our study while cancer patients who did not have fever served as controls. Discarded whole blood samples were collected and stored at -80 degree C. DNA was extracted (Molzyme) and Real-Time PCR analysis was performed using primers specific to conserved regions of 16S and 18S rRNA genes of bacteria and fungi respectively. Amplicon was sent for sequencing to identify bacterial or fungal DNA based on SepsiTest-BLAST analysis (Molzyme). Clinical and demographic data were entered into database. Results: Of the 27 case samples, 19 were processed, 4 had positive blood cultures but only 1 of these was positive for bacteria by PCR. Of the 15 case samples that had blood cultures negative, 3 were positive for fungi by PCR. Of the 27 control samples, 21 were processed, 5 had positive PCR, of which 1 was positive for bacterial DNA, 2 were positive for fungal DNA and 2 were positive for both bacterial and fungal DNA. When compared with blood culture results (gold standard), PCR was true positive for 1, false positive for 3, false negative for 3 and true negative for 12 samples. The sensitivity of the PCR test was 25% and specificity was 80%. Conclusions: PCR test did not show a good sensitivity for bacterial or fungal infections. We believe this issue could be due to blood samples being frozen and stored which could have caused contamination.
1,123 Consecutive Adults with Non-APL Acute Myeloid Leukemia: The Mayo Clinic Experience
Authors: Kebede H. Begna, Walid Ali, Naseema Gangat, Michelle A. Elliott, Aref Al-Kali, Mark R. Litzow, C. Christopher Hook, Alexandra Wolanskyj, William J. Hogan, Mrinal M. Patnaik, Animesh Pardanani, Darci Zblewski, Dong Chen, Rong He, David S Viswanatha, Curtis A. Hanson, Rhett P. Ketterling, Ayalew Tefferi
Journal: Blood (2018)
Impact of chemotherapy-induced neuropathy on balance performance: Using wearable sensors for objective balance assessment.
Authors: Michael Schwenk, Dustin Holloway, Gurtej Grewal, Linda L. Garland, Stefanie Schwenk, Bijan Najafi
Journal: Journal of Clinical Oncology (2014)

e20687 Background: Chemotherapy-induced peripheral neuropathy (CIPN) may cause balance impairment and increased fall risk. However, little is known about the association between CIPN severity and its impact on balance. This study’s aim was to assess balance performance in CIPN patients (pts) using novel wearable technology. Methods: 17 cancer pts undergoing neurotoxic chemotherapy were enrolled (age: 67.9±9.7). CIPN severity was confirmed and quantified using vibratory perception threshold (VPT) test. 13 pts had CIPN (defined by VPT ≥25 volt); 4 without CIPN (VPT <25 volt) served as the control group. Postural balance was quantified using a wearable wireless sensor system (BalanSens) during 30sec bipedal standing during eyes-open and eyes-closed condition per Romberg protocol. A biomechanical model of the body was used for estimating sway of the center of mass (COM) in anterior-posterior (AP) and medial-lateral (ML) directions. A reciprocal compensatory index quantified postural compensatory strategy (PCS). Results: VPT score averaged 46.5±18.4 volt in CIPN pts and 16.4±7.0 volt in controls (p=0.007). No intergroup difference was observed for age (p=0.136). We noted significantly increased ML COM sway (+74%, p=0.033) and reduced ML PCS (-38%, p=0.001) in CIPN pts compared to controls during eyes open assessment. A similar non-significant trend was observed during eyes-closed (ML COM sway +69%, p=0.197; ML PCS -30%, p=0.161). A significant correlation was noted between severity of CIPN (VPT value) and balance impairment (ML PCS) during eyes open (r=.545, p=0.024) and eyes closed (r=.484, p=0.049). Conclusions: This pilot study shows that CIPN impacts balance performance. Notably, CIPN pts’ postural coordination between hip and ankle was reduced, hypothesized to be due to chemo-induced nerve toxicity in lower extremity. This in turn may increase the vulnerability of CIPN pts to falling and may impact on patient QOL. In addition, results demonstrate the proof-of-concept of a cost-effective wearable technology to objectively evaluate CIPN-related balance disorders, which could be implemented in the clinic and applied to measure the effect of experimental interventions for CIPN.
Polyneuropathy in the context of acute myeloid leukemia and myelodysplastic disorders.
Authors: Ahmad Jajeh
Journal: Journal of Clinical Oncology (2014)

e18008 Background: Polyradiculoneuropathy is not uncommon in the context of the treatment and complication seen in Acute Myeloid Leukemia AML and Myelodysplastic Disorders MDS. Immune mechanism rather than inflammatory demyelinating process is the most likely driving mechanism. This abstract describe our experience with six patients who developed polyradiculoneuropathy in the context of AML and MDS. Methods: This involve six patients who developed polyradiculoneuropathy in the context of treatment with AML and MDS. Mean age is forty two years old ( Range 28-59). Non of the patients had Diabetes mellitus or neuropathy at diagnosis. All patients were induced with high dose Cytosine Arabinoside ARA-C and Anthracyclines. All patients had no evidence of of CNS leukemic involvement or Progressive Multifocal Focal Leukoencephalopathy PML. Compound muscle action potential , Nerve conduction testing , CSF analysis and MRI of Brain and Spinal axis was done on most of the patients. Results: Mean age of of patients is 42. None of the patients had DM or neuropathy at diagnosis.Two males and four females. Three whites , two Hispanics and one Indian. Five patients with De novo AML and one patient with MDS with excess blasts more than 18 %. Two females developed debilitating neuropathy with skin rash and sclerodermoid changes. Two males developed foot drop. One patient developed Parkinson disease with debilitating motor and sensory neuropathy. One female developed transient motor neuropathy that resolved. All patients had no evidence of CNS leukemic involvement as per CSF and MRI testing.Sever attenuation of compound muscles action potential in lower limbs and slowing of nerve conduction in the intermediate nerve sigment were seen. Day Fourteen bone marrow biopsy post induction in all these cases showed absence of blasts with presence of sheets of plasma cells with stromal cells. Two patients are still alive. All four patients died with median duration of 18 months from diagnosis. Conclusions: The importance of microenvironment and plasma cell interaction could be the basis of the pathogenesis of polyradiculoneuropathy. POEMS Syndrome in those cases should be investigated,especially in the lack of gammopathy data and immunostaining.
Inverted U‐shaped relationship between vitamin D and ever‐reported eczema in US adults
Authors: Jia Wei, Tarannum Jaleel, Amanda S. MacLeod, John S. Ji
Journal: Allergy (2018)

Eczema is a skin condition which affects up to 10% to 20% of people worldwide. Previous literature finds that low vitamin D levels may be a risk factor for eczema, but the association is not clear.We used the cross-sectional data from U.S. National Health and Nutrition Examination Survey 2005-2006. Adults were defined as 20 years and older. The association between eczema and serum 25-hydroxyvitamin D [25(OH)D] was estimated using multivariate logistic regression models adjusted for patient demographics, lifestyle variables, stress, and medical comorbidities. Restricted cubic spline analyses were performed to explore nonlinear relationship. We also stratified by race.A total of 3921 adults were included in the analysis. The prevalence of ever-report of eczema was 7.94% in US adults. Reports of eczema were higher in people with higher socioeconomic status, depressive symptoms, previous history of asthma and hay fever, female, sampled in summer, and nonHispanic white. The logistic regression found higher odds ratio of eczema in vitamin D deficiency group (<50 nmol/L) compared to sufficiency group (>75 nmol/L) (OR = 1.81, 95% CI: 1.09-3.01, P = 0.02). The spline analysis found an inverted U-shaped relationship between eczema and serum 25(OH)D level. Eczema risk reached the highest at around 45 nmol/L, with decreasing risk in both directions away from this value. This relationship was absent in nonHispanic black population.Vitamin D is associated with reports of eczema in nonHispanic white population, but not in the nonHispanic black population in the United States.
Current practice and use of neoadjuvant therapy in ovarian cancer in the National Cancer Database.
Authors: Angela Jain, Elizabeth Handorf
Journal: Journal of Clinical Oncology (2014)

5586 Background: Most ovarian cancer (OC) patients can expect significant tumor cytoreduction with platinum based therapy, but unfortunately no better than a 10-20% chance of cure. A previous study demonstrated that neoadjuvant chemotherapy (NAC) was not inferior to primary surgery followed by chemotherapy, and survival depended on the ability to resect all macroscopic disease. This is a retrospective study using the National Cancer Database (NCDB) to understand national trends in using NAC in OC. Methods: We identified women with advanced stage OC diagnosed between 1998 and 2011 and treated with chemotherapy and surgery using the NCDB. Using Chi-squared tests and multivariate logistic regression, we analyzed rates of NAC by age, facility type, race, payor status, income, location, Charlson score, year of diagnosis and facility location. Due to data availability, survival analysis was restricted to patients diagnosed between 2003 and 2005. We used Kaplan-Meier curves and proportional hazards regression to assess overall survival in patients treated with neoadjuvant vs adjuvant chemotherapy. Results: Among the 58,048 patients, on multivariate analysis, women were more likely to receive NAC if they were older (<50, >70 years vs. 50-70 years, OR=0.61, 1.16, p<0.0001, respectively), have Medicaid or Medicare vs Private insurance (OR= 1.71, 1.21 respectively, p<0.0001), or had a Charlson score ≥1 (OR=1.19, P<0.0001). Race and rural/urban location were not associated with differences in therapy type in multivariate analysis. Use of NAC increased from 8.94% of patients in 1998 to 26.72% of patients in 2011 (p<0.0001). In the survival cohort (12,554 patients) median survival was 30.7 months vs 41.1 months for neoadjvant vs adjuvant patients (P<0.0001), and this difference remained on adjusted analysis (HR 1.31, p<.0001). Conclusions: The use of neo-adjuvant chemotherapy in OC has increased over time. Although we found significantly lower survival among patients given neoadjuvant therapy, this result is limited by potential selection bias. We found that patients treated with neoadjuvant therapy also had risk factors such as increased co-morbidities, coverage by Medicaid, and older age.
Abstract 18601: Risk of Arterial and Venous Thromboembolism in Patients With Atrial Fibrillation or Flutter: A 10-Year Nationwide Cohort Study
Authors: Jens Sundbøll, Erzsébet Hováth-Puhó, Kasper Adelborg, Anne Ording, Morten Schmidt, Hans Erik Bøtker, Henrik T Sørensen
Journal: Circulation (2016)

Introduction: Atrial fibrillation and flutter (AFF) create an intra-atrial stasis with the potential to cause thrombus formation and subsequent arterial and venous embolization. AFF is an establish...